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Biomedical subjects

M Elmér

Publications and source records attributed to M Elmér.

At least 19 recordsLinked to original sources
PubMed1991

[Diurnal enuresis in childhood is effectively treated with terodiline].

Efficacy and tolerance of the anticholinergic calcium antagonist, terodiline (Mictrol), were investigated in a placebo-controlled double-blind cross-over study of 42 children with diurnal enuresis. At a daily dosage of 25 mg, terodiline was well tolerated and, as compared with placebo, resulted in a statistically significant reduction in the daily frequency of wetting. Thus the findings show terodiline to be effective in the treatment of diurnal enuresis, an added advantage being the low incidence of side effects. A full report in English is given in Scand J Prim Health Care 1988; 6:119-24.

Adolescent↗
PubMed1988

Terodiline in the treatment of diurnal enuresis in children.

Efficacy and tolerance of the anticholinergic and calcium antagonistic drug terodiline (Mictrol) were investigated in comparison to placebo in 42 children with diurnal enuresis. The study was double-blind with a modified cross-over design with 2 treatment periods of 4 weeks. Terodiline in a daily dose of 25 mg was well tolerated. A statistically significant decrease in the number of wet episodes per day was found with terodiline when compared to placebo. In addition a high patient preference for terodiline was observed. This study shows that terodiline is effective in the treatment of daytime enuresis in children. The low incidence of side-effects also favours the use of terodiline in children.

Adolescent↗
PubMed1987

Urinary bladder innervation in children.

Muscle strips from the fundus, trigone, and distal ureter obtained from children at operation for vesicoureteric reflux were studied using histochemical and immunohistochemical methods, and electrical nerve stimulation in an organ bath. A rich supply of cholinergic nerves was found and the transmitter causing contraction of the detrusor muscle was regarded as being acetylcholine. The adrenergic innervation was very sparse except around the ureteric orifices. No contractile alpha-adrenoceptors could be detected but beta-receptor-mediated relaxation was found. The type was not beta 1 or beta 2, suggesting a third type of beta-receptor. Peptidergic nerves containing vasoactive intestinal peptide (VIP) were demonstrated in a few nerve terminals. No nerves containing enkephalin, somatostatin, or substance P were found. VIP affected the detrusor muscle, indicating a possible role as a modulator of transmitter action. Imipramine, used for enuresis, had no anticholinergic effect on the bladder in the doses used clinically. The anticholinergic and calcium antagonistic drug terodiline inhibited all muscle activity, making it suitable for treatment of diurnal enuresis.

Acetylcholinesterase↗
PubMed1986

Innervation of the child urinary bladder.

Muscle strips from the fundus, trigonum and distal ureters obtained from children at operations for vesico-ureteric reflux were studied using histochemical and immunohistochemical methods, and electrical nerve stimulation in an organ bath. A rich supply of cholinergic nerves was found and despite a partial atropine resistance the neurophysiological experiments indicated that the transmitter causing contraction of the detrusor muscle is acetylcholine. Imipramine, which is used in the treatment of enuresis, had no anticholinergic effect on the bladder in the doses used clinically. The adrenergic innervation was very sparse except around the ureter orifices. No contractile alpha-adrenoceptors could be detected but beta receptor mediated relaxation was found, which was neither of the beta 1 nor beta 2 type. A third type of beta receptor is postulated. Peptidergic nerves containing vasoactive intestinal peptide, VIP, were demonstrated in a few nerve terminals running along bundles of smooth muscle. No nerves containing enkephaline, somatostatine or substance P were found. VIP affected the detrusor muscle indicating a possible role as a modulator of transmitter action, while substance P had no effect. The anticholinergic and calcium antagonistic drug terodiline inhibited all muscle activity, whether it was induced by nerve stimulation, cholinergic drugs or a potassium rich solution, making it suitable for treatment of diurnal enuresis.

Adrenergic Fibers↗
PubMed1984

Terodiline in children with diurnal enuresis.

The effect of terodiline, a drug with both anticholinergic and calcium antagonistic properties, was studied in vitro on muscle strips from the urinary bladder of children and in vivo in children with diurnal enuresis. Terodiline inhibited all muscle activity in the urinary bladder strips whether induced by nerve stimulation or by drugs with different mechanisms of action. In most children treated the daytime enuresis disappeared completely, with a larger amount of urine at micturition and a lower voiding frequency. Cystometry indicated increased functional bladder capacity and decreased premicturition pressure.

Adolescent↗
PubMed1983

Supersensitivity in the isolated urethra of the rat following "chemical sympathectomy".

The circular muscle activity of the urethra of the male rat was isometrically measured in vitro in response to noradrenaline, phenylephrine and isoprenaline. The urethra was found to be supplied with both alpha- and beta-adrenoceptors mediating contraction and relaxation, respectively. The substance 6-hydroxydopamine is known to cause a selective destruction of adrenergic nerves. In the present study 6-hydroxydopamine (100 mg/kg) was injected intravenously into a group of rats twice with a weekly interval. When the urethra was examined 2-3 weeks after the first injection a supersensitivity mediated both via alpha- and beta-adrenoceptors was found to have developed, suggesting that the urethra of the male rat normally is under the influence of adrenergic activity. The findings are discussed in relation to denervation supersensitivity of the neurogenic bladder in man.

Animals↗
PubMed1980

Compensatory increase of responses to nerve stimulation of the partially denervated rat urinary bladder.

The rat urinary bladder was deprived of half of its innervation by removing the pelvic ganglion on one side. The motor response of such a partially denervated bladder to stimulation of the pelvic nerve on the other side were examined 1 week, 1 month and 2 months postoperatively. On all three occasions the increase in pressure of the operated bladder was larger than that of the control bladder; the enlargement was most marked 2 months after operation. The responses were further enlarged by eserine, and markedly reduced by atropine. The present results combined with those of previous investigations, showing a rapid recovery in the activity of the acetylcholine forming enzyme from a reduced level and a transient supersensitivity to chemical stimuli after unilateral removal of the pelvic ganglion, suggest that the enlarged responses to nerve stimulation 1 week postoperatively are mainly due to sensitization, while those observed at the later stages are due to collateral sprouting from the cholinergic nerve fibres of the intact pelvic nerve.

Adrenergic Fibers↗
PubMed1978

Transient supersensitivity in the partially denervated urinary bladder of the rat.

When examined 6-7 days after the unilateral removal of the pelvic ganglion, the detrusor muscle of the rat was found to be sensitized to methacholine and noradrenaline. The threshold doses were lower while the intravesical pressure responses to doses above threshold were increased. In contrast, bladders examined 25-30 days after the partial denervation lacked signs of sensitization. It is suggested that the contralateral nervous pathway is responsible for the rapid disappearance of the supersensitivity.

Animals↗
PubMed1978

Cholinergic mechanisms in the rat detrusor muscle.

The motor response of the urinary bladder to nerve stimulation is resistant to atropine, and it has been proposed that the nerves are non-cholinergic, but are possibly purinergic. In this review evidence is presented suggesting a cholinergic transmission in the rat detrusor muscle, part of the receptors being inaccessible to atropine. The rat bladder receives postganglionic cholinergic fibres not only from the pelvic but also from the hypogastric nerves, some fibres passing outside the pelvic ganglia and some relaying distal to them. There is a functional overlap between the right and the left pelvic nerve, but the contractile response to stimulation of the hypogastric nerves is added to the pelvic nerve response with no functional overlap or antagonism.

Acetylcholinesterase↗
PubMed1977

Choline acetyltransferase activity in the denervated urinary bladder of the rat.

After extirpation of the pelvic ganglia the choline acetyltransferase activity decreased markedly indicating that most of the postganglionic cholinergic neurones of the bladder take this route. A small decrease in the activity of this enzyme was found after section of the hypogastric nerve, showing that these nerves contribute to some extent to the cholinergic innervation. The residual enzyme activity found after a combination of the two surgical procedures suggests that neurones relay distal to the level of the section of the hypogastric nerves and pass outside the pelvic ganglia and (or) that neurones pass the pelvic ganglia and relay distal to them. Electrical stimualtion of the hypogastric nerves after extirpation of the pelvic ganglia and the use of blocking drugs showed on the existence of cholinergic neurones passing outside the pelvic ganglia, some of them relaying distal to the point of stimulation.

Animals↗
PubMed1976

Responses of the denervated rat urinary bladder to alfa adrenoceptor stimulation.

The contractile responses of the rat detrusor muscle to noradrenaline were increased 2-3 weeks after partial denervation but had returned to control values 6-9 weeks after the denervation, probably because of reinnervation of denervated muscle cells. 6-9 weeks after partial denervation the excitatory alpha-adrenoceptor mediated response to stimulation of the remaining intact nerves was predominant, masking the subsequent inhibitory beta-receptor response, which at this time was seen only after alpha-receptor blockade. The possibility of an outgrowth of adrenergic fibres activating alpha-receptors in muscle cells normally not innervated by adrenergic nerves is discussed.

Animals↗
PubMed1975

Atropine sensitivity of the rat urinary bladder during nerve degeneration.

The pressure response of the rat urinary bladder to electrical stimulation of the pelvic nerve at a low stimulation frequency was found to be almost completely atropine resistant. However, the response to stimulation of the degenerating pelvic nerve 20-30 h after section of the nerve postganglionically using maximal stimulation frequency was totally abolished by atropine or the parasympatholytic agent Hoechst 9980. The responses were not affected by hexamethonium or dihydroergotamine, but were potentiated by eserine. The non-adrenergic portion of the bladder response to stimulation of the degenerating hypogastric nerves was also abolished by atropine or Hoechst 9980. It is concluded that the transmitter activating the detrusor muscle at stimulation of the pelvic nerve or the non-adrenergic part of the hypogastric nerve probably is acetylcholine.

Amides↗
PubMed1975

Adrenergic and cholinergic innervation of the rag urinary bladder.

The autonimic innervation of the rat urinary bladder was studied using histochemical methods and nerve stimulations. A sparse adrenergic innervation of the detrusor muscle was found. It was supposed to originate from long adrenergic neurones. The trigonum area had a rich ssupply of adrenergic fibres, probably derived from short adrenergic neurones. A uniformly rich supply of acetylcholine-esterase (AChE)-positive nerves was found in the WHOLE BLADDER. Postganglionic sympathetic denervation caused no detectable change of adrenergic or AChE-positive nerves in the bladder, while parasympathetic decentralization or denervation produced a total disappearance of adrenergic fibres. The AChE-positive nerves were appreciably reduced in number after parasympathetic decentralization and not detectable after postganglionic denervation. Neither adrenergic nor AChE-positive ganglion cells could be demonstrated in the bladder wall. Electrical stimulation of the hypogastric nerves or the pelvic nerves distal to the pelvic ganglia elictied contraction of the detrusor muscle. The responses were not affected by hexamethonium, dihydroergotamine or proparanolol but were slightly reduced by guanethidine, reduced to about 40% by atropine and potentiated by eserine. Stimulation of the pelvic nerve proximal to the pelvic ganglion was partially blocked by hexamethonium. It si concluded that the urinary bladder of the rat is supplied by postganglionic adrenergic fibres mainly via the pelvic nerves and only to a lesser extent via the hypogastric nerves. Probably cholinergic fibres pass to the bladder mainly via the pelvic nerves but also via the hypogastric nerves, having their cellbodies outside the bladder wall, partly proximal to the pelvic ganglia.

Acetylcholinesterase↗
PubMed1975

Stimulation of adrenergic nerve fibres to the urinary bladder of the rat.

The contraction of the rat detrusor muscle caused by electrical stimulation of the hypogastric or pelvic nerves was followed by relaxation when the nerves were stimulated for a short period. The relaxation was more pronounced when the initial contraction was reduced by atropine. It was found to be mediated by adrenergic fibres acting on inhibitory beta2-receptors. Stimulation of the hypogastric or pelvic nerves at high frequencies increased the contractile response probably via adrenergic fibres activating excitatory alpha-receptors.

Adrenergic beta-Antagonists↗