Co-Investigator(Kenkyū-buntansha) |
YOSHIOKA Nobuhiro Kinki University School of Medicine, Department of Urology, Assistant, 医学部, 助手 (50330288)
HANAI Tadashi Kinki University School of Medicine, Department of Urology, Assistant, 医学部, 助手 (00288911)
MATSUMOTO Seiji Kinki University School of Medicine, Department of Urology, Instructor, 医学部, 講師 (10288912)
山本 和彦 近畿大学, 医学部, 講師 (00166787)
山本 豊 近畿大学, 医学部附属病院, 助手 (60340808)
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Budget Amount *help |
¥3,600,000 (Direct Cost: ¥3,600,000)
Fiscal Year 2003: ¥900,000 (Direct Cost: ¥900,000)
Fiscal Year 2002: ¥600,000 (Direct Cost: ¥600,000)
Fiscal Year 2001: ¥2,100,000 (Direct Cost: ¥2,100,000)
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Research Abstract |
This paper reports the evaluation of the residual bladder function in patients with bladder outlet obstruction(BOO) such as those with benign prostatic hyperplasia(BPH), and determination of the appropriate timing for a surgical procedure. The study mainly researched factors contributing to preserve the bladder function, the use of culturing protain on bladder smooth muscle cells, and their structural changes. First of all, we examined factors affecting the residual bladder function in patients with animal BOO model. From these experiments, we found that the influence by chronic bladder ischemia that was derived from BOO, and following bladder blood flow reperfusion injury are important factors. In addition, we found that free radicals and active oxygen affect the bladder function. Accordingly, we found that dosing free radical scavengers and vitamin E provide relief for the bladder dysfunction. As for the bladder ischemia-reperfusion animal model, we noticed that neutrophil elastase in
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hibitors have a protective effect on bladder smooth muscle, and various factors related to the residual bladder function. As to the relationship with the bladder blood flow, we also examined urination load timing(diuresis). The results showed that even diuresis before BOO, by stopping diuresis after BOO, protection and preservation effects of the bladder smooth muscle decreased and disappear, and it was found that diuresis affects the residual bladder function. Next, the study of cultured bladder smooth muscle cells in rats after following BOO indicated that the bladder hypertrophy of bladder was derived from the smooth muscle layer, and it was possible that b-FGF is one of growth factor. Further, after examining the structural change of the bladder smooth muscle cells in rats using a phenotype concept, the ratio of non-contractile phenotype was increased in the bladder smooth muscle cells after BOO. At the same time, using a molecular biological method, we measured protein markers that are related to bladder contraction. Moreover, the result showed that caldesmon is the most useful marker for grasping a morbid state. We tested this method on human bladder smooth muscle cells and found that levels of non-contractile phenotype was increased in bladder after BOO and bladder dysfunction, and the change of these can be parameters to determine the suitable period of surgical procedures for the BPH. Less
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