Abstract.One hundred twenty-six bilateral selective arteriographic examinations of the iliopudendal vascular tree were performed after comprehensive multidisciplinary evaluation in patients with chronic erectile dysfunction. Best imaging results were obtained by performing the arteriography under epidural anesthesia after intracavernous injection of a vasoactive drug combination. The arteriography is mandatory prior to revascularization procedures. It is further indicated in primary erectile dysfunction and posttraumatic erectile failure. The importance of cavernosography and selective arteriography in primary erectile dysfunction is stressed. Increasing knowledge about the influence of vasoactive drugs on penile hemodynamics has led to its application in diagnosis and therapy of erectile dysfunction. Pharmacocavernosography, Doppler-ultrasound of penile arteries after intracavernous injection of a vasoactive drug combination, and pharmacoarteriography are refined techniques to prove a vascular etiology of erectile dysfunction. The results of the morphologic studies of the vascular system are correlated with functional testing of erectile capacity by intracavernous application of a papaverinephentolamine drug combination.
Disturbances of the topographical distribution of theta activity in the EEG spectra before and during voluntary movements were investigated in 31 neuroleptic-treated and in 13 untreated schizophrenics and matched controls as well as in 15 normals medicated with haloperidol. All 4 groups demonstrated similar topographical distribution of theta mean power density, with highest values over the midfrontal region. In the center frequency of the theta band, however, treated and untreated schizophrenics had lower values over the midfrontal region than at parietal electrodes. In controls and normals medicated with haloperidol, this frontoparietal "gradient" demonstrated the inverse picture, with highest values at the frontal midline electrode. Patients and controls differed significantly in this gradient. The slower theta activity over the midfrontal cortex in the schizophrenic patients is related to the hypofrontality hypothesis.
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ZusammenfassungBei 100 multidisziplinär untersuchten Patienten mit mindestens ljähriger erektiler Dysfunktion (E. D.) wurde zu diagnostischen Zwecken ein pharmakologisches Testverfahren mit intrakavernöser Applikation eines PapaverinPhetolamingemisches angewandt. Aufgrund dieses pharmakologischen Testes gelingt eine Einordnung in 1. nichtvaskulär bedingte E. D., 2. vaskuläre E. D. mitpathologischen inflow-Bedingungen und 3. vaskuläre E. D. mit pathologischen outflow-Bedingungen. Gruppe I (n = 13) erreichte mit durchschnittlich 0,43 ml unserer SKAT-Lö-sung eine Erektion mit mittlerer Rigidität, Gruppe II (n = 68) benötigte durchschnittlich 1,05 ml. Bei 13 von 19 Patienten der Gruppe III kam es nach intrakavernöser Gabe von 3 ml nicht zu einer Erektion, die übrigen 6 Patienten mit pathologischen Ausflußbedingungen erzielten mit 3 ml eine für Kohabitation noch ausreichende Erektion. Mit Hilfe des pharmakologischen Testes unter Anwendung vasoaktiver Substanzen läßt sich rationell eine therapierelevante Differenzierung zwischen vaskulärer und nicht-vaskulärer E. D. herbeiführen. Das aufwendige Untersuchungsprogramm kann dadurch gestrafft und optimiert werden.
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