Pharmacological Effects of Berberine and Palmatine on the Prostatic and Urethral Smooth Muscle of the Rabbit

PURPOSE: One of the major medical treatments for benign prostatic hyperplasia is targeted toward reducing bladder outlet obstruction by alpha-adrenoceptor blockade to relax the smooth muscle tone of the prostate. Berberine and palmatine, an isoquinoline alkaloids, have varied pharmacological actions and have been extensively used in folk medicine. A previous large scale screening test revealed that berberine derivatives have antagonistic effects at the alpha1-adrenoceptors, although they are less potent than prazosin. The aim of this study is to investigate the effect of the berberine and palmatine on the contractility of the isolated prostate, urethral and vascular smooth muscle tissues of the rabbit. MATERIALS AND METHODS: Muscle strips of the prostate, urethra and renal artery were obtained from 10-week-old male New Zealand White rabbits. In vitro isometric contraction was measured using organ bath study. Cumulative concentrations of phenylephrine as an agonist were added to produce concentration-response relationships. Breberin (1-500 microM) and palmatine (1-500 microM) were added to the bath before the repeated phenylephrine-induced concentration-response curve was made. Responses of developed tension to phenylephrine were plotted as percentage of the maximal increase for each concentration-response curve in the prostate, urethra and renal artery strips. RESULTS: Phenylephrine produced concentration-dependent contractions on the rabbit prostatic and urethral preparations. Berberine and palmatine induced a dose-dependent rightward shift of the dose-response curve of phenylephrine-induced contraction of both prostate and urethra with a reduction of maximal response, indicating the interactions of the two agents with phenylephrine in noncompetitive antagonism. The rank order of potency of the inhibitory effect was palmatine > berberine in the urethral tissue, while there was no significant difference between the two agents in the prostatic tissue. In the renal artery strips, both berberine and palmatine did not significantly inhibited the maximal contractile response to phenylephrine (1-50 microM). Higher concentration of berberine (500 microM) and palmatine (100-500 microM) decreased maximal contractile response induced by phenylephrine (0-10 microM), while they paradoxically increased maximal contraction induced by higher concentrations of phenylephrine (50-100 microM). CONCLUSIONS: Our results indicated that berberine or palmatine inhibited phenylephrine-induced contractions in urethral and prostatic smooth muscles, with no significant inhibition in the renal artery smooth muscle at lower concentration ranges of berberine and palmatine. A deeper understanding of the action mechanisms of berberine and palmatine would widen our therapeutic options for voiding disorders.

Relationship among Symptom Score, Urinary Flow Rates, and Prostate Volume in 620 Men with Lower Urinary Tract Symptoms / 대한비뇨기과학회지

PURPOSE: We aimed to investigate the relationships among age, International Prostate Symptom Score(IPSS), uroflowmetry and prostate volume in men with lower urinary tract symptom(LUTS). MATERIALS AND METHODS: Among the 847 men who participated in the BPH awareness program, 620 men(73.2%) who had not LUTS or had LUTS without concomitant conditions(except BPH) known to interfere with normal voiding were selected. All of them completed IPSS questionnaire, uroflowmetry and transrectal ultrasonography. We calculated correlation coefficient to investigate the association among age, maximal flow rate, mean flow rate, and prostate volume. Additionally, total men were stratified by 3 age groups and 3 IPSS groups, and we also evaluated relationships among the parameters according to these groups. RESULTS: The statistically significant correlations were found among the age, uroflowmetry and prostate volume. Total symptom score did not show significant correlation with age. However, irritative symptom score increased with increasing age in statistically significant manner. When we stratified men into three age groups, most of the correlations were stronger in the younger than 60 years old group than those observed in the entire population. According to a multivariate regression analysis, age and prostate volume did not show statistically significant correlation with IPSS. When the all men were classified according to the IPSS, there were significant differences between maximal flow rate, mean flow rate and prostate volume. CONCLUSIONS: Emerging from this analysis showed that age is the important factor influencing the relationship among symptom score, urinary flow rate and prostate volume. LUTS may be affected by some factor such detrusor tone as well as prostate volume. We suggest that the development of more objective and sophisticated studies such as urodynamic study, molecular biologic study for functional morphology of detrusor and community-based study with longitudinal measurements will be necessary to approach the pathogenesis of LUTS.

A Case of Recurred Hydatid Cyst in Pelvic Cavity / 대한비뇨기과학회지

Hydatid disease is Echinococcus granulosus infection in its larva form. It is endemic in many sheep- and cattle-raising countries throughout the world. In Korea seventeen cases have been reported but relapsed case is not. We report relapsed hydatid disease in pelvic cavity 10 years after primary surgery for Echinococcal cysts in the liver and pelvic cavity. The cysts were surgically removed and the patient was managed with postoperative adjuvant treatment with albendazole and followed with serologic test for anti-echinoccocus antibodies by ELISA.

Mutations of the Human Androgen Receptor Gene in Men Infertile from Testicular Causes / 대한남성과학회지

PURPOSE: Many men with a normal phenotype but decreased or absent production may have abnormalities of the androgen receptor (AR). Here, we investigated men with severe oligospermia and azoospermia to ascertain wether mutations of the AR gene are associated with male infertility having testicular causes. PATIENTS AND METHODS: A total of 43 infertile men with a normal phenotype and severe oligospermia or azoospermia and three normally fertile men entered this study. Included was one man with known incomplete androgen insensitivity syndrome (AIS). Deoxyribonucleic acid was isolated from peripheral blood samples of the subjects, and polymerase chain reaction (PCR) was carried out using sets of primers designed to amplify sequences of eight exons of the AR gene. For convenience and repidity of analyses, the multiplex PCR method was employed. RESULTS: PCR resulted in amplification of all eight exons. In all samples, amplified products were shown to be appropriate-sized bands on agarose gels. No gross abnormalities were found in most of the infertile patients. However, an increased number of CAG repeat in exon 1 of the AR gene and point mutations (T to C, nt 3897; A to T, nt 3903) in exon 7 were found in the AIS subject. CONCLUSIONS: Our results showed no gross deletions of the AR gene in most infertile subjects. However, point mutations may have been overlooked by the techniques used, as demonstrated in the AIS subject. Further study will be required to clarify expression and localization of AR I the testis and consequently to understand the precise roles of the AR in regulating the normal spermatogenesis.