Age-Dependent Effects of Oxytocin and Oxytocin Receptor Antagonists on Bladder Contractions: Implications for the Treatment of Overactive Bladder Syndrome.

Overactive bladder (OAB) is an age-related disorder characterised by unstable bladder contractions resulting in disruptive lower urinary tract symptoms (LUTS), thus creating a profound impact on an individual's quality of life. The development of LUTS may be linked to the overexpression of oxytocin receptors (OXTRs) within the bladder detrusor muscle, resulting in increased baseline myogenic tone. Thus, it is hypothesised that targeting OXTRs within the bladder using oxytocin antagonists may attenuate myogenic tone within the bladder, thereby providing a new therapeutic avenue for treating OAB. Organ bath contractility and immunohistochemistry techniques were conducted on bladder tissue sourced from young rats (7-8 weeks and 10-12 weeks) and older rats (4-5 months and 7-9 months). Organ bath studies revealed that oxytocin (OT) significantly increased bladder contractions, which were significantly attenuated by [ß-Mercapto-ß,ß-cyclopentamethylenepropionyl1, O-Me-Tyr2, Orn8]-Oxytocin) (1 µM) (**** p < 0.0001) and atosiban (10 µM) in both young and older rats (** p < 0.01); in contrast, cligosiban (1 µM and 10 µM) did not inhibit OT-induced contractions in both young and older rats (p ≥ 0.05). Interestingly, cligosiban (1 µM and 10 µM) significantly reduced the frequency of spontaneous contractions within the bladder of both young (*** p < 0.001) and older rats (**** p < 0.0001), while atosiban (10 µM) only demonstrated this effect in older rats (** p < 0.01). Furthermore, immunohistochemistry (IHC) analysis revealed significant colocalization of nuclear-specific oxytocin receptors (OXTRs) in the contractile (smooth muscle) cells within young (** p < 0.01) and older rats (* p < 0.05), indicating OT may be a key modulator of bladder contractility.

The Effects of Age on Prostatic Responses to Oxytocin and the Effects of Antagonists.

Benign prostatic hyperplasia (BPH) is an age-related enlargement of the prostate with urethral obstruction that predominantly affects the middle-aged and older male population, resulting in disruptive lower urinary tract symptoms (LUTS), thus creating a profound impact on an individual's quality of life. The development of LUTS may be linked to overexpression of oxytocin receptors (OXTR), resulting in increased baseline myogenic tone within the prostate. Thus, it is hypothesised that targeting OXTR using oxytocin receptor antagonists (atosiban, cligosiban, and ß-Mercapto-ß,ß-cyclopentamethylenepropionyl1, O-Me-Tyr2, Orn8]-Oxytocin (ßMßßC)), may attenuate myogenic tone within the prostate. Organ bath and immunohistochemistry techniques were conducted on prostate tissue from young and older rats. Our contractility studies demonstrated that atosiban significantly decreased the frequency of spontaneous contractions within the prostate of young rats (**** p < 0.0001), and cligosiban (* p < 0.05), and ßMßßC (**** p < 0.0001) in older rats. Additionally, immunohistochemistry findings revealed that nuclear-specific OXTR was predominantly expressed within the epithelium of the prostate of both young (*** p < 0.001) and older rats (**** p < 0.0001). In conclusion, our findings indicate that oxytocin is a key modulator of prostate contractility, and targeting OXTR is a promising avenue in the development of novel BPH drugs.

Type of Treatment Supporters in Successful Completion of Tuberculosis Treatment: A Retrospective Cohort Study in Pakistan.

BACKGROUND: The World Health Organization has recommended a patient-centered approach to tuberculosis drug administration. A central element of the patient-centered strategy is the use of treatment supporters to evaluate and elevate adherence to the treatment regimen and to address poor adherence when it occurs. This study was led to determine the part of various treatment supporters in the successful completion of treatment. METHOD: This study was conducted in two locales of Sindh, Hyderabad and Mirpurkhas. Information gathered included age, gender, regions, sort of treatment supporters (relatives, community and health facility workers) and treatment outcomes. RESULTS: Of the 773 patients incorporated into the study, 86.8% picked a family supporter, 7.63% selected community worker and 5.56% chose health facility worker as their treatment supporter. Women and younger patients were more likely to prefer that family members supervise their treatment. Treatment achievement rates among the patients regulated by the three kinds of treatment supporters, were not altogether unique in relation to each other (p=0.23 Chi square). CONCLUSION: The study demonstrates that TB patients ought to be urged to pick the supporter of their inclination as selection of treatment supporter outside the health system does not adversely affect TB treatment outcomes in limited resource settings.

Surface anatomy of major anatomical landmarks of the neck in an adult population: A Ct Evaluation of Vertebral Level.

To compare the projectional surface anatomy of healthy individuals in an adult population with those with a thyroid mass, using computed tomography (CT). Sixteen slice CT images of 101 individuals were analyzed using a 32-bit Radiant DICOM viewer to establish the relationships among major anatomical landmarks in the neck and their vertebral levels. The structures investigated included: hard palate (HP), hyoid bone (HB) including body and lesser horns, soft palate (SP), thyroid gland (TG) (both superior and inferior poles), thyroid gland anteroposterior (APD) and superoinferior (SID) diameters, thyroid isthmus (TI) superoinferior dimension, epiglottis, vertebral arteries (right and left), and both right and left parotid glands (superior and inferior extents). The vertebral levels noted most frequently were: body of hyoid bone (C4, 42.71%); lesser horns of hyoid bone (C3, 36.46%); thyroid gland superior pole (C6, 31.25%); and thyroid gland inferior pole (T2, 30.2%). TG-ID, TG-APD, and TG-SID were not significantly different between males and females in the healthy group; however, there was a significant gender difference in thyroid gland inferior diameter in the pathology group [males 2.16(±1.16) vs. females 3.37(±1.30), P = 0.01, paired sample t-test]. Further studies are needed to determine whether neck pathology in those with a thyroid mass affects the dimensions of the thyroid gland. Moreover, the surface anatomy of the neck should be revisited using modern imaging techniques to address inconsistencies in anatomy and clinical reference texts. Clin. Anat. 30:781-787, 2017. © 2017Wiley Periodicals, Inc.

Revisiting thoracic surface anatomy in an adult population: A computed tomography evaluation of vertebral level.

To compare key thoracic anatomical surface landmarks between healthy and patient adult populations using Computed Tomography (CT). Sixteen slice CT images of 250 age and gender matched healthy individuals and 99 patients with lung parenchymal disease were analyzed to determine the relationship of 17 thoracic structures and their vertebral levels using a 32-bit Radiant DICOM viewer. The structures studied were: aortic hiatus, azygos vein, brachiocephalic artery, gastroesophageal junction (GEJ), left and right common carotid arteries, left and right subclavian arteries, pulmonary trunk bifurcation, superior vena cava junction with the right atrium, carina, cardiac apex, manubriosternal junction, xiphisternal joint, inferior vena cava (IVC) crossing the diaphragm, aortic arch and junction of brachiocephalic veins. The surface anatomy of all structures varied among individuals with no significant effect of age. Binary logistic regression analysis showed a significant association between individual health status and vertebral level for brachiocephalic artery (P = 0.049), GEJ (P = 0.020), right common carotid (P = 0.009) and subclavian arteries (P = 0.009), pulmonary trunk bifurcation (P = 0.049), carina (P = 0.004), and IVC crossing the diaphragm (P = 0.025). These observations differ from those reported in a healthy white Caucasian population and from the vertebral levels of the IVC, esophagus, and aorta crossing the diaphragm in an Iranian population. The differences observed in this study provide insight into the effect of lung pathology on specific thoracic structures and their vertebral levels. Further studies are needed to determine whether these are general changes or pathology-specific. Clin. Anat. 30:227-236, 2017. © 2017 Wiley Periodicals, Inc.

Mental foramen morphometry in a population from Khyber Pakhtunkhwa (KP) Pakistan / Morfometría del foramen mental en una población de Khyber Pakhtunkhwa (KP) Pakistán

Knowledge of variations in MF location, size and shape is important when anesthetizing nerves of the mandibular region in dental procedures. The location, shape and position of the MF were determined in 119 human mandibles of unknown age and sex from different KP medical institutions. Parameters determined were: MF length and width; accessory mental foramen (AMF) width; MF and AMF to midline (MF-ML) (AMF-ML), upper (MF-UM) (AMF-UM) and lower mandibular margins (MF-LM) (AMF-LM) and posterior border of the mandibular ramus (MF-PRM) (AMF-PRM). AMF position in relation to the MF was also noted. MF were mainly oval and situated below the second premolar. MF mean length and width were: 2.4 ± 0.89 (right) and 2.4 ± 0.727 mm (left), and 3.0 ± 0.80 (right) and 2.9 ± 0.94 mm (left) respectively. MF-ML, MF-UM, MF-LM and MF-PRM distances on the right and left sides were: 29.1 ± 2.19 mm and 28.1 ± 2.12 mm; 11.0 ± 3.99 mm and 11.2 ± 3.98 mm; 13.1 ± 1.83 mm and 12.8 ± 1.74 mm; and 69.3 ± 5.52 mm and 68.7 ± 5.02 mm, respectively. Double mental foramen (DMF) were observed on both sides (10.9 % right, 12.6 % left) with length and width 0.7 ± 0.42 mm and 0.9 ± 0.34 mm (right) and 0.8 ± 0.32 mm and 1.0 ± 0.47 mm (left): they were mainly oval (5.8 % right, 7.56 % left). DMF-MF distance was 8.9 ± 4.58 mm on the right and 6.6 ± 4.11 mm on the left. An oval accessory mental foramen was observed in one mandible. There was no difference between right and left MF; however differences in the parameters measured were observed in relation to other populations indicating the need to be aware of such differences when undertaking surgical procedures around the MF.

El conocimiento de las variaciones del foramen mental (FM), su ubicación, tamaño y forma es importante al momento de anestesiar los nervios de la región mandibular en procedimientos dentales. La ubicación, forma y posición del FM se determinó en 119 mandíbulas humanas, de edad y sexo desconocidos, de diferentes instituciones médicas de Pakistan. Los parámetros determinados fueron: longitud y ancho; ancho del foramen mental accesorio (FMA); MF y AMF a la línea mediana (FM-LM) (FMA-LM), margen superior (FM-MS) (FMA-MU) y margen inferior (FM-MI) (FMA-MI) y el margen posterior de la rama mandibular (FM-RMP) (FMA-RMP). También se observó la posición del FMA en relación con el FM. La forma del FM fue principalmente ovalada y situado por debajo del segundo premolar. Los datos de longitud y anchura del FM fueron: 2,4 ± 0,89 (derecha) y 2,4 ± 0,727 mm (izquierda), y 3,0 ± 0,80 (derecha) y 2,9 ± 0,94 mm (izquierda), respectivamente. Las distancias FM-LM, FM-MS, FM-MI y FM-MRP en el lado derecho e izquierdo fueron: 29,1 ± 2,19 mm y 28,1 ± 2,12 mm; 11.0 ± 3.99 mm y 11,2 ± 3,98 mm; 13,1 ± 1,83 mm y 12,8 ± 1,74 mm; y 69,3 ± 5,52 mm y 68,7 ± 5,02 mm, respectivamente. Se observaron foramenes mentales dobles (FMD) en ambos lados (10,9 % derecho, 12,6 % a la izquierda) con una longitud y ancho de 0,7 ± 0,42 mm y 0,9 ± 0,34 mm (derecha) y 0,8 ± 0,32 mm y 1,0 ± 0,47 mm (izquierda): fueron principalmente ovalados (5,8 % derecha, izquierda 7,56 %). La distancia FMD-FM fue de 8,9 ± 4,58 mm a la derecha y 6,6 ± 4,11 mm en el izquierdo. Se observó un foramen mental accesorio ovalado en una mandíbula. Hubo diferencia entre FM derecho e izquierdo. Sin embargo, las diferencias en los parámetros medidos fueron observados en relación con otras poblaciones que indican la necesidad de ser conscientes de estas diferencias al realizar procedimientos quirúrgicos en todo el MF.