Ejaculatory disorder caused by alpha-1 adrenoceptor antagonists is not retrograde ejaculation but a loss of seminal emission

AIM: The etiology of the ejaculatory disorder induced by alpha-1 blockers is still controversial, although it has been suggested to be retrograde ejaculation. The aim of this study was to investigate the distribution of alpha-1 adrenoceptor subtype mRNA in human seminal vesicles, and to analyze the prevalence and etiology of the disorder in healthy men. METHODS: Experimental Study. Seminal vesicles from 10 surgical specimens (eight radical prostatectomy, two radical cystectomy) were dissected. Real-time PCR was conducted for quantification of mRNA expression of each alpha-1 adrenoceptor subtype. Clinical Study. Ejaculatory disorder was investigated using 17 healthy male volunteers. Tamsulosin (0.2 mg and 0.4 mg) and naftopidil (50 mg and 100 mg) were administered in a crossover manner for 3 days. The ejaculatory volume, sperm count in midstream urine after ejaculation, and fructose concentration in seminal plasma were investigated. RESULTS: Real-time PCR revealed that alpha-1a mRNA was significantly predominant in seminal vesicles (P < 0.001; 1a, 75.0%; 1b, 11.7%; 1d, 13.3%). Ejaculatory volume (baseline 2.72 +/- 0.28 mL) significantly decreased in the tamsulosin group (0.2 mg, 1.75 +/- 0.31 mL; 0.4 mg, 1.51 +/- 0.39 mL; P < 0.05), but not in the naftopidil group (50 mg, 2.70 +/- 0.24 mL; 100 mg, 2.48 +/- 0.26 mL; P = NS). There was no sperm in midstream urine after any ejaculation. CONCLUSIONS: The current study demonstrates that alpha-1a mRNA is predominant among the adrenoceptor subtypes in human seminal vesicles. Decreased capacity of contraction of the seminal vesicles is proposed as the cause of the ejaculatory disorder induced by alpha-1 blockers.     

Dissimilarity in the mechanisms of action of KRN2391, nicorandil and cromakalim in canine renal artery

Abstract— In the present study, we examined the mode of action of KRN2391 (N-cyano-N′-(2-nitroxyethyl)-3-pyridinecarboximida-mide monomethanesulphonate) in isolated canine renal artery compared with those of nicorandil and cromakalim. KRN2391 (10^?8-3 × 10^?5 m ), nicorandil (10^?7-3 × 10^?4 m ) and cromakalim (10^?8-3 × 10^?5 m ) relaxed renal arteries contracted by 25 Mm KCl in a concentration-dependent manner. KRN2391-induced relaxation was inhibited by methylene blue (10^?5 m ) and glibenclamide (10^?6 m ). Nicorandil-induced relaxation was inhibited by methylene blue, but not by glibenclamide. The concentration-relaxation curve for cromakalim displayed a rightward parallel shift in the presence of glibenclamide. In the control observation, KRN2391 and nicorandil also produced full relaxation, but cromakalim did not. The present results suggest that KRN2391 acts as both a nitrate and a potassium channel opener, and nicorandil acts only as a nitrate and only in canine renal artery.     

Effect of sildenafil on arterial stiffness, as assessed by pulse wave velocity, in patients with erectile dysfunction

BACKGROUND: The problems of patients with erectile dysfunction have been recognized, leading to the emergence of sildenafil, which has led to successful treatment in many cases. The purpose of this study is to examine the effect of sildenafil on the pulse wave velocity of patients with erectile dysfunction. METHODS: Fifteen patients with erectile dysfunction were enrolled for this study. The brachial/ankle pulse wave velocity was determined before dosing and at 30, 60, 120, and 180 min after dosing with 25 or 50 mg of sildenafil citrate. Concurrently, the changes in blood pressure, heart rate, and brachial/ankle pulse wave velocity were measured. For the consideration of revised brachial/ankle pulse wave velocity by blood pressure, the systolic blood pressure-derived brachial/ankle pulse wave was also investigated, and we classified and examined those results with and without risk factors for arteriosclerosis. RESULTS: The systolic blood pressure decreased significantly at 60 min after dosing compared with the placebo control. The heart rate decreased at 120 min after dosing compared with the placebo control but that decrease was not significant. The brachial/ankle pulse wave velocity transiently decreased at 30 or 60 min after dosing compared with the placebo control, but the decrease was not significant; however, the systolic blood pressure-derived brachial/ankle pulse wave velocity decreased significantly. In those patients with risk factors for arteriosclerosis, the pulse wave velocity decreased significantly. CONCLUSION: In patients with erectile dysfunction who were administered sildenafil, the pulse wave velocity, along with blood pressure, tended to decrease transiently after dosing. There is a possibility that sildenafil affects the improvement of erectile dysfunction via the decrease of pulse wave velocity, especially in patients with risk factors for arteriosclerosis.     

Comparison of the effects of KRN2391 and other coronary dilators on porcine isolated coronary arteries of different sizes

Abstract— The present study was performed to determine whether KRN2391 (N-cyano-N′-(2-nitroxyethyl)-3-pyridinecarboximidamide monomethanesulphonate), a novel vasodilator, shows different effects on porcine isolated coronary arteries of different sizes. The vasodilating effects of KRN2391 on porcine large (2·5–3·0 mm outer diam.) and small (0·8–1·0 mm) coronary arteries were also compared with those of cromakalim, nicorandil, nifedipine, nitroglycerin and adenosine. The relaxant effects of these drugs were examined in coronary arteries contracted by 25 Mm KCl. Nitroglycerin caused greater relaxation in large vessels than in small vessels. In contrast, adenosine, nifedipine and cromakalim caused greater relaxation in small vessels. However, there was no difference between large and small vessels in the relaxing effects of KRN2391 and nicorandil. These unique features of KRN2391 and nicorandil appear to be beneficial in ischaemic heart disease.     

Actin Like Filaments in the Peritubular Cells of Human Testis Chemical Extraction and Binding with Heavy Meromyosin

In den peritubulären Zellen des Hodens sind zwei Typen von cytoplasmatischen Filamenten nachgewiesen: dünne Filamente (50–80 Å) und 100 Å Filamente. Die dünnen Filamente sind zahlreich und dicht gepackt im Cytoplasma der peripheren Zellprozesse und bilden Bündel. Diese Bündel sind parallel mit der Längsachse der Zellen angeordnet. Dichte Areale werden gelegentlich zwischen den Filamenten oder unterhalb der Zellmembran gesehen, an welche die dünnen Filamente verankert sind. Die 100 Å Filamente sind grundsätzlich um die perinukleäre Region oder in der Mittelpartie des Cytoplasmas lokalisiert. Die dünnen Filamente sind nach Inkubation mit Hasselbach-Schneider-Lösung unverändert. Diese Filamente verschwinden dagegen im Cytoplasma, wenn mit einer 0, 6 M KI-Lösung extrahiert wurde. Außerdem bilden die dünnen Filamente charakteristische Pfeilspitzkomplexe, wenn mit HMM inkubiert wird, während diese Komplexe nicht nachweisbar waren, wenn mit HMM plus ATP inkubiert wurde. Die 100 Å Filamente zeigen keine Reaktion gegenüber HMM. Infolgedessen wird behauptet, daß die dünnen Filamente Aktin oder Aktin-ähnlich sind und daß ein kontraktiles System in den peritubulären Zellen vorhanden ist, welches bei dem Transport der unbeweglichen Spermatozoen und bei der Durchdringung der Samenkanälchen-Wände beteiligt sind.     

PAROXYSMAL ELECTROENCEPHALOGRAPHIC DISCHARGES DURING ENFLURANE ANAESTHESIA IN PATIENTS WITH A HISTORY OF CEREBRAL CONVULSIONS

The electroencephalogram (EEG) was monitored through all phasesof enflurane anaesthesia in dental outpatients with a historyof cerebral convulsions which had been well controlled withanticonvulsant drugs. Abnormal EEG activity which differed fromthe background activity was observed in three patients. Theircase reports are presented.     

THE SIGNIFICANCE OF THE DIFFERENCE IN BACTERIAL ADHERENCE BETWEEN BLADDER AND ILEUM USING RAT ILEAL AUGMENTED BLADDER

OBJECTIVES: Intestinal segments are frequently used in the reconstruction of the urinary tract. Chronic bacteriuria is frequently observed in these patients, but the reason is not clearly understood. Therefore, we studied the difference in bacterial adherence between bladder and ileum using the rat ileal augmented bladder model to investigate the cause of chronic bacteriuria. MATERIALS AND METHODS: Augmentation of the bladder using ileum and a sham operation were performed under sodium pentobarbital in 102 and 10 Sprague-Dawley rats, respectively. At three months after the operation, urinary pH and plasma concentration of sodium, chloride and potassium were measured and urinary culture was done. Urovirulence factors of Escherichia coli aspirated from augmented bladder were detected by polymerase chain reaction (PCR). Five to six rats with negative urinary cultures after the augmentation were used for each experimental cystitis. E. coli with type I pili aspirated from augmented rats and three clinically isolated strains of E. coli, C5 (type I pili, aerobactin), C92 (type I pili, aerobactin, P fimbriae), and C189 (type I pili, aerobactin, P fimbriae, CNF), were transurethrally inoculated into the augmented bladder of rats. Fourteen days after inoculation, rats were sacrificed and colony-forming units (CFU) per mg. of tissue of bladder and ileum were measured. RESULTS: After operation, urinary pH and the serum level of chloride in all augmented groups were higher than those of the controls. Bacterial colonization was observed in 56 of 89 rats. Most of them were E. coli having only type I pili as a virulence factor. In contrast, the sham operated group revealed no bacterial colonization. In experimental cystitis, E. coli with only type I pili aspirated from augmented rats and E. coli C5 were clearly adhered to ileum rather than to bladder, but E. coli C92 and C189 showed no significant difference with respect to adherence to the two tissues. In experimental cystitis II, E. coli C5 with D-mannose were washed out in 3 of 5 rats by 14 days, while E. coli C5 without D-mannose were not washed out in all rats by 14 days. CONCLUSIONS: These results suggested that the difference in bacterial adherence due to urovirulence factors, especially type I pili, is one of the main causes of asymptomatic bacteriuria after urinary reconstruction.     

SOLUBLE FAS AND INTERLEUKIN-6 AND INTERLEUKIN-8 LEVELS IN SEMINAL PLASMA OF INFERTILE MEN

The seminal plasma levels of soluble Fas (sFas) and interleukins IL-6 and IL-8 were measured and their relationship with semen qualities was examined. The seminal plasma sFas level in fertile males was significantly higher than that in the infertile group. On the other hand, seminal plasma level of IL-6 was significantly lower in fertile males than in the infertile group. In the infertile group, patients with oligozoospermia had a lower seminal plasma sFas and a higher IL-6 level than those with normal sperm concentration. There was an inverse correlation between IL-6 and sperm concentration in infertile patients. Seminal plasma IL-8 was not correlated with sperm parameters. It would appear that certain kinds of cytokine in the seminal plasma might play an important role in improving semen quality.     

Marked improvement in delirium with ramelteon: five case reports

Delirium is a common and serious acute neuropsychiatric syndrome characterized by inattention and global cognitive dysfunction. Delirium is associated with higher morbidity, higher mortality and longer hospitalization, but its aetiology remains unclear. We successfully treated five cases of delirium within 1 day with ramelteon, a novel selective melatonin receptor agonist. This suggests that correction of the circadian rhythm disturbance, one of the main symptoms of delirium, plays a crucial role in its treatment and sheds new light on a therapeutic strategy for treatment of delirium.