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  • 1
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: This double-blind, multicenter study compared the efficacy and tolerability of tolterodine (Pharmacia, Los Angeles, USA) with that of oxybutynin (Alza, Palo Alto, USA) in Asian patients with overactive bladder. Methods: Two-hundred-and-twenty-eight adults with overactive bladder symptoms were randomized to receive tolterodine 2 mg twice daily (bid) (n = 112) or oxybutynin 5 mg bid (n = 116). After 8 weeks’ treatment, changes in micturition diary variables, patients’ perception of treatment benefit, and tolerability endpoints were determined. Results: The mean (± SD) number of micturitions/24 h decreased by 2.6 ± 2.9 (−21%) with tolterodine and 1.8 ± 4.2 (−15%) with oxybutynin (both P = 0.0001 vs baseline). The mean number of incontinence episodes/24 h decreased by 2.2 ± 2.3 (−85%) in the tolterodine group and by 1.4 ± 1.8 (−58%) in the oxybutynin group (both P = 0.0001 vs baseline). Patient perception of treatment benefit was over 70% in each treatment group. Adverse events were significantly lower in the tolterodine group compared with oxybutynin-treated patients (55% vs 82%; P = 0.001). Dry mouth was reported by significantly fewer patients on tolterodine, compared with oxybutynin (35% vs 63%; P = 0.001) and withdrawals due to adverse events were lower in the tolterodine group than with those treated with oxybutynin (10% vs 16%). There were no safety concerns. Conclusions: Tolterodine 2 mg bid is equally or more effective than oxybutynin 5 mg bid in the treatment of Asian patients with overactive bladder, and shows significantly better tolerability. This may enhance compliance during long-term treatment.
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  • 2
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: We investigated changes in zinc concentrations in serum and prostatic tissue after an intraprostatic injection of zinc, and compared two forms of zinc delivery: solution and liposome.Methods: Ninety-six male Wistar rats were used in the study (24 controls, 72 test rats). The test animals were randomly divided into two groups and were injected intraprostatically with 2 mL of 0.04 mol/L zinc sulfate according to the form of zinc delivery. Nine rats in each test group were sacrificed 1 day, 7, 14 and 28 days after injection, and 24 normal rats were injected intraprostatically with 2 mL of distilled water as controls. Serum and prostatic zinc concentrations of each group were measured by inductively coupled plasma atomic emission spectrometry. Blood chemistries, routine urinalysis, urine culture and histopathologic examination were also performed.Results: Serum zinc concentrations did not change significantly after the intraprostatic injection of zinc. Prostatic zinc concentrations were found to be significantly greater (P 〈 0.05) in zinc-injected groups than in the control group. The intraprostatic injection of zinc solution and zinc liposome increased zinc levels in both ventral and dorsolateral lobes significantly. Prostatic zinc levels increased progressively following injection, reaching a peak level in 7 days and maintaining a high value throughout the experimental period. The prostatic zinc level of the 1-day zinc liposome group was higher than that of the 1-day zinc solution group, while no significant difference was observed between the solution and liposome group in 7, 14, 28 days. No abnormal findings were observed in any of the laboratory and histopathologic examinations; however, an acute inflammatory response was observed in the 1-day groups.Conclusion: These findings suggest that an intraprostatic injection of zinc in normal rats increases and maintains the prostatic zinc level for at least 4 weeks without causing any systemic or local toxicities. These findings suggest the potentially important clinical applicability of local zinc to the treatment of chronic prostatitis.
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  • 3
    ISSN: 1440-1681
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: 1. Calcium regulation has been reported to be associated with the development of diabetic nephropathy. Thus, changes in Ca2+ uptake induced by ATP, an important regulator of Ca2+ uptake, in the diabetic condition and related signal pathways were examined in primary cultures of rabbit renal proximal tubule cells (PTC).2. Under low (5 mmol/L) glucose conditions, 10−4 mol/L ATP inhibited Ca2+ uptake early on (〈 30 min), whereas Ca2+ uptake was stimulated at later time points (〉 2 h). However, under high (25 mmol/L) glucose conditions, ATP stimulated both the early and late uptake of Ca2+.3. The adenylate cyclase inhibitor SQ 22536, the protein kinase (PK) A inhibitor PKI amide 14–22, Rp-cAMP, staurosporine, bisindolylmaleimide I and H-7 (PKC inhibitors) blocked the change in ATP effect on Ca2+ uptake in the presence of 25 mmol/L glucose. However, none one of these drugs blocked the effect of ATP on Ca2+ uptake in the presence of 5 mmol/L.4. At 25 mmol/L, glucose increased cAMP content and PKC activity, whereas ATP had no effect on either parameter.5. In conclusion, high glucose levels alter ATP-induced Ca2+ uptake via cAMP and PKC pathways in the PTC.
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  • 4
    ISSN: 1440-1797
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: SUMMARY:  Chinese herb nephropathy contains a variety of clinical features of progressive renal failure (indicated by studies conducted in Belgium) to the variant type of Fanconi's syndrome. Fanconi's syndrome has mostly been reported in Asian countries, and is characterized by proximal tubular dysfunction and slower progression to end-stage renal disease (ESRD); it also often revealed a reversible clinical course. We describe a 43-year-old woman who presented with polyuria and polydipsia caused by Fanconi's syndrome. The cause of Fanconi's syndrome was not identified because the patient denied the intake of the Chinese herbal mixture at first. Fanconi's syndrome seemed to be reversible in its early stage, but it rapidly progressed to renal failure after 3 months, despite the interruption of Chinese mixture use. A renal biopsy revealed typical findings of aristolochic acid-induced nephropathy. Aristolochic acids were also detected in the Chinese herbs that were consumed. This case highlights the variety of the clinical spectrum of aristolochic acid induced nephropathy (AAN). We emphasize that AAN should be suspected in all patients with Fanconi's syndrome, even if patients deny the intake of any Chinese herbal preparation.
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  • 5
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract  Background:  Chronic bacterial prostatitis (CBP) is the most common urological disease in adult men. Antibiotic therapy is the gold standard of treatment. However, long-term therapy resulted in many side-effects and bacterial resistance. Because of these reasons, we need new treatment modality that could replace traditional antibiotic therapy. Catechin, an extract of green tea, has antimicrobial effect against various bacteria and synergy effect to antibiotics. We evaluate the synergistic effects of catechin on the treatment of CBP in an animal model.Methods:  An experimental CBP model was induced in 70 male Wistar rats by instillation of 0.2 mL bacterial suspension (E-coli Z17, O2:K1:H-) containing 1 × 108 CFU/mL into the prostatic urethra. Microbiologically and histologically proven CBP model was demonstrated in 58.6% (41 of 70) of the rats after 4 weeks of bacterial instillation. The 41 rats demonstrating CBP were randomly divided into four groups; the control, catechin, ciprofloxacin and catechin with ciprofloxacin groups. All drug treatments were conducted over a period of 2 weeks. After treatment, the results were analyzed with microbiological cultures and histological findings of the prostate and urine samples to compare each group.Results:  Microbiological cultures and histological findings of the prostate and urine samples demonstrated reduced bacterial growth and improved inflammatory responses in all three experimental groups compared with the control group. The catechin group showed coherent trends of decrease in bacterial growth and improvements in prostatic inflammation compared with the control group, but not to a statistically significant degree (P 〉 0.05). However, the ciprofloxacin and catechin with ciprofloxacin groups showed statistically significant decreases in bacterial growth and improvements in prostatic inflammation compared with the control group (P 〈 0.05). The catechin with ciprofloxacin group showed a statistically significant decrease in bacterial growth and improvements in prostatic inflammation compared with the ciprofloxacin group (P 〈 0.05).Conclusions:  These results suggest that catechin may be an effective material in CBP treatment. Particularly, combination treatment of catechin and ciprofloxacin has synergistic effect. Therefore, we suggest that the combination of catechin and ciprofloxacin may be effective in treating CBP with a higher success rate.
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  • 6
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Cystic testicular masses have been considered rare but due to advances in ultrasonographic technologies their incidence has risen. Many testicular cystic masses are benign but there is a chance of malignancy. Psammoma bodies are found in various malignancies that occur in the genital tract of women but rarely in men. We report a case of testicular tunica albuginea cyst with psammoma bodies.
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  • 7
    ISSN: 1440-1681
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: 1. The present study was conducted to examine the involvement of oxidative stress in bee venom-induced inhibition of the Na+/glucose cotransporter (α-methyl-d-glucopyranoside (α-MG) uptake), a typical functional marker of proximal tubules, in primary cultured rabbit renal proximal tubule cells (PTC).2. Bee venom (≥ 1 μg/mL) increased lipid peroxide (LPO) formation over 30 min. The increase in [3H]-arachidonic acid (AA) release and LPO formation and the inhibition of α-MG uptake induced by bee venom (1 μg/mL) and melittin (a major component of bee venom; 0.5 μg/mL) were blocked by N-acetyl-l-cysteine, vitamin C and vitamin E, anti-oxidants.3. Bee venom- and melittin-induced increases in LPO formation and inhibition of α-MG uptake were significantly prevented by mepacrine and AACOCF3, phospholipase A2 inhibitors. In addition, nordihydroguaiareic acid (a lipoxygenase inhibitor) and econazole (a cytochrome P-450 epoxygenase inhibitor), but not indomethacin (a cyclo-oxygenase inhibitor), prevented bee venom- and melittin-induced increases in LPO formation and inhibition of α-MG uptake.4. Nordihydroguaiareic acid prevented bee venom- and melittin-induced increases in Ca2+ uptake. Moreover, anti- oxidants significantly prevented bee venom- and melittin-induced increases in Ca2+ uptake.5. In conclusion, bee venom inhibits α-MG uptake via the phospholipase A2–oxidative stress–Ca2+ signalling cascade in primary cultured rabbit renal proximal tubule cells.
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  • 8
    ISSN: 1440-1681
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: 1. In the present study, we assessed the protective effects of chronic hypoxia preconditioning against heatstroke-induced injury in urethane-anaesthetized rats. Heatstroke was induced by exposing the animals to an ambient temperature of 42°C. The time at which both the mean arterial pressure (MAP) and local cerebral blood flow (CBF) in the striatum began to decrease from peak levels was taken as the onset of heatstroke. Control rats were exposed to a temperature of 24°C.2. Mean arterial pressure, CBF, blood pH, PaO2, PaCO2 and survival time (the interval between onset of heatstroke and cardiac arrest) after heat stress were all lower than in control rats (in which ‘survival time’ was defined as 〉 360 min). However, blood lactate concentrations were greater in rats exposed to heat. Rats placed at high altitude (HA), when exposed to the same heat stress (42°C) survived much longer (113 ± 26 min; n = 8) than rats maintained at sea level (SL; 20 ± 2 min; n = 8).3. After the onset of heatstroke, blood pH and lactate concentrations were found to be significantly higher and lower, respectively, in HA rats than in SL rats.4. Western blot assay revealed that chronic hypoxia preconditioning induced heat shock protein (HSP) 72 expression in both the kidneys and lungs.5. Thus, it appears that the observed benefit of chronic hypoxia preconditioning is related to attenuation of tissue acidification and elevations of HSP72 expression in both kidneys and lungs during heatstroke.
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  • 9
    ISSN: 1440-1797
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: SUMMARY: The pathogenetic mechanisms of IgA nephropathy are diverse and are not yet clearly elucidated. We believe pro-inflammatory cytokines, Th1/Th2, and chemokines would be involved in the pathogenetic pathways and would affect the functional and histological consequences of IgA nephropathy. By using semiquantitative reverse transcriptase–polymerase chain reactions (RT-PCR), we measured the level of intrarenal gene expression of various cytokines and chemokines in 61 renal core biopsy specimens confirmed as IgA nephropathy. And, by using immunohistochemistry (IHC), the degree of expression and the location of various cytokines and chemokines in renal tissues in 29 of the above patients were attempted to be determined. In RT-PCR, the γ-interferon (IFN-γ)/interleukin-10 (IL-10) ratio was higher in patients with renal dysfunction than in those with normal renal function. The levels of pro-inflammatory cytokine gene transcripts (tumor necrosis factor-α (TNF-α), IL-1β) were high in patients with significant proteinuria. In patients with severe glomerular sclerosis, the ratio of IFN-γ/IL-10 gene transcripts was high. The level of IL-10 gene transcript was related to the severity of tubular atrophy and interstitial fibrosis. The extent of intrarenal arteriolar lesions correlated with the expression of the IL-8 gene transcript. The degree of IgA deposition in glomeruli was related to the expression of IL-15 and IL-6. In IHC, TNF-α, IFN-γ and IL-2 were immunostained dominantly in the mesangial region, but not in the tubulointerstitial region. In contrast, positive reactions for IL-10 were observed primarily in tubules. Significant reactions for IL-8 were noted in the periarteriolar and arteriolar areas. The results of RT-PCR and IHC showed positive relationships, but these were not statistically significant. This study suggests that pro-inflammatory, Th1/Th2 cytokines and chemokines are involved in the specific processes of inflammation and immunological injury in IgA nephropathy.
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  • 10
    ISSN: 1440-1797
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Aim:  Body weight (BW) might be related to total body water, and the difference between a patient's actual BW and ideal BW (IBW) might be the volume marker. However, there has been no information about the association between IBW and dry weight (DW) in haemodialysis (HD) patients.Methods:  First, we analysed the relationship between DW and IBW in 51 HD patients. The IBW was calculated by 21 × Height (Ht)2. Weight status was analysed by the WHO classification. Second, in 12 436 controls, linear equations using Ht2 were sought to predict the BW in each sex and WHO class. Third, using these equations, predicted BW (PW) was compared with DW in each WHO class at the initiation and after 1 year in 619 new HD patients, retrospectively.Results:  Among 51 HD patients, 38 were normal weight in whom there was no difference between DW and IBW. In each sex and WHO class of the 12 436 controls, linear equations using Ht2 were developed to predict BW. These equations were applied to 619 new HD patients. In males, there were no differences between PW and DW in underweight (UW), overweight (OW), obese (OB) and extremely obese (EOB) patients at the initiation of the HD. In females, there were no differences between PW and DW in OW patients. Despite no statistical differences, there were wide ranges of distribution from −6 to 6 kg between PW and DW.Conclusions:  BW had a linear relationship with Ht2 and might be predictable by the WHO class-specific equation using Ht2. These equations might be useful as a crude indicator of DW in HD patients.
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