Masaki Nakazawa

A Retroperitoneal Bronchogenic Cyst: Laparoscopic Treatment

Subdiaphragmatic bronchogenic cysts are rare, and those located retroperitoneally are exceptional. We describe a retroperitoneal cyst presenting as an asymptomatic adrenal mass which was treated with laparoscopic surgery with three trocars.,

Expression of 5-Hydroxytryptamine Receptors in Human Urinary Bladders with Benign Prostatic Hyperplasia

IntroductionThis study investigated the mRNA expression pattern and distribution of 5-hydroxytryptamine (5-HT) receptors 5-HT2A, 5-HT2B, 5-HT3A, 5-HT4, and 5-HT7 within the urothelium and detrusor of normal bladder tissue and in the urothelium of bladders from patients with benign prostatic hyperplasia (BPH).MethodsNormal urinary bladder specimens were obtained from 13 patients undergoing radical cystectomy due to bladder cancer (normal group) and BPH specimens were obtained from 27 benign prostatic obstruction patients receiving transurethral prostatectomy or retropubic prostatectomy. Receptor subtype mRNA expression was determined by real-time reverse transcription polymerase chain reaction on urothelium, detrusor, and whole mucosal preparations. Receptor distribution was determined by immunohistochemistry.ResultsIn normal tissues, expressions of 5-HT2B and 5-HT7 receptor mRNAs in the urothelium, detrusor, and whole mucosa were greater than the average expression for all receptor subtype mRNAs. 5-HT2B receptor protein was distributed in the apical urothelium and among the detrusor smooth muscle layers. In contrast, the 5-HT7 receptors were within the urothelium middle cell layers and detrusor smooth muscle cells. The expression pattern of each 5-HT receptor subtype mRNA within the BPH urothelium was similar to that in the normal urothelium. The expression level of 5-HT2A receptor mRNA in the BPH group was significantly lower than the normal group; however, the expressions of both 5-HT3A and 5-HT7 mRNAs were significantly higher. The expressions of both 5-HT2B and 5-HT4 mRNAs were not significantly different between the normal and BPH groups.ConclusionIn normal urinary bladders, the expressions of both 5-HT2B and 5-HT7 mRNAs were higher compared to the 5-HT2A, 5-HT3A, and 5-HT4 mRNAs. The distributions of 5-HT2B and 5-HT7 receptors were different in the urothelium and detrusor layers. The 5-HT3A and 5-HT7 receptor mRNAs in the BPH group were significantly higher compared to the normal urothelium, while the 5-HT2A mRNA was significantly lower.FundingAsahi Kasei Pharma Corporation.

Muscarinic receptors mediate cold stress-induced detrusor overactivity in type 2 diabetes mellitus rats

This study determined if muscarinic receptors could mediate the cold stress‐induced detrusor overactivity induced in type 2 diabetes mellitus rats.

Engineered bone marrow-derived cell sheets restore structure and function of radiation-injured rat urinary bladders.

Previously, we reported that implantation of isolated single bone marrow-derived cells into radiation-injured urinary bladders could restore structure and function. However, injections of isolated single cells had some limitations. Thus, in this study, we produced bone marrow-derived cell sheets in temperature-responsive culture dishes that release the monolayer sheets intact. We then determined whether the produced cell sheets could restore function to irradiated urinary bladders. Twenty female 10-week-old Sprague-Dawley (SD) rats were irradiated with 2 gray once a week for 5 weeks. Bone marrow cells harvested from two male 17-week-old green fluorescence protein-transfected SD rats were placed in primary culture for 7 days. Bone marrow cell-derived outgrowths were harvested by enzymatic digestion and transferred into the atelocollagen-coated temperature-responsive culture dishes for 2 days. To harvest the secondarily cultured cells as monolayer sheets, a support membrane was put in each culture dish, and then the temperature was reduced to 20°C. Each released cell sheet was then patched onto the irradiated anterior bladder wall (n=10). As controls, cell-free sheets were similarly patched (n=10). After 4 weeks, transplanted cells were detected on the bladder walls. The cell sheet-transplanted bladders had smooth muscle layers and acetylcholinesterase-positive nerve fibers in proportions that were significantly larger than those of the control bladders. In addition, the cell sheet-transplanted bladders had reduced prolyl 4-hydroxylase beta (P4HB)-positive regions of collagen synthesis and apoptosis within the smooth muscle layers. In cystometric investigations, threshold pressures, voiding interval, micturition volume, and bladder capacity in the cell sheet-transplantation group were significantly higher than those in the control group. Residual volume of the cell sheet-transplantation group was significantly lower compared with the control. There were 24 growth factor mRNAs in the cell sheet-transplanted urinary bladders that were expressed greater than or equal to two-fold over the controls. In conclusion, cell sheet engineering has great potential to restore damaged urinary bladders.

Combined treatment with a β3-adrenergic receptor agonist and a muscarinic receptor antagonist inhibits detrusor overactivity induced by cold stress in spontaneously hypertensive rats

This study determined if combined treatment with the muscarinic receptor (MR) antagonist solifenacin and the β3‐adrenergic receptor (AR) agonist mirabegron could inhibit detrusor overactivity induced by cold stress in spontaneously hypertensive rats (SHRs).

Modified sonourethrography assists urethral catheterization

Sonourethrography (SUG) is an infrequently used modality to observe the male urethra. We modified SUG to examine the reasons for difficulty in urethral catheterization and to determine a safe approach to resolve these problems. Following retrograde urethral jelly injection, modified SUG (mSUG) was performed in male patients with difficulty in urethral catheterization. mSUG was performed using transcutaneous ultrasonography in patients for whom the catheter became lodged in the penile urethra. In other patients, mSUG was performed using transrectal ultrasonography. We divided the causes of difficult indwelling urethral catheterization into physiological and pathological conditions. With regard to physiological conditions, the urethral catheter became stuck in the bulbous portion, membranous urethra, and prostatic urethra. mSUG distinguished the problematic part of the urethra in real time, and it assisted in overcoming the problem. With regard to pathological conditions, urethral stricture after trauma or surgery was clearly demonstrated in the penile and prostatic portions of the urethra. As with physiological conditions, mSUG images assisted in navigating the catheter through the problematic pathological areas or demonstrated the need to abandon the catheterization. mSUG can visualize the male urethra clearly during urethral catheterization and provide real-time assistance with the procedure.

Pathways Involving Beta-3 Adrenergic Receptors Modulate Cold Stress-Induced Detrusor Overactivity in Conscious Rats

To investigate pathways involving beta‐3 adrenergic receptors (ARs) in detrusor overactivity induced by cold stress, we determined if the beta‐3 AR agonist CL316243 could modulate the cold stress‐induced detrusor overactivity in normal rats.

MP41-05 BIOFABRICATED BONE MARROW-DERIVED CELL PATCHES RESTORE STRUCTURE AND FUNCTION OF RADIATION-INJURED URINARY BLADDERS IN RAT

groups compared with PBS group (Figure 1). Hematoxylin/eosin staining demonstrated that loss of urothelial integrity in PBS group was restored in IV and BL group. Neutrophil infiltration was also decreased in IV and BL group compared with PBS group. Histological examination revealed a significant decrease in the total number of infiltrated mast cells in IV and BL rats compared with the PBS rats (p<0.05), (Figure 2). CONCLUSIONS: This is the first study to investigate the efficacy of CHA1 for chronic IC model. Submucosal injection of CHA1 in chronic IC showed improvement of voiding pattern and histological restoration and this suggest that CHA1 might have a therapeutic potential for IC. Further studies are required to evaluate the mechanism of CHA1 treatment.

Transient receptor potential channel superfamily: Role in lower urinary tract function

Lower urinary tract symptoms associated with neurogenic bladder and overactive bladder syndrome are mediated in part by members of the transient receptor potential channel superfamily. The best studied member of this superfamily is the vanilloid receptor. Other transient receptor potential channels, such as the melastatin receptor and the ankyrin receptor, are also active in the pathogenesis of lower urinary tract dysfunction. However, the detailed mechanisms by which the transient receptor potential channels contribute to lower urinary tract symptoms are still not clear, and the therapeutic benefits of modulating transient receptor potential channel activity have not been proved in the clinical setting. In the present review, to better understand the pathophysiology and therapeutic potential for lower urinary tract symptoms, we summarize the presence and role of different members of the transient receptor potential channel superfamily in the lower urinary tract.

PD8-07 BONE MARROW-DERIVED CELL SHEET ENGINEERING IMPROVES URINARY FUNCTIONS OF RADIATION-INJURED URINARY BLADDERS IN RAT

INTRODUCTION AND OBJECTIVES: The present study was performed to investigate human mesenchymal stem cells (B10) directly transplanted to the bladder wall are capable of inhibiting collagen deposition and improve cystometric parameters in SCI rats. METHODS: B10 were labeled with fluorescent silica magnetic nanoparticles (MNP) contained rhodamine B isothiocyanate (RITC) conjugated to terminal silanol groups.. Forty 6-week old female Sprague-Dawley rats were divided into 4 groups (group 1: control, group 2: sham operation, group 3: SCI, group 4: SCI rats receiving B10). For SCI model, contusion was performed on the thoracic spinal cord very severe intensity weight drop. Four weeks after the onset of SCI, B10 were injected into the bladder wall. Serial T2-weighted MR images were taken immediately B10 injection (1�106 cells) and at 4 weeks post-transplantation. Locomotor behavioral tests were performed using rotarod, BassoeBeattieeBresnahan (BBB) test and voiding response was assessed at 4 weeks after transplantation and bladder was harvested. Nissl staining of spinal cord sections was performed. RESULTS: The hindlimbs of all the animals with SCI were completely paralyzed one day after contusion injury. Both of rotarod and BBB score were 0 and the development of SCI was confirmed and still preserved until 8 weeks after SCI. MR imaging of MNP-labeled B10 cells in the bladder showed hypointense signal intensities on T2weighted images until 4 weeks post-transplantation. B10 cells positive for human mitochondria antigen were found in the transplantation site indicating that MNP-labeled B10 cells survived in the bladder at 4 weeks after transplantation. Transplanted B10 differrentiated to smooth muscle cells. The SCI group showed a higher collagen deposition than the sham operation group (P<0.05). The group with transplantation of B10 hMSCs after SCI showed a lower collagen deposition than the group with SCI (P<0.05, Fig. 7). Intercontraction interval decreased after SCI but it recovered after B10 treatment. Maximal voiding pressure and residual urine volume increased after SCI but it recovered after B10 treatment. MNP-B10 transplanted into rat bladder survived 4 weeks post-transplantation using antihuman nuclear antibody staining and MR imaging. CONCLUSIONS: Transplanted B10 directly transplanted to the bladder wall inhibited the bladder fibrosis and mediated recovery of bladder dysfunction in the rat SCI model. Transplantation of mesenchymal stem cells could be a novel therapeutic strategy against bladder dysfunction in patients with SCI.