Chronotropic effect of the antithrombotic agent cilostazol in a patient with sick sinus syndrome and syncope.

In this case report we describe an 80-year-old man with sick sinus syndrome (SSS) who developed syncope attacks. The diagnosis of SSS was based on electrocardiographic evidence of markedly prolonged sinus arrests associated with syncope attacks while in hospital. The patient was given cilostazol, an antithrombotic agent that selectively inhibits cyclic nucleotide phosphodiesterase type 3, at a dose of 100 mg twice daily. The syncope attacks ceased, and an electrocardiogram obtained 1 week after the start of cilostazol administration showed no evidence of sinus arrest. The outcome of this case suggests that cilostazol may be useful in patients with syncope attacks due to SSS, although the long-term chronotropic effects of cilostazol need to be evaluated.

[Effects of terodiline on lower urinary tract function].

The effects of terodiline on lower urinary tract function were studied using decerebrated dogs. The micturition cycles were investigated by pressure flow EMG study before and after the administration of terodiline. The statistical analysis was carried out on the urodynamic parameter. Terodiline at a dose of 1 mg/kg decreased the opening pressure, contraction pressure, and flow rate and increased the residual volume. A decrease in threshold pressure, average flow rate and an increase in bladder compliance also occurred after the administration of terodiline at the dose of 3 mg/kg. Terodiline appears to decrease bladder activity and is useful for pollakisuria.

Role of the sympathetic nerve in bladder and urethral sphincter function during the micturition cycle in the dog evaluated by pressure flow EMG study.

The role of the sympathetic nerve on bladder and urethral sphincter function during the whole micturition cycle, including the collecting and emptying phases, was evaluated on 10 decerebrated dogs by pressure flow EMG study. A series of experiments was performed before and after hypogastric nerve transection. In the control condition and after hypogastric nerve transection, reflex micturition with bladder contraction and spasmodic rhythmic sphincter contractions occurred. Urodynamic parameters of the micturition cycle were statistically compared between control and nerve transection experiments. Threshold volume, threshold pressure and opening pressure showed a small but significant change after nerve transection. A decrease in voided volume seems to be secondarily accompanied with a decrease in threshold volume. It seems that adrenergic nerves play a certain role in bladder function during the collecting phase of the micturition cycle.

Effects of dobutamine on the in vivo urethra in the female dog.

The effect of dobutamine on the proximal urethra was investigated in vivo in female dogs. Dobutamine administered intra-arterially at the bifurcation of the iliac artery produced a rise in pressure and shortening along the transverse axis in the urethra.

Measurement of detrusor contractility in the reflex micturition of the decerebrate dog.

Detrusor contractility was measured in the reflex micturition of the decerebrate dog, using a computer directly connected to a urodynamic setup. Detrusor contractility parameters seem to be useful for evaluation of bladder function.

Effects of the autonomic antagonists on canine urethral responses to autonomic nerve stimulation.

The effects of the autonomic antagonists on urethral activity was studied in female dogs. Urethral responses produced by autonomic nerve stimulation were measured with pressure and motility changes in control conditions and after administration of autonomic antagonists. Phentolamine and guanethidine reduced both hypogastric and pelvic nerve mediated responses. It seems that urethral smooth muscle function is greatly influenced by adrenergic drugs.

Effects of autonomic agonists on in vivo female canine urethral motility.

The response of the urethra to intra-arterially administered autonomic agonists was studied in vivo by measuring the motility and pressure changes in female dogs. Phenylephrine produced shortening along the transverse axis with an increase in urethral pressure in a dose-dependent manner. Isoproterenol produced lengthening along the transverse axis with a decrease in urethral pressure. Both acetylcholine and dimethylphenylpiperazinium did not produce consistent patterns in urethral response. It seems that adrenergic drugs act predominantly on the circular muscle layer and cholinergic drugs act equally on both the circular and longitudinal muscle layers.

[Role of the striated urethral sphincter in the voiding cycle of the decerebrated dog].

The role of the striated urethral sphincter on the dynamics of micturition was studied using 4 decerebrated dogs. The voiding cycles were analyzed by pressure flow EMG and pressure flow plot studies before and after the administration of suxamethonium. In the control condition, highly reproducible reflex micturition with bladder contraction and spasmodic rhythmic sphincter contractions was demonstrated. After the administration of suxamethonium reflex micturition occurred, but there was decreased bladder emptying as well as absence of spasmodic rhythmic sphincter contractions. The striated urethral sphincter would seen to play an important role in bladder emptying of decerebrated dogs.

Application of ultrasonic M-mode scanning and computer evaluation on urodynamics.

The M-mode scanning images of urethra, detrusor pressure and urine flow rate during voiding were recorded together on the line scan recorder, and allowed for plotting and calculation of some valuable urodynamic parameters by computer evaluation. This procedure will permit first application of M-mode scanning and new direction on urodynamics.

Percutaneous introduction of suprapubic double lumen catheter into bladder for urodynamic examination.

A modified method of percutaneous introduction of a suprapubic double lumen catheter (8 Fr) into the bladder for urodynamic examination is described. This method permits to fill the bladder at the filling rate about 50-60 ml/min from the standard drip set, and the catheter can be percutaneously introduced into the bladder with safety.

Paired extraluminal strain gauge force transducers for measuring urethral movements.

Paired extraluminal strain gauge force transducers were implanted in the urethra to measure separately and simultaneously both longitudinal and transverse movements of the urethra. The advantage of our paired strain gauge force transducers is that both longitudinal and transverse changes of urethral movements can be detected.

Effect of verapamil on the lower urinary tract.

The effect of verapamil on the in-vivo bladder and urethra was investigated in female dogs. The bladder and urethral pressure responses to electrical stimulation of the pelvic and hypogastric nerves were decreased by verapamil.

Urethral response to nerve stimulation measured by strain gauge force transducer.

This paper presents a study of urethral responses to efferent nerve stimulation in dogs. The pelvic, hypogastric and pudendal nerves were stimulated using a programmed instrument under three different in vivo conditions. The preparations consisted of: (A) bladder, urethra, and rectum; (B) urethra and rectum, and (C) urethra only. Stimulation of the pelvic nerve in preparation A resulted in elongation and constriction of the mid and proximal urethra with a resultant rise in pressure. However, this response was reduced in preparations B and C. Similar observations were made with hypogastric nerve stimulation. The results of pudendal nerve stimulation were significantly different, in that the pressure rise occurred in the mild and distal urethra and varied in elongation response.