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Akira Joraku

Publications and source records attributed to Akira Joraku.

3 recordsLinked to original sources

Bladder reconstruction using a collagen patch prefabricated within the omentum.

OBJECTIVE: We present our experience with a novel bladder reconstruction model using a collagen sponge pre-embedded within the omentum. The aim of the study is to evaluate tissue regeneration of the reconstructed bladder and the effect of prefabricating the collagen patch within the omentum. MATERIALS AND METHODS: Twenty pigs were divided into three groups. For the prefabricated patch group (PFP; n=10), collagen sponge was inserted into the omentum. After 1 week, the pigs underwent a hemicystectomy and the sponge with an attached omental flap was brought to close the defect. For the non-prefabricated patch group (NPFP; n=6), pigs received hemicystectomy and closure with a collagen sponge without prefabricating in the omentum. Four other pigs received hemicystectomy alone as a control (C; n=4). All animals in the NPFP and C groups, and 7 of 10 in the PFP group were sacrificed at 4 or 8 weeks. Three other pigs in the PFP group were sacrificed at 12 weeks. Resected bladders were submitted to hematoxylin-eosin, and immunohistochemical staining. RESULTS: All animals except for two in the NPFP group survived. At the time of grafting, the collagen sponge was covered with thick omental methothelial layers, and neo-vascularization from the omentum was observed. At each time point, only slight adhesion was observed around the patch in the PFP group, while severe adhesion between the patch and the bowel was observed in the NPFP group, suggesting that prefabricated collagen sponge within the omentum prevented urine leakage from the bladder. Histologically, the patch was well vascularized, and the luminal surface was covered with urothelium at 4 weeks in both groups. However, in the PFP group, there was mild inflammation in the submucosa and in-growth of smooth muscle derived from the adjacent muscle layers was observed with time, whereas severe inflammation was observed and in-growth of smooth muscle was limited in the NPF group. CONCLUSIONS: Prefabricating of a collagen patch within the omentum stimulated early neo-vascularization before grafting, and this procedure appears to offer an advantage for bladder reconstruction over a non-prefabricated procedure in terms of prevention of urine leakage and inflammation, and favorable tissue regeneration.

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Chemopreventive effects of cyclooxygenase-2 inhibitor and epidermal growth factor-receptor kinase inhibitor on rat urinary bladder carcinogenesis.

OBJECTIVE: To examine the chemopreventive effects of a selective cyclooxygenase (COX)-2 inhibitor, meloxicam, and a selective epidermal growth factor (EGF)-receptor tyrosine kinase inhibitor, gefitinib (as a single agent) on a carcinogen-induced rodent bladder carcinogenesis model. MATERIALS AND METHODS: The study comprised 103 male Fisher-344 rats (8 weeks old); after initial carcinogen treatment for 8 weeks with 0.05%N-butyl-N-(4-hydroxybutyl)nitrosamine (BBN) in drinking water, the rats were divided into five groups, i.e. group 1, control (vehicle only); group 2, gefitinib high-dose (15 mg/kg by gavage once daily); group 3, gefitinib low-dose (5 mg/kg); group 4, meloxicam high-dose (1.8 mg/kg by gavage once daily); and group 5, meloxicam low-dose (0.6 mg/kg). Twelve weeks later the rats were killed; after fixing the bladder in 10% formalin, the number and size of hyperplasia and carcinoma foci were recorded microscopically in sections stained with haematoxylin and eosin, submitted entirely as multiple strips. RESULTS: The incidence of carcinoma, confirmed microscopically, was: control 14/20 (70%); high-dose gefitinib, 7/20 (35%); low-dose gefitinib, 7/20 (35%); high-dose meloxicam 7/21 (33%); and low-dose meloxicam, 12/20 (60%). The mean numbers of carcinomas per bladder in groups 1-5 were 1.2, 0.5, 0.4, 0.5 and 1.1, respectively. The incidence and the mean number of carcinomas per bladder were significantly lower in the treatment groups (P < 0.05) than in the control group, except in the low-dose meloxicam group. There were no significant adverse effects. CONCLUSION: Both meloxicam and gefitinib have inhibitory effects on rat bladder carcinogenesis with no significant adverse effects. A combination of these drugs would be worth studying for their synergistic effects.

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Tissue engineering of functional salivary gland tissue.

OBJECTIVES: Treatment of conditions that lead to salivary hypofunction, such as radiation induced xerostomia, is currently limited to the administration of saliva substitutes and sialogogues. The transient effect of these medications necessitates frequent administration, and systemic side effects may be intolerable. The creation of implantable, functional salivary gland tissue from autologous glandular cells would provide a physiologic solution to this problem. We investigated the feasibility of engineering such tissue in vivo. METHODS: Primary human salivary gland cells were grown, expanded, and seeded on biodegradable polymer scaffolds. A total of 48 scaffolds with cells and 16 control polymers without cells were implanted subcutaneously in athymic mice. The implants were retrieved 2, 4, and 8 weeks after the implantation for phenotypic and functional analyses. RESULTS: Human salivary gland epithelial cells retained their phenotypic and functional characteristics at all culture stages. Histologically, formation of acinar gland-like structures was observed within the engineered tissue by 4 weeks after implantation. Immunocytochemical and Western blot analyses of the implanted tissues demonstrated the expression of human a-amylase, cytokeratins AE1/AE3, and aquaporin-5 using cell-specific antibodies. Reverse-transcription polymerase chain reaction analyses confirmed the expression of human salivary type of alpha-amylase (sigma-amylase) mRNA. The retrieved tissues demonstrated the production of human alpha-amylase over time using a biochemical amylase detection system.

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