Effect of Long-Term Estrogen Replacement on Bladder Function in Old Female Rats

The effects of estradiol (E2) on urodynamic parameters were studied with twenty 16-month-old female Wistar rats. They were divided into 4 groups, i.e., Group I: untreated; Groups II and III: treated with E2 for 4 and 8 weeks, respectively; Group IV: treated with a placebo for 8 weeks. After treatment, we measured their plasma E2 levels, and recorded their voiding behavior for 24 h. Cystometry was performed and urodynamic parameters were analyzed. Particularly, bladder capacity as well as voided volume and frequency were surveyed. The results obtained were compared among groups. Levels of bladder capacity in the E2-replaced groups (Groups II, 0.52 ± 0.14 mL and Groups III, 0.58 ± 0.09 mL) were significantly (P < 0.05) higher than in the other groups (Group I, 0.38 ± 0.09 mL and Group IV, 0.40 ± 0.11 mL) respectively. The average voided volume was significantly (P < 0.05) higher in the E2-replaced groups (Groups II, 1.06 ± 0.22 mL and Groups III, 1.01 ± 0.16 mL) than in Group IV (0.79 ± 0.15 mL), respectively. Concerning the number of daily micturition per day, a significant difference (P < 0.05) was observed only between Group III (14.2 ± 2.7) and Group IV (18.8 ± 3.7). This suggests that E2-replacement therapy positively affects bladder function

Effect of Estrogen Replacement Therapy on Bladder Circulation in Old Female Rats

The effect of estradiol (E2) on the urinary bladder of old female rats was investigated by examining the histology and blood flow in the bladders. A total of 20 female Wistar rats aged 16 months were divided into 4 groups: Group I, 5 normal controls; Group II, 5 rats treated with E2 for 4 weeks; Group III, rats treated with E2 for 8 weeks; and Group IV, 5 rats receiving a placebo for 8 weeks. After the treatment, we removed the bladders, then weighed and stained them with hematoxylin and eosin. The muscle content was analyzed with the Elastica-van Gieson method, and the number of blood vessels with the Masson's trichrome method. Blood circulation in the bladders was also measured. The E2-replaced groups showed higher levels than the other groups in terms of blood flow in the bladder (20.6 ± 1.8 mL/min for Group II and 23.4 ± 1.5 mL/min for Group III, both P < 0.05 versus Groups I and IV), muscle content (2.33 ± 0.47 and 3.11 ± 0.48 for Groups II and III, respectively, both P < 0.05 versus Groups I and IV) and bladder weight (185.3 ± 6.2 mg and 193.2 ± 23.5 mg for Groups II and III; Group III showed P < 0.05 versus Groups I and IV). Differences in body weight and number of blood vessels among groups were not significant. We observed an increase in blood circulation, muscle content and weight of the bladder: E2-replacement therapy positively affected bladder functions

Effects of Testosterone Replacement on Lower Urinary Tract Functions in Elderly Male Rats

Testosterone has been clinically used to improve hormone deficiency in the aging male; however, investigations how testosterone exerts its effects on lower urinary tract functions are not many. In order to shed light on the efficacy of testosterone on the functions, we replaced teststerone in elderly male Wistar rats aged 19 months. A relevant dose (120 mg) of testosterone was subcutaneously replaced through an implanted silastic tube into 6 rats for 4 weeks (treated group). Another 6 rats received no treatment for 4 weeks (control group). After the end of the 4-week period, we measured plasma testesterone, weight of bladder, prostate and body, bladder muscle content, spontaneous micturition behavior and cystometric parameters, and compared the results between the 2 groups. The daily micturition frequency (18.8 ± 1.5 times/day versus 15.5 ± 1.9 times/day), volume of residual urine at cystometry (0.66 ± 0.10 mL versus 0.24 ± 0.03 mL), bladder capacity (1.03 ± 0.06 mL versus 0.65 ± 0.05 mL), bladder weight (258 ± 9 mg versus 198 ± 19 mg), prostate weight (2.08 ± 0.22 g versus 1.29 ± 0.22 g) and ratio of smooth muscle area/connective tissue area (3.59 ± 0.13 versus 2.59 ± 0.36) were significantly higher in the treated group (P < 0.05). In contrast, the average volume of spontaneous micturition was significantly lower in the treated group (0.84 ± 0.07 mL versus 0.98 ± 0.09 mL). Differences in body weight and volume of 24-h urine were not significant between groups. Daily micturition frequency and volume of residual urine at cystometry were increased in the treated group. Testosterone replacement exerted unfavorable effects on the lower urinary functions of elderly rats, including prostatic hypertrophy

Retroperitoneal Laparoscopic Radical Nephrectomy for Renal Cell Carcinoma: A Report on 2 Initial Cases

We report our experience with retroperitoneal laparoscopic radical nephrectomy in 2 patients with renal cell carcinoma. In this procedure, a working space in the retroperitoneum is created using the blunt balloon dissection technique. Carbon dioxide insufflation is performed, and 4 trocars are inserted into the retroperitoneal cavity through the lateral abdominal wall. The kidney is removed together with the perirenal fat and Gerota's fascia in a muscle-splitting fashion. Using this procedure, a right nephrectomy was performed in a 65-year-old man with a 2.4-cm tumor and in a 54-year-old woman with a 3.5-cm tumor. Operative time was 220 min and 195 min, respectively, and estimated blood loss was 10 mL and 115 mL, respectively. There were no major perioperative complications. Although a long-term follow-up is necessary to evaluate the efficacy of this procedure, it will probably become a standard treatment modality for localized renal cell carcinoma

Elevated Fasting Blood Glucose Levels Are Associated With Lower Cognitive Function, With a Threshold in Non-Diabetic Individuals: A Population-Based Study.

BACKGROUND:Cognitive dysfunction has been recognized as a diabetes-related complication. Whether hyperglycemia or elevated fasting glucose are associated with cognitive decline remains controversial. We aimed to investigate the relationship between fasting glucose levels and cognitive function in diabetic and non-diabetic individuals.METHODS:Participants were Japanese diabetic (n = 191) and non-diabetic (n = 616) men, aged 46-81 years, from 2010-2014. Blood samples were taken after a 12 h fast. The Cognitive Ability Screening Instrument (CASI), with a maximum score of 100, was used for cognitive assessment. Cognitive domains of CASI were also investigated. Fractional logit regression with covariate adjustment for potential confounders was used to model cross-sectional relationships between fasting blood glucose and CASI score.RESULTS:For diabetic individuals, CASI score was 0.38 (95% confidence interval: 0.66-0.12) lower per 1 mmol/L higher fasting glucose level. Short-term memory domain also exhibited an inverse association. For non-diabetic individuals, a reverse U-shaped relationship was observed between fasting glucose and cognitive function, identifying a threshold for highest cognitive performance of 91.8 CASI score at 3.97-6.20 mmol/L (71.5-111.6 mg/dL) fasting glucose. Language ability domain displayed a similar relationship with fasting glucose.CONCLUSIONS:Elevated fasting glucose levels in diabetic men were associated with lower cognitive function, in which short-term memory was the main associated domain. Interestingly, in non-diabetic men, we identified a threshold for the inverse relationship of elevated fasting glucose with cognitive function. Contrastingly to diabetic men, language ability was the main associated cognitive domain among non-diabetic men

Alcohol consumption and cognitive function in elderly Japanese men.

Although heavy alcohol consumption has been identified as a risk factor for adverse cognitive functioning, it currently remains unclear whether moderate alcohol consumption exerts similar effects. Observational studies previously reported the potential benefits of moderate alcohol consumption on cognition, particularly in the elderly; however, these effects have not yet been demonstrated in Asian populations. The aim of the present study was to investigate the relationship between alcohol consumption levels and global and domain-specific cognitive functions in cognitively intact elderly Japanese men. Cross-sectional data from the Shiga Epidemiological Study of Subclinical Atherosclerosis (SESSA), an ongoing prospective, population-based study in Shiga, Japan, were used to examine the relationship between alcohol consumption and cognitive function. Men (n = 585) aged ≥65 years provided information on their weekly consumption of alcohol, and the data obtained were used to construct categories of never, ex- (quit before interview), very light (23-46 g/day), and heavy (>46 g/day) drinkers. Cognitive function was measured using the Cognitive Abilities Screening Instrument (CASI). A fractional logistic regression model adjusted for age, education, body mass index, smoking, exercise, hypertension, diabetes, and dyslipidemia showed that the CASI scores for global and domain-specific cognitive functions were not significantly different between all subgroups of current drinkers and never-drinkers. However, the CASI score of ex-drinkers (multivariable adjusted mean CASI score [SD]) was significantly lower than that of never-drinkers in the global [never vs. ex: 90.16 (2.21) vs. 88.26 (2.58)] and abstraction and judgment domain [never vs. ex: 9.48 (0.46) vs. 8.61 (0.57)]). The present results do not suggest any beneficial or adverse relationship between current alcohol consumption levels and cognitive functioning (both global and domain specific) in elderly Japanese men; however, low cognitive function among ex-drinkers warrants future investigations to identify the factors causing drinkers to quit

Proteinuria and Reduced Estimated Glomerular Filtration Rate Are Independently Associated With Lower Cognitive Abilities in Apparently Healthy Community-Dwelling Elderly Men in Japan: A Cross-sectional Study.

Background:The association of proteinuria and reduced estimated glomerular filtration rate (eGFR) with cognition needs more clarification. We cross-sectionally examined whether proteinuria and reduced eGFR, even in moderate stages, were independently associated with lower cognition in a community-based sample of elderly men.Methods:Our cohort initially comprised 1,094 men aged 40-79 years from a random sample from Shiga, Japan in 2006-2008. Of 853 men who returned for the follow-up examination (2009-2014), we analyzed 561 who were ≥65 years, free of stroke, and completed the Cognitive Abilities Screening Instrument (CASI) at follow-up (higher CASI scores [range 0 to 100] indicate better cognition). Proteinuria was assessed via dipstick. eGFR was calculated according to the Chronic Kidney Disease Epidemiology Collaboration Equation. Participants were divided into three groups either by eGFR (≥60, 59-40, and <40 mL/min/1.73 m2) or by proteinuria (no, trace, and positive), considered normal, moderate, and advanced, respectively. Using linear regression, we computed mean CASI score, with simultaneous adjustment for proteinuria and eGFR in addition to other potential confounders.Results: Significant trends of lower cognition were observed across the groups of worse proteinuria and lower eGFR independently: multivariable-adjusted mean CASI scores were 90.1, 89.3, and 88.4 for proteinuria (Ptrend = 0.029), and 90.0, 88.5, and 88.5 for eGFR (Ptrend = 0.015) in mutual-adjustment model.Conclusions: Proteinuria and reduced eGFR, even in their moderate stages, were independently associated with lower cognition in a community-based sample of elderly men. The results suggest the importance of proteinuria and low eGFR for early detection and prevention of cognitive decline