Usefulness of Computed Tomography in the Diagnosis of an Overdose

Computed tomography (CT) is superior for the detection of substances with low radiolucency in comparison with abdominal roentgenograms. In the present study, medical chart review was retrospectively performed for patients who were admitted and underwent plain CT including the stomach on arrival to investigate whether CT is useful for diagnosing overdose (OD). The subjects were divided into patients with OD who did not undergo gastric lavage (OD group) and those without OD (Control group). The presence of a radiopaque area (Hounsfield number over 100 on a range of interest of 3mm2) in the stomach on CT was defined as a positive finding. The average Glasgow Coma Scale in the OD group (n＝11) was significantly lower than that in the Control group (n＝137). Positive findings on CT were found more frequently in the OD group than in the Control group (100 vs. 19.7%, p＜0.0001). Based on the finding of a high-density deposition in the bottom of the stomach, the CT predicted OD with 98.5% specificity. Accordingly, CT findings of a high-density deposition in the stomach of a patient with a diminished consciousness may suggest the presence of a recent overdose

Differentiation of Smooth Muscle Cells from Human Amniotic Mesenchymal Cells Implanted in the Freeze-Injured Mouse Urinary Bladder

Background: The multipotency of human amniotic mesenchymal cells (HAMCs) has been reported, but the role of HAMCs in urinary tract regeneration is unknown. Objective: The aim of the study was to determine if cells derived from HAMCs support the structural and functional reconstruction of freeze-injured mouse bladders. Design, setting, and participants: HAMCs were harvested from an amnion membrane, and cells were cultured for 7 d prior to injection into the freeze-injured bladder walls of nude mice. Intervention: Three days prior to implantation, the posterior bladder walls were freeze injured for 30 s. The cultured HAMC-derived cells (0.5 x 10(5) cells per 50 mu l) were implanted into the injured regions. Control bladders received a cell-free injection. At 1, 2, 4, and 6 wk after the cell implantation, the experimental bladders were extirpated. Measurements: The bladder tissues were examined by immunohistochemistry for alpha-smooth muscle actin (SMA). The HAMC-derived cells were detected by antihuman nuclei antibody (HuNu). Separately, bladder muscle strips were examined for contractile responses to potassium. Results and limitations: At 1 wk after implantation, the HAMC-derived cells, which were detected by HuNu, differentiated into muscular layers composed of SMA-positive cells. From 2 to 6 wk after implantation, abundant layers of SMA-positive and HuNu-positive cells developed. In control bladders, few SMA-positive cells remained at the injured regions at 1 wk, but by 6 wk, more were present. At 1 wk, the contractile responses to potassium of the cell-implanted bladders were significantly higher than those of the control-injected ones. Control-injected bladders also recovered by 6 wk, but the rate of recovery was slower. Conclusions: Freeze-injured mouse bladders implanted with HAMC-derived cells recovered morphology and function faster than control-injected bladders.ArticleEUROPEAN UROLOGY. 58(2):299-306 (2010)journal articl

Recovery of Cryo-injured Rabbit Urethras by Biofabricated C-shaped Adipose-derived Mesenchymal Cell Structures

Article信州医学雑誌 68(6): 357-370(2020)journal articl

Biofabricated Structures Reconstruct Functional Urinary Bladders in Radiation-Injured Rat Bladders

The ability to repair damaged urinary bladders through the application of bone marrow-derived cells is in the earliest stages of development. We investigated the application of bone marrow-derived cells to repair radiation-injured bladders. We used a three-dimensional bioprinting robot system to biofabricate bone marrow-derived cell structures. We then determined if the biofabricated structures could restore the tissues and functions of radiation-injured bladders. The bladders of female 10-week-old Sprague-Dawley (SD) rats were irradiated with 2-Gy once a week for 5 weeks. Adherent and proliferating bone marrow-derived cells harvested from the femurs of male 17-week-old green fluorescence protein-transfected Tg-SD rats were cultured in collagen-coated flasks. Bone marrow-derived cell spheroids were formed in 96-well plates. Three layers of spheroids were assembled by the bioprinter onto a 9x9 microneedle array. The assembled spheroids were perfusion cultured for 7 days, and then the microneedle array was removed. Two weeks after the last radiation treatment, the biofabricated structures were transplanted into an incision on the anterior wall of the bladders (n=10). Control rats received the same surgery but without the biofabricated structures (sham-structure, n=12). At 2 and 4 weeks after surgery, the sham-structure control bladder tissues exhibited disorganized smooth muscle layers, decreased nerve cells, and significant fibrosis with increased presence of fibrosis-marker P4HB-positive cells and hypoxia-marker hypoxia-induced factor 1 (HIF1)-positive cells. The transplanted structures survived within the recipient tissues, and blood vessels extended within them from the recipient tissues. The bone marrow-derived cells in the structures differentiated into smooth muscle cells and formed smooth muscle clusters. The recipient tissues near the transplanted structures had distinct smooth muscle layers and reconstructed nerve cells, and only minimal fibrosis with decreased presence of P4HB- and HIF1-positive cells. At 4 weeks after surgery, the sham-structure control rats exhibited significant urinary frequency symptoms with irregular and short voiding intervals, and low micturition volumes. In contrast, the structure-transplanted rats had regular micturition with longer voiding intervals and higher micturition volumes compared with the control rats. Furthermore, the residual volume of the structure-transplanted rats was lower than for the controls. Therefore, transplantation of biofabricated bone marrow-derived cell structures reconstructed functional bladders.ArticleTISSUE ENGINEERING PART A.24(21-22):1574-1587(2018)journal articl

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

ObjectiveTo 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. MethodsTwodays prior to cystometric investigations, the bladders of 10-week-old female Sprague-Dawley rats were cannulated. Cystometric measurements of the unanesthetized, unrestricted rats were taken to estimate baseline values at room temperature (RT, 272 degrees C) for 20min. They were then intravenously administered vehicle, 0.1, or 1.0mg/kg CL316243 (n=6 in each group). Fiveminutes after the treatments, they were gently and quickly transferred to the low temperature (LT, 42 degrees C) room for 40min where the cystometric measurements were again made. Afterward, the rats were returned to RT for final cystometric measurements. The cystometric effects of CL316243 were also measured at RT (n=6 in each group). ResultsAt RT, both low and high dose of CL316243 decreased basal and micturition pressure while the high dose (1.0mg/kg) significantly increased voiding interval and bladder capacity. During LT exposure, the high dose of CL316243 partially reduced cold stress-induced detrusor overactivity characterized by increased basal pressure and urinary frequency. The high drug dose also significantly inhibited the decreases of both voiding interval and bladder capacity compared to the vehicle- and low dose (0.1mg/kg)-treated rats. ConclusionA high dose of the beta-3 agonist CL316243 could modulate cold stress-induced detrusor overactivity. Therefore, one of the mechanisms in cold stress-induced detrusor overactivity includes a pathway involving beta-3 ARs.ArticleLUTS-LOWER URINARY TRACT SYMPTOMS.7(1):50-55(2014)journal articl

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

AimsThis study determined if combined treatment with the muscarinic receptor (MR) antagonist solifenacin and the (3)-adrenergic receptor (AR) agonist mirabegron could inhibit detrusor overactivity induced by cold stress in spontaneously hypertensive rats (SHRs). MethodsThirty-two female 10-week-old SHRs were fed an 8% NaCl-supplemented diet for 4 weeks. Cystometric measurements of the unanesthetized, unrestricted rats were performed at room temperature (RT, 272 degrees C) for 20min. The rats were then intravenously administered vehicle, 0.1mg/kg solifenacin alone, 0.1mg/kg mirabegron alone, or the combination of 0.1mg/kg mirabegron and 0.1mg/kg solifenacin (n=8 each group). Five minutes later, the treated rats were exposed to low temperature (LT, 42 degrees C) for 40min. Finally, the rats were returned to RT. After the cystometric investigations, the (3)-ARs and M-3-MRs expressed within the urinary bladders were analyzed. ResultsJust after transfer from RT to LT, vehicle-, solifenacin-, and mirabegron-treated SHRs exhibited detrusor overactivity that significantly decreased voiding interval and bladder capacity. However, treatment with the combination of solifenacin and mirabegron partially inhibited the cold stress-induced detrusor overactivity patterns. The decreases of voiding interval and bladder capacity in the combination-treated rats were significantly inhibited compared to other groups. Within the urinary bladders, there were no differences between expression levels of M-3-MR and (3)-AR mRNA. The tissue distribution of M-3-MRs was similar to that of the (3)-ARs. ConclusionsThis study suggested that the combination of solifenacin and mirabegron act synergistically to inhibit the cold stress-induced detrusor overactivity in SHRs. Neurourol. Urodynam. 36:1026-1033, 2017. (c) 2016 The Authors. Neurourology and Urodynamics Published by Wiley Periodicals, Inc.ArticleNEUROUROLOGY AND URODYNAMICS.36(4):1026-1033(2016)journal articl

Development of Bilayered Bone Marrow-derived Cell-Gelatin Grafts for Augmentation Cystoplasty and Reconstruction of Bladder Tissues in Rats

Background : This study attempted to produce a novel graft composed of bone marrow-derived mesenchymal cell (BMC) layer-gelatin sheets for bladder augmentation cystoplasty. Then, we determined if the grafts could reconstruct bladder tissues. Methods : BMCs harvested from the femurs of green fluorescence protein (GFP)-transfected Sprague-Dawley (SD) rats were adherent and proliferating cells on collagen dishes. The cells were then cultured on temperatureresponsive culture dishes. Following this, the BMCs maintaining cell-cell contacts within the monolayer itself were applied to a gelatin sheet. Two BMC layer-gelatin sheets were overlaid together with the cell sides juxtaposed with one another (bilayered BMC-gelatin graft). Bladder top of SD rats were incised and transplanted with the bilayered BMC-gelatin grafts. Similarly, urinary bladders irradiated with 2 Gy once a week for 5 weeks were also conducted. As control, bilayered acellular-gelatin grafts were used. At 4 weeks after transplantation, the bladders were histologically investigated. Results : At 4 weeks after transplantation into either normal or radiation-injured urinary bladders, incised regions closed. The closed regions of bladder top had reconstructed tissues that were formed with urothelium, and smooth muscle layers. Within the reconstructed tissues, the thickness of the smooth muscle layers in the bilayered BMC-gelatin graft-transplanted bladders were larger compared to controls. The GFP-positive transplanted BMCs were detected. Some of the cells were simultaneously positive for smooth muscle or nerve cell markers. Conclusion : This study showed that the bilayered BMC-gelatin grafts that were experimentally produced could reconstruct bladder tissues. The grafts would be developed as grafts for bladder augmentation cystoplasty.Article信州医学雑誌 71(3) : 167-177, (2023)journal articl

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

Introduction: This 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). Methods: Normal 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. Results: In 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. Conclusion: In 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.ArticleADVANCES IN THERAPY.32:S29-S37(2015)journal articl