Biomedical subjects

T Klotz

Publications and source records attributed to T Klotz.

At least 19 recordsLinked to original sources

PubMed2003

[Early death of the stronger sex. Could behavior change influence men's fate].

Life expectancy in men is approximately 6.5 years shorter than in women. As an explanation for this difference, isolated consideration of the higher prevalence of coronary heart disease and cancer in men is inadequate. But it would also appear erroneous to postulate that differences in male and female thinking and behavior patterns in regard to health-risk behavior are subject to controllable socialization processes and "rational" realizations. The interaction of genetic and environmental risk factors and socialization is largely unknown. A sex-specific consideration of risk behavior and quality of life suggest that a healthy lifestyle, relevant information and preventive measures - in particular in males - must be initiated before puberty if they are to have a positive effect on mortality and morbidity during the course of a person's life.

Adolescent↗

PubMed2003

[Interdisciplinary oncologic after-care exemplified by second primary tumors after bladder carcinoma].

The primary intention of oncological follow-up for patients with bladder cancer is the early diagnosis of recurrent local tumors or metastatic disease. The question of subsequent independent tumors has not been assessed as very important. Data from the central cancer registry of Regensburg/Germany for the period 1990-1997 were examined to determine the risk of second primary cancers following an initial bladder cancer. Records of 921 males (mean age: 65.4 years) and 339 females (mean age: 68.0 years) with the primary diagnosis of bladder cancer were analyzed. The minimal follow-up has been 5 years. Bladder cancer patients experience an excess risk of subsequent independent malignancies. The ratio of observed cases to expected cases of subsequent tumors was increased. During the follow-up period, subsequent tumors have been found in 153 (16.6%) male patients and 35 (10.3%) female patients. The most common subsequent malignancies in males were prostate cancer (71 cases) and bronchial cancer (19 cases). Breast cancer (nine cases) and colon cancer were predominant in females. This confirms the good sense of regular oncological follow-up. In this context attention should be directed at tumors of non urological origin, and an interdisciplinary approach with an individual oncological follow-up seems to be useful. The focus should be on the prostate and lung for males and the breast and colon for females.

Aftercare↗

PubMed2002

[Fitness in the elderly].

A healthy way of growing old is supposed to postpone for as long as possible the physiological loss of functional organ capacity and preserve a high quality of life. While the individual predisposition depends on genetic variables, behavioral and environmental influences have a strong modulating effect on the aging process. According to our current knowledge, there is no doubt that physical fitness prolongs life and prevents cardiovascular diseases in particular. Physical activity and sports have many positive effects, which are well proven. In addition to the cardiovascular system, bone metabolism and immune status should be mentioned here. Furthermore, the increase in quality of life through physical training is undisputed, with positive effects for persons of any age. Current data prove that regular moderate training provides the greatest benefits.

Aged↗

PubMed2002

MAP kinase 1/2 (Erk 1/2) and serine/threonine specific protein kinase Akt/PKB expression and activity in the human corpus cavernosum.

Nitric oxide (NO) is an important mediator in the cavernosal smooth muscle relaxation that causes erections. The purpose of this study was to examine the existence, distribution and phosphorylation stage of two recently discovered key enzymes for NO regulation in human cavernosal tissue, the MAP Kinase 1/2 (Erk 1/2) and the serine/threonine specific protein kinase Akt/PKB. The expression of the enzymes was examined in corpus cavernosum specimens taken from both potent men and from patients with long-term impotence. There was a distinct difference in the activation stage of the MAP Kinase 1/2 (Erk 1/2) between endothelium and smooth muscle cells in potent patients. This finding gives evidence for a cell-type-specific regulation of the eNOS-dependent NO release. Furthermore, we found a higher basal level of active MAP Kinase 1/2 (Erk 1/2) in impotent patients. This finding gives the first evidence for an inhibitory influence of MAP Kinase 1/2 (Erk 1/2) on cavernosal eNOS activity.

Adolescent↗

PubMed2002

Epidemiology of Peyronie's disease.

Francois Gigot de la Peyronie, surgeon to Louis XV of France, has become synonymous with the rather enigmatic though not uncommon condition of Peyronie's disease (PD), a localized connective tissue disorder of the penile tunica albuginea. The true prevalence of Peyronie's disease is unknown. Therefore, we decided to perform an evaluation of existing epidemiological data. A prevalence rate of 3.2% was determined in male inhabitants of the greater Cologne area. This is much higher than revealed by the data reported up to now, thus rendering the accepted prevalence rates of 0.3% to 1% untenable. The actual prevalence of Peyronie's disease may be even higher, considering many patients' reluctance to report this embarrassing condition to their physicians. Along these lines, most clinicians note that the number of Peyronie's patients has increased since the advent of oral sildenafil. Comparably high prevalences are known for diabetes and urolithiasis, suggesting a greater frequency of this rare disease than formerly believed.

Age Distribution↗

PubMed2001

[Changes in penile blood flow during cycling--how does one prevent a decreased perfusion?].

BACKGROUND AND OBJECTIVES: An increased incidence of erectile dysfunction has been observed in cycling enthusiasts. Compression of the perineal region during cycling seems to cause decreased penile perfusion. The resulting hypoxaemia in the corpus cavernosum is associated with penile fibrosis, which leads in the long run to erectile dysfunction. This study set out to determine if cycling can cause changes in penile perfusion and, if so, what precautions can be taken to avoid any associated health hazards, including whether various saddle forms and designs might influence penile blood flow. COHORTS AND METHODS: In 100 healthy athletic men (aged 36 +/- 6.2 years) transcutaneous penile oxygen pressure (tpO (2)) at the glans penis was measured during cycling in different positions and with different types of saddle, using a modified Clark oxygen electrode. RESULTS: The penile blood supply decreased significantly during cycling in a seated position. Cycling in a standing or reclining position (on a reclining bicycle) did not lead to any decrease in penile blood flow. Saddle width was the most important factor for ensuring adequate penile perfusion while cycling in a seated position. CONCLUSION: This study demonstrates that changing from a seated to a standing position during cycling leads to a significant increase in penile perfusion. Therefore we suggest frequent changes from a seated to a standing position during cycling. Additionally we suggest taking sufficient breaks during prolonged and vigorous bike tours, in order to avoid any possible health hazards. Another, not yet widespread, alternative for avoiding a reduction in penile blood flow is cycling on a reclining bicycle.

Adult↗

PubMed2001

Vardenafil increases penile rigidity and tumescence in erectile dysfunction patients: a RigiScan and pharmacokinetic study.

The pharmacodynamic effect on penile rigidity and tumescence and the pharmacokinetic properties of single oral doses of 10 and 20 mg vardenafil, a new PDE5-inhibitor, were investigated in 21 erectile dysfunction patients. Patients were evaluated with RigiScan on three occasions in a randomized, placebo-controlled, double-blind crossover fashion, while receiving visual sexual stimulation. Relative to placebo, a single dose of 10 mg vardenafil led to a mean increase in the duration of >60% penile rigidity of 24.4 min (95% CI: 7.4 to 41.3) at the base and of 24.8 min (8.5 to 41.1) at the tip. For the 20-mg dose, the increase in duration of > 60% penile rigidity relative to placebo was 37.2 min (20.2 to 54.1) at the base and 28.7 min (12.7 to 44.7) at the tip. Single doses of 10 and 20 mg vardenafil led to a rapid rise in the plasma concentrations of vardenafil, with a median tmax of 0.9 h and 0.7 h and a geometric mean Cmax of 9.1 microg/l (geometric SD = 1.63) and 20.9 microg/l (geometric SD = 1.83), respectively. In the post-absorptive phase, the concentrations declined with an average terminal t 1/2 of 4.2 h (geometric SD = 1.27) and 3.9 h (geometric SD = 1.31). The systemic exposure of vardenafil expressed as AUC normalized for dose and body weight was dose-proportional (associated 90% CI: -4 to 30%) as well as Cmax (associated 90% CI: -12 to 33%). The treatments were well tolerated. There was a small, clinically irrelevant reduction in blood pressure with a small compensatory rise in heart rate. There were no electrocardiographic effects or relevant changes of the safety laboratory screens. The observed pro-erectile properties, pharmacokinetic characteristics and safety profile make vardenafil a suitable candidate for further evaluation in the treatment of erectile dysfunction.

3',5'-Cyclic-GMP Phosphodiesterases↗

PubMed2001

Sildenafil (Viagra): is there an influence on psychological performance?

BACKGROUND: Sildenafil (Viagra) is a well-introduced medicine for erectile dysfunction; many studies about effects and side effects are published. Beside these aspects of treatment the influence of sildenafil on psychophysical performance is of interest. cGMP is one of the most important second messengers in the central nervous system (CNS), so even very small changes of the intracellular cGMP-level caused by phosphodiesterases inhibition may be relevant for CNS-function. We wanted to verify the hypothesis whether sildenfail influences human psychomotor performance, especially under the aspect of traffic safety, or not. METHODS: Designed as a pilot study we tested 6 male healthy volunteers using a test battery of 7 different psychophysical performances tests. Each individual did the test battery twice, once without drug and once after a single oral dose of 100-mg sildenafil. 3 persons did the first and 3 others did the second experiment under the influence of drug (UID). All results (37 parameters) were analysed by t-test for paired samples using a confidence interval of 95%. RESULTS: Only two parameters of 2 different tests showed significant differences. In the simple choice reaction test (DR2) the mean reaction time got better in the group with sildenafil; in the multiple choice reaction test with stress induction (RST3) the amount of wrong answers indicated a weak influence of performance without statistical significance, six parameters (dominantly in the speed anticipation test (DEST)) represented an increase and one other (RST3 second part) showed a decrease UID. The uppermost parameters (76% of all items) stayed on equal levels for both groups. CONCLUSION: Sildenafil showed no important impairment of psychophysical performance, no strong improvement was found as well. With a look at the therapeutically indication of sildenafil the improvement in sexual activity may indicate no incapacity in traffic and other psychomotoric/psychophysical functions.

Adult↗

PubMed2001

The prevalence of Peyronie's disease: results of a large survey.

OBJECTIVES: To determine the prevalence of Peyronie's disease, a localized connective tissue disorder of the penile tunica albuginea, the symptoms of which include palpable plaque, painful erections and curvature of the penis, in a large sample of men in Germany. SUBJECTS AND METHODS: A standardized questionnaire was sent to 8000 male inhabitants (age range 30-80 years) of the greater Cologne area (approximately 1.5 million inhabitants). Three questions about the self-diagnosis of Peyronie's disease were previously assessed for validity on 158 healthy men and 24 patients with confirmed Peyronie's disease. To optimize the response rate, the questionnaire was mailed three times to all the men. RESULTS: The response rate after the third mailing was 55.4% (4432 men): 142 men (3.2%, mean age 57.4 years, SD 13.4) reported the new appearance of a palpable plaque which, from the previous validation, was the most sensitive question and the main symptom of the disease. In men aged 30-39 years only 1.5% reported localized penile induration, compared with 3.0% in those 40-49 and 50-59 years, 4.0% in those 60-69 years and 6.5% of those > 70 years old. Newly occurring angulation was reported by 119 of the 142 men (84%) and painful erection by 66 (46.5%). The combination of the three symptoms (plaque, deviation and painful erection) was reported by 46 of the 4432 respondents (1.04%), i.e. 32% of the 142 men with penile induration; 58 of the 142 men (41%) reported erectile dysfunction. CONCLUSIONS: This is the first large cross-sectional, community-based study to examine the prevalence of Peyronie's disease. Using previously validated questions the prevalence of Peyronie's disease in the sample was 3.2%; this is much higher than indicated in previous reports. A comparably high prevalence is reported for diabetes and urolithiasis, suggesting that this 'rare' disease is more widespread than previously thought.

Adult↗

PubMed2001

Impotence and genital numbness in cyclists.

Cyclists often complain of genital numbness and even of impotence. The purpose of this study was to determine if perineal compression during cycling causes changes in the penile blood supply, impotence and penile numbness. Forty healthy athletic men with a mean age of 30 +/- 5.3 years took part in the study. Transcutaneous penile oxygen pressure was obtained using a device consisting of a modified Clark pO2 electrode, attached to the glans of the penis. All men were measured in a standing position before, in a seated and standing position during and in a standing position after cycling. Additionally, a detailed interview was carried out with each man. The penile blood supply--which correlates with the transcutaneous PO2 at the glans-- decreased significantly in over 70% of the test subjects during cycling in a seated position. Cycling in a standing position did not show any alteration in the penile blood supply as compared to the values measured before exercising. Numbness of the genital region was reported by 61% of the cyclists. 19% of cyclists who had a weekly training distance of more than 400 km complained of erectile dysfunction. The results of the present study showed that there is a deficiency in penile perfusion due to perineal arterial compression. This could be a reason for penile numbness and impotence in long-distance cyclists. Therefore, we suggest restricting the training distance, and taking sufficient pauses during the course of prolonged and vigorous bicycle riding, in order to avoid penile numbness and impotence.

Adult↗

PubMed2001

Modulation of human platelet aggregation by the phosphodiesterase type 5 inhibitor sildenafil.

The aim of this study was to investigate if the phospodiesterase type 5 inhibitor sildenafil inhibits collagen- or ADP-induced human platelet aggregation and bleeding time. To investigate this, two studies were designed. In the first, a single oral dose of sildenafil, 100 mg, was administered to healthy men. Bleeding time was determined and agonist (ADP and collagen)-induced platelet aggregation (ex vivo in platelet rich plasma) was measured 0, 1, and 4 h after application. In the second, a single oral dose of sildenafil, 50 mg, was administered and, in addition to the parameters in the first study, we also determined the platelet aggregation after 24 h and measured the effect of a nitric oxide donor (S-nitroso-N-acetylpenicillamine [SNAP]) in combination to mimic a physiologic nitric oxide release from the endothelium. The bleeding time of 1 h after sildenafil medication (100 mg) was significantly prolonged but recovered toward control values after 4 h, whereas application of sildenafil at a lower dose (50 mg) did not alter the bleeding time. Sildenafil (100 and 50 mg) did not inhibit the ADP-induced aggregation, whereas the collagen-induced aggregation (100 mg) was markedly reduced after 1 h and significantly inhibited 4 h after application. This inhibitory effect was overcome by higher concentrations of collagen. SNAP (0.5 microM) induced an inhibition of platelet aggregation that was potentiated after taking sildenafil (50 mg, 1 and 4 h afterward) and abrogated after 24 h. These data indicates that sildenafil may inhibit collagen-induced platelet aggregation ex vivo. After co-administration of nitric oxide, collagen- and ADP-induced platelet aggregation was significantly inhibited, which may reflect physiologic conditions of an in vivo system.

Adenosine Diphosphate↗

PubMed2001

Comparison of individual urologists' performance.

OBJECTIVE: In the last few years, comparative outcome quality statistics have been one of the key topics for discussion in health care. Comparative audits using overall mortality and morbidity figures can be misleading as they do not take into account variations in urological procedure and patient fitness. The purpose of our study was to compare the crude operative morbidity and mortality rates with the predicted rates using an established scoring system (POSSUM). MATERIALS AND METHODS: To examine these effects, we compared 5 urological operations (transurethral resection of the prostate, transurethral resection of the bladder, radical nephrectomy, suprapubic enucleation of the prostate and radical prostatovesiculectomy) performed by 2 urologists in a prospective study during a 12-month period. POSSUM consists of a simple preoperative physiological score, a postoperative score and defined kinds of complications. RESULTS: One urologist operated on 160 patients, with an operative mortality of 2.5% and morbidity of 31.3%. The other urologist operated on 144 patients, with an operative mortality of 0.7% and morbidity of 9%. At first sight, there appear to be significant differences in operative outcome between the 2 urologists. However, analysis using the POSSUM system predicts a mortality rate of 3.1% for the first urologist and 0.7% for the second urologist (morbidity rates of 35% for the first urologist and 10.4% for the second urologist). Receiver operating curve analysis demonstrated no significant difference between the 2 urologists. CONCLUSION: The present study demonstrates how misleading crude mortality and morbidity figures can be when comparing different urologists. By producing a single assessment of physiological status at the time of operation and of operative severity, POSSUM analysis allows a more realistic comparison between different urologists.

Medical Audit↗

PubMed2001

Erectile dysfunction in cyclists. Is there any difference in penile blood flow during cycling in an upright versus a reclining position?

OBJECTIVE: Perineal compression during bicycling appears to be responsible for some cases of erectile dysfunction. MATERIAL AND METHODS: In 46 healthy athletic men transcutaneous penile oxygen pressure (tpO(2)) at the glands of the penis was measured, using a transcutaneous measurement device. It has been shown that the tpO(2) levels measured at the glans correlate with the penile blood flow. Our measurements were performed before, during and after cycling in an upright and a reclining position in a crossover study. RESULTS: The mean transcutaneous pO(2) at the glans in a standing position before biking was 60.5+/-8.1 mm Hg. It decreased after sitting on the saddle in an upright position to 17.9+/-3.9 mm Hg. Continued cycling in a seated upright position showed pO(2) levels of 18.3+/-5.2 mm Hg, with a full return to normal pO(2) values after a 10-min recovery period in a standing position. Cycling in a reclining position resulted in pO(2) levels of 59.4+/-4.2 mm Hg, a similar level to that obtained before exercising. CONCLUSIONS: The results of the present study demonstrated that there is a deficiency in penile perfusion caused by perineal arterial compression. Cycling in a reclining position - in which no perineal compression was seen - caused no alteration in penile blood flow during exercising. Therefore, we suggest cycling in a reclining position to avoid health hazards - such as penile numbness and hypoxygenation of the corpora cavernosa, which can result in impotency.

Adult↗

PubMed2001

'Viagra effect' - influence of mass media on patient behavior.

INTRODUCTION: The effects of modern mass media and communication on the public health system are well known. So far however, these different influences of the media have not been objectively evaluated by physician-patient contacts. PATIENTS AND METHODS: In this study we asked urologists, primary care physicians and internists in private practices in Cologne and a rural area (Erftkreis, Germany) to quantify their weekly contacts with patients suffering from erectile dysfunction (ED). The poll was conducted by four separately mailed questionnaires whereas a double counting was avoided. Between the second and third mailing, an unbelievable public attention was seen following the FDA approval of Viagra in the United States. When Viagra was available in Germany, a fourth questionnaire was sent (4 months later) to all practitioners (n = 751). RESULTS: During this time span, there was a statistically (p <or= 0.01; t test) significant increase in weekly physician-patient contacts (WPC; 13.1-19.1 WPC for urologists, 4.4-5.5 WPC for general practitioners/internists) for ED in the region of Cologne-Erftkreis. In the fourth mailing, there was a slight decrease, but overall WPC was still higher compared to the first two mailings (17 WPC for urologists, 5.2 WPC for other specialists). CONCLUSIONS: Our investigation shows that urologists are accepted as the competent advisory partners for therapy with Viagra. This was seen by the higher increase (20.1%) in patient contacts with urologists in comparison to colleagues of other medical disciplines (45.8 vs. 25.7% between mailing 1+2 and 3). In this investigation we were able to demonstrate the effects of mass media on patient behavior.

Adult↗

PubMed2001

Measurement of vaginal and minor labial oxygen tension for the evaluation of female sexual function.

PURPOSE: Female sexual dysfunction is a new, rapidly expanding area of sexual medicine. Female sexual arousal disorder may, in part, be due to decreased pelvic blood flow. Therefore, we developed a simple noninvasive reproducible technique to measure vaginal and minor labial blood flow. MATERIALS AND METHODS: The study included 12 healthy young women able to have orgasm through self-stimulation. Observations at orgasm were recorded in the 12 subjects after self-stimulation. Measurements were obtained intravaginally and on the minor labia using a modified Clark oxygen electrode to obtain partial oxygen pressure (pO(2)). RESULTS: Mean basal vaginal value was 3.8 +/- 0.9 mm Hg and mean basal pO(2) on the minor labia was 18.3 +/- 3.7 mm. Hg. As soon as self-stimulation was initiated an increase in oxygen tension occurred and continued during sexual stimulation. Just before orgasm a further increase was noted with peak values measured immediately after the orgasm began (pO(2) 28.6 +/- 3.1 mm Hg intravaginally and 47.3 +/- 4.1 labial). Labial pO(2) measurement decreased relatively rapidly soon after orgasm. The time to return to basal vaginal values after orgasm varied from 20 to 30 minutes. CONCLUSIONS: Previously, changes in female sexual arousal responses have been difficult to evaluate and quantify clinically. We developed a simple noninvasive reproducible technique to measure vaginal and minor labial blood flow. Age based and cycle dependent normograms now can be produced for vaginal and labial blood flow using this method.

Adult↗

PubMed2001

Localization of constitutive nitric oxide synthase isoforms and the nitric oxide target enzyme soluble guanylyl cyclase in the human bladder.

PURPOSE: Nitric oxide is a free radical gas synthesized from L-arginine by a family of isoenzymes called nitric oxide synthase that has an important role in smooth muscle relaxation. L-arginine, the substrate for nitric oxide synthase, may be beneficial under pathophysiological conditions in the bladder, as in interstitial cystitis. We determined the localization of nitric oxide synthase and the target enzyme of NO, soluble guanylyl cyclase, in the human bladder. MATERIALS AND METHODS: Benign bladder tissues were obtained from 18 patients with localized superficial bladder tumors undergoing transurethral bladder resection. Histochemical nicotinamide adenine dinucleotide phosphate-diaphorase staining, nitric oxide synthase immunohistochemical testing and soluble guanylyl cyclase immunoreactivity studies were performed in all benign tissue specimens. RESULTS: A different pattern of nitric oxide synthase expression was confirmed by nicotinamide adenine dinucleotide phosphate-diaphorase staining and immunohistochemical testing for endothelial and neuronal nitric oxide synthase. In addition to endothelial nitric oxide synthase expression, detrusor smooth muscle was recognized as an important location of endothelial nitric oxide synthase, while the urothelium had only small endothelial nitric oxide synthase positive cell clusters. Neuronal nitric oxide synthase expression was only found in nitrinergic fibers of the submucosal surface and between muscle cells. Detrusor and vascular smooth muscle as well as interstitial cells, nerve fibers and transitional epithelium were recognized as targets of nitric oxide, as shown by soluble guanylyl cyclase expression. CONCLUSIONS: The distribution of constitutive nitric oxide synthase isoforms and soluble guanylyl cyclase provides evidence of nitric oxide-cyclic guanosine monophosphate mediated regulation of detrusor smooth muscle relaxation, neurotransmission and blood flow. Furthermore, the urothelium may also be a target of nitric oxide.

Aged↗

PubMed2001

Risk adjustment for evaluating the outcome of urological operative procedures.

PURPOSE: Considerable public and media attention has been directed in recent years toward comparing performance at individual hospitals. So-called death league tables have been published in the media, ranking hospitals according to crude mortality rates. Crude rates of mortality and morbidity are clearly misleading. Therefore, scoring systems comparing treatment outcomes among physicians or hospitals on an objective basis are urgently required. MATERIALS AND METHODS: During a 12-month period we prospectively evaluated 651 patients at 2 urological units using a simple and well validated surgical scoring system. Patients had been admitted to the units for routine urological operations. The scoring system consists of a simple preoperative physiological score, a postoperative severity score and defined types of complications. RESULTS: The morbidity and mortality rates for unit 1 were 7.4% and 1.3%, respectively. For unit 2 the morbidity and mortality rates were 14% and 8.8%, respectively. Despite the marked differences in these crude rates risk adjusted analysis revealed no significant difference (p <0.05). Receiver operating characteristics curve analysis likewise demonstrated no significant difference in mortality and morbidity for the 2 units. CONCLUSIONS: Raw rates of mortality and morbidity are often inappropriately used to compare the performance of various surgical procedures, especially vascular and cardiothoracic surgery. In Great Britain at some institutions urological units are ranked according to mortality and morbidity outcome. As a consequence, important variables, such as patient physiological state at surgery and the type of procedure, are not considered. Our study shows that the scoring system applied is suitable for urological audit and may be a valuable tool for comparing performance at various units.

Female↗

PubMed2000

Soluble guanylate cyclase and cGMP-dependent protein kinase I expression in the human corpus cavernosum.

Nitric oxide (NO) as a mediator in smooth muscle cells causes rapid and robust increases in cGMP levels. The cGMP-dependent protein kinase I has emerged as an important signal transduction mediator for smooth muscle relaxation. The purpose of this study was to examine the existence and distribution of two key enzymes of the NO/cGMP pathway, the cGMP-dependent kinase I (cGK I) and the soluble guanylate cyclase (sGC) in human cavernosal tissue. The expression of the enzymes were examined in corpus cavernosum specimens of 23 patients. Eleven potent patients suffered from penile deviations and were treated via Nesbit's surgical method. Nine long-term impotent patients underwent implantation of flexible hydraulic prothesis. Three potent patients underwent trans-sexual operations. Expression of the sGC and cGK I were examined immunohistochemically using specific antibodies. In all specimens of cavernosal tissue a distinct immunoreactivity was observed in different parts and structures. We found a high expression of sGC and cGK I in smooth muscle cells of vessels and in the fibromuscular stroma. The endothelium of the cavernosal sinus, of the cavernosal arteries, and the cavernosal nerve fibers showed an immunoreactivity against sGC. The distribution analysis of cGK I revealed a predominately vesicular localization in smooth muscle cells. The examination of the endothelium showed no clear immunoreactivity against cGK I. There was no distinct difference in immunoreactivity and cellular distribution between potent and impotent patients.

Actins↗