New Derivatives of Quinoxaline – Syntheses, Complex Formation and their Application as Controlling Ligands for Zinc Catalyzed Epoxide-CO2–Copolymerization

A series of amino-(type 3) as well as hydrazino-substituted quinoxalines (type 8) have been synthesized in order to study their ability to complex with iron(III) and zinc(II) ions. Cyclization of 2,3-dichloroquinoxaline (1) with a bis-amidine 9 leads to ring-fused quinoxalines of type 10. One of these compounds (10a) forms a unique macrocyclic hexameric complex 14 with zinc ions in the presence of 2,6-diisopropyl phenolate. In an analogous manner, the monomeric complexes 12 and 13 could be synthesized. All of these new zinc complexes catalyze the copolymerization of cyclohexene oxide and carbon dioxide with a high degree of selectivity in the resulting polymers.

Interposition of sural nerve restores function of cavernous nerves resected during radical prostatectomy

PURPOSE

The permanent loss of erectile function when both neurovascular bundles are widely resected at radical prostatectomy as well as the successful use of autologous nerve grafts in reconstructive surgery led us to perform bilateral nerve grafts in an effort to restore erectile function in potent patients treated for prostate cancer who underwent radical retropubic prostatectomy and resection of both neurovascular bundles.

MATERIALS AND METHODS

Radical retropubic prostatectomy with deliberate resection of both neurovascular bundles was recommended for high grade, locally extensive prostate cancer in 9 select, sexually active men who reported normal erectile function. After the prostate was removed but before vesicourethral anastomosis an autologous sural nerve graft was interposed between the divided ends of the cavernous nerves bilaterally. Erectile function was monitored by patient interview, questionnaire and nocturnal penile tumescence testing after the operation.

RESULTS

Four to 5 months postoperatively patients noticed slowly improving spontaneous erections, as manifested by mild tumescence regularly every several hours. Nocturnal penile tumescence testing with the RigiScan device at 4 to 6 months in 2 cases revealed erections that approached minimal criteria for normalcy. Approximately 14 months after surgery a rigid erection sufficient for penetration and intercourse developed in 1 patient. He described this event as "an erection of substance-hard, not just fluffy."

CONCLUSIONS

We have developed a technique using sural nerve grafts to restore continuity of the cavernous nerves, which are resected during radical prostatectomy. The early return of spontaneous partial erections in our patients suggests that interposition nerve grafts may enhance the recovery of erectile function when the neurovascular bundles are resected.