Safety and efficacy of silodosin for the treatment of benign prostatic hyperplasia

Lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) are highly prevalent in older men. Medical therapy is the first-line treatment for LUTS associated with BPH. Mainstays in the treatment of male LUTS and clinical BPH are the α1-adrenergic receptor antagonists. Silodosin is a new α1-adrenergic receptor antagonist that is selective for the α1A-adrenergic receptor. By antagonizing α1A-adrenergic receptors in the prostate and urethra, silodosin causes smooth muscle relaxation in the lower urinary tract. Since silodosin has greater affinity for the α1A-adrenergic receptor than for the α1B-adrenergic receptor, it minimizes the propensity for blood pressure-related adverse effects caused by α1B-adrenergic receptor blockade. In the clinical studies, patients receiving silodosin at a total daily dose of 8 mg exhibited significant improvements in the International Prostate Symptom Score and maximum urinary flow rate compared with those receiving placebo. Silodosin showed early onset of efficacy for both voiding and storage symptoms. Furthermore, long-term safety of silodosin was also demonstrated. Retrograde or abnormal ejaculation was the most commonly reported adverse effect. The incidence of orthostatic hypotension was low. In conclusion, silodosin, a novel selective α1A-adrenergic receptor antagonist, was effective in general and without obtrusive side effects. This review provides clear evidence in support of the clinical usefulness of silodosin in the treatment of LUTS associated with BPH

Comparison of Tracheal Diameter Measured by Chest X-Ray and by Computed Tomography

Assessments of tracheal diameter (TD) are important to select proper endotracheal tubes. Previous studies have used X-ray and physical indices to estimate tracheal diameter but these may not reflect the actual TD. We compared TD measured by X-ray (TD-XP) and by computer tomography (TD-CT) in 200 patients. Also, we analyzed correlation of TD-CT with physical indices such as age, height, weight, and BMI. TD-XP and TD-CT were significantly correlated (male: n = 55, P = .0146; female: n = 91, P = .001). TD-XP was 0.4 mm wider in male and 1.0 mm wider in female than TD-CT. However, correlation coefficients of TD-XP and TD-CT are very weak (male: r = 0.36; female: r = 0.653). TD-CT did not correlate with age, height, weight, or BMI. Our findings suggest that correlations of TD-XP and TD are statistically significant but not clinically significant. Physical indices are not useful to estimate TD

Donepezil reverses buprenorphine-induced central respiratory depression in anesthetized rabbits

Buprenorphine is a mixed opioid receptor agonist-antagonist used in acute and chronic pain management. Although this agent's analgesic effect increases in a dose-dependent manner, buprenorphine-induced respiratory depression shows a marked ceiling effect at higher doses, which is considered to be an indicator of safety. Nevertheless, cases of overdose mortality or severe respiratory depression associated with buprenorphine use have been reported. Naloxone can reverse buprenorphine-induced respiratory depression, but is slow-acting and unstable, meaning that new drug candidates able to specifically antagonize buprenorphine-induced respiratory depression are needed in order to enable maximal analgesic effect without respiratory depression. Acetylcholine is an excitatory neurotransmitter in central respiratory control. We previously showed that a long-acting acetylcholinesterase inhibitor, donepezil, antagonizes morphine-induced respiratory depression. We have now investigated how donepezil affects buprenorphine-induced respiratory depression in anesthetized, paralyzed, and artificially ventilated rabbits. We measured phrenic nerve discharge as an Índex of respiratory rate and amplitude, and compared discharges following the injection of buprenorphine with discharges following the injection of donepezil. Buprenorphine-induced suppression of the respiratory rate and respiratory amplitude was antagonized by donepezil (78.4 ± 4.8 %, 92.3% ± 22.8 % of control, respectively). These findings indicate that systemically administered donepezil restores buprenorphine-induced respiratory depression in anesthetized rabbits

Effect of instillation method on the absorption of phenolsulphonphthalein as a model drug from the liver and small intestinal serosal surface in rats

The aim of this study is to examine the effect of the instillation method on absorption of a drug from the liver and small intestinal serosal surface in rats. We performed continuous microinstillation via an infusion pump and bolus instillation via a syringe. Phenol red as a model was absorbed after continuous microinstillation of 2.35 mg in 235 ?L for 5 min on the liver and small intestinal serosal surface in rats with a significantly higher AUC of the plasma concentration profile until 60 min, compared with that after bolus instillation. A similar trend was observed after continuous microinstillation of 2.35 mg in 117.5 ?L for 2.5 min. The calculated absorption rate constants Ka after continuous microinstillation of phenol red based on a two-compartment model with first-order absorption were higher than those after bolus instillation on the liver and small intestinal serosal surface at either instillation concentration. Moreover, Ka was increased after continuous microinstillation of 2.35 mg in 117.5 ?L on either instillation site. In the comparison between instillation sites, instillation of phenol red on the liver surface resulted in 1.2 to 2.3-fold higher Ka, compared to small intestinal serosal surface. This tendency was marked after continuous microinstillation of 2.35 mg in 117.5 ?L. In conclusion, absorption could be enhanced by instilling a small amount of drug solution on the liver surface gradually and continuously, suggesting a promising approach for instillation site-selective drug delivery in the peritoneal cavity

Cationic liposomes-mediated plasmid DNA delivery in murine hepatitis induced by carbon tetrachloride.

In order to elucidate the influence of hepatic disease stage on cationic liposomes-mediated gene delivery, we investigated the cationic liposomes-mediated plasmid DNA delivery with time in murine hepatitis induced by subcutaneous injection of CCl(4). Liver injury after injection of CCl(4) was confirmed by the determination of serum aspartate aminotransferase and alanine aminotransferase activities. Two kinds of liposomes constructed with N-[1-(2,3-dioleyloxy)propyl]-N,N,N-trimethlylammoniumchloride and dioleylphosphatidylethanolamine (DOTMA-DOPE) or DOTMA and cholesterol (DOTMA-CHOL) were used for the gene-delivery vector. We determined luciferase activities in various organs after the intravenous administration of the lipoplexes. The CCl(4)-treated mice administered with DOTMA-DOPE lipoplexes showed the more significant decreases of transgene expression in the liver and spleen at 18 hours after CCl(4) injection. On the other hand, the CCl(4)-treated mice administered with DOTMA-CHOL lipoplexes showed a significant increase in the liver at 48 hours. In conclusion, our findings demonstrate that murine hepatitis induced by CCl(4) can influence cationic liposomes-mediated plasmid DNA delivery. The extent of influences was also affected by lipid contents. These results indicate the necessity of considering the timing and the formulation for gene therapy according to the disease stage.This is an electronic version of an article published in Journal of liposome research, 19(2), pp.141-147; 2009. Journal of liposome research is available online at:http://dx.doi.org/10.1080/08982100802666514

イッパンサンタイモンダイニオイテウンドウガソウキョクダエンテキデアルタメノジュウブンジョウケンノケンキュウ

京都大学0048新制・論文博士理学博士乙第2477号論理博第463号新制||理||193(附属図書館)3963UT51-49-B43(主査)教授 清水 彊, 教授 川口 市郎, 教授 宮本 正太郎学位規則第5条第2項該当Kyoto UniversityDA

Development of lightweight precision ball screw shaft by swaging process

In recent years, the demand for lighter and more compact equipment has been increasing due to reduce product manufacturing time and the viewpoint of environmental load. Therefore, further lightweighting is demanded with the ball screw. The ball screw has step shape on both ends of shaft. Therefore, the lightweighting method of drilling to center of ball screw shaft makes it difficult to significantly reduce weight due to the thicker wall thickness to secure the strength of the shaft end. The lightweighting method devised is to form the step shape of the shaft end by swaging process to have a structure with a large space inside, which enables a significant weight reduction. The appearance and surface roughness of the lightweight ball screw shaft does not differ from that of conventional shaft. The weight of 0.70 kg is 0.55 times that of the conventional shaft, which enables a significant weight reduction. In the rotary bending fatigue test, the fatigue limit decreases with the ratio of wall-thickness, but the allowable torsional stress of the conventional shaft is satisfied. The axial rigidity is approximately 0.76 times that of the conventional shaft, which is smaller due to the reduction of the area moment of inertia in the hollow structure. The maximum torque is 0.02 Nm, satisfying the specified value of ±0.41 Nm. The torque fluctuation ratio is ±5 %, satisfying the best accuracy grade of ±15 %. The quietness is equivalent to number of revolutions above 2100 and improve at number of revolutions below 1000. Vibration characteristic is on the high-frequency side of resonance frequency in bending vibration, which increases the allowable rotational speed by approximately 1.2 times