An Insulin-induced, Endothelium-dependent Relaxation Mechanism of Normal Rabbit Cavernous Smooth Muscle / 대한비뇨기과학회지

Purpose: Insulin is known to induce relaxation in various vasculatures by increasing the release of nitric oxide or the expression of nitric oxide synthase. However, its action mechanisms on the corpus cavernosum remain to be uncovered. This study aimed to investigate the relaxative responses and the mechanism of normal cavernous smooth muscles to insulin. Methods and Materials: Rabbit corpus cavernous tissues were prepared in 2x2x8 mm sized strip for isotonic tension recording. The dose-dependent relaxation responses of norepinephrine (10(-4)M)-precontracted strips to insulin (10(-6)M)were measured. The relaxation responses of NE (10(-4)M)-precontracted strips to insulin (10(-6)M) were measured under low to high glucose concentrations (0, 0.1, 1 and 11mM) in physiological solution. The relaxation responses of the NE-precontracted strips to insulin (10(-6)M) were also observed after endothelial denudation, 30-minute preincubation with L-NAME (5mM) or 30-minute preincubation with indomethacin (10(-4)M). Results: The cavernosal strips were relaxed by insulin in a dose-dependent manner. The insulin-induced relaxation was dose-dependently increased by glucose. The endothelial denudation or indomethacin pretreatment almost abolished the insulin-induced relaxation, but L-NAME rarely affected the relaxation. Conclusions: Insulin induces an endothelium-dependent relaxation of rabbit cavernous smooth muscles, which is mostly NO-independent, but seems to be related with prostaglandins or their metabolites.

Stone Localization by Use of Intravenous Contrast Material during in-situ SWL of Ureteral Stones / 대한비뇨기과학회지

PURPOSE: We studied the usefullness of intravenous administration of contrast material to facilitate in situ shock wave lithotripsy(SWL) of ureteral stones in cases that stone localization was difficult as radioluscent, less radiodense, small stone, and interference with visualization by bone or intestinal gas. MATERIALS AND METHODS: From March 1992 to June 1997 we treated 831 patients with ureteral stone by in-situ SWL using EDAP-LT02 piezoelectric lithotriptor which utilizes ultrasono and fluroscopy for stone localization. Among 831 patients, intravenous contrast material were used in 53 cases to facilitate stone localization during SWL treatments. To evaluate the effectiveness of stone localization by the assistance of intravenous contrast media we compared success rate, storages, treatment sessions, durations, and side effects of two groups with or without intravenous contrast material, based on the location and the size of stones. RESULTS: Among 53 patients, stone was localized without ureteral catheterization in 5.7%(25/437) of upper ureteral stone, 18.2%(18/99) of mid-ureteral stone, and 3.4%(10/295) of lower ureteral stone after administration of intravenous contrast material. There were no significant differences in success rate, storages, treatment sessions, and durations(p>0.05). There were no significant complications except dye hypersensitivity in two patients, who were managed conservatively. CONCLUSIONS: The administration of intravenous contrast material during SWL allows effective localization of ureteral stones that otherwise could not be imaged adequately without ureteral catheterization. We believe that the use of intravenous contrast material for localization of ureteral stone in SWL have the benefits of inexpensiveness, noninvasiveness, and painlessness.

Efficacy of Oral Pharmacotherapy according to Results of Biothesiometry, BCRL and DNSEP in Patients with Premature Ejaculation / 대한비뇨기과학회지

PURPOSE: To determine whether biothesiometry, bulbocavernous reflex latency(BCRL), and dorsal nerve somatosensory evoked potential(DNSEP) test could predict efficacy of tricyclic antidepressant(TCA) or selective serotonin reuptake inhibitor(SSRI) to prolong the ejaculatory latency in premature ejaculation. MATERIALS AND METHODS: A total of 33 patients with pramature ejaculation(mean age: 44 years) completed the entire study, Patients took each of clomipramine(50mg), sertraline(1 00mg), and fluoxetine(40mg) consecutively during a 4-week period per each agent. We obtained increased intravaginal ejaculatory latency by the most effective drug among 3 drugs. We analyzed correlations of the increased intravaginal ejaculatory latency with vibration threshold of penile shaft and glans, BCRL, and latency and amplitude of DNSEP. RESULTS: According to Pearson's correlation analysis, there was no correlation of intravaginal ejaculatory latency with vibration threshold of penile shaft and glans, BCRL, and latency and amplitude of DNSEP(all p> 0.05). There was no difference in intravaginal ejaculatory latency between the groups of high and low vibration threshold, long and short BCRL, long and short latency of DNSEP, and large and small amplitude at cerebral cortex on DNSEP test(all p> 0.05). CONCLUSIONS: It seems that biothesiometry, BCRL, and DNSEP test can not predict the efficacy of tricyclic antidepressant or selective serotonin reuptake inhibitor to prolong the ejaculatory latency in premature ejaculation.