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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The usefulness of a chemical prosthesis was studied for the diagnosis and treatment of 20 patients with erectile impotence (14 due to diabetes, 2 due to pelvic surgery and 4 due to psychogenic factors) using papaverine hydrochloride and phentolamine mesilate. Absolute erection was observed in 16 patients (80%) and coital penetration was possible in all 9 patients who actually tried sexual intercourse. Penile arterial blood flow was measured in 15 patients using a real-time mechanical sector duplex scanner (Diasonics DRF/400V) just before and after the chemical prosthesis, and a marked increase in blood flow was observed in all patients after administration. From these results, it is considered that measurement of the penile blood flow using a mechanical sector duplex scanner is useful in the diagnosis and monitoring of impotence. Furthermore, a chemical prosthesis is suitable mainly for the treatment of impotence due to diabetes, by adjusting the dosage and administration.
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PMID:[Diagnosis and treatment of impotence with administration of chemical prosthesis using real-time mechanical sector duplex scanner--with special reference to diabetic patients]. 247 55

Inappropriate ACTH secretion with bilateral diffuse or macronodular adrenal hyperplasia is the most common cause of Cushing's syndrome. This report describes a patient with Cushing's syndrome and feminization due to ACTH-independent bilateral macronodular adrenal hyperplasia. A 47-yr-old black man presented with Cushingoid features, diabetes mellitus, hypertension, impotence, and gynecomastia. Urinary cortisol and 17-hydroxycorticosteroid excretion were 94 nmol/mmol creatinine (normal, less than 32) and 5.8 mumol/mmol creatinine (normal, 0.6-3.6), respectively. Both decreased by less than 30% after administration of dexamethasone (8 and 16 mg/day), and urinary 17-hydroxycorticosteroid excretion did not increase after metyrapone (750 mg, orally, every 4 h for six doses). Plasma ACTH was undetectable (less than 1 pmol/L) and was not stimulated by administration of metyrapone or ovine CRH. Serum testosterone was 5.2 nmol/L (normal, 7-30), FSH was 5 U/L (normal, 3-18), LH was 2.8 U/L (normal, 1.5-9.2), and estrone was 767 pmol/L (normal, 55-240). Both adrenal glands were enlarged, with a total weight of 86 g (normal, 8-10), and contained multiple nodules (diameter, greater than 0.5 cm) composed of two active cell types, one of which was also observed between the nodules. Cushing's syndrome with feminization due to ACTH-independent bilateral macronodular adrenal hyperplasia is an unusual process of unknown etiology that should be included with the other known causes of Cushing's syndrome.
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PMID:Adrenocorticotropin-independent bilateral macronodular adrenal hyperplasia: an unusual cause of Cushing's syndrome. 253 45

The aetiology and management of diabetic impotence is well-documented; the effects of diabetes on female sexuality are not so clear. In this study, 48 diabetic women were assessed clinically and answered detailed sexual questionnaires during a semistructured interview with a sexual counsellor. Twenty-four of the women reported one-or-more sexual dysfunctions: decreased libido, slow arousal, inadequate lubrication, anorgasmia or dyspareunia. There was no significant relationship between the presence of dysfunction and recent glycaemic control, the duration of diabetes, the presence of clinical complications or of neuropathy alone, or the attitude to sexuality. The sexual dysfunction(s) were present at the onset of diabetes in the majority of those so affected (17 of 24 patients), or were attributed to other causes in the remainder. It is suggested that sexual dysfunction in diabetic women should be treated actively as in "normal" women, since diabetes is not the major aetiological factor.
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PMID:Factors in sexual dysfunction in diabetic female volunteer subjects. 259 88

A double-blind, partial crossover study on the therapeutic effect of yohimbine hydrochloride on erectile dysfunction was done in 82 sexually impotent patients. All patients underwent a multifactorial evaluation, including determination of penile brachial blood pressure index, cavernosography, sacral evoked response, testosterone and prolactin determination, Derogatis sexual dysfunction inventory and daytime arousal test. After 1 month of treatment with a maximum of 42.0 mg. oral yohimbine hydrochloride daily 14 per cent of the patients experienced restoration of full and sustained erections, 20 per cent reported a partial response to the therapy and 65 per cent reported no improvement. Three patients reported a positive placebo effect. Maximum effect takes 2 to 3 weeks to manifest itself. Yohimbine was active in some patients with arterial insufficiency and a unilateral sacral reflex arc lesion, and in 1 with low serum testosterone levels. The 34 per cent response is encouraging, particularly in a Veterans Administration population presenting with a high incidence of diabetes and vascular pathological conditions not found in regular office patients. Only few and benign side effects were recorded, which makes this medication worth an attempt, often as a first line of treatment even at a dose of 8 tablets.
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PMID:Effect of yohimbine hydrochloride on erectile impotence: a double-blind study. 265 5

The authors present the results from a retrospective study conducted on 42 patients with Peyronie's disease. For each case, all possible etiological factors were investigated, such as family history, history of trauma, history of other collagenoses, of diabetes, and so on. These studies yielded results comparable to published data. Calcifications within the plaques were found on simple X-ray films in 10.8% of cases. Out of 20 radiological examinations of the corpora cavernosa that were performed, 80% demonstrated pathological processes. It was possible, in some of the cases, to measure echographically the plaque widths, while autophotography was useful in a small number of cases. We were more particularly concerned with sexual dysfunction, impotence, and premature ejaculation, which could be observed in 14 patients.
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PMID:[Etiologic and diagnostic aspects of Peyronie's disease. Apropos of 42 cases]. 267 50

In 657 impotent patients in whom erection was induced by intracavernous injection of papaverine, we evaluated changes in the pulsation, diameter, and blood flow velocity of the penile arteries by duplex sonography and pulsed Doppler spectrum analysis. An additional 18 patients who were proved to have good erection by nocturnal tumescence testing were used as controls. All patients were studied before achieving full erection after papaverine injection. In the flaccid state, the inner diameter of the deep penile arteries averaged 0.51 mm, and blood flow velocity was rarely measurable. The normal arterial reaction to papaverine was an initial increase in the inner diameter of the scanned segment of the cavernous artery with good concentric pulsations and a mean peak blood flow velocity of 34.8 cm per second and a mean diameter of 0.89 mm. With this technique, we assessed the functional capability of each deep and dorsal artery. Arterial and erectile response allowed indirect evaluation of the venous system. Of the 657 patients, 48 had neurogenic or psychogenic impotence or both. In 97, impotence could be ascribed to venogenic causes, in 210 to arteriogenic causes, and to mixed arteriogenic and venogenic causes in 282 patients. The exact cause of impotence in the remaining 20 patients could not be determined. Statistically, patients who were older or had diabetes mellitus or coronary artery disease tended to have smaller penile arteries and lower peak blood flow velocity after papaverine injection.
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PMID:Functional evaluation of penile arteries with duplex ultrasound in vasodilator-induced erection. 268 8

The ability of the MMPI to discriminate between primary psychogenic impotence and primary organic impotence in males with diabetes mellitus was assessed. In order to provide the MMPI with the optimal situation to discriminate between the two groups, we attempted to form a homogeneous sample in terms of physical conditions. Thirty impotent diabetic males were classified as primary organic or primary psychogenic based on nocturnal penile tumescence data. Beutler et al.'s MMPI decision rules yielded a 63% misclassification of the two groups. Possible explanations for the lack of discriminative power of the MMPI with this sample of diabetic males were discussed in relation to previous findings. The power of nocturnal penile tumescence to classify men as having primary organic or primary psychogenic impotence was examined with reference to other vascular and endocrine variables.
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PMID:An evaluation of the Minnesota Multiphasic Personality Inventory as a discriminator of primary organic and primary psychogenic impotence in diabetic males. 271 88

Erectile tissue was removed from the corpora cavernosa of 25 impotent men undergoing surgery for insertion of penile prostheses. Strips, set up in an organ bath, were contracted by the alpha-adrenergic agonist phenylephrine. There was no significant difference between tissue taken from men with diabetes, alcoholism, Peyronie's disease or men with no obvious condition causing the impotence. The sensitivity of tissues from hypertensive patients was significantly reduced but this was probably due to drugs being taken for hypertension. Precontracted tissues could be relaxed by acetylcholine or isoprenaline. The responses, however, were inconsistent, so that no difference between the different groups of patients was apparent.
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PMID:Responses of erectile tissue from impotent men to pharmacological agents. 271 24

Forty milligrams papaverine HCl was intracavernously injected to 28 patients with erectile dysfunction for diagnosis and treatment in 14 cases in which it was injected a few times. We designed a brief manual method for measurement of penile hardness by artificial erection. Twenty of the patients corresponding to 71.4%, reacted, but only 16 (57.1%) had efficient erection for possibility of coitus. It was useful for the diagnosis of vascular dysfunction with dorsal penile arterial pulse sound examination in impotence. It was useful for the cases of small vascular impediment with preservation of nerve supply after the operation of intrapelvic malignancies, and self injection might be possible, but on the other hand, it had no effect for the patients of advanced age with vascular impediment and diabetes mellitus neuropathy, and with arteriosclerosis.
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PMID:[Investigation of intracavernous injection of papaverine for erectile impotence]. 272 23

1. The erectile response to the short-acting dopamine (DA) receptor agonist, apomorphine (Apo) HCl (0.25, 0.5, 0.75 and 1.0 mg sc), and placebo was evaluated in 28 impotent patients and penile circumference monitored using a mercury strain gauge and strip chart recording. 2. A full erection (increment in penile circumference greater than 2 cm and lasting at least one minute) occurred in 17 patients with Apo; no erection developed after placebo. An erection occurred in 6/8 patients with impaired glucose tolerance, 2/6 patients with diabetes mellitus and in both patients on lithium. 3. Nine patients who responded to Apo were treated in an open trial with bromocriptine; 6 reported improvement in potency. 4. Impairment in DA function may play a role in idiopathic impotence and in impotence associated with impaired glucose tolerance and diabetes mellitus. 5. An erectile response to Apo may predict therapeutic response to bromocriptine or other long acting dopaminergic agents. 6. Lithium, which inhibits DA-sensitive adenylate cyclase, does not prevent Apo-induced erections. This provides further support indicating that Apo induces erections by an effect on D2 receptors. 7. The yawning response to placebo and four doses of Apo HC1 (3.5, 5.0, 7.0, and 10.5 ug/kg sc) was evaluated in five normal men using a polygraphic technique. The yawning response was also assessed in normal young (less than 30 yrs; N = 16) and elderly (greater than 60 yrs; N = 12) volunteers. 8. Under experimental conditions of study, placebo induced spontaneous yawning. This was antagonized by 3.5 and 5.0 ug/kg Apo HC1 but increased by 7.0 ug/kg Apo HC1. These observations are compatible with the view that Apo HC1 in doses of 3.5-5.0 ug/kg stimulates presynaptic DA receptors whereas 7.0 ug/kg stimulates postsynaptic DA receptors. 9. Spontaneous and Apo-induced yawning were significantly decreased in the elderly which suggests that D2 receptor function declines with normal aging.
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PMID:Apomorphine: clinical studies on erectile impotence and yawning. 274 70


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