Sixteen prostatodynia cases entered the study on a trial of phenoxybenzamine (PBZ). We administered the PBZ with daily 10 mg dosage for 5 days (l st 5-day-course) to 16 cases, and then re-administered the PBZ (2nd 5-day-course) to the clinically recurred 5 cases. We obtained the following results. 1. After 1 st 5-day-course of PBZ, 7 cases of the 16 cases produced improvements on prostatic symptoms and urine flow rate, but recurrence was appeared in 5 cases of these 7 cases after 1-3 months of 1st 5-day-courSe of PBZ. 2. After 2nd 5-day-course of PBZ, 2 cases of these recurred 5 cases produced improvements on prostatic symptoms and urine flow rate. 3. 2 cases after 1st 5-day-course and 2 cases after 2nd 5-day-course produced improvements for about 1 year after 1 year after PBZ administration. Conclusively, 4 cases of the 16 cases (25%) produced improvements. >From the above data, we thought that PBZ trial to prostatodynia has a relatively considerable value.
Phenoxybenzamine* ; Recurrence

The author investigated the effect of adrenergic and adrenergic blocking agents on the phosphorylase activity of bovine extraocular muscle in vitro and obtained the following results: 1. The phosphorylase a activity of bovine extraocular muscle was revealed 53.6% in vitro. 2. The phosphorylase a activity of bovine extraocular muscle was slightly enhanced by the adrenergic agents such as epinephrine, norepinephrine and isoproterenol. 3. The phosphorylase a activity of bovine extraocular muscle was not affected by the adrenergic areceptor blocking agent, phenoxybenzamine but slightly inhibited by the adrenergic beta-receptor blocking agent, propranolol. 4. The phosphorylase a activity of bovine extraocular muscle previously treated with the adrenergic agents was blocked by a sole administration of propranolol or combined administrations of propranolol and phenoxybenzamine but not blocked by phenoxybenzamine alene.
Adrenergic Agents ; Adrenergic Antagonists* ; Epinephrine ; Isoproterenol ; Muscles* ; Norepinephrine ; Phenoxybenzamine ; Phosphorylase a ; Propranolol

We recently had a patient(46 year-old) who was to undergo resection of a pheochromocytoma. The patient was treated with phenoxybenzamine for about 2 weeks preoperatively. Thiopental was used for induction followed by N2O-O2-halothane. An endotracheal semiclosed circle absorption technique with controlled ventillatian was employed. The course of anesthesia was rather stormy, reflectedby hypertension, arrhythmia and hypotension, but the patient talerated the anesthesia and surgery well with appropriate cardiovascular control using regitine, levophed, lidocaineand intravenous fluids. Importance of preoparative preparation, sufficient sedation, smooth induction, complete analgesia, good muscuar relaxation, adequate alveolar ventillation and proper cardiovascular control has been discussed. Recently some reviews of the literature on the anesthetic management of pheochromocytoma suggest that the selection of an anesthetic agent is not as important as the adequate management of the characteristics of these agents which affect the anesthetic procedures.
Absorption ; Analgesia ; Anesthesia* ; Arrhythmias, Cardiac ; Humans ; Hypertension ; Hypotension ; Norepinephrine ; Phenoxybenzamine ; Phentolamine ; Pheochromocytoma ; Relaxation ; Thiopental

To evaluate the effect of steroid and alpha adrenergic blockade in experimental spinal cord trauma, pathological change was observed after 500 gm-cm force was impacted on the exposed cord of the 30 Mongoreal adult dogs. The progression of the pathological changes was compared in time lag with the groups of steroid adminstered and phenoxybenzamine treatment. In the group of the spinal cord trauma without treatment, histopathological findings were classical evolution namely from the central hemorrhage and necrosis to peripheral involvement up to amorphous necrotic pattern of entire cord at 24 hours preparation. In the steroid therapy group after the trauma, the pathological changes were confined in the gray matter around and posterior portion of the central canal in all intervals. Moreover the edematous changes and hemorrhagic necrosis were far less severe than the group without treatment. Although the pathologic change was somewhat less severe in the group which received phenoxybenzamine prior to the trauma than the group administered phenoxybenzamine afterward, these group revealed much severe edema and hemorrhagic necrosis than steroid therapy group. The pathologic change, however, in the groups which received phenoxybenzamine was less severe than the group of the spinal cord trauma without treatment.
Adult ; Animals ; Dogs ; Edema ; Hemorrhage ; Humans ; Necrosis ; Phenoxybenzamine ; Spinal Cord Injuries* ; Spinal Cord*

The bladder neck contracture is not uncommon in children and adult. The etiology remains controversial despite extensive studies, however it is usually accepted that bladder neck contracture is congenital in children and is due to previous lower urogenital infections in most of adult males. In spite of various modalities of treatment its high recurrence rate has been a perplexing problem. During the period from January 1, 1973 to December 31, 1976, 90 cases of adult male bladder neck contractures were studied clinically. Transurethral vesical neck resection was performed on 15 cases and phenoxybenzamine treatment was taken on 9 cases. The following results were obtained. 1) The age range of the patients in this study was from 17 to 79 years. 27.8% of the cases were between 30 and 39 years old and the most patients of group III were observed beyond 40 years of age. 2) The patients of group III usually has longer history of symptoms than group I and II patients. 55.6% of the cases had the onset of one year to 5 years. 3) Analysis of the 90 cases shows that common urinary symptoms were frequency(70%), diminished and weak stream(66.7%) and tenesmus(44.4%). 4) 88% of the cases was associated with the one or more diseases of chronic prostatitis, posterior urethritis or verumontanitis. 5) The bladder trabeculation was the most common finding(91.1%). In 73.3% of the cases interureteric ridge was elevated. Vesical outlet was narrowed as reversed V shape in almost all cases. 6) In 68.8% of the cases urine findings was normal, Pyuria was observed in 20% and microscopic hematuria in 16.6%. 7) Transurethral vesical neck resection was performed in 15 cases; All preoperative symptoms were relieved in 10 cases, but no improvement was observed in 5 cases. 8) 9 cases were treated with sympatholytic drug, phenoxybenzamine and significant improvement of all obstructive symptoms was obtained after 10 days or 2 weeks of treatment in all cases.
Adult* ; Child ; Contracture* ; Hematuria ; Humans ; Male* ; Neck* ; Phenoxybenzamine ; Prostatitis ; Pyuria ; Recurrence ; Urethritis ; Urinary Bladder*

Hypotension immediately after spinal anesthesia has been considered as the result of pre-ganglionic sympathetic paralysis and secondarily due to changes in cardiac output. And also the increase of vascular bed space about 20~25% was pointed ont during spinal anesthesia which was another cause of spinal hypotension. Same degree of increased vascular bed space was produced by vasodilators such as Dibenzyline and Arfonad. Therefore, vasopressors have been used as the drug of choice to prevent and treat this spinal hypotension. This study was attempted to combat the hypotension during spinal anesthesia by filling this increased vascular bed space with Lactated-Ringer's or Dextrose solution instead of giving vasopressors. Lactated-Ringer's or Dextrose solution was administered to 141 cases, before and immediately after. spinal anesthesia was performed. The given amount of fluid was about 12.5~15% of estimated total blood volume (Group A). And no intravenous fluid was given to 101 cases as control (Group B). Changes of the systolic, diastolic blood pressure and pulse rate were observed. In the Group A, significant changes of the systolic (t=2.52, p<0.02) and diastolic blood pressure (t=1.98, p<0. 05) was observed. The changes of pulse rate were found not significant in the both group series.
Anesthesia, Spinal* ; Blood Pressure ; Blood Volume ; Cardiac Output ; Glucose ; Heart Rate ; Hypotension ; Paralysis ; Phenoxybenzamine ; Vasodilator Agents

The mechanism of serotonin(5-HT) induced contraction and Ca++ mobilization was investigated in right cut from rat aorta. Since it is known that 5-HT can interact with alpha-adrenoceptors in addition to a specific action on 5-HT receptors, the effects alpha-adrenoceptors antagonists on these contractile responses to 5-HT were investigated. The results are as follows : 1) 5-HT produced a strong transient contraction and a concentration dependent contraction. 2) The contractile tension to 5-HT increased with extracellular Ca++ concentration (0.1-5mM). 3) The response produced by rings exposed to Ca++-free PSS was significantly weaker than that produced by rings exposed to calcium containing PSS. When rings of aorta that had been stimulated with 5-HT once for 30 min in Ca++-free TBT were washed 4 times for at least; 20 min in zero Ca++PSS to remove 5-HT, than reexposed to 5-HT in Ca++-free TBT, a phasic contraction was not seen during the second stimulation with 5-HT. 4) The contractile response of 5-HT was inhibited by alpha-adrenergic receptor blocker, phenoxybenzamine and phentolamine. Phentolamine(10(-8)M) antagonized response to high concentrations of 5-HT but responses to low concentrations of 5-HT were not antagonized. 5) The contraction induced by 5-HT in Ca++-free PSS was investigated with phentolamin, methysergide. It was blocked by methysergide but not blocked by phentolamine. 6) These results suggest that 5-HT -induced contraction is the effect of both transmembrane Ca++ influx and the mobilization of intracellular Ca++. Low concentration of 5-HT act on specific 5-HT receptors but high concentration of 5-HT also act on alpha-adreno-receptors.
Animals ; Aorta* ; Calcium ; Methysergide ; Phenoxybenzamine ; Phentolamine ; Rats* ; Receptors, Adrenergic ; Receptors, Serotonin ; Serotonin

It has been reported that a rapid elevation in the intracranial pressure is associated with increased arterial pressure, reduced heart rate and irregular respiration. In the present study an effort was directed to observe the possible blocking effect of dibenzyline, an alpha-sympathetic blocking agent, administered prior to the intracranial pressure elevation. Alhino rabbits were divided into two experimental groups: in one group, the intracranial pressure was raised by infusing normal saline into the extradural space and was sustained for 30 minutes, while in the other group, dibenzyline(12mg/kg B.W.) was administered 16 hours prior to the intracanial pressure elevation. In both groups, the arterial pressure, heart rate and respiratory rate were measured for 30 minutes at 5 minuteintervals. In the intracranial pressure elevated group, the arterial pressure increased to 99 mmHg at 10 minutes in comparison with 88mmHg in the beginning. At 25 minutes, it returned to or near its initial level. The slowing of the heart rate was seen toward the end of the response, i.e. in the beginning, 269 rate/min, at the end, 214 rate/min. The respiratory rate did not show any significant change. In the dibenzyline pretreated group, the arterial pressure and heart rate did not change markedly from the initial levels. From the above result, it can be stated that dibenzyline has blocking effects on the increased arterial pressure and reduced heart rate in rabbits during increased intracranial pressure.
Arterial Pressure ; Blood Pressure* ; Heart Rate* ; Heart* ; Intracranial Pressure ; Phenoxybenzamine* ; Rabbits* ; Respiration ; Respiratory Rate*

An anesthetic experience with bilateral adrenalectomy for pheochromocytoma in an 18 year old male has been reported. We chose fluothane as a primary anesthetic agent for the management of anesthesia 'with relative satisfaction. The patient was treated with phenoxybenzamine for a long time (about 40 days) and also with propranolol for a few days intermtteently before induction of anesthesia. During anesthesia and operation, the highest systolic blood pressure was 180 mmHg, the lowest was 80 mmHg and some variable arrhythmias with extrasystoles were present. But these were well controlled immediately after administration of regitine and propranoloL Recently some reviews of the literature on the anesthetic management of pheochromocytoma suggest that the selection of an anesthetic agent is not as important as the adequate management of the characteristics of those agents which affect the anesthetic procedures. Conclusively, we prefer to recommend that it is important to manage the patients with alpha & beta adenergic blocking agents for at least several weeks pre-operatively, and to use the anesthetic agents as far as possible which do not have the sensitizing effects to catecholamine on myocardium.
Adolescent ; Adrenalectomy* ; Anesthesia ; Anesthetics ; Arrhythmias, Cardiac ; Blood Pressure ; Cardiac Complexes, Premature ; Halothane ; Humans ; Male ; Myocardium ; Phenoxybenzamine ; Phentolamine ; Pheochromocytoma ; Propranolol

We report a case in which a 63-year-old male patient with pheochromocytoma developed persistent hypotension during surgery despite rapid volume replacement and administration of vasopressors. The patient was prepared for surgery with phenoxybenzamine for 13 days. Anesthesia was induced with thiopental sodium and maintained with N2O, O2, and enflurane. Sodium nitroprusside (SNP) was initiated and titrated based upon intraarterial blood pressure. Hypertensive episode during tumor manipulation was effectively managed by increased infusion of SNP. After surgical removal of tumor, this patient developed profound hypotension, which was aggressively managed by intravenous administration of crystalloid and blood as well as dopamine and epinephrine. However, this hypotension was persistent and aggravated. Accordingly, Infusion of norepinephrine (Levophed(R))was started and then the patient recoverd from his hemodynamic aberrations. We conclude that the cause of the persistent hypotension was cumulative and residual effect of preoperative phenoxybenzamine. Therefore, norepinephrine should be readily available for the treatment of hypotension resistant to other pharmacologic interventions.
Administration, Intravenous ; Anesthesia ; Blood Pressure ; Dopamine ; Enflurane ; Epinephrine ; Hemodynamics ; Humans ; Hypotension* ; Male ; Middle Aged ; Nitroprusside ; Norepinephrine* ; Phenoxybenzamine ; Pheochromocytoma* ; Thiopental