Differential Diagnosis of Vascular Impotence by Measurement of Papaverine Hydrochloride in Peripheral Blood.

用汞应变计、橡胶应变计和CaCl2应变计对阳萎患者阴茎海绵体注射盐酸罂粟碱后的勃起曲线进行分类，并用高效液相色谱法测定外周血中盐酸罂粟碱的流出量，对部分受试者的勃起曲线进行对比评价。因此，有人认为血管疾病，即动脉系统或静脉系统的疾病，或两者兼而有之，在某种程度上是可能的。但不可能得出可靠的结论，因为测量流入外周血的盐酸罂粟碱量的病例数量仍然很少。究其原因，罂粟碱的测定非常复杂。因此，寻找一种与罂粟碱相似的外流模式，其测量不像罂粟碱那么复杂；头孢替安被发现是一种理想的物质。头孢替安是一种不在血液中代谢的抗生素，通过同时测量注射到阴茎海绵体后流入外周血的头孢替安和罂粟碱的量，发现两种物质的流出模式非常密切(相关系数：0.82，危险率<1%)。我们通过测定外周血中头孢替安浓度代替罂粟碱流出浓度，评价了头孢替安的外周血药浓度与勃起曲线分型的关系，结果表明，只有观察勃起曲线的分型，临床医生才能正确判断血管病变的存在，并鉴别动脉和静脉功能障碍。

Classification of erection curve patterns in impotent patients was undertaken by recording with mercury strain gauge, rubber strain gauge and CaCl_2 strain gauge after administering papaverine hydrochloride into the cavernous body of the penis ; moreover, a comparative assessment of the curvepatterns was conducted in some subjects by measuring the outflow of papaverine hydrochloride into peripheral blood employing high performance liquid chromatography. As a result, it was considered that differentiation of vascular disorders, that is, disorders of the arterial system or venous system, or both, is possible to some extent.However, it was not possible to draw solid conclusions, because the number of cases in whom measurement was made of the amount of papaverine hydrochlorideFlowing into peripheral blood is as yet small in number. The reason for this is that the measurment of papaverine is very complicated. Therefore, a substance which exhibits an outflow pattern similar to that of papaverine, and measurement of which is not so complicated as that of papaverine was sought ; cefotiam was found to be an ideal substance. Cefotiam is an antibiotic which is notMetabolized in blood ; by concurrently measuring the amounts of cefotiam and papaverine flowing into peripheral blood after injection into the cavernous body of the penis, the outflow patterns of the both substances were found toResemble each other very closely (correlation coefficient : 0.82 risk rate less than 1%). We assessed the relation of the concentration of cefotiam inPeripheral blood with the pattern classification of erection curve by measuring the cefotiam in peripheral blood in place of measuring the outflow concentration of papaverine ; as a result, it was made clear that only by observation of the erection curve pattern can the clinician correctly determine the presence of vascular disorder and differentiate between arterial and venous dysfunction.