[Experience with multidrug chemotherapy for patients with head and neck malignant tumors--comparison between CP therapy and PTP therapy]

A combined chemotherapy regimen (CP chemotherapy) consisting of cisplatin (CDDP) and peplomycin (PEP) was employed to treat patients with head and neck malignant tumors. More recently, PTP chemotherapy added to CP chemotherapy with THP-adriamycin (THP-ADM) was employed. We proceeded to investigate the efficacy of these two chemotherapeutic regimens. The subjects of this study included 22 patients in the CP chemotherapy group (18 males and four females). The PTP chemotherapeutic regimen was administered to 23 patients (18 males and five females). The results showed response rates of 54.5% for the CP chemotherapeutic regimen and 60.9% for the PTP chemotherapeutic regimen. In both treatment groups, the response rate decreased as the disease stage increased. As adverse reactions to the chemotherapeutic regimens, nausea and vomiting occurred in 63.6% of the CP group and 69.6% of the PTP group. Leukopenia was detected in 18.2% of the CP group and 69.6% of the PTP group, while alopecia was seen only in the PTP group, at an incidence of 39.1%. Cardiotoxicity was not detected in either group.

Immunohistochemical detection of CEA, CA19-9, and DF3 in esophageal carcinoma limited to the submucosal layer

The immunohistochemical expression of CEA, CA19-9, and DF3 was studied in 20 normal epithelia, 11 cases of dysplasia, 32 squamous cell carcinomas restricted within the submucosal layer (SM carcinoma), and 42 advanced squamous cell carcinomas of the esophagus. The modes of expression were grouped into three patterns, i.e., negative, focal, and diffuse patterns. No diffuse expression of CEA, CA19-9, or DF3 was found in the normal squamous epithelium and dysplasia. In the carcinomas (32 SM carcinomas and 42 advanced carcinomas) the diffuse expression of CEA and CA19-9 was found in four lesions, and only one of the four lesions was an SM carcinoma, while the diffuse expression of DF3 was found in 16 of the 32 SM carcinomas and 25 of the 42 advanced carcinomas. These results indicated that the diffuse expression of these tumor-associated antigens were characteristic of tumor tissue in the esophagus, and particularly DF3 was diffusely expressed earlier than CEA or CA19-9. The expression of DF3 in the esophagus may, therefore, be a marker of the early stage of tumor growth.

[Effects of E. coli LPS on human platelet aggregation]

The effects of E. coli lipopolysaccharide (LPS) on washed platelets of the healthy volunteers were studied by measuring ADP induced aggregation and intracellular ionized calcium concentration ([Ca2+]i) by fluorescent calcium indicator, quin 2. Addition of LPS in platelets suspension in saline, caused an increased platelet aggregation. Adding LPS, however, in platelet suspension in Na(+)-citrated platelet poor plasma inhibited ADP aggregation. These trends were not affected by cyclooxygenase inhibitor, but partially antagonized by dibutyryl cyclic AMP, and verapamil. The intracellular calcium ion concentration ([Ca2+]i) was significantly increased (334 +/- 141 nM to 150 +/- 45 nM in control) on addition of LPS in platelet suspension containing ionized calcium. On the other hand, there was no significant difference observed with those suspended in calcium free solution (50 +/- 16 to 45 +/- 15 in control). These results indicate that changes of platelet aggregation by LPS were mediated by cyclic AMP and Ca2+, but not by arachidate derivatives. The author concludes that LPS changed the mechanism of Ca2+ influx of platelet membrane and elevated [Ca2+]i of platelets. These findings, however, probably are not the cause of aggregation of platelets during DIC.

Potentiation of antitumor effect of bleomycin by local electric pulses in mouse bladder tumor

C3H mice bearing subcutaneously transplanted mouse bladder carcinoma (MBT-2) were treated with intramuscular injection of bleomycin followed by local delivery of electric pulses at the tumor site. The tumors markedly reduced and even disappeared for several days after this treatment. Neither electric pulses nor bleomycin administration alone showed a significant inhibitory effect on the tumor growth. Thus, it is demonstrated that in mouse bladder tumor the antitumor effect of bleomycin can be considerably potentiated by local electric pulses.

A subpopulation of olivocerebellar projection neurons express neuropeptide Y

By neuropeptide Y (NPY) immunohistochemistry and in situ hybridization histochemistry with digoxigenin-labeled oligonucleotide probes for this peptide, a subpopulation of neurons in the caudal portions of the rat dorsal and medial accessory olives were found to express NPY immunoreactivity and mRNA. In the cerebellum, NPY-immunolabeled climbing fibers were distributed to the flocculus and parts of vermal cortex. The results suggest particular association of NPY with the climbing fiber system presumably mediating spinal, visual and vestibular inputs.

Identification of the cerebral motor cortex by focal magnetic stimulation: clinical application to neurosurgical patients

A figure-8 coil was designed that was capable of generating currents over a relatively limited area. In this study, we used the figure-8 coil to localize human cerebral motor cortex by transcranial magnetic stimulation and assessed its value as a diagnostic tool for neurosurgical disease. The subjects were 10 normal volunteers and 12 neurosurgical patients. The points obtaining a response were plotted and the response area was delineated for each stimulus output. Rectangular coordinates were subsequently determined for the C3-Cz-C4 line with the stimulation sites set 1.0 cm apart. Then amplitude and latency maps were displayed by a computer wave map program. In normal volunteers, the posterior margin of the site where a threshold +5% stimulus obtained a response from the THE or ADM muscles almost coincided with the central sulcus. The optimal areas were relatively narrow on the amplitude and latency maps. In the patient with a left frontal convexity meningioma, the left threshold +5% area for the THE and ADM muscles showed marked anterolateral shift. No threshold map could be obtained on the affected side in patients with metastatic tumor and astrocytoma. Low perfusion areas caused by moyamoya disease and arteriovenous malformations produced narrowing of the optimal zone on the threshold map of the affected side. Hyperexcitability of the motor cortex was recognized in the arteriovenous malformation patients. Transcranial focal magnetic stimulation is a useful noninvasive diagnostic method for identification of the human cerebral motor cortex. It provides important information about changes in the localization and excitability of the motor cortex in neurosurgical patients and should be helpful for treatment planning.

Automated monitoring of cell concentration and viability using an image analysis system

In order to automate measurements of cell concentration and viability in a suspended animal cell culture, we have developed an in situ microscopic image analysis system with an effective cell recognition algorithm. With a small amount of sample, this system can measure the cell density rapidly and aseptically. In addition, it can measure a cell size histogram including cell debris small particle distribution. These small particles have been found to be related to the viability of the mouse-mouse hybridoma STK1 cell line. By using cell debris small particle density as an indicator of cell viability, the developed system provides non-destructive viability monitoring without trypan blue staining.

Calcium control of actin-myosin-based contraction in Triton-treated murine bladder tumor cells

Using mouse bladder tumor cells (MBT-2 cells) and epithelial cells, the present study evaluated the functional characteristics of the actomyosin system in bladder cancer cells. An immunofluorescence study demonstrated the presence of contractile proteins (actin and myosin) in MBT-2 cells as well as bladder epithelial cells. Triton-treated MBT-2 cells and epithelial cells showed a Ca(2+)-dependent contraction. This was inhibited by N-ethylmaleimide-modified myosin subfragment 1 (NEM-S1), demonstrating that the interaction between actin and myosin is responsible for the contraction of Triton-treated cells. The extent of Ca(2+)-dependent contraction was much greater in MBT-2 cells than in epithelial cells. These results suggest that MBT-2 cells possess a locomotive apparatus consisting of actin and myosin, and that Ca2+ can activate this actomyosin system, leading to the contraction or active locomotory movement of tumor cells.

Operative procedures of reconstruction after resection of esophageal cancer and the postoperative quality of life

To investigate the influence of the operative procedures of reconstruction after resection of esophageal cancer on the postoperative quality of life, an interview was conducted and subjective and objective factors related to the quality of life were evaluated in 50 patients without a recurrence of esophageal cancer. Among the 50 cases, reconstruction by the antethoracal route was performed in 9 (group I) and by the retrosternal route in 24 (group II). Intrathoracic anastomosis was done in 17 (group III). A postoperative disturbance of the food passage was seen 22.0, 41.6, and 5.9% in groups I, II, and III, respectively. Dumping symptom was evident 11.1, 12.5, and 11.8%, respectively. Heartburn was seen only in two cases, in group III. A body weight loss of more than 1.0 kg from preoperative weight was seen in 33.3, 41.7, and 41.2% of groups I, II, and III, respectively. There was no difference in the postoperative performance status or laboratory data among the groups. Thus, although intrathoracic anastomosis was favorable for postoperative food passage, there was no significant difference in any other factors in the quality of life among the routes of reconstruction, and the quality of life gradually improved in patients of all groups as postoperative time passed in the cases without postoperative recurrence of esophageal cancer.

[Effects of testosterone on smooth muscle in the isolated rabbit corpus cavernosum penis]

It has been reported that there is no relationship between serum testosterone level and erectile function and that testosterone mainly acts on the brain and not on the penis. However, we have found that erectile dysfunction in some patients with low serum testosterone improved after androgen replacement therapy. We therefore studied the effects of testosterone on the contraction and relaxation of the corpus cavernosum penis. Four groups of rabbits were studied over a similar time span. The testosterone group were non-operated and received testosterone propionate 10 mg/day for 14 days before sacrifice. Two groups (castration+testosterone group and castration group) were castrated 28 days before sacrifice. The castration group received sesame oil for 14 days, and the castration+testosterone group received testosterone 10 mg/day for 14 days. Entire penis were removed immediately after death by desanguination and dissected to obtain corpus cavernosum strips. These strips were suspended under 1 g tension in a 20 ml organ bath containing Tyrode's solution. After equilibration for 2 hours, the addition of drugs was started. Changes in tension were monitored with an isometric transducer and recorded. The vasoactive drugs used were norepinephrine bitartrate, 1-phenylephrine hydrochloride, clonidine hydrochloride, acetylcholine chloride and vasoactive intestinal polypeptide. The contractility of the corpus cavernosum strips increased significantly in the testosterone group and the castration + testosterone group, but decreased significantly in the castration group as compared with the control after adding norepinephrine, phenylephrine and clonidine.(ABSTRACT TRUNCATED AT 250 WORDS)

[A case of chondrosarcoma of the thoracic vertebra]

A case of chondrosarcoma of the thoracic vertebra in a 47-year-old female is described. Chest X-ray, CT and MRI disclosed an abnormal mass lesion in the posterior mediastinum. The lesion was surgically removed through right thoracotomy. The operative findings revealed that the lesion, hard and measuring 6.5 x 4.5 x 4.5 cm in diameter, was originated from the 7th and 8th thoracic vertebra. The lesion was histopathologically diagnosed chondrosarcoma. The chondrosarcoma arising from the thoracic vertebra is very rare, and only 10 cases have hitherto been reported in the Japanese literature.

Mediastinal drainage prevents fatal pyothorax from anastomotic leakage after intrathoracic anastomosis in reconstruction for carcinoma of the esophagus

In our experience, anastomotic leakage occurred in five of 69 patients with intrathoracic anastomosis after resection of carcinoma of the esophagus. In the early period, only an ordinary right thoracic drain was put in place, and when leakage occurred, two patients died because of pyothorax, while one patient was saved by surgical drainage. However, in the recent period, in addition to the ordinary right thoracic drain, another drain has also been placed just distal to the anastomosis through the esophageal hiatus through the abdominal cavity, exiting the abdominal wall. After such procedure, drainage has been adequate without any occurrence of pyothorax, even when anastomotic leakage occurred, as in the two most recent instances. Therefore, unless drainage is inadequate and surgical drainage is indicated, as in instances of necrosis of substitutes, mediastinoabdominal drainage seems to be effective in the treatment of intrathoracic anastomotic leakage.

Correlation of expression of ABH blood group carbohydrate antigens with metastatic potential in human lung carcinomas

METHODS. The expression of ABH blood group carbohydrate antigens was examined histochemically in tumors and adjacent nontumorous tissues of 89 cases of human lung carcinoma in which nontumorous tissues expressed blood group carbohydrate antigens compatible with the erythrocyte blood group types. RESULTS AND CONCLUSIONS. Loss of ABH blood group antigens in lung carcinomas correlated with their metastatic potential, especially with the recurrence of hematogenous metastasis. Consequently, patients with tumors that retained compatible ABH blood group antigens showed a better prognosis than patients with tumors of altered antigenic profiles. The loss of blood group B antigen more significantly affected both the hematogenous metastasis and prognosis than that of A and H antigens.

Multif requency three-dimensional optical read-only memory disks using metallic island films: preliminary experiments

Basic operation of new multifrequency three-dimensional (3-D) optical read-only memory (ROM) disks has been demonstrated experimentally. Several types of metallic island film exhibiting a selectiveresonance absorption in a visible-near infrared region are used as recording layers on the 3-D disks. The monochromatic light with a suitable wavelength near the resonance wavelength of each layer is used for the readout of information. We demonstrate that bar-code patterns recorded in silver and copper island layers can be read by using transmitted or reflected light. Furthermore, we also show that the 3-D disks with ≥3 recording layers can be realized.

Vibrio parahaemolyticus has a homolog of the Vibrio cholerae toxRS operon that mediates environmentally induced regulation of the thermostable direct hemolysin gene

In an effort to identify the regulatory gene controlling the expression of the tdh gene, encoding the thermostable direct hemolysin of Vibrio parahaemolyticus, we examined total DNA of AQ3815 (a Kanagawa phenomenon-positive strain) for sequences homologous to that of the toxR gene of Vibrio cholerae. The extracted DNA gave a weak hybridization signal under reduced-stringency conditions with a toxR-specific DNA probe. Cloning and sequence analysis of the probe-positive sequence revealed an operon (Vp-toxRS) which was highly similar to the toxRS operon of V. cholerae (Vc-toxRS) (52 and 62% similarities in the two genes, respectively). The deduced amino acid sequences of the Vp-toxRS gene products (Vp-ToxRS) contained regions similar to the proposed transmembrane and activity domains of the Vc-toxRS gene products (Vc-ToxRS). All clinical and environmental strains of V. parahaemolyticus examined possessed the Vp-toxRS genes. In the presence of Vp-ToxS, Vp-ToxR promoted expression of the tdh2 gene, one of two tdh genes (tdh1 and tdh2) carried by Kanagawa phenomenon-positive strains. The DNA sequence located 144 bp upstream of the tdh2 coding region was shown to be important for the Vp-ToxR-stimulated expression of the tdh2 gene in an Escherichia coli background. Comparative analysis of AQ3815 and its isogenic Vp-toxR null mutant gave the following results: (i) Vp-ToxR promoted, in an AQ3815 background, expression of the tdh gene to different degrees in various culture media, with KP broth (2% peptone, 0.5% NaCl, 0.03 M KH2PO4, pH 6.2) being most effective (12-fold); (ii) the promotion of tdh gene expression in KP broth was at the level of transcription; and (iii) Vp-ToxR was essential for demonstration of enterotoxic activity of AQ3815 in the rabbit ileal loop, a model previously used to demonstrate thermostable direct hemolysin-mediated enterotoxic activity of AQ3815. These results demonstrate that Vp-ToxR and Vc-ToxR share a strikingly similar function, i.e., direct stimulation at the transcriptional level of the gene encoding a major virulence determinant (enterotoxin) of a Vibrio species.

Endoscopic ultrasonography in the diagnosis of an early esophageal carcinoma

Patients with epithelial or mucosal carcinoma of the esophagus are considered to have a much better prognosis than those with submucosal carcinoma, although both lesions are classified as superficial carcinomas of the esophagus. With this in mind, we evaluated the usefulness of endoscopic ultrasonography for pre-operatively distinguishing either epithelial or mucosal carcinoma from submucosal carcinoma by comparing the results of endoscopic ultrasonography with the histological findings established in resected specimens. Between 1987 and 1991, 26 patients with no pre-operative treatment were confirmed histologically to have epithelial (2 cases), mucosal (11 cases) or submucosal (13 cases) carcinomas of the esophagus. In 13 patients with epithelial or mucosal carcinoma, 10 were correctly diagnosed with endoscopic ultrasonography (76.9%), while the remaining 3 were overdiagnosed as being submucosal. In 13 patients with submucosal carcinoma, 12 were correctly diagnosed by endoscopic ultrasonography (92.3%), although another case was overestimated. Including one patient with an advanced carcinoma who was underdiagnosed by endoscopic ultrasonography as having a submucosal lesion, the overall accuracy of endoscopic ultrasonography was 81.5% for diagnosing the depth of invasion of a superficial esophageal carcinoma. The above results show that endoscopic ultrasonography can provide surgeons with important information in the pre-operative assessment of a superficial esophageal carcinoma.

Hyperthermo-chemo-radiotherapy for patients with early carcinoma of the esophagus

Hyperthermia combined with irradiation and chemotherapy (hyperthermo-chemo-radiotherapy) was prescribed pre-operatively for 21 patients with submucosal carcinoma of the esophagus, and its effectiveness was evaluated by a comparison with patients who also had massive submucosal carcinoma, but received no pre-operative treatment (n = 12). There was no difference in the survival rates of these groups (hyperthermo-chemo-radiotherapy group: 3-year survival in 56.6%), but the patients who responded well to the HCR therapy (n = 6) demonstrated better survival rates (3-year survival in 83.3%) than did the patients without any pre-operative treatment (3-year survival in 33.9%). An HCR sensitivity test using the succinate dehydrogenase inhibition test was devised and showed good correlation with the clinical remedial values (the diagnostic specificity was 0.89). An accurate diagnosis of the esophageal lesion and appropriate selection of potentially treatable cases are considered essential for the optimal use of HCR therapy in patients with submucosal carcinoma.

[A case of successful surgical treatment for bilateral pulmonary arteriovenous fistulas]

A 55-year-old man was admitted to our hospital with chief complaints of exertional dyspnea and chest x-ray abnormalities. On physical examinations, clubbing and systolic murmur were detected. The patient's hemoglobin rose to a level of 19.0 g/dl, with a rise in hematocrit to 58.8%. While the patient was breathing room air, the PaO2 was 52.8 mmHg, the PaCO2 33.3 mmHg and the pH 7.43. In chest x-ray film, oval well-margined 38 x 30 mm density with enlarged afferent and efferent vessels in the left upper lobe (lts4) and 15 x 13 mm "coin lesion" in the right lower lobe (rts7) were observed. Pulmonary angiography demonstrated that these lesions were arteriovenous fistulas. In cardiac catheterization, an estimated right to left shunt of 31.1% was calculated. Because of the exertional dyspnea and the large shunt, a segmentectomy of the lingula and a wedge resection of the rts7 were simultaneously performed. After the treatment, exertional dyspnea, hypoxia and polycythemia disappeared. As far as we know, this patient is one of the most elderly patients in Japan to be successfully treated surgically for bilateral pulmonary arteriovenous fistulas.

Carcinomatous invasion and lymphocyte infiltration in early esophageal carcinoma with special regard to the basement membrane. An immunohistochemical study

We examined 24 cases of superficial esophageal carcinoma and evaluated 94 areas, including 43 intra-epithelial (ep), 36 mucosal (m) and 15 submucosal (sm) areas, using the immunohistochemical staining of laminin to detect the basement membrane. The staining pattern was divisible into three patterns, i.e., continuous, fragmentary and defective. Defective patterns were observed in 14%, 53%, and 73% of the ep, m, and sm lesions, respectively (p < 0.01). With regard to the degree of lymphocyte infiltration, 77% of the continuous areas were accompanied by a low lymphocyte infiltration, while 56% of the defective areas were accompanied by dense infiltrations with follicle formation. Lymphocyte infiltration was thus statistically significantly (p < 0.01) more closely associated with the defective areas than with the continuous areas. Furthermore, urokinase-type plasminogen activator was detected immunohistochemically in 11.1% of the defective areas, and in none of the continuous areas. These findings suggested 1) that superficial esophageal carcinoma might progress while destroying the basement membrane, and 2) that as host immune reactions lymphocytes might infiltrate the lesions where the basement membranes were destroyed and cancer cells exposed to the underlying layer. The findings also suggested the possibility that the degradation of the basement membrane might be caused by proteolytic enzymes produced by cancer cells.

DNA ploidy as a prognostic factor in early esophageal carcinoma

Cell nuclear DNA content was cytophotometrically determined in biopsy specimens obtained from thirty-five patients with superficial esophageal carcinoma. The relationship between the DNA distribution pattern and histopathological features, prognosis and postoperative survival time was then investigated. Patients with a low ploidy pattern had a more favorable postoperative course, with 62% attaining a 5-year survival rate, than those with high ploidy, of whom 34% attained a 5-year survival rate (p < 0.01). The recurrence rate was higher for the high ploidy pattern (64.3%) than for the low ploidy pattern (35.3%). Moreover, the rate of recurrence within 2 years was 50% in high ploidy, which was higher than the 5.9% rate in the case of low ploidy (p < 0.05). Although there was no clearly established relationship between the DNA distribution pattern and clinicopathological features, a multivariate analysis revealed that the DNA distribution pattern was one of the independent and significant prognostic factors of superficial esophageal carcinoma. These results thus suggest the usefulness of a preoperative DNA analysis of biopsy specimens in predicting the prognosis and determining perioperative therapeutic strategy for both superficial esophageal carcinoma and for advanced cases.

Histopathology of early esophageal carcinoma and squamous epithelial dysplasia

To examine the histogenesis of esophageal cancer and the pathological relationship between dysplasia and carcinoma of the esophagus, 44 cases of superficial esophageal carcinoma (restricted to within the submucosal layer) who received no pre-operative treatment were reviewed retrospectively. There were 40 dysplastic lesions in 17 cases (38.6%) and epithelial dysplastic lesions were classified into 6 with mild, 17 with moderate and 17 with severe, degrees of dysplasia. Although the continuity of dysplastic lesions with the carcinomatous areas was not frequent (35.0%), it was more often encountered in severe dysplasia than in moderate or mild dysplasia, suggesting some relationship between the severity of dysplasia and carcinoma. In the cases with a dysplastic lesion, multiplicity of squamous cell carcinoma was more frequently seen (p < 0.01), suggesting a multicentric occurrence of dysplastic lesions and carcinomas.

Optimality analysis of vascular-tissue system in mammals for oxygen transport

The efficiency of the vascular-tissue system in mammals for oxygen (O2) transport to tissue was evaluated by employing the following simulation models; (i) the spherical tissue model for assessing the maximum tissue mass for which a certain number of capillaries located in the center of each sphere can deliver sufficient O2; (ii) the minimum volume model of the multi-terminal vascular system for estimating the energy cost of blood flow supply to that number of capillaries; and (iii), the efficiency evaluation of the whole system by the ratio (the maximum O2 uptake)/(the energy cost). The computer simulation was carried out by inputting the physiological estimates of tissue O2 consumption rate and cardiac output of mammals in the resting and exercising states, which were calculated from the statistically determined power functions of body weight (the allometric relationship) in the range of 10 g to 500 kg. The results obtained from the data during exercise revealed that the optimum capillary number attaining the maximum efficiency alters nearly in proportion to the body weight and that the total tissue mass corresponding to the optimum capillary number agrees well with the actual tissue mass for virtually all the mammals, while their maximum efficiency remains constant. From these results, it is concluded that any mammal is provided with an equally efficient mass transport system, which is optimized for O2 transport to tissue under the highest metabolic activity, regardless of body weight variation. This may suggest one of the reasons why so many species of mammals with greatly different sizes can exist on the earth.

Expression of Sialyl-Tn antigens in normal squamous epithelium, dysplasia, and squamous cell carcinoma in the esophagus

Two monoclonal antibodies, TKH2 and B72.3, directed toward the Sialyl-Tn antigen (SA 2, 6GalNAc alpha-O-Ser/Thr), were examined immunohistochemically to analyze the expression of these antigens in 20 areas of normal squamous epithelium, 12 lesions of dysplasia, and 86 cases of squamous cell carcinoma including 32 with superficial carcinoma in the esophagus. No expression of TKH2 or B72.3 was found in the normal squamous epithelium. Among the 12 lesions of dysplasia only one expressed TKH2. In carcinoma the expression of TKH2 and B72.3 was found in 40 (47%) and 21 (24%) of the 86 carcinomas, respectively; however, the number of positive malignant cells with TKH2 and B72.3 totaled less than half that in the tissue, and no relationship was found between either prognosis or lymph node metastasis and the expression of Sialyl-Tn antigen. These results indicate that Sialyl-Tn antigen appears in the process of malignant transformation or tumor progression in esophageal squamous cell carcinoma; however, the positive expression of Sialyl-Tn antigen was not directly connected to either prognosis or lymph node metastasis.

[Intracavernous injection of lipo prostaglandin E1 for the diagnosis of impotence: a comparative study with prostaglandin E1-CD]

Intracavernous injection of 20 micrograms prostaglandin E1-CD (PGE1-CD, 8 cases), 5 micrograms lipo prostaglandin E1 (Lipo PG-E1, 8 cases) or 10 micrograms Lipo PGE1 (9 cases) was performed in patients with functional impotence in order to comparatively analyze the diagnostic efficacy of these drugs. Full erection was observed in all patients who received intracavernous injection of 20 micrograms PGE1-CD or 10 micrograms Lipo PGE1. However, full erection was observed in 4 out of 8 patients administered 5 micrograms Lipo PGE1. RigiScan was used on all patients, and latency until erection (achievement of maximum rigidity of the base) after injection, maximum rigidity of the penile tip and base and circumferential expansion rate of the penile tip and base were measured. With regard to these RigiScan data and duration of erection, there were no significant differences among the 3 groups. There were no severe side effects in any of the patients. These findings indicate that 10 micrograms Lipo PGE1 and 20 micrograms PGE1-CD have similar effects and that Lipo PGE1 may be an effective drug for the diagnosis and treatment of impotence.