Methyl Palmitate Modulated NMDA-Induced Cerebral Hyperemia in Hypertensive Rats.

N-methyl-D-aspartate (NMDA) receptors were found to be dysfunctional in hypertensive rats. Methyl palmitate (MP) has been shown to diminish the nicotine-induced increase in blood flow in the brainstem. The aim of this study was to determine how MP modulated NMDA-induced increased regional cerebral blood flow (rCBF) in normotensive (WKY), spontaneously hypertensive (SHR), and renovascular hypertensive (RHR) rats. The increase in rCBF after the topical application of experimental drugs was measured using laser Doppler flowmetry. Topical NMDA application induced an MK-801-sensitive increase in rCBF in anesthetized WKY rats, which was inhibited by MP pretreatments. This inhibition was prevented by pretreatment with chelerythrine (a PKC inhibitor). The NMDA-induced increase in rCBF was also inhibited by the PKC activator in a concentration-dependent manner. Neither MP nor MK-801 affected the increase in rCBF induced by the topical application of acetylcholine or sodium nitroprusside. Topical application of MP to the parietal cortex of SHRs, on the other hand, increased basal rCBF slightly but significantly. MP enhanced the NMDA-induced increase in rCBF in SHRs and RHRs. These results suggested that MP had a dual effect on the modulation of rCBF. MP appears to play a significant physiological role in CBF regulation.

Automated Urine Particle Analyzer UF-1000i Can Pre-Estimate the Treatment Response of Women's Uncomplicated Urinary Tract Infections to Antibiotics.

PURPOSE: To evaluate the ability of bacterial scatter diagrams generated from the automated urine particle analyzer (UF-1000i, Sysmex, Kobe, Japan) to pre-estimate the treatment efficacy of oral cefalexin in treating women with uncomplicated urinary tract infection (uUTI). MATERIALS AND METHODS: Over 3 years, women 20-80 years old with symptoms suggestive of uUTI (Urinary Tract Infection Symptoms Assessment symptom score, ,UTISA > 3) and bacteriuria (bacterial count ≥ 100/uL) were enrolled. After informed consent, patients took cephalexin 500mg 4 times/day for 7 days. The voided urine specimens were classified into rods or cocci/mixed group automatically through the built-in software of the UF1000i. Patients were followed up with UTISA on the 3rd day after treatment and returned to the clinic on the 7th day and followed for additional UTISA and urine analysis. Symptom and laboratory improvement were defined as UTISA < 4 and bacterial count < 100/uL, respectively, on the 7th day. RESULTS: Of 99 women (age: 49.91 ±15.32 years) eligible for analysis, 80 were classified as having urine that contained rods and 19 as cocci/mixed. Symptom improvement was observed in 62 women in the rods group and 11 women in the cocci/mixed group (p = 0.08). Laboratory improvement was noted in 64 women in the rods group and 10 women in the cocci/mixed group (p = 0.01). On day 7, treatment success with both symptom and laboratory improvement was more observed in rods than in cocci/mixed group (61.3% vs. 26.3%, p < 0.01). CONCLUSION: The automatic urine particle analyzer can pre-estimate the treatment response of antibiotics in women with uUTI.

Hydrogen Protons Modulate Perivascular Axo-axonal Interactions in the Middle Cerebral Artery of Rats.

Previous studies have demonstrated that nicotine can induce relaxation of the middle cerebral artery (MCA). However, whether this relaxation is associated with the activity of sensory calcitonin gene-related peptide (CGRP) nerves and whether this is modulated by hydrogen protons (H), facilitating the release of CGRP from sensory CGRPergic nerve terminals in the MCA, remains unclear. In this study, we examined the role of H in the modulation of neurogenic vasomotor responses in the rat-isolated endothelium-denuded MCA. Wire myography was used to measure vasoreactivity and indicated that nicotine-induced relaxation was sensitive to tetrodotoxin and lidocaine and drastically reduced levels of guanethidine (an adrenergic neuronal blocker), N-nitro-L-arginine (L-NNA), CGRP8-37, vasoactive intestinal polypeptide (VIP)6-28, capsaicin, capsazepine (a transient receptor potential vanilloid-1 inhibitor), and tetraethylammonium. However, this nicotine-induced relaxation was not sensitive to propranolol. Lowering the pH of the buffer solution with HCl caused pH-dependent vasorelaxation and deceased intracellular pH in the MCA rings, which was sensitive to L-NNA, CGRP8-37, VIP6-28, capsazepine, 4-aminopyridine (a voltage-gated potassium channel antagonist), and paxilline (a large conductance Ca-activated K channel antagonist). However, HCl-induced relaxation was not inhibited by glibenclamide (an ATP-sensitive K channel blocker). These results suggested that electrical and chemical activation of cerebral perivascular adrenergic nerves led to the release of H, which then facilitated the release of NO, VIP, and CGRP, resulting in vasorelaxation. Lowering the pH of the buffer solution caused potassium channels of vascular smooth muscle cells and perivascular nerves to open. In conclusion, our results demonstrated that H may act as a modulator on MCA perivascular nerves and/or smooth muscles.

A quantitative approach to the interpretation of uroflowmetry in children.

PURPOSE: We hypothesized that by correcting for volume and creating a flow index (FI) we could develop a reproducible and reliable means to estimate flows in children without the use of a flow nomogram. Our second hypothesis was that this volume corrected FI could define objective parameters for the different flow curves that are described in the ICCS document. METHODS: Uroflowmetry curves of 1,268 healthy children were analyzed. Quadratic equations using nonlinear regression for both sexes were generated for each set of presumed normal voiders (learning data) (NV). The NV test data were used to verify the equations. Linear regression analysis was used to compare the variance between actual and estimated flow rates. A FI (Actual Qavg/Estimated Qavg) was created and ROC analysis for all flow types was performed. Sensitivity and specificity analysis was performed on all voids to validate the accuracy of the FI to predict flow pattern. RESULTS: Analysis of the FI from the first void to the second confirmed the accuracy and reproducibility in both males and females using various means of analysis. ROC analysis shows that there are very strong AUC's for Bell, plateau, and tower flow patterns. Sensitivity and specificity analysis reveals that defined FI parameters are able to predict the flow patterns. CONCLUSION: Our predictive formulas allow for direct comparison of one flow to the next in a single patient when the FI is used. Utilizing the FI, we can predict the type of flow pattern removing subjectivity from the analysis of uroflow patterns. Neurourol. Urodynam. 35:836-846, 2016. © 2015 Wiley Periodicals, Inc.

Outpatient biofeedback relaxation of the pelvic floor in treating pediatric dysfunctional voiding: a short-course program is effective.

INTRODUCTION: We report the treatment results of a short course of biofeedback relaxation of the pelvic floor (BRPF) in treating children with dysfunctional voiding. MATERIALS AND METHODS: Fourteen girls and 6 boys with videourodynamically proved dysfunctional voiding were enrolled. To increase the awareness of the abnormal voiding pattern, the anatomy of the pelvis and the results of a voiding diary and videourodynamics were extensively explained to the patients/parents. Surface electromyography and uroflowmetry were used as biofeedback tools to teach the adequate relaxation of the pelvic floor during voiding. The child was asked to practice the relaxation technique at home at least twice a day. BRPF was performed once a week until the child had 2 consecutive normal bell-shaped uroflow recordings. Patients were reevaluated at 4, 8, 12 and 24 weeks after BRPF training. RESULTS: The mean patient age was 8.3 +/- 3.8 years. The mean number of BRPF training sessions was 2.2 +/- 0.9. The mean follow-up period was 18.9 months. Normalization of abnormal uroflowmetry was achieved in 18 patients (90%). The mean maximal uroflow rate and voided volume increased from 13.3 +/- 4.3 to 18.0 +/- 3.4 ml/s (p < 0.01) and from 138 +/- 56 to 193 +/- 65 ml (p < 0.01), respectively. The postvoiding residual urine decreased from 54.5 +/- 47.6 to 21.3 +/- 10.6 ml (p < 0.01). Complete and partial resolution of voiding symptoms was achieved in 14 (70%) and 6 patients (30%), respectively. Recurrence was noted in 2 of the 10 patients who had complete resolution of symptoms and who had been followed up for more than 6 months. CONCLUSIONS: Short-course outpatient BRPF is an effective treatment of pediatric dysfunctional voiding.