• 대한약리학회지
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• 제28권1호
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• pp.81-89
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• 1992

항우울제에 속하는 imipramine은 유뇨증에 대한 치료제로서도 널리 사용되고 있다. Imipramine이 유뇨증 치료제로서의 명백한 치료효과를 보이기는 하나, 그 작용기전에 대해서는 아직 논란이 많다. 그 중 가장 유력한 설은 말초성 자율신경에 대한 작용으로서 무스카린성 길항작용과 교감신경말단에서의 catecholamine 재섭취 방해작용 및 직접적인 방광근 이완 작용 등이 제시되고 있다. 또 최근에는 방광 평활근에 대한 직접작용에 칼슘 이동 억압 작용이 중요한 역할을 한다고 주장되고 있다. 이에 본 실험에서는 흰쥐의 적출방광 배뇨근 절편을 사용하여 imipramine의 항유뇨작용과 calcium동원과의 관련성을 추구하여 다음과 같은 결과를 얻었다. 1. 배뇨근 절편은 전기장자극에 의해 주파수의존적으로 수축하였는데, 이 전기장자극 유발 수축반응은 imipramine에 의해 농도 의존적으로 억제되었고 고농도에서는 완전히 소실되었으나, atropine에 의해서는 고농도에서도 소실되지 않았다. 2. Imipramine은 자발수축 및 기본 장력에 대하여 이들을 농도 의존적인 양상으로 억제하였으며, 이 억제작용은 diltiazem에 의한 억제와 유사하였다. 그러나 atropine은 배뇨근절편의 기본장력이나 자발수축에 아무런 영향도 미치지 않았다. 3. $^*Imipramine$은 bethanechol 유발수축과 adenosine triphosphate (ATP) 유발수축을 농도의존적으로 억압하였다. 4. Imipramine은 칼슘배제용액에서 칼슘 첨가에의한 수축성의 회복을 억제하였는데, 이러한 작용은 diltiazem보다 그 효력이 낮았으나 그 작용양상은 유사하였다. 5. Imipramine에 의해 감소되었던 배뇨근절편의 기본장력은 calcium ionophore인 A23187에 의해 회복되었다. 칼슘배제 영양액에 장시간 노출됨으로써 기본장력은 소실되었으며, imipramine을 전처치한 경우는 A23187첨가에 의해 장력이 회복되지 않았으나, 세포내칼슘 유리억제제인 trimethoxybenzoic acid 8-(diethylamino)octyl ester [TMB-8]을 전처치한 경우 A23187은 배뇨근의 기본장력을 현저히 회복시켰다. 이상의 결과로 미루어 보아 imipramine의 배뇨근 수축 억제작용의 기전에는 무스카린성 및 퓨린성 수용체봉쇄작용도 관여하나, 주된 기전은 평활근세포에 직접 작용하여 세포외 칼슘의 유입을 억제하는 것으로 사료된다.

• Journal of Yeungnam Medical Science
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• 제11권2호
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• pp.293-302
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• 1994

유뇨증의 치료제로서 널리 사용되고 있는 imipramine의 작용기전에 관한 학설이 여러가지가 있으나 그 중 콜린성수용체 봉쇄작용을 관찰하기 위한 방법으로 평활근 세포를 분리배양하여 단일세포에 대한 acetylcholine의 수축작용과 이에 대한 imipramine의 길항작용을 atropine의 그것과 비교해 보기로 하였다. 개의 방광을 적출하여 $0{\sim}4^{\circ}C$의 K-H 용액내에서 $2{\times}2mm$크기의 평활근 절편을 얻어 $36^{\circ}C$의 collagenase 용액에 넣고 95%/5% $O_2/CO_2$, 혼합산소 공급하에서 17~20분동안 배양하여 분리된 부유세포군을 5 ml test tubes에 나누어 담고 acetylcholine을 $10^{-14}M{\sim}10^{-9}M$의 농도로 첨가하였다. Acrolein 1%를 가하여 수축한 세포를 고정시킨 후, 위상차 현미경에 장착한 CCTV camera로 채취한 영상을 microscaler로 전송하고 monitor상에서 세포의 길이를 측정하였다. 분리된 세포들은 acetylcholine에 의해 5초 이내에 최대 수축을 보였으며 이후 120초까지 수축상태를 지속하였다. Atropine은 acetylcholine 유발 수축을 atropine $10^{-7}M$ 에서부터 농도의존적으로 억제하였으며, imipramine도 acetylcholine 유발수축을 atropine과 같은 경향으로 농도의존적으로 억제하였는데, imipramine $10^{-9}M$의 저농도에서도 유의한 억제를 보였다. 이상의 결과를 종합하면 본 실험에 사용된 조건하에서의 collagense를 이용한 세포 분리법은 단일세포를 대상으로 하는 실험을 위하여 가용한 방법이며, imipramine은 개의 방광평활근 단일세포에서 atropine보다 더 강력한 콜린성 수용체 봉쇄작용을 나타낸다고 생각되었다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권6호
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• pp.2477-2479
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• 2012

Objective: To study the histomorphological pattern of urothelial tumors of the urinary bladder in Manipur and to evaluate whether any correlation exists between tumor grade and muscle invasion. Methods: A 10 year retrospective study of all consecutive cases diagnosed in the Department of Pathology RIMS - Imphal, between $1^{st}$ January 2001 to $31^{st}$ December 2010. Results: The study included 26 cases of transitional cell tumors of urinary bladder. The male to female ratio was 1.5:1 and the ages ranged from 38 years to 73 years (medians of 60 and 64 years, respectively). Of the total, 14 (53.9%) cases were low grade, 9 (34.6%) were high grade, 2 (7.7%) were papillomas and 1 (3.9%) was a papillary urothelial neoplasm of low malignant potential (PUNLMP). Pathological staging showed that 14 (53.9%) of the cases were stage PTa, four (15.4%) PT1, and eight (30.9%) PT2. Some 18.2% of low grade tumors and 75% of high grade tumors were invasive to the detrusor muscle layer. Conclusion: Bladder cancer is an uncommon disease, transitional tumors being the only histological type observed. It was more common in males than females, with peak incidence in seventh decade. Most of the tumors were non-invasive (PTa) and invasion to the detrusor muscle layer was seen in more than half of the high grade tumors. There is a definite correlation between advancing tumor grade and muscle invasion.

• Archives of Plastic Surgery
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• 제48권5호
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• pp.528-533
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• 2021

Bladder acontractility affects several thousand patients in the United States, but the available therapies are limited. Latissimus dorsi detrusor myoplasty (LDDM) is a therapeutic option that allows patients with bladder acontractility to void voluntarily. Our goal was to conduct a systematic review of the literature to determine whether LDDM is a better option than clean intermittent catheterization (CIC) (standard treatment) in patients with bladder acontractility. On January 17, 2020, we conducted a systematic review of the PubMed/MEDLINE, Cochrane Clinical Answers, Cochrane Central Register of Controlled Trials, Embase, and ClinicalTrials.gov databases, without time frame limitations, to identify articles on the use of LDDM for bladder acontractility. Of 75 potential articles, 4 fulfilled the eligibility criteria. The use of LDDM to treat patients with bladder acontractility was reported in four case series by the same group in Europe. Fifty-eight patients were included, and no comparison groups were included. The most common cause of bladder acontractility was spinal cord injury (n=36). The mean (±standard deviation) operative time was 536 (±22) minutes, postoperative length of hospital stay ranged from 10 to 13 days, and follow-up ranged from 9 to 68 months. Most patients had complete response, were able to void voluntarily, and had post-void residual volume less than 100 mL. Although promising outcomes have been obtained, evidence is still weak regarding whether LDDM is better than CIC to avoid impairment of the urinary tract among patients with bladder acontractility. Further prospective studies with control groups are necessary.

• The Korean Journal of Pain
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• 제9권2호
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• pp.412-414
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• 1996

Herpes zoster is an infection by the varicella zoster virus in a partly immune compromised person such as old age, cancer, immune deficiency disease. When either the upper lumbar or sacral segments are involved, serious urinary retention caused by central spread of herpes zoster from dorsal root ganglion can occur. The urinary disturbance appears to have been due to motor dysfunction of detrusor muscle, trigone muscle, and internal sphincter. We experienced two cases of zoster affecting different segments of the spinal cord and resulting in urinary retention.

• 대한전기학회:학술대회논문집
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• 대한전기학회 2007년도 심포지엄 논문집 정보 및 제어부문
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• pp.43-45
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• 2007

We developed a portable urodynamics monitoring system using personal digital assistance (PDA) and proposed a new method for measuring the abdominal pressure in non invasive mode using surface EMG signals. This system is consisted of a signal conditioning and control module and could measure the vesical, abdominal and detrusor pressure. The result showed a high correlation coefficient between the practical abdominal pressure, using a conventional rectal catheter and the estimated values, by our proposed algorithm (r=0.81). This system should prove a useful tool in the future evaluations of ambulatory urodynamics monitoring study.

• 한국시뮬레이션학회:학술대회논문집
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• 한국시뮬레이션학회 2005년도 춘계학술대회 논문집
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• pp.112-115
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• 2005

In this paper, had known weighing machine from the urine weight measuring, nonflexible net type resistant installed on uroflowmetry measures of occured uroflow from the origin voided flow vector force and detrusor action related to gain newly form's uroflowmetry embodied and than, whether clinical application took usefulness assessment.

• The Korean Journal of Physiology and Pharmacology
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• 제16권1호
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• pp.37-42
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• 2012

The aim of the present study was to elucidate the direct effects of melatonin on bladder activity and to determine the mechanisms responsible for the detrusor activity of melatonin in the isolated rat bladder. We evaluated the effects of melatonin on the contractions induced by phenylephrine (PE), acetylcholine (ACh), bethanechol (BCh), KCl, and electrical field stimulation (EFS) in 20 detrusor smooth muscle samples from Sprague-Dawley rats. To determine the mechanisms underlying the inhibitory responses to melatonin, melatonin-pretreated muscle strips were exposed to a calcium channel antagonist (verapamil), three potassium channel blockers [tetraethyl ammonium (TEA), 4-aminopyridine (4-AP), and glibenclamide], a direct voltage-dependent calcium channel opener (Bay K 8644), and a specific calcium/calmodulin-dependent kinase II (CaMKII) inhibitor (KN-93). Melatonin pretreatment ($10^{-8}{\sim}10^{-6}M$) decreased the contractile responses induced by PE ($10^{-9}{\sim}10^{-4}M$) and Ach ($10^{-9}{\sim}10^{-4}M$) in a dose-dependent manner. Melatonin ($10^{-7}M$) also blocked contraction induced by high KCl ($[KCl]_{ECF}$; 35 mM, 70 mM, 105 mM, and 140 mM) and EFS. Melatonin ($10^{-7}M$) potentiated the relaxation response of the strips by verapamil, but other potassium channel blockers did not change melatonin activity. Melatonin pretreatment significantly decreased contractile responses induced by Bay K 8644 ($10^{-11}{\sim}10^{-7}M$). KN-93 enhanced melatonin-induced relaxation. The present results suggest that melatonin can inhibit bladder smooth muscle contraction through a voltage-dependent, calcium-antagonistic mechanism and through the inhibition of the calmodulin/CaMKII system.

• Journal of Acupuncture Research
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• 제23권4호
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• pp.225-236
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• 2006

Objectives : This report intended to estimate effects taken by using Dong-Qi Acupuncture Therapy on a patient with neurogenic bladder induced by transverse myelitis(712, L1 level). Methods : From 6th May, 2005 to 30th June, 2005. The patient received Dong-Qi Acupuncture Therapy. Results : 1. Since being hospitalized, the patient's voiding has improved from intermittent catheterization to independent urination state. And the volume of residual urine has decreased from 150cc-350cc to 0cc-l0cc. 2. The urodynamic findings showed that first sensation, maximal detrusor pressure, compliance and maximal bladder capacity changed from 456ml to 195mL, from 29cmH2O to 31cmH2O, from none to 25.31mL/cmH2O, from under 650mL to 590mL, respectively. Conclusion : We considered Dong-Qi Acupuncture Therapy had a useful effect on Neurogenic Bladder.

• 한국지능정보시스템학회:학술대회논문집
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• 한국지능정보시스템학회 2001년도 The Pacific Aisan Confrence On Intelligent Systems 2001
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• pp.478-485
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• 2001

In this study, we have developed a prototype of clinical decision support systems (CDSS) for diagnosing neurogenic bladder and compared its predicted diagnoses with the actual diagnoses using 92 patient\`s Urodynamic study cases. The CDSS was developed using a Visual Basic based on the evidence-based rules extracted from guidelines and other references regarding a diagnosis of neurogenic bladder. To compare with the 92 final diagnoses made by doctors at the Yonsei Rehabilitation Center, we classified all diagnoses into 5 groups. The predictive rates of the CDSS were: 48.0% for areflexic neurogenic bladder; 60.0% for hyperreflexic neurogenic bladder in a spinal shock recovery stage; 72.9% for hyperreflexic neurogenic bladder, and 80.0% for areflexic neurogenic bladder in a spinal shock stage, which was the highest predicted rate. There were only 2 cases for hyperreflexic neurogenic bladder in a well controlled detrusor activity, and its predictive rate was 0%. The study results showed that CDSS for diagnosing neurogenic bladder could provide a helpful advice on decision-making for doctors. The findings also suggest that physicians should be involved in all development stages to ensure that systems are developed in a fashion that maximizes their beneficial effect on patient care, and that systems are acceptable to both professionals and patients. The future studies will concentrate on including more validating the system.