摘要:

Phosphodiesterases (PDE) are key enzymes regulating intracellular cyclic nucleotide metabolism and, thus, contraction and relaxation of the muscle. At present, five different families of isoenzymes of PDE exist that show a distinct species-specific and organ-specific distribution. The aim of the present study was to analyze the PDE isoenzymes present in the human ureter and to evaluate the functional effects of isoenzyme-specific inhibitors in this tissue. Normal ureteral tissue was obtained during radical nephrectomies, homogenized, centrifuged, and the supernatant fraction was separated using DEAE-Sephacel anion-exchange chromatography. PDE assay was then performed and the isoenzymes characterized on the basis of their kinetic characteristics and their sensitivity to allosteric modulators and inhibitors. In vitro, longitudinal ureteral strips as well as ureteral rings were precontracted, and different selective and nonselective PDE inhibitors were added incrementally. Three different PDE isoenzymes were identified: PDE I (Ca/calmodulin-stimulated), PDE II (cyclic guanosine monophosphate-stimulated), and PDE IV (cyclic adenosine monophosphate-specific). All PDE inhibitors relaxed the strips dose-depen-dently with an EC50 of 30 µM for papaverine, 40 µM for zaprinast, 25 µM for quazinone, and 0.1 µM for rolipram. The existence of three different PDE isoenzymes was shown in this study. The ureter-relaxing effect of the PDE IV inhibitor at low concentrations, combined with its low effect on the systemic circulatory parameters, may open a possibility of using selective PDE IV inhibitors in the treatment of ureteral colics or ureteral sto

ISSN:0042-1138    

DOI:10.1159/000282783

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Methods have been sought for the in vivo marking of tiny papillary tumors of the bladder and flat urothelial lesions such as dysplasia or carcinoma in situ, which can easily be missed during conventional endoscopy under white light. A new procedure is reported for the fluorescence detection of urothelial dysplasia and early bladder cancer. The method is based on intravesical application of 5-aminolevulinic acid (ALA). ALA if applied exogenously induces accumulation of protoporphyrin IX (PPIX) in the urothelium of the bladder. PPIX is an intensively red fluorescing agent. The mean ratio of fluorescence intensity between urothelial cancer and normal epithelium was found to be 17:1. Fluorescence excitation was achieved by violet light from a krypton ion laser (λ = 406.7 nm) or from a xenon arc lamp with a bandpass filter system (λ = 375–440 nm). Both light sources proved to be of equal suitability for fluorescence excitation. Fluorescence microscopy revealed that the PPIX fluorescence is strictly limited to the urothelium. It could not be detected from the submucosa or muscle of the bladder. Bladder wall biopsies were taken from 90 patients with suspicion of bladder cancer under fluorescence view. The fluorescence detection proved to be of high sensitivity (98%). No serious side effects which would preclude further clinical testing, especially no cutaneous photoreaction, were observed. Tumor-associated fluorescence induced by topical ALA application offers new perspectives in the diagnosis and treatment of bladder cancer. In case of suspicious or positive urine cytologic findings, ALA fluorescence cystoscopy may be useful for detecting the precise site of the malignancy. The procedure might be helpful in complete resection or coagulation of urothelial neoplasms. Due to this, diminishing recurrence rates are expected. However, this hypothesis has to be studied in prospective clinical tri

ISSN:0042-1138    

DOI:10.1159/000282784

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Photodynamic therapy (PDT) has recently attracted mucht attention, especially among urologists, because it appears to be a selective form of cancer treatment which causes minimal damage to normal surrounding tissues. In this study we made use of a new class of photosensitizers for the laser-induced fluorescence diagnosis (LIFD) and photodynamic therapy of human renal cell carcinoma xenotransplanted into nude mice. The purpose of this study was to evaluate the recently developed photosensitizing drug THOPP-MPEG for its efficacy as photosensitizer for LIFD and PDT of renal cell carcinoma. THOPP-MPEG was injected intraperitoneally (0.5 µg/g body weight) into the mice 6–8 days after tumor transplantation. On the 18th day after transplantation, the tumors reached a diameter of 3–4 mm. Seven days after administration of the drug the tumor-bearing kidney was irradiated percutaneously with a total light dose of 2 × 60 J/cm2 and a power density in the irradiated area of less than 150 mW/cm2. A continuous-beam argon-pumped dye laser (656 nm) was used. After excitation with laser light (488–514 nm), the vital tumor clusters and the surrounding tissues invaded with tumor cells showed intense red coloration by laser-induced fluorescence. Subsequent to the light exposure (656 nm), a heavy tumor necrosis of up to 3–5 mm resulted. No THOPP-MPEG phototoxicity in normal surrounding tissue at a dose of up to 100 mg/ kg body weight was seen. We believe the future role of PDT in the management of tumors of the kidney to be adjuvant within the concept of conservative kidney-preservin

ISSN:0042-1138    

DOI:10.1159/000282785

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

The influence of serotonin (5-hydroxytryptamine, 5-HT) on human ureteral smooth muscle was explored in a series of in vitro experiments. 5-HT evoked a dose-dependent contraction of the ureter. The effect of 5-HT was unaltered by blockade of 5HT3 and 5HT4 receptors and muscarinic cholinergic receptors. The 5HT2 receptor antagonist ketanserin (KT; 10––5–10––4M) and mixed 5HT1/5HT2 receptor antagonist methysergide (MS; 5 × 10––5M) inhibited the effect of 5-HT. Since the antagonist dissociation constant at 5HT2 receptors for both KT and MS is found to be approximately 10––9M, it is concluded that this contractile effect may have been mediated by some other, as yet uncharac-terized 5-HT receptor. We believe that 5-HT is a potential neurotransmitter in the human upper uret

ISSN:0042-1138    

DOI:10.1159/000282786

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

To investigate the effect of flavoxate (Urispadol®) treatment on patients with symptomatic benign prostatic hypertrophy (BPH), with the main weight on the irritative symptoms, a randomized, double-blind, parallel-group, placebo-controlled and multicenter investigation was carried out. Seventy patients entered the study, 37 were allocated to flavoxate treatment on a daily dose of 1,200 mg (400 mg t.i.d.) for 12 weeks, and 33 patients were allocated to placebo treatment. In spite of a sufficient power, the study did not discriminate the two treatment groups in a statistically significant way (p > 0.05), when considering the main endpoints: the irritative symptom score and the global patient evaluation. Conservative treatment of micturition disorders accompanying BPH with flavoxate in doses of 1,200 mg/day cannot be recommended for clinical use

ISSN:0042-1138    

DOI:10.1159/000282787

出版商:S. Karger AG    

年代:1995

数据来源: Karger

ISSN:0042-1138    

DOI:10.1159/000282788

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Twenty-one patients with large adrenal tumor on the right side were operated on at Yamagata University Hospital. Bilateral anterior subcostal incision with a vertical midline incision extending from the xiphoid and subsequent use of self-retraction system provided satisfactory exposure of anterior liver and diaphragma area. Successive retraction of the liver exposed the right adrenal tumor and its vascular pedicles. 14 (66.7%) of the 21 patients received right adrenalectomy with liver mobilization, and 7 (33.3%) received right adrenalectomy without mobilizing the liver. Despite the average weight of removed tumors was 152.9% (p < 0.01) greater in the liver mobilized group than in the liver nonmobilized group, the incidence of good exposure of right adrenal central vein including adjacent organs was higher in the former group. In addition, incidence of blood transfusion was identical in both groups. Although postoperative liver function was slightly impaired in the liver mobilized group as compared with the liver nonmobilized group, all examined valuables manifesting liver function in the former group returned to preoperative levels within 3 weeks. The operative procedure described above appears to be useful for the removal of right large adrenal tumors with less risk of serious accident.

ISSN:0042-1138    

DOI:10.1159/000282789

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

We report a rare case of malignant mesothelioma of the tunica vaginalis testis. A 67-year-old man was hospitalized with a complaint of swelling on the right side of the scrotal contents. Right high orchiectomy was performed, and the pathological examination revealed malignant mesothelioma of the tunica vaginalis testis. The surgery was thought to have been radical, but 4 months post-operation, local recurrence in the inguinal skin and distant metastasis in the para-aortic lymph node were found. The tumors were treated by surgical resection and radiation therapy. Two months after the second treatment, multiple lung metastasis and a second local recurrence in the inguinal skin were found. High-dose chemotherapy with cisplatin and doxorubicin was performed, but no change was confirmed after 4 weeks. The disease progressed, resulting in death within 8 months of diagnosis. The response of mesothelioma to chemotherapy is thought to be poor histologically as indicated by this case and previously reported cases, so initial radical surgery and adjuvant procedures soon after diagnosis are necessary to achieve cure.

ISSN:0042-1138    

DOI:10.1159/000282790

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Extramedullary plasmacytomas of the testes are extremely rare tumors, especially when occurring in the absence of precocious or concurrent diagnosis of multiple myeloma. This is a case report of an 83-year-old man with a solitary plasmacytoma of the left testis. Immunoperoxidase studies, performed on his-tologic specimens after radical orchiectomy, showed a monoclonal staining of intracellular immunoglobulin for IgG-λ type. He has been well for more than 14 months with no evidence of local recurrence or multiple myeloma

ISSN:0042-1138    

DOI:10.1159/000282791

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

A 65-year-old diabetic man presented with a painful swelling of his right epididymis. Urine culture was sterile. Semicastration was performed and histology revealed malacoplakia of the epididymis without involvement of the testis. Histologic workup demonstrated typical von Hansemann cells and Michaelis-Gutmann bodies stained by von Kossa’s stain. This is the 19th case of epididymal malacoplakia and the 9th case of epididymal malacoplakia without concurrent involvement of the testis. Literature review shows that the present case is typical with respect to the clinical presentation and with regard to the age of presentation. The fact that this patient was suffering from diabetes mellitus lends some support to the assumption that a compromised immune status could be etiologic in malacoplaki

ISSN:0042-1138    

DOI:10.1159/000282792

出版商:S. Karger AG    

年代:1995

数据来源: Karger