1993 Fiscal Year Final Research Report Summary
SIMPLE, NONINVASIVE, RISK-FREE DIFFERENTIAL DIAGNOSIS OF VASCULOGENIC IMPOTENCE
| Project/Area Number |
03670762
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Urology
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| Research Institution | TOHO UNIVERSITY SCHOOL OF MEDICINE |
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Principal Investigator |
SHIRAI Masafumi TOHO UNIVERSITY SCHOOL OF MEDICINE, UROLOGY, PROFESSOR, 医学部, 教授 (50004841)
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| Co-Investigator(Kenkyū-buntansha) |
TAKANAMI Masaharu TOHO UNIVERSITY, UROLOGY, ASSISTANT PROFESSOR, 医学部, 講師 (60163226)
MATSUHASHI Motomu TOHO UNIVERSITY, UROLOGY, ASSISTANT, 医学部, 助手 (30181746)
MIURA Kazukiyo TOHO UNIVERSITY, UROLOGY, ASSOCIATE PROFESSOR, 医学部, 助教授 (00057697)
ISHII Nobuhisa TOHO UNIVERSITY, UROLOGY, ASSOCIATE PROFESSOR, 医学部, 助教授 (10111270)
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| Project Period (FY) |
1991 – 1993
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| Keywords | Impotence / Vasculogenic impotence / Papaverine hydrochloride / Cefotiam / Penogram / Arteriogenic impotence / Venogenic impotence |
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| Research Abstract |
VASCULOGENIC IMP0TENCE CAN BE DIAGNOSED BY INJECTING THE VASOACTIVE DRUG, PAPAVERINE HYDROCHLORIDE, INTRACAVERNOUSLY, BUT THIS DOES NOT ENABLE THE DIAGNOSTICIAN TO DETERMINE WHETHER THE AFFERENT ARTERIAL OR EFFERENT VENOUS SYSTEM IS IMPAIRED.IN THIS STUDY, WE DEVELOPED A TECHNIQUE THAT ENABLES US TO DETERMINE WHICH OF THESE TWO SYSTEMS IS INVOLVED.TO TEST FOR THE AFFERENT ARTERIAL SYSTEM, TC-99m LABELED HUMAN SERUM ALBUMIN WAS ADMINISTERED INTRAVENOUSLY TO THE CORPUS CAVERNOSUM PENIS TO PRODUCE A TIME-DEPENDENT SCINTIGRAM USING A GAMMA CAMERA.THE REGION OF INTEREST WAS SET UP TO DELINEATE PENILE HEMODYNAMICS AS A PENOGRAM CURVE.AFTER ISOTOPE INJECTION, PAPAVERINE WAS ADMINISTERED INTO THE CORPUS CAVERNOSUM PENIS TO SIMULTANEOUSLY RECORD CHANGES IN BOTH THE PENOGRAM CURVE AND PENILE CIRCUMFERENCE AND RIGIDITY.THE SECOND GENERATION ANTIBIOTIC CEFOTIAM, WHICH CANNOT BE METABOLIZED IN VIVO TOGETHER WITH PARAVERINE AND SHOWS AN EFFERENT PATTERN (r=0.82, p<0.01) EXTREMELY SIMILAR TO THAT OF PAPAVERINE, WAS ADMINISTERED INTO THE PENIS TO MEASURE ITS TIME-DEPENDENT CONCENTRATIONS IN PERIPHERAL BLOOD.THE RESPONSE OF THE PENOGRAM CURVE TO PAPAVERINE LOADING WAS EXPRESSED SIMULTANEOUSLY IN A PENOGRAM INDEX (PI), AND THE CEFOTIAM EFFERENCE INDICATED AS A CEFOTIAM CLEARANCE INDEX (CCI). THESE INDICES WERE COMPARED WITH THE DEGREE OF ERECTION.THE PI WAS 75.5 (〕SY.+-.〔) 8.4 FOR THE COMPLETE -ERECTION GROUP AND 46.8 (〕SY.+-.〔) 16.0 FOR THE INCOMPLETE-ERECTION GROUP.THE PI OF THE NON-ERECTION GROUP WAS 40.5 (〕SY.+-.〔) 10.4. THE PI DECREASED SIGNIFICANTLY FOR THE INCOMPLETE-ERECTION AND NON-ERECTION GROUPS, COMPARED TO THE COMPLETE-ERECTION GROUP.WITH REFERENCE TO CHANGES IN PENILE ARTERIES SHOWN USING A COLOR DOPPLER FLOWMETER, WE DIAGNOSED PATIENTS AS HAVING ARTERIOGENIC IMPOTENCE WHEN THEIR PI WAS LESS THAN THE NORMAL VALUE OF 60. IN CONTRAST, THE CCI SHOWED NO SIGNIFICANT DIFFERENCE BETWEEN GROUPS, PROBABLY BECAUSE THE CCI WAS AFFECTED BY THE AFFERENT BLOOD FLOW VOLUME AND RATE.
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