Effect of Robaveron tablet (KN-7) in the long-term therapy for urinary disturbances

Long-term therapeutic effect of Robaveron tablet (KN-7) was studied on 10 female patients of middle and old age with ptosis of urinary bladder and 9 patients with neurogenic bladder. The patients had mainly complained of such subjective symptoms as pollakisuria, difficulty of urination, sense of residual urine, lower abdominal discomfort and urinary incontinence. Robaveron tablet was administered at 2 tablets t.i.d. for 3-26 months. And the drug efficacy was evaluated by residual urine, cystometric findings and subjective symptoms. A significant decrease in the residual urine rate and a significant increase of pressure amplitude were obtained, and improvement of subjective symptoms was seen with an effective rate of about 70%. Overall effectiveness, rated slightly improved or better was 89.5%. No cases of side effects or abnormalities in laboratory tests were observed. Robaveron tablet is safe and effective for patients with urinary disturbance accompanied by ptosis of urinary bladder, as a myogenic disorder, as well as neurogenic bladder in the long-term therapy.     

Long-term therapy with Robaveron tablet (KN-7) for urinary disturbance

Sixteen patients with benign prostatic hypertrophy (BPH, 5 cases) and neurogenic bladder (NB, 11 cases) were treated with Robaveron tablets (KN-7) containing an extract of swine prostate gland 20 mg/T. at the dose of 2 tablets t.i.d. for a long term of 6-33 months. Evaluation of drug efficacy and safety were based on decrease of residual urine, improvement of subjective symptoms, complaints of side effects and clinical laboratory tests recorded every three months. Significant decrease of residual urine rate and good improvement of various subjective symptoms such as difficulty in urination, pollakisuria, urinary incontinence, etc. were obtained and maintained. The overall effectiveness, rated as slightly improved or better on the final evaluation of these cases was 68.8%. No cases of side effects or abnormal changes in the laboratory tests directly due to the test drug were observed. Robaveron tablet is both safe and effective for the long-term therapy of urinary disturbance.     

Therapeutic effect of Robaveron tablet (KN-7) on urinary disturbance by benign prostatic hypertrophy

Therapeutic effect of Robaveron tablet (KN-7) was studied on 101 patients with urinary disturbance accompanied by benign prostatic hypertrophy. Robaveron tablet, which contains 20 mg of a swine prostatic extract per tablet, was administered 6 tablets daily for 3 weeks in principle. Evaluation of drug efficacy was based on residual urine, cystometric findings, urethral pressure profile, uroflowmetry and subjective symptoms. Remarkable decrease of residual urine was observed at all stages of Guyon classification, in parallel with increases of cystometric pressure amplitude and average flow rate. Rate of residual urine reduction rose in proportion to the higher stage or bulkier volume of residual urine. Improvements of subjective symptoms were also obtained. The overall effectiveness, rated slightly improved or better was 76.8%. Side effects were seen at a low rate of 3.9%, and there were no abnormal changes directly due to the drug in clinical laboratory tests. These results indicate that Robaveron tablets act on the detrusor muscle and contribute to improve the depressed voiding efficiency and incidental symptoms of the subjects.     

Therapeutic effect of Robaveron tablet (KN-7) on neurogenic bladder

Therapeutic effect of Robaveron Tablet (KN-7) was studied on 128 patients suffering from neurogenic bladder. Robaveron Tablet was administered 6 tablets daily for 3 weeks. The effect was evaluated by the residual urine, subjective symptoms, cystometric findings, urethral pressure profile and uroflowmetry. Remarkable decrease of residual urine was observed regardless of position of injury. The pressure amplitude defined as the difference between the maximum voiding pressure and the maximum resting pressure increased on any group of neurogenic bladder. The effectiveness, rated as moderately improved or better was 76.9% for brain disorders, 58.3% for upper motor neuron lesion and 75.7% for lower motor neuron lesion of spinal injuries, 58.3% for peripheral nervous injuries and 100% for others. No remarkable abnormality was observed in the results of side effects or clinical laboratory tests.     

Assessment of the use of oxybutynin hydrochloride (Pollakisu tablets) in the elderly]

Oxybutynin hydrochloride (Pollakisu tablets) was administered at a daily dose of 6 or 9 mg to 75 elderly patients with urinary tract disorders, including neurogenic bladder and unstable bladder, with chief complaints of pollakisuria, urgency on urination and urinary incontinence. A post-marketing follow-up survey (phase IV study) was then performed to evaluate the efficacy safety and usefulness of Pollakisu tablets in these patients. The administration of Pollakisu tablets produced good results in the comprehensive assessment of overall improvement, being rated as "improved" or better in 57.5% of the patients and "slightly improved" or better in 89.0%. The assessment of general safety revealed that the drug caused almost no problems, with "no problem in safety" accounting for 97.3% of the responses. The assessment of the usefulness indicated that Pollakisu tablets are highly useful, being rated as "useful" or better in 58.9% and as "slightly useful" or better in 82.2%. Evaluation of the results according to daily dose indicated that a dose of 6 mg per day was appropriate for elderly patients from the viewpoint of drug efficacy and safety. With respect to adverse reactions, thirst was found in 5 and dysuria in 3 of the 73 patients. The overall incidence of adverse reactions was 11.0%. The above results indicate the efficacy, safety and usefulness of Pollakisu tablets in treating elderly patients with pollakisuria, urgency on urination and urinary incontinence.     

Efficacy of an echo contrast agent, SH/TA-508, in color doppler sonography of mass lesions in urology

We performed a clinical phase III study with a galactosebased ecoo contrast agent, SH/TA-508, to evaluate its efficacy, safety, and usefulness for mass lesions in urology. SH/TA-508 was prepared as a suspension containing stabilized micro-air bubbles by adding water for injection just before use. SH/TA-508 was administered into the antecubital vein at an initial dose of 300 mg/ml × 5 ml followed by higher doses of 400 mg/ml × 4 ml, 300 mg/ ml × 10 ml or 400 mg/ml × 8 ml when a sufficient effect was not obtained. Efficacy was evaluated by color Doppler signal enhancement, the duration of blood flow signal enhancement, and improvement of diagnostic capacity. Fifty-nine patients with mass lesions in the kidney, prostate, testis, adrenal gland, and bladder were enrolled in the study. Up to the third dose the cumulative efficacy rates (≥2+) of color Doppler signal enhancement and duration of blood flow signal enhancement were 92% and 87%, respectively. Consequently, diagnostic capacity in 76% of the patients was remarkably improved. A light transient angialgia occurred in one patient but no other clinically significant changes were observed. It was confirmed that SH/TA-508 is a safe echo contrast agent that offers satisfactory color Doppler signal enhancement in the urologic organs mentioned above.     

经皮椎体成形术治疗骨质疏松性椎体骨折

目的观察经皮椎体成形术（PVP）治疗骨质疏松性椎体压缩性骨折的初步临床疗效。方法自2003年2月至2005年12月，使用强生公司PMMA（聚甲基丙烯酸甲酯）作为充填材料，在C臂X线机（以下简称C臂）透视监视下，经皮单侧或双侧椎弓根穿刺行椎体成形术41例共45个骨质疏松性胸、腰椎压缩性骨折的椎体。结果成功率100％。PMMA在胸椎平均充填4ml，腰椎平均充填5ml，术中PMMA渗漏7例，但无1例发生严重并发症。随访3～12个月，完全缓解（CR）、部分缓解（PR）、轻微缓解（MR）和无效（NR）分别为56．1％，39．O％，4．9％，0；总有效率为95．1％。结论PVP可有效地缓解骨质疏松性压缩骨折引起的疼痛。     

A randomized study of pirarubicin (THP) versus adriamycin (ADM) for intravesical instillation therapy against superficial bladder cancer]

To determine the antitumor action by intravesical instillation prior to transurethral resection TUR, a randomized study on pirarubicin (THP) versus adriamycin (ADM) was performed for superficial, papillary and initially detected bladder cancers with participation of 21 Urological Clinics in 3 Tokai Prefectures. The instillation dose of 500 micrograms/ml was given 3 times per week for 3 weeks in both THP (n = 33) and ADM (n = 30) groups. The complete and partial response rates were 56.3% in THP group and 26.7% in ADM group. THP instillation was more effective against multiple tumors than a single tumor, stage Ta than T1 and grade G1 than G2 and G3. However, these findings were not statistically significant. Untoward effects were mainly bladder irritability and its frequency was 60.6% in the THP group and 23.3% in the ADM group. Contracted bladder was found in 2 of the 33 patients in the THP group and 2 of the 30 patients in the ADM group. The antitumor effect of a half dose of THP was equivalent to that of one dose of ADM, and the THP group showed a twofold higher frequency of side effects. Therefore, a clinical trial should be made comparing the effect of 500 micrograms/ml of THP and that of 1,000 micrograms/ml of ADM.     

Preliminary results of suburothelial injection of botulinum a toxin in the treatment of chronic interstitial cystitis

PURPOSE: Treatment of interstitial cystitis is usually not successful in eradicating bladder pain and increased bladder capacity. This study was designed to evaluate the clinical effectiveness of suburothelial injection of botulinum A toxin in patients with chronic interstitial cystitis. METHODS: Eight women and 2 men with chronic interstitial cystitis who had failed conventional treatments were enrolled in this study. In 5 patients, 100 units of botulinum A toxin was injected suburothelially into 20 sites, and an additional 100 units was injected into the trigone in the other 5 patients. Therapeutic outcome including functional bladder capacity, number of daily urinations, bladder pain, and urodynamic changes were compared between baseline and 3 months after treatment. RESULTS: In 2 patients bladder pain and urinary frequency were improved 3 months after treatment. Mild difficulty in urination was reported by 7 patients. Functional bladder capacity recorded in a voiding diary was significantly increased (155+/-26.3 vs. 77+/-27.1 ml, p<0.001), and the frequency of daily urinations (18+/-7.7 vs. 24.2+/-10.3, p=0.025) and the pain score (2.4+/-1.6 vs. 3.2+/-1.1, p=0.003) were mildly but significantly reduced after treatment. Only the cystometric capacity improved significantly (287+/-115 vs. 210+/-63.8 ml, p=0.05) in urodynamic results. Trigonal injection had no therapeutic effect on symptom or urodynamic improvement. No adverse effect was reported. CONCLUSIONS: The clinical result of suburothelial botulinum A toxin injection was disappointing. None of the patients was symptom free and only a limited improvement in bladder capacity and pain score was achieved in 2 patients.     

盐酸伐昔洛韦片治疗带状疱疹的效果

目的 分析盐酸伐昔洛韦片治疗带状疱疹的效果。方法 选取新疆生产建设兵团第十三师红星医院 2020年7月-2022年7月收治的100例带状疱疹患者为研究对象,采用随机数字表法分为对照组与观察组,各 50例。对照组予以静脉滴注阿昔洛韦注射液,观察组予以口服盐酸伐昔洛韦片,比较两组临床疗效、病情 改善情况、生活质量及不良反应发生情况。结果 观察组治疗总有效率为90.00%,高于对照组的86.00%,差 异无统计学意义（P＞0.05）;观察组疼痛消失时间、皮损停止时间、结痂时间、脱痂时间均短于对照组, 差异有统计学意义（P＜0.05）;观察组社会功能、生理职能、生理功能和精神健康评分均高于对照组,差 异有统计学意义（P＜0.05）;观察组不良反应总发生率为6.00%,低于对照组的22.00%,差异有统计学意 义（P＜0.05）。结论 通过阿昔洛韦注射液或者盐酸伐昔洛韦片治疗带状疱疹均能够获得较为理想的临床 疗效,但采用盐酸伐昔洛韦治疗更利于病情好转,可提升患者生活质量,且安全性较高,值得临床应用。     

Detrusor thickness in healthy children assessed by a standardized ultrasound method.

PURPOSE: We determine the ultrasonographic detrusor thickness in healthy infants and children. MATERIALS AND METHODS: We studied 150 healthy children, 79 boys and 71 girls, from newborns to 13 years old. The detrusor of the ventral and dorsal wall was measured with a previously established ultrasonographic technique, and the variation with age and bladder fullness was assessed. RESULTS: Detrusor thickness varied significantly with the degree of bladder fullness (thinner at higher volumes). It also increased slightly with age. At bladder fullness of 10% or greater of expected bladder capacity (EBC), calculated using the formula EBC (ml.) = age (years) x 30 + 30, a practical upper limit for the detrusor thickness of the ventral wall at all ages was 2.0 mm. at a bladder fullness up to 50% of expected bladder capacity or 1.5 mm. at a higher degree of fullness. The detrusor of the ventral wall was slightly thicker in boys than in girls and also somewhat thicker than the detrusor of the dorsal wall. CONCLUSIONS: The results indicate that ultrasonographic measurements of detrusor thickness in children may serve as a diagnostic tool and its usefulness in clinical as well as research work should be explored.     

Angiotensin-II combined intra-arterial chemotherapy for locally advanced bladder cancer: a case series study at a single institution

Patients with locally advanced bladder cancer are at significant risk for metastases. We aimed to evaluate the usefulness of intra-arterial chemotherapy (IAC) combined with angiotensin-II (AT-II) in such patients. The possibility of bladder preservation is also discussed. Patients were enrolled if they had muscle-invasive bladder cancer (stage T2 to T4NxM0). Cisplatin, pirarubicin, and AT-II were infused through the tumor-feeding arteries. Cause-specific survival was the end point. We enrolled 37 patients who were treated with neoadjuvant IAC and 5 patients with adjuvant IAC. There were 7 patients (16.7%) with pathological complete remission. Overall 5-year and 10-year survival rates of the patients were 61.3% and 47.7%, respectively. The 5-year cause-specific survival rate was 100% for the clinical T2 group and 63% for the T3-4 group, and the 8-year survival rate was 33% and 63%, respectively. There was no statistically significant difference between these two groups (P=0.445). Multivariable analysis using tumor number, pattern of growth, and tumor size seemed to independently correlate with cause-specific survival, but there were no significant differences. Our results suggest that intra-arterial chemotherapy combined with AT-II is a useful treatment for patients with locally advanced bladder cancer, since this modality achieves a favorable response rate without severe toxicity or mortality.     

Clinical effects of oxybutynin hydrochloride in the treatment of unstable bladder and overactive neurogenic bladder: a long-term clinical trial

Clinical effects and therapeutic usefulness of oxybutynin hydrochloride were evaluated in a long-term clinical trial on patients with unstable bladders and neurogenic bladders. Of the 46 patients entered into the trial, 37 were those diagnosed with an unstable bladder and 9 with a neurogenic bladder with overactive detrusor. In 37 of the cases (80%), the period of drug administration reached up to 12 weeks and in 16 cases (34%) the drugs were administered for more than 24 weeks. The average administration period was 165.9 days. The average total given dose was 1776.9 mg and average dose per day was 10.7 mg. Excellent and good responses were obtained in 76.3, 88.9 and 69.6% at 12 and 24 weeks after start of administration and at the time of discontinuing the drug, respectively. The cystometric changes at pre- and post-administration were evaluated on 23 cases and revealed a significant increase in volume at first sensation and maximum desire to void. Maximum resting intravesical pressure was significantly declined and uninhibited detrusor contractions were significantly suppressed. Side effects were noted in 11 of the 46 cases (23.9%), most of which were well tolerated by the patients. In 4 cases the drug had to be discontinued because of the side effects. Dry mouth was the most common side effect, occupying almost half of the incidents. No significant abnormality was noted on blood laboratory data, blood pressure or heart rate, following the drug administration. In one case slight increase in serum glutamic-oxalacetic transaminase and glutamic-pyruvic transaminase was encountered, but its relationship with the drug was obscure. The clinical usefulness of this drug (excellent and good) was 78.9, 88.9 and 69.6% at 12 and 24 weeks after start of administration, and at the time of drug discontinuation, respectively. The present long-term trial proved that oxybutynin hydrochloride is an exceedingly effective and safe agent for clinical management of unstable bladder and overactive neurogenic bladder.     

人脐带间充质干细胞移植治疗小脑萎缩

目的 研究人脐带间充质干细胞(Human umbilical-cord mesenchymal stem cells,hUMSCs)治疗小脑萎缩(Cerebellar atrophy,CA)的临床疗效.方法 健康新生儿脐带中分离MSCs,连续体外扩增,采用鞘内注射(2.5×1075 mL)结合静脉滴注(7.5×107100 mL)的方法,治疗57例小脑萎缩患者,每次治疗剂量为1.0× 108个细胞.结果 所有患者随访6个月,治疗3个月后有效率为72.0%,治疗6个月后有效率为79.0%,无明显并发症.结论 应用hUMSCs治疗小脑萎缩安全有效,但远期疗效尚待进一步观察.     

A model of orthotopic transplantation in mice using MBT-2

We attempted to produce a malignant urinary bladder carcinoma in mice by transplanting MBT-2 cells. MBT-2 carcinoma about 3.0 x 10(3) cells/0.02 ml were successfully transplanted into the bladder wall with an incidence of 80% (20/25) after three experimental weeks. Inoculated tumor cells grew expansively into the bladder cavity from the bladder submucosa, and invaded the muscle layer. We observed that tumors caused gross hematuria and bilateral hydronephrosis. This malignant tumor model in which a tumor is implanted into its original organs seems to be useful for predicting clinical effectiveness in experimental cancer therapy.     

Quantitative study of phenol as a neurolytic agent in the urinary bladder

The endoscopic subtrigonal injection of a 6% aqueous phenol solution is an effective technique for denervating the bladder but its clinical usefulness is limited by unpredictable side effects. This study explored the possibility of making this procedure safer by comparing the neurolytic effects of different concentrations and carriers of phenol. Phenol in 2.5 and 5% solutions in three different carriers (water, glycerine and oil) was injected into the rectovesical pouch in 35 rats. After 3 weeks the bladders were excised and the effects on the density of acetylcholinesterase-positive nerves were assessed in each animal using morphometric techniques. The density of enzyme-containing nerves was reduced by 20% in the phenolised animals when compared with controls. This reduction was maximum when water was used as the carrier for either 2.5 or 5% phenol solutions.     

Clinical studies of terodiline hydrochloride and clenbuterol hydrochloride for urinary frequency and incontinence]

The clinical effectiveness and safety of terodiline hydrochloride and clenbuterol hydrochloride were studied on 51 patients with neurogenic bladder, stress incontinence, unstable bladder and others, the chief complaints of which were urinary frequency or urinary incontinence. Overall improvement was graded as marked in 6 patients (11.8%), moderate in 20 patients (39.2%), slight in 11 patients (21.6%), unchanged in 13 patients (25.5%) and aggravated in one. The patients impression was "good" or better in 56.9%. There were a total of 13 cases (25.5%) of adverse reactions, namely, 7 cases of finger tremor, 3 cases of dry mouth and others. These reactions disappeared rapidly after the discontinuance of drug administration. The clinical efficacy in the treatment of subjective symptoms was 71.4% for urinary incontinence, 56.4% for diurnal pollakisuria. The examination of lower urethral functions demonstrated a significant (p less than 0.01) increase in bladder capacity at first desire and maximum desire to void. However, we found no significant increase in urethral clossure pressure. The findings of this study suggest that terodiline hydrochloride and clenbuterol hydrochloride are very useful for the treatment of urinary frequency and incontinence.     

良性前列腺增生患者术前压力-流率测定的局限性

目的评估良性前列腺增生(BPH)患者术前行压力一流率测定的应用价值。方法BPH患者69例,根据尿动力学检查直线被动尿道阻力关系(PURR)图结果分为膀胱出口梗阻(BOO)组50例,无或可疑BOO组19例,术前行剩余尿、尿流率、膀胱有效容量和压力-流率测定,国际前列腺症状评分(IPSS)、生活质量评分(QOL)。术后3个月复查比较尿动力学指标变化。结果无或可疑BOO组和有BOO组平均Qmax分别为12.8 ml/s和7.6 ml/s,差异有统计学意义(P<0.01),2组年龄、膀胱最大容量、剩余尿、膀胱有效容量、IPSS和QOL等参数差异无统计学意义(P>0.05)。术后2组平均Qmax分别提高了7.2 ml/s和10.8 ml/s,BOO组Qmax提高幅度与无或可疑BOO组比较差异有统计学意义(P<0.05);2组IPSS和QOL与术前比较差异有统计学意义(P<0.05),IPSS和QOL的改善幅度2组间差异无统计学意义(P>0.05)。BOO组术前逼尿肌活动过度21例(42%),无或可疑BOO例组逼尿肌活动过度7例(37%)。BOO组和无或可疑BOO组术后3个月IPSS和QOL等参数改善不明显分别有15例(30%)和6例(32%)。结论压力-流率测定有无BOO,对大部分BPH患者仍有预测疗效的作用;但术前膀胱有效容量大小以及逼尿肌活动过度等因素影响了手术疗效。部分伴严重下尿路症状(LUTS)的BPH患者无BOO,手术疗效满意。术前BPH患者压力-流率测定应有选择应用,结果分析个体化。     

Treatment of priapism with intracavernous injection of etilefrine hydrochloride

A case of priapism following epidural anesthesia was reported. A 67 year old man received epidural anesthesia for the transurethral resection of a malignant bladder tumor. Epidural anesthesia which he had wanted to receive was given through the L3 to L4 intervertebral space with 18 ml of 2% lidocaine. The penile erection occurred while he was prepared and draped. Additional 8 ml of 1% lidocaine failed to overcome it and the operation cancelled. After this episode, he had anesthesia on 5 occasions in 2 years. General anesthesia was given 3 times without penile erection, but epidural block was tried on 2 occasions, which was followed by penile erection. For the penile erection, intracavernous injection of etilefrine hydrochloride was effective and surgical procedure could be done smoothly. The mechanism of priapism remained unclear but imbalance of the autonomic nervous system may be a involved. This case suggests that intracavernous injection of etilefrine hydrochloride is effective for treatment of penile erection during transurethral surgery.     

Funktionelle Ergebnisse nach temporärer Dauerableitung der hypokontraktilen Blase

BACKGROUND: Impaired bladder emptying is a common problem in older people and a challenging task in treatment. Conservative and medical treatment options have shown beneficial effects on micturition; however, in a substantial number of patients the effectiveness of these therapies is disappointing. In the end the decompensated bladder needs indwelling catheterisation. To study the effects on the detrusor function, we analysed the urodynamic data of 31 patients during long-term bladder drainage retrospectively. PATIENTS AND METHODS: All 17 female and 14 male patients showed impaired detrusor contractility, enlarged bladder capacity, decreased sensitivity and a high post-void residual urine volume (PVR). After exclusion of an acute pathology, the patients were treated continously with a suprapubic catheter for an average of 13.1 weeks. By urodynamic measurements before and after the drainage period, we analysed the filling parameters, pressure-flow patterns, PVR and detrusor contractility. RESULTS: At the end of the drainage period, significant changes in the detrusor function were obvious. Compared with the pre-treatment situation, the bladder volume at first desire to void decreased from 306.92 ml to 281.7 ml and the maximum bladder capacity from 691.8 ml to 496.8 ml, respectively. The compliance of the detrusor muscle diminished in the same period of time from 65.6 ml/cmH2O to 51.8 ml/cmH(2)O. The PVR dropped by 227.2 ml in average. The maximum flow rate was 9.4 ml/s, and the maximum detrusor pressure increased slightly up to 23.6 cmH(2)O. CONCLUSION: The continuous drainage of the bladder results in significant changes in the motoric as well as sensoric detrusor function. The reduced bladder capacity and the decreased PVR might be indications of a regenerating process of the detrusor. The long-term drainage of the bladder shows beneficial and therefore therapeutic effects. It still remains to be investigated on a functional as well as structural basis to what extent age, gender and pathogenesis influences the rehabilitation of the detrusor.