Yasuyuki Suzuki

Prognostic evaluation of transcatheter arterial embolization for unresectable renal cell carcinoma with distant metastasis.

Objective To evaluate the efficacy of transcatheter arterial embolization (TAE) in patients with unresectable renal cell carcinoma (RCC) and distant metastasis at the time of diagnosis.

Interstitial cystitis, gynecologic pelvic pain, prostatitis, and their epidemiology

Abstract Aim: To determine a uniform definition of interstitial cystitis (IC) and to develop a strategy on how to study its epidemiology.

Transient receptor potential A1 receptor-mediated neural cross-talk and afferent sensitization induced by oxidative stress: implication for the pathogenesis of interstitial cystitis/bladder pain syndrome.

Although the pathogenesis of interstitial cystitis/bladder pain syndrome remains unknown, there is a significant correlation of interstitial cystitis/bladder pain syndrome with other chronic pain disorders, such as irritable bowel syndrome, endometriosis and fibromyalgia syndrome. In this review, we highlight evidence supporting neural cross‐talk in the dorsal root ganglia, spinal cord and brain levels, which might play a role in the development of chronic pain disorders through central sensitization. In addition, we focus on transient receptor potential V1 and transient receptor potential A1 as the receptor targets for chronic pain conditions, because transient receptor potential V1 and transient receptor potential A1 act as a nocisensor to mediate not only an afferent signal to the dorsal horn of the spinal cord, but also an efferent signal in the periphery through secretion of inflammatory agents, such as substance P and calcitonin gene‐related peptide in nociceptive sensory neurons. Furthermore, peripheral inflammation produces multiple inflammatory mediators that act on their cognate receptors to activate intracellular signal transduction pathways and thereby modify the expression and function of transient receptor potential V1 and transient receptor potential A1 (peripheral sensitization). During tissue damage and inflammation, oxidative stress, such as reactive oxygen species or reactive carbonyl species is also generated endogenously. The highly diffusible nature might account for the actions of free radical formation far from the site of injury, thereby producing systemic pain conditions without central sensitization through neural cross‐talk. Because oxidative stress is considered to induce activation of transient receptor potential A1, we also discuss exogenous and endogenous oxidative stress to elucidate its role in the pathogenesis of interstitial cystitis/bladder pain syndrome and other chronic pain conditions.

Urethral compensatory mechanisms to maintain urinary continence after pudendal nerve injury in female rats

Introduction and hypothesisThis study was conducted to investigate the urethral compensatory mechanisms to maintain urinary continence after pudendal nerve injury.MethodsIn naive, acute pudendal nerve transection (PNT) and 4xa0weeks after PNT (PNT-4w) female rats, leak point pressures (LPPs) during bladder compression were measured before and after the application of hexamethonium (C6), propranolol, and Nω-nitro-l-arginine-methyl ester (l-NAME), or terazosin and atropine. Responses to carbachol and phenylephrine of proximal and middle urethral muscle strips from naive and PNT-4w rats were also examined.ResultsLPPs were significantly decreased in PNT rats but not in PNT-4w rats. LPPs in PNT rats were significantly increased by C6 or L-NAME while LPPs in PNT-4w rats were significantly decreased by C6, or terazosin and atropine. Excitatory responses to carbachol and phenylephrine in the proximal urethral muscle were significantly larger in PNT-4w rats.ConclusionsThese results suggest that α1-adrenoceptor and muscarinic receptor-mediated contractility is upregulated in the proximal urethra 4xa0weeks after PNT.

Eight case reports on sex‐hormone profiles in sexually mature male Down syndrome

Down syndrome (DS) is a congenital disorder usually caused by an extra copy of chromosome 21. Although the number of postpubertal patients with DS is increasing, only limited information is available on their gonadal and sexual development. The aim of this case report was to examine sex‐hormone profiles in sexually mature male patients with DS. Eight postpubertal male patients with trisomy 21 (mean age 28 years, range 15–54 years) participated in this study. The serum level of luteinizing hormone and follicle‐stimulating hormone was significantly elevated and testosterone was slightly decreased. The testicular volume was smaller in all eight cases than that observed in healthy male subjects. The elevated luteinizing hormone and follicle‐stimulating hormone levels, the lower testosterone levels and a smaller testicular volume observed in all eight cases suggest a significant degree of germinal cell hypoplasia in mature male patients with DS.

Time-dependent changes in bladder function and plantar sensitivity in a rat model of fibromyalgia syndrome induced by hydrochloric acid injection into the gluteus

What’s known on the subject? and What does the study add?

Female urology: What method will you select?

When I was a resident, my leader taught me that the gold standard forpatients with stress incontinence is the Marshall–Marchetti–Krantz(MMK) procedure. But a few years later, urologists who could performadvanced techniques showed me needle suspension as the best methodat a urological meeting. Fortunately my boss gave me a chance for ahand-to-hand lesson of the stamay procedure by the specialist. Sincethen, I have been selecting this procedure for a few years. Withoutdoubt, this needle suspension was the gold standard at that time.But now most urologists do not select this technique because of badresults. After I had mastered the technique of tension-free vaginal tape(TVT), I could see the smiling faces of patients after the operation. Atthat time I believed that TVT would be the gold standard for thiscondition. But the present status is what you know.Recently most specialists, including myself, believe that using‘mesh’ is the best operation for patients with pelvic organ prolapse. Isthis tendency good for the patients in the long run? No one can predictthe results of this procedure more than ten years from now.God knows what procedure will be the gold standard in the future.Assistant Professor Yasuyuki Suzuki

α2‐Adrenoceptor as a New Target for Stress Urinary Incontinence

Objectives: We examined glutamate and/or α2‐adrenoceptor (AR) mechanisms in the control of external urethral sphincter (EUS) activity in response to stress conditions.