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Biomedical subjects

H Kiwamoto

Publications and source records attributed to H Kiwamoto.

At least 19 recordsLinked to original sources

A new enzymic method for the isolation and culture of human bladder body smooth muscle cells.

Cultured cells of the human urinary bladder smooth muscle are useful for investigating bladder function, but methods for culturing them are not well developed. We have now established a novel enzymic technique. The smooth muscle layer was separated out and incubated with 0.2% trypsin for 30 min at 37 degrees C. The samples were then minced and incubated with 0.1% collagenase for 30 min and centrifuged at 900 g. The pellets were resuspended in RPMI-1640 medium containing 10% fetal calf serum (FCS) and centrifuged at 250 g. The smooth muscle cells from the supernatant were cultured in RPMI-1640 containing 10% FCS. The cells grew to confluence after 7-10 days, forming the "hills and valleys" growth pattern characteristic of smooth muscle cells. Immunostaining with anti-alpha-actin, anti-myosin, and anti-caldesmon antibodies demonstrated that 99% of the cells were smooth muscle cells. To investigate the pharmacological properties of the cultured cells, we determined the inhibitory effect of muscarinic receptor antagonists on the binding of [3H]N-methylscopolamine to membranes from cultured cells. The pKi values obtained for six antagonists agreed with the corresponding values for transfected cells expressing the human muscarinic M2 subtype. Furthermore, carbachol produced an increase in the concentration of cytoplasmic free Ca2+ an action that was blocked by 4-diphenylacetoxy-N-methylpiperidine methiodide, an M3 selective antagonist. This result suggests that these cells express functional M3 muscarinic receptors, in addition to M2 receptors. The subcultured cells therefore appear to be unaffected by our new isolation method.

Calcium↗

Identification of muscarinic receptor subtypes of cultured smooth muscle cells and tissue of human bladder body.

BACKGROUND: Muscarinic receptor subtypes of cultured smooth muscle cells from the human bladder body were investigated by the receptor binding assay method. The result was compared with that obtained from the human bladder body tissue to confirm whether the receptor subtypes of the cells are not changed after several passages of cell culture. METHODS: Inhibitory effects of various muscarinic antagonists on the binding of [3H]-N-methylscopolamine ([3H]-NMS) to membrane preparations obtained from cultured smooth muscle cells from the fourth subculture of the human bladder body were compared with those prepared from the human bladder body tissue and cells expressing human muscarinic receptor subtypes. RESULTS: Binding-inhibition constants (pKi) for atropine, pirenzepine, methoctramine, 4-diphenylacetoxy-N-methylpiperidine methiodide (4-DAMP), oxybutynin and propiverine obtained from membrane preparations of cultured smooth muscle cells were 8.91, 6.35, 8.24, 8.53, 7.29 and 5.61, respectively. pKi values of these muscarinic receptor antagonists against the membrane preparation of human bladder body tissue were 9.08, 6.66, 8.05, 8.79, 7.53 and 6.04, respectively. pKi values of cultured smooth muscle cells and tissue from human bladder body were correlated closely with those of insect cells expressing the cloned human M2 receptor subtype. CONCLUSION: The binding affinities for various muscarinic receptor antagonists of cultured human smooth muscle cells were maintained through the fourth subculture and it was suggested that the M2 receptor subtype is predominantly expressed in cultured smooth muscle cells of human bladder body as well as in tissue of the human bladder body.

Cells, Cultured↗

Existence of a beta3-adrenoceptro and its functional role in the human ureter.

PURPOSE: We tried to determine the beta-adrenoceptor (AR) subtypes distributed in the human ureter and to clarify their functional role in ureteral relaxation. MATERIALS AND METHODS: 1) Effects of beta-AR agonists on either spontaneous or KCl-induced contractions of the human ureter and the antagonism by beta-AR antagonists on isoprenaline (a non-selective beta-AR agonist)-induced effects were evaluated in vitro. 2) Displacement by beta-AR antagonists of [3H]-dihydroalprenolol binding to a membrane preparation derived from human ureteral smooth muscle was evaluated. 3) A reverse transcription polymerase chain reaction assay was performed to determine the expression of the mRNA for beta1-, beta2- and beta3-ARs in human ureteral smooth muscle. RESULTS: 1) Isoprenaline and procaterol (a beta2-AR agonist) concentration-dependently suppressed both spontaneous and KCl-induced contractions of the human ureter. The beta3-AR agonists, CGP-12177A and CL-316243, also suppressed these ureteral contractions, but dobutamine (a beta1-AR agonist) had little relaxing effect. The rank order of relaxing potency for the catecholamines was isoprenaline > adrenaline > noradrenaline. ICI-118,551 (a beta2-AR antagonist) only partially antagonized the isoprenaline-induced relaxation. 2) Propranolol (a non-selective beta-AR antagonist) and ICI-118,551 concentration-dependently displaced [3H]-dihydroalprenolol binding to the membrane with Ki values of 1.5 x 10-9 M and 6.3 x 10-9 M, respectively, while metoprolol (a beta1-AR antagonist) was less effective in this assay. 3) beta1-, beta2- and beta3-AR mRNAs were all expressed in human ureteral smooth muscle. CONCLUSION: The present results provide the first evidence that the beta3-AR subtype is distributed in human ureteral smooth muscle and that it, and beta2-AR, mediate the ureteral relaxation induced by adrenergic stimulation.

Adult↗

[A case of primary transitional cell carcinoma of the prostate].

We report a rare case of primary transitional cell carcinoma of the prostate. A 66-year-old man was referred to our hospital with the chief complaints of pollakisuria and residual urine sensation on January 21, 1998. Under a preoperative diagnosis of benign prostatic hyperplasia, transurethral resection of the prostate was performed. Histopathological examination revealed grade 3 transitional cell carcinoma. Then the transrectal needle biopsy of the prostate and random biopsy of the urinary bladder were performed. Since no metastatic tumors or tumor cells were detected in either the prostate or urinary bladder or any other organs, this patient was diagnosed with primary transitional cell carcinoma of the prostate. Three courses of adjuvant chemotherapy (M-VAC) were performed, and tumor recurrence was not recognized 9 months after the operation. This is the 35th case of primary transitional cell carcinoma of the prostate in the Japanese literature.

Aged↗

[Urodynamic evaluation of alpha-1 blocker tamsulosin on benign prostatic hyperplasia using pressure-flow study].

BACKGROUND: In order to evaluate the precise effect of alpha-1 blocker on benign prostatic hyperplasia, symptomatic and urodynamic parameters were compared between before and after 4 week administration of tamsulosin hydrochloride (0.2 mg/day) on 18 patients with untreated benign prostatic hyperplasia. METHODS: Symptoms were scored with international prostate symptom score (I-PSS) and urodynamic parameters were measured with pressure-flow study. RESULTS: The total score of I-PSS decreased significantly although the peak urinary flow rates, average flow rates or post-void residuals did not show a significant improvement after the treatment. On the other hand, the statistical analysis of pressure-flow studies revealed a significant decrease of vesical pressure at opening, at peak flow and at end of voiding after the treatment. In one patient, in whom the voided volume and urinary flow rate kept the same level throughout the treatment course, the total energy expelled from the bladder was calculated with the formula given as W = integral (pQ)dt. Both the detrusor work and vesical work (sum of detrusor contraction and abdominal straining) showed a marked decrease after the treatment. CONCLUSIONS: It is suggested that alpha-1 blocker relieves overload of the detrusor and improves symptoms by reducing the energy demands for bladder emptying, even in case the flow rate does not improve. The urodynamic procedure including pressure flow study is a useful means for not only diagnosing bladder outflow obstruction but also assessing overload or impaired contractility of the detrusor.

Adrenergic alpha-Antagonists↗

Endoscopic correction of vesicoureteral reflux in patients with neurogenic bladder dysfunction.

Transurethral injection of Teflon paste (TUI) was carried out in 24 ureters of 16 patients with vesicoureteral reflux (VUR) secondary to neurogenic bladder dysfunction at an age ranging from 4 to 77 years, and the results were compared with those of conventional open surgery. During the mean follow-up period of 20.1 months, reflux disappeared in 19 ureters (79%), so that the success rate of endoscopic operation was considered to be satisfactory as compared with that of conventional open surgery, in which reflux disappeared in 16 (80%) of 20 ureters in 16 patients with neurogenic bladder dysfunction at our department. No exacerbation of hydronephrosis was observed postoperatively, and no complication was noted. This procedure, which is minimally invasive and technically simple, may be regarded as the first choice for VUR secondary to neurogenic bladder dysfunction.

Adolescent↗

[How does thermotherapy effectively work on benign prostatic hyperplasia--an experimental study].

Isometric contractile force of rabbit prostatic tissue in response to electric field stimulation (EFS), KCl, and phenylephrine were measured at incubation temperature of 37 degrees C, before and after thermal exposure to 42 degrees C, 45 degrees C, 48 degrees C and 50 degrees C for 30 minutes. The contractile force in response to EFS decreased after thermal exposure above 45 degrees C, and the contractile force in response to KCL or phenylephrine decreased after thermal exposure above 48 degrees C. All the contractile response abolished after thermal exposure to 50 degrees C. The results indicate that the nerve is more hear-sensitive than the smooth muscle in the prostate. Histological examination revealed shrinkage of cell body and dark staining of nuclear chromatin of the smooth muscle cells after thermal exposure above 48 degrees C. The same histological change of the smooth muscle as well as degenerative change of the nerve cells was observed on the prostate 3-7 months after clinical thermotherapy. From these results, it is suggested that clinical effect of thermotherapy is brought about from both neural and muscular damage of the prostate. Since the least temperature to cause an irreversible tissue damage ranges from 48 degrees C through 50 degrees C, we believe it is ideal to heat the prostate around 50 degrees C to obtain a good clinical effect of thermotherapy on benign prostatic hyperplasia as a minimum invasive treatment.

Aged↗

[The adrenoceptor and calcitionin-gene related peptide receptor in the striated urethral sphincter in male rabbit].

BACKGROUND: The objective of this study is to analyze the adrenoceptor and calcitonin-gene related peptide receptor in the isolated striated urethral sphincter from a male rabbit. METHODS: The striated urethral sphincter preparations were suspended in 2ml tissue chamber filled with Krebs Ringer solution, and the changes of isometric twitch contraction induced by electrical field stimulation (EFS-contraction) were recorded in the presence of 3-isobutyl-1-methyl-xanthine (IBMX, 10(-5) M). RESULTS: The EFS-contraction was almost completely attenuated by tetrodotoxin (TTX, 10(7) M), vecronium (10(-4) M) and suxamethonium (10(-4) M). Norepinephrine (NE, 10(-8) M-10(-4) M) did not affect the EFS-contraction, but increased the tonic contraction in a dose-dependent manner. The tonic contractions induced by NE was significantly blocked by phentolamine (10(-6) M). Clonidine (10(-7) M), yohimbin (10(-7) M) and propranolol (10(-9) M-10(-6) M) did not affect the EFS-contraction. Isoproterenol (10(-9) M-10(-6) M) did not reduce the carbachol (10(-5) M) induced tonic contraction. Calcitonin-gene related paptide (CGRP, 10(-7) M-3 x 10(-6) M) did not affect the EFS-contraction and did not increase the tonic contraction. CONCLUSION: These results suggested that alpha 1-adrenoceptors of the striated urethral sphincter play a role to modulate the resting tension level, but alpha 2-adrenoceptors, beta-adrenoceptors and CGRP receptors play no role in this regard.

Adrenergic alpha-Antagonists↗

Burst activities of cremasteric motor units.

Electromyographic activities of the ipsilateral cremaster muscle evoked by electrical stimulation of either the thigh or the penis were analyzed for latencies and burst durations. Response latencies were 30 ms on thigh stimulation and 30-35 ms on penile stimulation. With the increase in stimulus intensity the latencies decreased to 30 ms in both cases. The changes were stepwise, indicating the switching between different reflex arcs. The burst duration on thigh stimulation was about 50 ms, and that for penile stimulation was 45 ms. Impulses producing the burst consisted of larger and smaller spikes, and this indicates the grouping of motor units for wing tonic and phasic units. The results suggest the existence of parallel neuronal circuitries for the spinal cremasteric reflex, and it is expected to provide a clue for evaluating the clinical significance of the cremasteric reflex.

Adult↗

Urinary incontinence in senile dementia of the Alzheimer type (SDAT).

Twenty patients (1 male and 19 females) with senile dementia of the Alzheimer type were studied using cystometry in combination with sphincter electromyography, brain computed tomography (CT) and evaluating the activities of daily life (ADL), with special reference to urinary incontinence. Seven of the patients were continent and the remainder were incontinent. Cystometry revealed uninhibited detrusor contraction in 8 out of the 13 incontinent patients, while no uninhibited contraction was found in 7 continent patients. There was a significant correlation between uninhibited detrusor contraction and urinary incontinence (p < 0.05). Brain CT showed that the degree of brain atrophy was more severe in those with uninhibited contraction than those without (p < 0.05). There was no clear relationship between sphincter coordination and the occurrence of incontinence. The ADL score tended to be lower in incontinent patients, although no significant difference was apparent (0.05 < p < 0.1). Uninhibited detrusor contraction and poor ADL functioning caused by brain atrophy are thought to be major causes of urinary incontinence in patients with senile dementia of Alzheimer type.

Activities of Daily Living↗

[A case of 48 XXYY Klinefelter's syndrome].

We observed a patient with 48 XXYY Klinefelter syndrome who visited our hospital because of a short penis as chief complaint. The patient was a 21-year-old, tall and obese man. He had gynecomastia. The penis was short and bilateral testes were underdeveloped. Endocrinologically the LH and FSH showed high level and the testosterone was low. A diagnosis of very rare 48 XXYY Klinefelter was made based of the chromosomal analysis.

Adult↗

[Clinical statistics on patients operated at the Department of Urology, Kaizuka Municipal Hospital during ten years (from 1983 to 1993)].

A statistic survey was made on the patients undergoing operations between July, 1983 and June, 1993. The total number of patients was 1780, comprising 1469 males and 311 females. The most frequent organ was the prostate with 526 cases (29.6%), followed by 415 (23.3%) penile and scrotum cases, and 290 (16.3%) bladder cases. Major operations were transurethral resection of prostate (418 cases) and bladder tumor (191 cases).

Adult↗

[Morphometric study of low compliant bladder].

Low compliant bladder is an important cause of detrusor dysfunction, although its cause is unknown. Two groups of patients who developed low compliant bladder have been studied by the morphometric technique. One group consisted of patients with neurogenic low compliant bladder, and the other group consisted of patients with non-neurogenic low compliant bladder. Control materials were obtained from postmortal samples offered from the department of anatomy. Bladder wall samples were obtained during bladder augmentation surgery. Morphometric computer analysis was used to measure the proportions of connective tissue and muscle layer in the bladder wall samples. In the non-neurogenic group, there was a significant increase in connective tissue and a marked decrease in muscle layer proportion than the control group. On the other hand, there was a mild increase in connective tissue, but no decrease in muscle layer proportion was observed in patients with neurogenic low compliant bladder. Comparison of the results obtained from the two groups suggested that low bladder compliance in neurogenic patients is mainly caused by functional alteration of the bladder wall, whereas that in non-neurogenic patients is caused by an organic change of the bladder wall.

Adolescent↗

[A new method of measurement of the urinary bladder blood flow in patients with low compliant bladder].

Laser-doppler blood flowmetry, a new instrument for measurement of tissue blood flow, was used to evaluate the changes occurring in the bladder blood flow and the intravesical pressure during bladder distension in 4 patients with normal detrusor function, 4 patients with neurogenic bladder dysfunction and one patient with non-neurogenic contracted bladder. In patients with normal detrusor function and normal compliance, the bladder blood flow relatively decreased, but the intravesical pressure was not affected by the bladder distension. On the other hand, the bladder distension in patients with low compliant bladder caused a significant decrease of the bladder blood flow and marked increase of the intravesical pressure. These observations suggest that the reduction of the bladder compliance is related to the decrease of the bladder blood flow. Furthermore, the bladder over distension and the high intravesical pressure in patients with low compliant bladder are thought to induce deterioration of bladder compliance and upper urinary tract.

Atrophy↗

[Anticholinergic therapy of urinary incontinence and urinary frequency associated with the elderly--with special reference to dementia].

Pharmacotherapy with anticholinergic agents was studied in a total of 80 patients aged 65 years or older with chief complaints of urinary frequency (4 patients) and/or ugency incontinence (76 patients). The subjects were 45 men and 35 women at the age ranging between 65 and 92 (mean 73.7). The patients received anticholinergic agents (terodiline hydrochloride 24 mg/day, oxybutynin hydrochloride 6 mg/day, propantheline bromide 60 mg/day separately or in combination) for more than two weeks. Subjective symptoms and objective findings were assessed before and after the administration. In addition, according to the result of Hasegawa's dementia rating scale the patients were divided into dementia group and non-dementia group for further evaluation of the study drugs. As a result, cystometrogram revealed significant increase of maximum bladder capacity in either dementia group or non-dementia group. There was no significant difference in rate of objective improvement between both groups. On the other hand, rate of subjective improvement was significantly higher in non-dementia group (40%) than in dementia group (15%). As mentioned above, improvement of cystometrogram findings was not associated with improvement of subjective symptoms in the demented patients. This suggests that the major cause of incontinence in demented patients is not the bladder dysfunction but the specific conditions of demented patients such as agnosia and apraxia.

Aged↗

[Quantitative electromyographic analysis of the external urethral sphincter using automatic decomposition electromyography on normal subjects].

Motor unit action potentials (MUPs) of the external urethral sphincter muscle during cystometry were analysed on six normal males. Electrodes were of concentric needle type having the exposed tip surface of 0.07 mm2, and the potential changes were analysed by automatic decomposition electromyography (ADEMG), for isolation and characterization of unit discharges. Number of analysed units was as follows: Two at rest, 4 at first desire to void, and 6 at maximum desire to void. Number of the recorded units and the firing rate were increased along with the degree of bladder filling. Average MUP figures as follows: Amplitude of 206 microV, 8.3 msec. duration, and 5.4 Hz firing rate at rest; 246 microV, 9.7 msec and 7.3 Hz at first desire to void; 277 microV. 9.7 msec and 7.2 Hz at maximum desire to void, respectively. It is concluded that external urethral sphincter maintains its urinary continence by excitation of the neuromuscular units, and by the increase in the firing rate of individual MUP during bladder filling.

Action Potentials↗

[Effect of verapamil on urinary calcium and oxalate excretion in renal stone formers].

The effect of the calcium antagonist verapamil on urinary calcium and oxalate excretion was examined and compared with that of trichlormethiazide to evaluate whether verapamil is useful in the prevention of calcium oxalate renal stones. Twenty-four-hour urine of 16 renal stone formers was measured at the outpatient clinic before and after administration of 120 mg/day verapamil for a mean duration of 2.7 months (range, 2 weeks to 6 months). The 24-hour urine was analyzed for creatinine, calcium, oxalic acid, magnesium and citric acid and the results compared with those in 20 renal stone formers who were administered trichlormethiazide. Verapamil was found to significantly reduce the urinary oxalate excretion of the 5 hyperoxaluric (> or = 50 mg/day) patients but no significant effect on urinary calcium, magnesium or citric acid was observed. Conversely, trichlormethiazide significantly decreased urinary calcium excretion in the hypercalciuric (> or = 250 mg/day) patients. Calcium oxalate risk index of hypercalciuric and hyperoxaluric patients was significantly reduced after the administration of verapamil. These findings suggest that verapamil is effective in reducing urinary oxalate excretion in the hyperoxaluric patients.

Calcium↗

Functional electrical stimulation in the management of incontinence: studies of urodynamics.

Intermittent functional electrical stimulation (FES) was employed for the control of incontinence. One FES session lasted for 30 minutes. It was repeated at intervals of 3 days to 1 week via an anal plug electrode. The success rate was 64% in 41 patients with pollakiuria, urgency and/or urge incontinence, and 43% in 7 patients with stress incontinence. Detrusor activity measured by cystometry did not correlate significantly with the effect on subjective symptoms and the urethral pressure did not increase. The remarkable clinical effect was observed in patients with overactive detrusor function. It seems that FES indirectly inhibits detrusor contraction by suppressing the intrasacral pathway for detrusor activity.

Adult↗