OBJECTIVESTo supply clinical data for drug selextion in the treatment of erectile dysfunction through intracavernosal injection.

METHODSFifty-six ED patients were randomly classified into 2 groups and received phentolamine along with papaverine (for group 1) or phentolamine, papaverine and ligustrazin hydrochloride(for group 2).

RESULTSPatients in group 2 enjoyed a longer time of erection. More patients in group 2 succeeded in having enough erection time and hardness to complete sexual intercourse (P < 0.05).

CONCLUSIONSThe extrainjection of ligustrazin hydrochloride injection can help prolong erection duration and hardness and reduce tubercles that might occur in the corpus carvernosal. Therefore it is a safe and inexpensive drug in the intracarvernous injection treatment.

Adult ; Erectile Dysfunction ; drug therapy ; Humans ; Injections ; Male ; Middle Aged ; Papaverine ; administration & dosage ; Phentolamine ; administration & dosage ; Pyrazines ; administration & dosage

BACKGROUND AND OBJECTIVES: It has been assumed that salivary glands receive secretory fibers both from parasympathetic and sympathetic nerves. In fact, however, the existence of sympathetic secretory fibers in the cervical sympathetic nerve has not been established yet, because the salivary response to the cervical sympathetic stimulation is variable and short-lasting, and it tends to cease in spite of continued stimulation. This study investigated whether or not the cervical sympathetic nerve contains specific secretory fibers. MATERIALS AND METHODS: Salivary and blood flow responses to different frequency stimulation of the cervical sympathetic nerve, and often some autonomic drugs administration were observed from the submandibular gland in chloralose-anesthetized cats. RESULTS: 1) Low frequency stimulation (1-2 Hz) of the sympathetic nerve did not evoke salivary outflow and any change of blood flow, whereas high frequency stimulation of the nerve evoked salivary outflow and decrease of blood flow, in which salivary response tended to cease in spite of continued stimulation. 2) The salivary and blood flow responses to high frequency stimulation (20 Hz) of the nerve were not affected by the intravenous administration of propranolol, but were abolished by regitine. 3) Noradrenalin evoked salivary outflow and decreased blood flow which were not affected by the administration of propranolol but were abolished by regitine. 4) Isoproterenol increased blood flow but did not evoke salivary outflow, and the blood flow response was abolished by propranolol. CONCLUSION: These results suggest that the cervical sympathetic nerve does not contain specific secretory fibers and salivary outflow response to high frequency stimulation of the nerve may be due to either excitation of motor fibers innervating contractile elements of the excretory duct or chemical transmitters released from the vasomotor fibers.
Administration, Intravenous ; Animals ; Autonomic Agents ; Cats* ; Isoproterenol ; Phentolamine ; Propranolol ; Salivary Glands ; Submandibular Gland*

PURPOSE: To investigate the chemical stability of papaverine/phentolamine/alprostadil (Standro(R)) used for intracaver nous injection in patients with erectile dysfunction. MATERIALS AND METHODS: Samples of lyophilized Standro(R) were stored at room temperature (25+/-2 degrees C) or in the refrigerator (4+/-2 degrees C). The pH and concentration of papaverine HCl, phentolamine mesylate, and alprostadil were measured at intervals by high-performance liquid chromatography. RESULTS: At 24 months, the concentrations of papaverine, phentolamine, and alprostadil stored in the refrigerator and at room temperature were 99.7%, 98.9%, and 98.7% and 98.4%, 96.3%, and 93.3% of the original concentrations, respectively. When the product was stored in solution in the refrigerator for 19 weeks, the concentrations of the three drugs were 98.7%, 97.2%, and 88.0%, respectively. In 5 days at room temperature, the concentration of alprostadil dropped to 86.4%, which is below the minimum concentration for the product specified by the Korean Food and Drug Administration, although the concentrations of papaverine and phentolamine remained stable (99.6%, 98.4%). The pH of the three agents did not change significantly regardless of the storage conditions (temperature, duration, lyophilized or dissolved). CONCLUSIONS: Lyophilized papaverine/phentolamine/alprostadil (Standro(R)) is chemically stable for at least 2 years at room temperature, although solutions need to be kept in the refrigerator and become less effective with prolongation of storage.
Alprostadil ; Chromatography, Liquid ; Erectile Dysfunction ; Humans ; Hydrogen-Ion Concentration ; Male ; Papaverine ; Phentolamine ; United States Food and Drug Administration

The corporeal blood gas changes in accordance with the duration of the prolonged erection which developed after intracorporeal pharmacotherapy with papaverine and phentolamine were investigated in 62 impotence patients. The picture of the corporeal blood taken from 15 psychogenic impotence patients (a control group) at 10 minutes after intracavernous injection when they showed full erections was arterial but there was pCO2 rise and pH drop compared to femoral artery blood taken simultaneously. As the erection lasted longer, significant gas changes of the cavernous blood began to appear (p<0.0001): increase in pCO2 and decrease in pO2 from 4 hours, decrease in pH from 5 hours, decrease in O2 saturation from 6 hours. Erections lasting for more than 16 hours showed significantly worse hypoxia (p<0.05). Therefore, to prevent hypoxia and metabolic acidosis, drug-induced prolonged erection would be better decompressed before it lasts for more than 4 hours.
Adult ; Carbon Dioxide/*blood ; Erectile Dysfunction/*blood/drug therapy ; Femoral Artery ; Humans ; Hydrogen-Ion Concentration ; Male ; Middle Aged ; Oxygen/*blood ; Papaverine/administration & dosage/therapeutic use ; Penile Erection/*drug effects ; Phentolamine/administration & dosage/therapeutic use ; Time Factors

ObjectiveTo investigate the application value of Toshiba 320-row dynamic volumetric CT angiography in the diagnosis of venous erectile dysfunction (VED).

METHODSWe enrolled in this study 33 patients diagnosed with ED by audiovisual sexual stimulation screening in the outpatient department. Penile erection was induced in the patients by injection of 2 mg phentolamine plus 30 mg papaverine into the corpus cavernosum, followed by that of contrast agent of iobitridol through the vein and corpus cavernosum successively. Then 320-row dynamic volumetric CT angiography was performed and the images of the corpus cavernosum in the arterial and venous phases were collected and processed.

RESULTSDifferent degrees of abnormal venous drainage were observed in 29 of the patients, including 7 cases (24.1%) of back deep venous leakage, 6 cases (20.7%) of foot venous leakage, 3 cases (10.3%) of dorsal superficial venous leakage, 1 case (3.5%) of intervertebral venous leakage, 2 cases (6.9%) of cavernous venous leakage, and 10 cases (34.5%) of mixed venous leakage. Ten of the patients underwent surgery, dorsal deep penile vein ligation in 2 cases, dorsal deep vein embedding plus foot vein ligation in 4, and foot vein ligation in the other 4. Eight of the patients were followed up for 3－12 months post-operatively, during which 2 achieved obvious erectile improvement, while the other 6 gained normal penile erection.

CONCLUSIONSToshiba 320-row dynamic volumetric CT angiography is a reliable method for the diagnosis of VED, which displays the precise location of venous leakage for clinical treatment, with the advantages of clearer images, lower doses of contrast agent and radiation, and faster examination than X-ray penile angiography.

Adult ; Arteries ; diagnostic imaging ; Computed Tomography Angiography ; Contrast Media ; Drug Combinations ; Erectile Dysfunction ; diagnostic imaging ; Humans ; Injections ; Iohexol ; analogs & derivatives ; Ligation ; Male ; Middle Aged ; Papaverine ; administration & dosage ; Penile Erection ; Penis ; diagnostic imaging ; physiopathology ; Phentolamine ; administration & dosage ; Veins ; diagnostic imaging ; surgery

OBJECTIVETo re-evaluate the effects of different treatments to prevent from phlebitis induced by Chansu injection.

METHODPatients treated with Chansu injection were divided randomly into 4 groups with 50 per group, control group, the magnesium sulfate group, phentolaminum group, and anisodamine group. Patients in the control group only received the routine nursing treatment, and patients in the various experiment group received different interventions. The comparison was made in the morbidity and the starting time of occurrence of phlebitis, the severity of pain, duration of pain.

RESULTThe morbidity of phlebitis was 8%, 8%, 6% respectively. The starting time of phlebitis occurrence was (21 +/- 9.31) , (22.34 +/- 10.15), (20.19 +/- 11.23) h, respectively. The NRS of pain was (4. 15 +/- 1.03), (3.26 +/- 1.17), (4.32 +/- 1.36), respectively. The duration time of pain was (4.05 +/- 1.21), (3.37 +/- 1.17), (3.19 +/- 1.67) d, respectively. In control group, the morbidity of phlebitis, the starting time of occurrence of phlebitis, the severity of pain, duration of pain was 24%, (17 +/- 6.32) h, (6.58 +/- 1.29), (5.32 +/- 1.12) d, respectively. As compared with the control group, a significance difference was found between every group in three test groups and control group respectively (P<0.05).

CONCLUSIONThe morbidity and the starting time of occurrence of phlebitis, the severity of pain, duration of pain was significantly reduced respectively by external appication of magnesium sulfate, anisodamine, and intravenous drip infusion of phentolaminum.

Adult ; Aged ; Aged, 80 and over ; Bufanolides ; adverse effects ; Female ; Humans ; Infusions, Intravenous ; Magnesium Sulfate ; therapeutic use ; Male ; Middle Aged ; Morbidity ; Phentolamine ; administration & dosage ; Phlebitis ; chemically induced ; prevention & control ; Solanaceous Alkaloids ; therapeutic use ; Time Factors

OBJECTIVETo re-evaluate the effects of different "cocktail therapy" to prevent from phlebitis induced by Chansu injection.

METHODPatients treated with Chansu injection were divided randomLy into 4 groups with 90 per group, control group, phentolaminum group, the magnesium sulfate group-phentolaminum group, and anisodamine-phentolaminum group. Patients in the control group only received the routine nursing treatment, and patients in the various experiment group received different interventions. The comparison was made in the morbidity and the starting time of occurrence of phlebitis, the severity of pain, duration of pain.

RESULTThe morbidity of phlebitis was 8%, 8%, 6%, respectively. The starting time of phlebitis occurrence was (22 +/- 4), (27 +/- 5), (28 +/- 7) h, respectively. The NRS of pain was (4.75 +/- 1.51), (3.27 +/- 1.02), (2.71 +/- 1.63), respectively. The duration time of pain was (4.25 +/- 1.36), (2.51 +/- 1.05), (2.19 +/- 1.13) d respectively. In control group, the morbidity of phlebitis, the starting time of occurrence of phlebitis, the severity of pain, duration of pain was 30%, (16 +/- 4) h, (6.34 +/- 1.21), (5.47 +/- 1.07) d, respectively. As compared with the control group, a significance difference was found between every group in three test groups and control group respectively (P<0.05).

CONCLUSIONThe morbidity and the starting time of occurrence of phlebitis, the severity of pain, duration of pain was significantly reduced respectively by two different "cocktail therapy".

Adult ; Aged ; Animals ; Anura ; Bufanolides ; administration & dosage ; adverse effects ; Drug Therapy, Combination ; Humans ; Magnesium Sulfate ; therapeutic use ; Male ; Middle Aged ; Phentolamine ; therapeutic use ; Phlebitis ; drug therapy ; etiology ; prevention & control ; Solanaceous Alkaloids ; therapeutic use ; Young Adult

Stimulation of the trigeminal nerve can elicit various cardiovascular and autonomic responses; however, the effects of anesthesia with pentobarbital sodium on these responses are unclear. Pentobarbital sodium was infused intravenously at a nominal rate and the lingual nerve was electrically stimulated at each infusion rate. Increases in systolic blood pressure (SBP) and heart rate (HR) were evoked by lingual nerve stimulation at an infusion rate between 5 and 7 mg·kg(-1)·h(-1). This response was associated with an increase in the low-frequency band of SBP variability (SBP-LF). As the infusion rate increased to 10 mg·kg(-1)·h(-1) or more, decreases in SBP and HR were observed. This response was associated with the reduction of SBP-LF. In conclusion, lingual nerve stimulation has both sympathomimetic and sympathoinhibitory effects, depending on the depth of pentobarbital anesthesia. The reaction pattern seems to be closely related to the autonomic balance produced by pentobarbital anesthesia.
Adjuvants, Anesthesia ; administration & dosage ; pharmacology ; Adrenergic alpha-Antagonists ; pharmacology ; Animals ; Autonomic Nervous System ; drug effects ; Cats ; Dose-Response Relationship, Drug ; Electric Stimulation ; Electrocardiography ; drug effects ; Hemodynamics ; drug effects ; Hexamethonium ; pharmacology ; Hypnotics and Sedatives ; administration & dosage ; pharmacology ; Infusions, Intravenous ; Lingual Nerve ; drug effects ; physiology ; Male ; Neural Inhibition ; Phentolamine ; pharmacology ; Trigeminal Nerve ; drug effects ; physiology

This study assessed the roles of chronic stress (CS) in the stimulation of the sympathetic nervous system and explored the underlying mechanisms of periodontitis. Using an animal model of periodontitis and CS, the expression of tyrosine hydroxylase (TH) and the protein levels of the alpha1-adrenergic receptor (alpha1-AR) and beta2-adrenergic receptor (beta2-AR) were assessed. Furthermore, human periodontal ligament fibroblasts (HPDLFs) were stimulated with lipopolysaccharide (LPS) to mimic the process of inflammation. The proliferation of the HPDLFs and the expression of alpha1-AR and beta2-AR were assessed. The inflammatory-related cytokines interleukin (IL)-1beta, IL-6 and IL-8 were detected after pretreatment with the alpha1/beta2-AR blockers phentolamine/propranolol, both in vitro and in vivo. Results show that periodontitis under CS conditions enhanced the expression of TH, alpha1-AR and beta2-AR. Phentolamine significantly reduced the inflammatory cytokine levels. Furthermore, we observed a marked decrease in HPDLF proliferation and the increased expression of alpha1-ARfollowing LPS pretreatment. Pretreatment with phentolamine dramatically ameliorated LPS-inhibited cell proliferation. In addition, the blocking of alpha1-ARsignaling also hindered the upregulation of the inflammatory-related cytokines IL-1beta, IL-6 and IL-8. These results suggest that CS can significantly enhance the pathological progression of periodontitis by an alpha1-adrenergic signaling-mediated inflammatory response. We have identified a potential therapeutic target for the treatment of periodontal disease, particularly in those patients suffering from concurrent CS.
Adrenergic alpha-1 Receptor Antagonists/*therapeutic use ; Animals ; Cells, Cultured ; Cytokines/immunology ; Fibroblasts/immunology/pathology ; Humans ; Lipopolysaccharides/administration & dosage/immunology ; Male ; Periodontal Ligament/cytology/immunology/pathology ; Periodontitis/*drug therapy/*etiology/immunology/pathology ; Phentolamine/*therapeutic use ; Rats ; Rats, Wistar ; Receptors, Adrenergic, alpha-1/analysis/*immunology ; Signal Transduction/drug effects ; *Stress, Physiological/drug effects ; Tyrosine 3-Monooxygenase/analysis/immunology