No abstract available.
Alprostadil ; Gastrointestinal Motility ; Lubiprostone

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

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

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

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: 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

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

Penile necrosis is a very rare complication because of its rich collateral supply. Conservative management is apt to be ineffective; thus penectomy is usually performed. We present a case of penile necrosis and claudication of both legs with multiple atherosclerosis in a type II diabetes mellitus patient who was successfully treated with angioplasty, penoplasty, and additional intracavernous injections of prostaglandin E1. The treatment resulted in relief of the leg pain and healing of the penile ischemic lesions.
Alprostadil ; Angioplasty ; Atherosclerosis* ; Diabetes Mellitus ; Humans ; Leg ; Male ; Necrosis* ; Penis*

Duplex ultrasonography (USG) is an accepted method to assess noninvasively arterial inflow to the penis. Optimal pharmacological agents as well as timing of the scan and stimulation during the scan continue to be debated. Between August 1994 and May 1996, 24 normal males (control group) and 45 impotent patients (impotence group) underwent penile doppler sonography, and their records were reviewed. Scans were performed at 1, 3, 5, 10, 15, 20 and 30 minutes after intracavernous injection of PGE1 (10 pg) in all subjects. Any subject not having a full erection at 15 minutes performed private self-stimulation for at least 5 minutes before the 30 minute scan. If we define normal arterial inflow as a peak systolic velocity (PSV) of 30 cm. per second or greater in the best artery, 46% of control group and 55% of impotence group achieved this velocity until 5 minutes. One (4%) of control group and three (6%) of impotence group achieved maximum velocity at 1 or 3 minutes but continually PSV of 30 cm. per second or greater after 5 minutes, so any subject may not have had an incorrect diagnosis. When we calculated maximum velocity in the best artery in relation to percentage tumescence, maximum velocity were recorded most often at 10% tumescence (46% of control group and 51% of impotence group). If we define normal arterial inflow as PSV of 30 cm. per second or greater in best artery, the cumulative percentage of patients who achieved this velocity at 1, 3, 5, 10, 15, 20 and 30 minutes were 4, 34, 46, 88, 96, 96 and 100% in control group and 6, 28, 55, 90, 92, 94 and 96% in impotence group. In conclusion, we support delaying the initial scan until 5 minutes, performing the additional scans until 30 minutes and self-stimulation when necessary. We believe all efforts should be made to have studies performed in the setting of least anxiety to the patient.
Alprostadil* ; Anxiety ; Arteries ; Diagnosis ; Erectile Dysfunction ; Humans ; Male ; Penis ; Ultrasonography*

PURPOSE: To assess the erectile response to intracavernous injection of prostaglandin E1 (PGE 1) or papaverine in the impotence patients with diabetes mellitus (DM), and to determine the factors which would predict good response to either drug. MATERIALS AND METHODS: We injected papaverine (10~60 mg) or PGE1 (10~20 mg) into cavernosal tissues of 305 impotence patients with DM (mean age; 56.1 years). Erectile response was classified into poor, moderate, or good, and was comparatively analyzed according to kinds of vasoactive agents, patients` age, duration of DM and impotence, and treatment modality of DM. RESULTS: The frequency of good response to PGE1 was significantly higher than to papaverine (61.5% vs. 42.8%; p<0.05). However, no association between erectile response and patients` age, duration of impotence and DM, and treatment modality of DM was noted. CONCLUSIONS: Prostaglandin E1 seems to be more effective substance than papaverine for intracavernous injection therapy in impotence patients with DM.
Alprostadil* ; Diabetes Mellitus* ; Erectile Dysfunction* ; Humans ; Male ; Papaverine*