Effects of simulated 100 m Trimix conventional diving on oxidative stress and inflammatory reaction in rabbits / 中国应用生理学杂志

OBJECTIVE@#To investigate the effects of simulated 100 m Trimix conventional diving on tissue inflammatory cytokines in rabbits.@*METHODS@#Eight New Zealand rabbits were performed a simulated 100 m Trimix conventional diving program which was established according to the Haldane theory. The expression levels of interferon-gamma(IFN-), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8), myeloperoxidase(MPO) and matrix metallo proteinase-9 (MMP-9) in rabbits lung and brain tissues were detected by Elisa after diving decompression. The tissue wet/dry ratio was calculated. The serum levels of superoxide dismutase (SOD),glutathione(GSH), catalase(CAT), malondiadehyde(MDA) and lipid peroxide(LPO) were detected by Elisa method in rabbits before and after diving.@*RESULTS@#The expressions of IFN-, TNF-α, IL-6, IL-8, MPO and MMP-9 in simulated diving group rabbits were significantly increased compared with the intact group(<0.05, <0.01); the simulated diving rabbits tissues wet/dry ratio had no significant changes compared with the intact group. After diving, the activities of SOD and GSH were decreased significantly (<0.01), while the contents of CAT, MDA and LPO were increased significantly (<0.01).@*CONCLUSIONS@#The simulated 100 m Trimix conventional diving had significant impact on oxidative stress and inflammatory reaction in rabbits, the results of wet/dry ratio showed that the diving rabbits had no tissue edema after decompression.

Prediction of Sildenafil Response according to Intracavernosal Injection Test in Patients with Erectile Dysfunction / 대한남성과학회지

PURPOSE: The aim of our study was to assess whether an intracavernous injection test can predict the effectiveness of sildenafil oral medication in patients with erectile dysfunction (ED). MATERIALS AND METHODS: A total of 80 patients with ED underwent an intracavernous injection test with trimix (papaverine 18.75 mg+phentolamine 0.625 mg+PGE1 6.25microgram/ml) 0.2 ml. Patients were divided into 2 groups according to rigidity formation following trimix injection: group I had no rigidity formation, group II had some rigidity formation. All patients received a starting dose of 50 mg sildenafil. The dose was adjusted to 100 mg based on its efficacy and tolerability. Erectile function was measured before and during the therapy using the International Index of Erectile Function (IIEF) questionnaire. RESULTS: All patients had erection function (EF) domain scores of the IIEF less than 16, denoting moderate to severe ED (group I, 50 patients; group II, 30 patients). The response rates with sildenafil 50 mg were 24% (12/50) in group I and 87% (26/30) in group II. The overall response rates with sildenafil (50 mg or 100 mg) were 68% (34/50) in group I and 93% (28/30) in group II. The change in ED domain score was significantly higher in group II (9.87+/-3.18 to 15.40+/-4.50; p<0.001) compared to group I (7.80+/-2.43 to 9.08+/-3.84). CONCLUSIONS: The erectile response from the intracavernosal injection test was correlated with the sildenafil response rate. This result implies that intracavernosal injection test may predict the erectile response to oral phosphodiesterase type 5 inhibitor.

Trimix Intracavernosal Self-injection Therapy: Long-term Follow-up Results in the Patients with Erectile Dysfunction / 대한비뇨기과학회지

PURPOSE: Trimix, the mixture of papaverine, phentolamine and PGE1 , has been widely used in intracavernosal therapy for patients with erectile dysfunction. Although several results have been reported in Korean patients using the Trimix, no long-term follow-up studies have been carried out. Therefore, we analysed our long-term follow-up results of Trimix therapy PATIENTS AND METHODS: A total of 216 patients(46.2 years of mean age) with erectile dysfunction underwent intracavernosal self-injection therapy with the Trimix(mixture of papaverine 48mg, phentolamine 2mg, PGE1 18microgram in 2 microliter solution). Once chosen, all patients were tested for an appropriate dosage. They were also given education upto 5 times for an successful self-injection therapy. During follow-up periods, ranging 12 to 34 months, evaluations of the effectiveness and safety of the therapy were made by inteNiewing patients upon their visits to our clinic. RESULTS: The final drop-out rate of cases were 107(49.5%). Most drop-out cases (80 cases) occurred within the first month of the therapy. It was also found that drop-out rate was Inversely correlated with number of attendance at the preself-injection education(p< 0.05). A total of 168 patients failed to attend more than 3 times. The drop-out rate of this group was 55%(92 cases) while 31% in those with more than 3 attendances. A total of 109(50.5%) patients completed longer than 12-month follow-up durations and 85(77%) patients were satisfied with the therapy. Their mean dosage was 0.16 microliter and mean frequency of applications was 5.0 times per month, Although no patient developed corporal fibrosis or infection, other side-effects including prolonged erection(14 cases) and penile pain during intercourse(3 cases) were reported. CONCLUSIONS: Trimix intracavernous injection therapy is minimally invasive, safe and effective for the treatment of patients with erectile dysfunction. While high drop-out rate was thought to be a major problem with this therapy, our results suggest that adequate educations can encourage patients to a certain degree.

Trimix Intracavernosal Injection Therapy in Patients with Erectile Dysfunction: Long-term Follow-up Result / 대한비뇨기과학회지

PURPOSE: Vasoactive pharmacotherapy is now being widely used as practical and reliable method for the treatment of the patients with erectile dysfunction. The synergistic effect and low drug volume of each vasoactive drug in polypharmacotherapy for erectile dysfunction have made it possible to reduce both systemic and local complications with excellent success rate. We evaluated the treatment outcome of intracavernosal injection therapy with Trimix(the mixture of papaverine, phentolamine and prostaglandin E1). MATERIALS AND METHOD: From July 1993 to June 1997, 1000 patients with erectile dysfunction underwent a trial of intracavernous self injection therapy with Trimix(the mixture of papaverine 4.8mg, phentolamine 0.2mg and prostaglandin E1 1.8 microgram in 0.2ml). Underlying diseases were diabetes mellitus (33.1%), hypertension(7.5%) and others(12.3%). 471(47.1%) patients had no underlying disease. The volume of drug used ranged from 0.03 to 0.6ml(average: 0.18ml). RESULTS: After a mean follow-up of 10.9 months(3-44 months), 524 patients stayed on the home injection program. The drop-out rate was 47.6% with most of the cases during early home phase. The reasons for drop-out were inadequate response to medication, failure of injection, return of spontaneous erection, switch to other treatments, priapism, fear of needle or injection, loss of interest and economic reason. 88.3% of patients and 85.3% of the partners were satisfied wilts the result of home injection program. Priapism(3.9%), pain or discomfort(2.4%) and granuloma on injection site(1.5%) were noticeable complications, but corporal fibrosis and systemic side effect were not noticed. CONCLUSIONS: Trimix intracavernosal injection therapy is minimally invasive, simple, relatively safe and most of all, very effective method for the treatment of the patients with erectile dysfunction.

Intracavernosal Self-Injection Therapy for the Patients with Erectile Dysfunction: Comparison of Erectile Response and Complications between Bimix and Trimix Solution / 대한비뇨기과학회지

PURPOSE: To compare the efficacy of Bimix solution (27.3 mg/ml papaverine and 0.9 mg/ml phentolamine) versus Trimix solution (18.8 mg/ml papaverine, 0.6 mg/ml phentolamine and 6.3ug/ml prostaglandin El) in terms of erectile response and complications. MATERIALS AND METHODS: We comparatively analyzed the erectile response and the incidence of pain, prolonged erection (>4 hours), and corporal fibrosis of either medication in the 155 impotent patients who used Bimix solution for intracavernous pharmacotherapy (mean duration: 15 months) and thereafter used Trimix solution (mean 12 months). RESULTS: Erectile response to Trimix solution was significantly better than Bimix solution (p<0.01). The mean dose of Bimix solution was higher than Trimix solution (0.43 ml. vs. 0.34 ml, p<0.05). The severe pain enough for impediment to ntercourse occurred in 6.5% of the Trimix group, while no patient of the Bimix group experienced (p<0.01). The corporal fibrosis was noted in 8.4% of the Trimix group and 16.1% of the Bimix group. However, there was no significant difference between the two groups (p=0.08). The incidence of prolonged erection was significantly lower (p<0.05) in the Trimix group (2.6%) than in the Bimix group (12.3%). A total of 139 patients (89.7%) finally selected Trimix solution. CONCLUSIONS: The Trimix solution was more effective and safer than Bimix solution for the treatment of erectile dysfunction.

Intracavernosal Injection for Treatment of Erectile Dysfunction using Four-Mix Drugs / 대한비뇨기과학회지

PURPOSE: We evaluated the erectile response to intracavernosal injection of a combination of papaverine, phentolamine, prostaglandin E1, and verapamil (Four-Mix). A verapamil may attenuate fibrosis in the penile corpus cavernosum during the intracavernosal injection therapy. MATERIALS AND METHOD: We undertook an assessment of the time of rigid erection, rigidity of 26 patients after intracavernosal injection. All patients had only vasculogenic erectile dysfunction. We compared pH of the drugs. All patients were performed alternative injection (initial-Tri-Mix, second-Four-Mix, third-Tri-Mix, fourth-Four-Mix) of 0.3 ml once a week, over 4 weeks. We compared erectile responses to Four-Mix with Tri-Mix using by rigidity, tumescence, and erecting time. The grade of rigidity was determined by palpation and inspection of the penis according to a scale from 1 to 4 (1-parital tumescence, 2-full tumescence, 2.5- between 2 and 3, 3-incomplete rigidity, 3.5- between 3 and 4, 4- full rigidity). RESULTS: Mean value of rigidity and erecting time to the first intracavernosal injection of Tri-Mix was 3, 107 min, respectively. Mean value of rigidity and erecting time to the second intracavernosal injection of Four-Mix was 3.52, 121 min, respectively. Mean value of rigidity and erecting time to the third intracavernosal injection of Tri-Mix was 3.52, 138 min, respectively. Mean value of rigidity and erecting time to the fourth intracavernosal injection of Four-Mix was 3.77, 113 min, respectively. The rigidity to Four-Mix injected was better than Tri-Mix (P<0.05). The erecting time was longer in Tri-Mix than Four-Mix. There were 7 cases of priapism, 4 of them were occurred using by Tri-Mix and 3 of them were occurred Using by Four-Mix. CONCLUSION: The degree of erection achieved was better with Four-Mix than with Tri-mix. The erecting time to Four-Mix injected was shorter than Tri-Mix, although the incidence of prolonged erections (greater than 5 hours) was similar with both combinations.

Trimix Intracavernosal Injection Therapy in the Patients with Erectile Dysfunction / 대한비뇨기과학회지

Vasoactive pharmacotherapy is now being widely used as practical and reliable method for the treatment of the patients with erectile dysfunction. But the individual vasoactive agent has limitations in its clinical success and potential for side effects. So, the synergistic effect and low drug volume of each vasoactive drug in polypharmacotherapy of erectile dysfunction have made it possible to reduce both systemic and local complications with excellent success rate. A total of 223 patients with erectile dysfunction underwent a trial of intracavernous self injection therapy with Trimix(the mixture of papaverine, phentolamine and prostaglandin E1). Major underlying diseases were DM(115patients, 51.6%), hypertension(11 patients, 4.9%), spinal injury(three patients, 1.3%) and prior pelvic surgery(three patients, 1.3%). The volume of drug used ranged between 0.04 and 0.6ml(average:0.19ml). After a mean followup of 7.6 months(3-15 months), 141 patients(63.2%) left in the home injection program and among them, 125 patients(88.6%) had very high satisfaction. The drop-out rate was 36.8%(82 of 223) with most of the cases during early home phase. The causes of drop-out were the fear of needle or injection, inadequate response to injection, loss of interest and complications. Priapism(six patients, 3.8%), pain(six patients, 3.8%) and granuloma on injection site(one patient, 0.6%) were noticeable complications, but coporal fibrosis and systemic side effect were not noticed. In conclusion, Trimix intracavernosal injection therapy is minimally invasive, simple, relatively safe and, most of all, very effective method for the treatment of the patients with erectile dysfunctions.