No abstract available.
Alprostadil ; Gastrointestinal Motility ; Lubiprostone

No abstract available.
Allopurinol* ; Alprostadil* ; Skin*

No abstract available.
Alprostadil* ; Lower Extremity* ; Thromboangiitis Obliterans*

PURPOSE: Intracavernosal self injection therapy is now being widely used to treat patients with erectile dysfunction. However, there is a large number of patients who give up the self injection program due to the fear of injection. Therefore, less invasive route of drug administration is highly recommended. We investigated the efficacy of intraurethral instillation of Prostaglandin El (PGE1 ) solution in the patients who showed full erection with intracavernosal injection of PGE1. MATERIALS AND METHODS: Twenty-nine impotent patients who showed full erection with intracavernosal injection of PGE1 were included in this study. We estimated the grades and durations of the penile erection after intraurethral instillation of PGE1 RESULTS: Sixteen out of 29 patients(55.2%) showed full erection with intraurethral instillation. Two patients(6.9%) showed urethral pain which disappeared within 24 hours. But there was no systemic side effect CONCLUSIONS: Intraurethral instillation of PGE1 appears to be safe, well tolerated, and less invasive treatment modality Thus it can be selected as an alternative treatment of impotence in selected cases.
Alprostadil* ; Erectile Dysfunction* ; Humans ; Male ; Penile Erection

The survival of flap has a vital importance in the reconstructive surgery. This study was designed to investigate the relation of the survival area and the variation of flow value measured by laser Doppler flowmetry and to elucidate the effect of PGE1 on flap survival with an objective index. Sixteen New Zealand White rabbits were divided into 3 groups (8 of control group, 4 of intravenous PGE1 group and 4 of topical PGE1 group). The lower abdominal island flap (10 x 5 cm) based on the superficial epigastric pedicle was elevated and reset again at the previous location. The flow values were checked and it was taken as the value of LD. LD ratio was obtained by calculating the ratio of LD value in each experimental period to that of the baseline data taken before flap elevation. Finally, the data of flap survival area on the 8th experimental day was collected by using the plannimetry method. The results: the survival areas of intravenous PGE1 group (72.0 +/- 22.3%) and topical PGE1 group (78.0 +/- 22.7%) showed a significant increase compared to that of control group (46.5 +/- 14.3%, p < 0.01). The flap survival has the close relationship of the LD ratio measured immediately after flap elevation. The neovascularization period for the survival is considered at least 6 days. In conclusion, these experimental results can show an evident relation between the survival area of the flap and the LD ratio value measured immediately after the flap elevation. The LD ratio value measured immediately after flap elevation has the great significance as a critical limit for expecting the fate of flap survival. Therefore this value will be used as one of the beneficial standards for expecting the prognosis of microsurgical reconstruction in clinical trials.
Alprostadil* ; Laser-Doppler Flowmetry* ; Prognosis ; Rabbits

PURPOSE: To evaluate whether radial rigidity measured using RigiScan(R) represents the intracorporeal pressure effectively. MATERIALS AND METHODS: From January 1998 to May 1999, total of 23 patients with erectile dysfunction were evaluated by RigiScan(R) and duplex ultrasonography after the intracorporeal injection of prostaglandin E1. Peak systolic velocity and end diastolic velocity were measured by duplex ultrasonography and then the resistance index was calculated as (peak systolic velocity-end diastolic velocity)/(peak systolic velocity). Radial rigidity of penile tip and base was measured by RigiScanR . The results were analyzed statistically by PC-SPSS version 7.5. RESULTS: There were statistically significant correlations between radial rigidity of penile tip and base and the resistance index by Spearman's correlation analysis, respectively (r=0.680, p<0.001)(r=0.703, p<0.001). When radial rigidity of penile tip and base exceeded 60% of maximum, radial rigidity of penile tip and base again correlated well with the resistance index, respectively (r=0.659, p=0.020)(r=0.759, p=0.011). Based on clinically determined degree of erection, radial rigidity of penile tip and base represented the intracorporeal pressure effectively. CONCLUSIONS: Radial rigidity measured by RigiScan(R) represents the intracorporeal pressure effectively.
Alprostadil* ; Erectile Dysfunction ; Humans ; Male ; Ultrasonography

PURPOSE: The adverse reactions of prostaglandin E1(PGE1) are troublesome in the preoperative management of critical patients with ductus dependent congenital heart disease, and a preparation with less adverse reactions is preferable. The effects of Lipo PGE1, a new preparation of PGE1 contained in lipid microspheres, were compared with those of conventional PGE1(PGE1-CD). METHODS: Lipo PGE1 was infused at a rate of 5 ng/kg/min in 19 patients, PGE1-CD at a rate between 10 and 50 ng/kg/min in 15 patients. The effects of drugs were assessed in terms of clinical response rate and overall safety. RESULTS: Clinically, both treatment were effective in relieving cyanosis and hypoxemia except in patients already having either a closed ductus or severe hypoxemia and acidosis. The increments of PaO2 1 hour after infusion were 10.9 and 6.2 mmHg (p>0.1), respectively and those 4 hours postinfusion were 16.0 and 7.8 mmHg(p<0.05), respectively. Even though there was no significant difference in clinical response rate(78.9 vs 60.0%, p>0.1), the mean dose of Lipo PGE1 at appearance of response was about 1/5 of that of PGE1-CD in overall patients and also in patients with ductus dependent pulmonary circulation(6.7 vs 31.7 ng/kg/min, p<0.005). The adverse reactions occurred in 52.6% of the patients given Lipo PGE1, while it was 86.7% in those administered PGE1-CD(p<0.05). The adverse reactions in Lipo PGE1 group was much less severe than that in PGE1-CD group. There was a significant difference in overall safety between the two drugs(84.2 vs 40%, p<0.01). As the incidence of the adverse reactions increased at dose over 5 ng/kg/min, the initial dose of 5 ng/kg/min seemed to be appropriate for Lipo PGE1. CONCLUSIONS: Lipo PGE1 was effective at a lower dose than was PGE1-CD, and was associated with fewer or less severe adverse reactions, and is therefore judged to be more suitable for clinical use than conventional PGE1-CD.
Acidosis ; Alprostadil ; Anoxia ; Cyanosis ; Heart Defects, Congenital* ; Humans ; Incidence ; Microspheres

Intracavernosal self injection therapy is now being widely used to treat patients with erectile dysfunction. However, there is a large number of patients who gives up the self injection program due to the fear of needle or injection. Therefore, the less invasive route of drug administration is highly recommended. We investigated the efficacy of intraurethral instillation of PGE1 solution in comparison with the trimix intracavernosal injection. A total of 24 patients have been observed with either injection of trimix (11 patients), or intraurethral instillation of PGE1 (13 patients). All patients were evaluated with the penile doppler ultrasonography before 5,15,30 and 45 minutes after the drug administration. Penile length and circumference were measured before and after intraurethral administration of PGE1. Ten out of 11 patients (91%) showed positive response in trimix group and nine of 13 patients (69.2%) in PGE1 group. Mean length and circumference of penile shaft before and after the pharmacologic erection test showed significant difference in PGE1 group. The mean peak systolic velocity at 30 minutes was 28.5% 10.53 cm/sec in Trimix group and 28.2 t8.47 cm/sec in PGE, group (p=0.4773). The mean end diastolic velocity at 30 minutes was 8.4 5.23 cm/sec in Trimix group and 8.2=4.21 cm/sec in PGE1 group (p=0.4689). With the intraurethral administration of PGE1, urethral pain and irritation were the noticeable complications but systemic side effect was not noticed In conclusion, PGE1 intraurethral instillation can be satisfactorily used for the patients with erectile dysfunction of psychogenic, less prominent organic and neurogenic origin, although the effect of intraurethral instillation of PGE1 is obviously less than that of Trimix intracavernosal injection.
Alprostadil* ; Erectile Dysfunction* ; Humans ; Male ; Needles ; Prostaglandins E ; Ultrasonography, Doppler

Currently intracavernous pharmacotherapy is the second common therapeutic modality for erectile dysfunction after the introduction of Viagra. Nevertheless, intracavernous pharmacotherapy has increased in popularity for the past 15 years. While having an overwhelming safety after complete training in injection method, this treatment option can reveal unexpected complications related to self-injection. We report two cases of intracavernous needle breakage associated with alprostadil (Caverject , Pharmacia-Upjohn) and trimix self-injection therapy with a brief review of the literature.
Alprostadil ; Drug Therapy ; Erectile Dysfunction ; Male ; Needles* ; Sildenafil Citrate

PURPOSE: This study was aimed to compare the erectile response when phentolamine of intracavernous trimix(papaverine, phentolamine, alprostadil) was replaced with chlorpromazine. MATERIALS AND METHODS: A total of 65 patients with erectile dysfunction(63.3+/-9.19 years of age) who had already used intracavernous injection with trimix(4.5+/-2.12 years) were recruited for this study. The erection quality and adverse reactions of chlorpromazine solution were compared with those of trimix. RESULTS: Among 65 patients, the erection quality of the intracavernous chlorpromazine solution compared to that of trimix was worse in 26 patients(40%), better in 8(12.3%) and similar in 31(47.7%) when injected at the clinic. Among 45 patients who used the chlorpromazine solution for intracavernous self-injection at home for more than 3 months, however, the erection quality was worse in 13(28.9%), better in 8(17.8%) and similar in 24(53.3%). Intracavernous chlorpromazine solution-either injected at the clinic or self-injected-showed no significant adverse reaction. CONCLUSIONS: Chlorpromazine could be a safe and effective substitude of phentolamine of trimix.
Alprostadil* ; Chlorpromazine* ; Erectile Dysfunction ; Humans ; Male ; Papaverine* ; Phentolamine