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Biomedical subjects

C Sparwasser

Publications and source records attributed to C Sparwasser.

At least 37 records · Page 2Linked to original sources
PubMed1994

Isolation and biological activity of aspidospermine and quebrachamine from an Aspidosperma tree source.

The indolealkaloids aspidospermine and quebrachamine have been isolated in crystalline form by a relatively rapid fractionation from the extract of a powdered material designated "Quebracho" derived from an Aspidosperma tree species. We present a novel isocratic LC method that provides baseline resolution of these two compounds and of the structurally related yohimbine in less than 15 min. Gas chromatography-mass spectrometry was employed to identify these compounds as well as several minor derivatives of aspidospermine during and after the purification process. Aspidospermine and quebrachamine like yohimbine have been found to possess adrenergic blocking activities for a variety of urogenital tissues.

Alkaloids↗
PubMed1994

Smooth muscle tone regulation in rabbit cavernosal and spongiosal tissue by cyclic AMP- and cyclic GMP-dependent mechanisms.

The relaxing effects of several specific and nonspecific inhibitors of phosphodiesterases (PDE) on rabbit isolated corpus cavernosum (CC) and spongiosum (CS) were investigated. Preparations were mounted in organ baths, and isometric tension was recorded. The results were compared with the effects of direct administration of analogs of the second messenger cyclic nucleotides and the effects of forskolin, a direct stimulator of adenylate cyclase, and the nitric oxide donor 3-morpholinosydnonimine (SIN 1). All drugs relaxed the phenylephrine-induced contractions in CC and CS in a dose-dependent fashion. In CC and CS, type III (SK&F 95654) and type V (zaprinast and dipyramidole) PDE inhibitors, as well as the nonspecific inhibitors papaverine and trequinsin, showed no differences in IC50. The type IV inhibitor rolipram relaxed CC and CS at significantly lower concentrations (p < 0.005) than any other PDE inhibitor, and in CC the type III and IV inhibitor zardaverine was more potent (p < 0.05) than SK&F 95654. SIN 1 stimulates guanylate cyclase and effectively inhibits contractions in CC and CS. Activation of adenylate cyclase by forskolin also was highly effective (p < 0.005). It is concluded that PDE inhibition constitutes an effective relaxing mechanism in rabbit CC and CS. The marked effects of the different types of PDE inhibitors support the importance of cyclic guanosine 3',5'-monophosphate and cyclic adenosine 3',5'-monophosphate in smooth muscle relaxation in erectile tissue.

Animals↗
PubMed1994

Significance of the evaluation of asymptomatic microscopic haematuria in young men.

OBJECTIVE: To evaluate the extent of diagnostic evaluation that is necessary in young men with asymptomatic microscopic haematuria. PATIENTS AND METHODS: A group of 157 men (mean age 24.8 years [range 18-53]) who presented with asymptomatic haematuria were investigated with repeated urine analysis. Addis count, urinary cultures, blood tests, ultrasonography, pyelography, cystourethroscopy and finally renal biopsy. RESULTS: The results showed pathological findings in 31.2% of patients. Of the 157 individuals, 33.1% did not complete the study. In 14.6% urological disease was found, including two patients with urothelial cancer. Renal biopsy detected glomerulopathy in 16.5% of all patients. IgA nephritis being the most common diagnosis (42% of all biopsies). CONCLUSION: Even in young patients, microscopic haematuria should be investigated and followed thoroughly. Renal biopsy seems to be optional: once a diagnosis is established repeated and unnecessary examinations can be avoided.

Adolescent↗
PubMed1994

Alpha-1 receptor mediated smooth muscle regulation in benign prostatic hyperplasia.

Symptoms in benign prostatic hyperplasia (BPH) are partially caused by an increased prostatic smooth muscle tone. This tone depends on extra- and intracellular Ca2+ stores and is regulated by various second messenger pathways. We investigated the role of intracellular Ca2+ stores and cyclic 3'-5' adenosine monophosphate (cAMP) in BPH. Contractions elicited by the specific alpha 1-receptor agonist phenylephrine (PE) were inhibited by the selective alpha 1-receptor antagonists prazosin and YM 617. To elucidate the contribution of intracellular Ca2+ stores to the alpha 1-receptor induced contraction nifedipine, a blocker of voltage dependent L-type Ca2+ channels (VDCC) was applied and found to inhibit the PE induced contractions up to 65%. To further confirm the participation of intracellular Ca2+ stores, we applied ryanodine (10 microM) which reduced the alpha 1-receptor mediated contractions up to 80%. The remaining contraction was sensitive to nifedipine. The cAMP pathway mediating smooth muscle relaxation by regulating intracellular Ca2+ concentrations ([Ca2+]i) was also investigated. Nonspecific phosphodiesterase (PDE) inhibitors such as papaverine (0.5 mM) and theophylline (1 mM) and the specific PDE inhibitor milrinone (0.5 mM), all of which prevent degradation of cAMP, suppressed the PE induced contractions by 82%, 91% and 68%, respectively. Forskolin (50 microM), an activator of adenylylecyclase (AC), inhibited the PE induced contractions by 83%. The membrane permeable cAMP analog, N6-2'-0-dibutyryladenosine derivative (dBcAMP) also reduced the PE induced response by 70%.

Adrenergic alpha-Antagonists↗
PubMed1994

Long-term results of therapy with intracavernousal injections and penile venous surgery in chronic erectile dysfunction.

A follow up study of 603 patients with chronic erectile failure was carried out concerning the long term effects of intracavernous injection therapy with papaverine/phentolamine (n = 172 evaluable) and venous surgery (n = 134 evaluable). Injection therapy was effective in 95.8% of injections. Side effects included prolonged erections in 0.15% of injections and fibrotic palpable indurations in 3.4%. Acceptance of therapy was high among patients and their partners and improvement of self image or partnership was reported in 77.8% and 79.5% respectively. Results of venous surgery were not satisfactory. Only 19.4% of patients achieved sufficient spontaneous erections and 35.1% needed adjuvant injections. Spongiosolysis yielded better results. Patients with neurological impairment, diabetes mellitus, postoperative onset of erectile dysfunction and age above 40 years showed poorer surgical results. Venous surgery should only be offered to a highly selected group of patients.

Adult↗
PubMed1994

[Bilateral ureteroiliac fistula coincident with radiotherapy and ureteral splint].

Fistulas between the iliac artery and the ureter are uncommon. Overall, fewer than 20 cases have been described in the literature. We report the first bilateral case, in which there was an association with indwelling bilateral ureteral stents and a history of radiation therapy following hysterectomy performed because of malignancy. The patient presented with massive gross haematuria.

Angiography↗
PubMed1992

Venous surgery in erectile dysfunction. The role of dorsal-penile-vein ligation and spongiosolysis for impotence.

We report here on our surgical experience with venous leakage of the cavernous bodies. Out of 159 patients operated on, 134 were available for long-term follow-up. Depending on the cavernosographic findings, one of three different surgical procedures was carried out: ligation of the deep dorsal vein of the penis, spongiosolysis, or ligation of the crura. 18% of the patients undergoing ligation of the deep dorsal vein, postoperatively attained spontaneous erections, while 35% needed adjuvant corpus cavernosum autoinjection therapy. Spongiosolysis gave a more favourable result: spontaneous erections in 30% and vasoactive drug-dependent erections in 35%. Crural ligation did not prove successful. No serious complications were encountered postoperatively. Our data suggest that venous surgery should only be offered to a selected group of patients comprising young impotent men with venous leakage, maybe in combination with arterial disease, and patients suffering from distal venous leakage. Old age, neurogenic disorders causing erectile dysfunction, and diabetes mellitus should represent exclusion criteria for venous surgery.

Combined Modality Therapy↗
PubMed1992

[Long-term results of corpus cavernosum auto-injection therapy in treatment of patients with chronic erectile dysfunction].

From May 1985 to July 1989, 143 patients suffering from chronic erectile dysfunction (21-70 years old) underwent constant corpus cavernosum auto-injection therapy (CCAT) with papaverine alone (1257 injections) or with a standardized papaverine-phentolamine mixture (11035 injections). On the basis of these 12,292 protocol auto-injections and over 4 years' experience with intracavernosal auto-injection therapy we conclude: CCAT, especially with the papaverine-phentolamine mixture, constitutes an effective therapy (full rigidity in 95.9%) with tolerable side-effects for chronic erectile dysfunction when preceded by careful patient selection and thorough multidisciplinary evaluation, especially in the case of arterial and/or neurogenic aetiology of the erectile dysfunction; in addition, the contraindications must be strictly observed, the treatment and technique fully explained, and a regular system instituted. CCAT is generally well accepted by the patients and their partners (100%/98.3%) and has distinct positive effects on self-esteem (77.8%), performance anxiety (84.4%) and partnership (79.5%). The most serious side-effect was prolonged erection (25 out of 12,292 injections). In 3 patients reversible fibrotic changes near the tunica albuginea were observed.

Dose-Response Relationship, Drug↗
PubMed1991

Unilateral extended amyloidosis of the renal pelvis and ureter: a case report.

Localized amyloidosis of the genitourinary tract is a rare phenomenon. The differential diagnosis between amyloidosis and malignancy is difficult. We report the case of an 81-year-old man with extensive unilateral localized amyloidosis of the renal pelvis, ureter and ureteral orifice. Diagnosis of amyloidosis was confirmed only postoperatively.

Aged↗
PubMed1991

[Nitroglycerin test for the diagnosis of erectile dysfunction].

In 33 patients with erectile dysfunction arterial inflow was measured by Doppler-sonography over the superficial dorsal and deep cavernous arteries in the proximal section after local application of 1.6 mg glycerol trinitrate (nitroglycerin) to the glans penis. With this test we were able to reveal a minimal increases in maximal systolic flow over both arteries at 29/66 measurement sites. This is thus an easier way of localizing penile vessels in the flaccid state. In no case did we see tumescence or rigidity.

Administration, Topical↗
PubMed1990

[Results of multidisciplinary assessment of patients with erectile dysfunction].

A total of 326 patients with chronic erectile dysfunction were investigated by a multidisciplinary approach. It was found that several causes combined (multifactorial genesis) in 77.1%. Organic causes alone were found quite frequently, viz. in 43.6%, while primarily psychogenic causes alone were found in only 5.5%; in contrast, combined organic and psychogenic causes were found in 46.0%. There were pathologic organic findings in 89.6%: vascular in 74.5% (arterial 64.1%, cavernous/venous 30.4%), neurogenic in 42.0%; side effects of drugs in (10.1%); endocrine (7.7%) and local penile causes (4.3%) are not so important in erectile dysfunction. Treatment suited to the pathogenesis was instituted (psychotherapy, vein ligation, self-injection of vasoactive drugs into the corpus cavernosum).

Adult↗
PubMed1988

[Segmental unilateral priapism--a case report].

A case of segmental priapism in a 24-year-old man with congenital spherocytosis is presented. Preoperative cavernosography and computer tomography clearly revealed thrombosis of the left proximal corpus cavernosum. Because the lesion had already been in existence for 5 weeks irrigation to flush out the thrombosis was no longer possible.

Adult↗
PubMed1988

[Diagnosis of enuresis--results of urodynamic studies].

The results of clinical evaluation of 71 patients with primary or secondary enuresis are presented. In 66 patients a complete urodynamic assessment was possible. 35 percent of these patients showed a normal urodynamic pattern, in 45 percent detrusor hyperreflexia and in 18 percent a combination of detrusor hyperreflexia and a functional infravesical obstruction was demonstrated.

Adolescent↗
PubMed1987

[Position of surveillance therapy in clinical stage I testicular non-seminoma].

Since the initiation of a 'surveillance' therapy the role of retroperitoneal lymph node dissection as standard treatment in the management of patients with clinical stage I nonseminomatous germ cell testicular tumor (NSGCTT) continues to be debated. Noninvasive staging techniques (CT scans, lymphography, ultrasound and serologic tumor markers) help to identify more accurately patients with distant metastases. 'Surveillance' alone as a possible treatment modality following orchidectomy in selected patients with clinical stage I NSGCTT requires cooperative and reliable patients. In our urological clinic surveillance alone is not justified any longer because of a noncompliance rate of 10% and a relapse rate of 30%, although the early detection of small-volume metastatic disease, lymphadenectomy and polychemotherapy result in a high rate of cure. Any patient should be excluded from 'wait and see' protocols if metastatic prognostic factors such as vascular infiltration of the primary tumor or local tumor stage greater than pT1 are identified.

Biomarkers, Tumor↗
PubMed1987

[Spongious autoinjection therapy following implantation of a penis prosthesis--case report].

Due to relative shortness of his penis a 67-year-old patient suffering from erectile dysfunction could not perform sexual intercourse, despite the implantation of a penile prosthesis. After intraspongious injection of 3 ml of a vasoactive substance mixture (papaverine 15 mg/ml and phentolamine 0,5 mg/ml) an increase in glandular circumference of 1.5 cm and in penile length of 1.8 cm took place, lasting for 1 1/2 h. By this means the patient regained the ability of a normal sexual life.

Aged↗
PubMed1984

[Systematic program for the differentiation of cystic and solid lesions of the kidney].

Renal cysts are found in up to 50% of the population beyond 50 years. The coexistence of a renal cyst and a tumor is observed in 0.3% to 2.9% and may appear in 5 different types, of which type 2, the cysticly degenerated renal cell carcinoma, is most commonly found since 10% of the renal cell carcinomas reveal this phenomenon. Type 1, a renal cyst close to a renal tumor, is found in the literature in 5%; while the intracystic tumors (type 3 and 4) are rare with only 50 cases reported so far. The diagnostic procedures should reliably exclude malignant tumor. A differentiation between a simple renal cyst and malignancy is possible by intravenous pyelography and tomography alone in only 50%, while Catscan and angiography increase the accuracy to 93%. The sensitivity and specificity of ultrasonic examination is found to be 90%, whereas the combination of sonography and percutaneous cyst aspiration reaches an accuracy of 97%. A diagnostic exploration should be done only if the previous procedures are unclear.

Biopsy, Needle↗