RESUMEN
BACKGROUND: The effects of female sex hormones on urinary stone formation are not known. This study was conducted to investigate the effects of these hormones on stone formation by using an ethylene glycol (EG) and vitamin D-induced rat urolithiasis model. METHODS: Adult female Wistar rats were fed the same diet for four weeks and were then divided into four groups (N = 10 each). One group was administered 0.5 ml of olive oil three times per week for four weeks as a control. The other three groups were administered 0. 5 microg of vitamin D3 and 0.5 ml of 5% EG three times per week for four weeks. The rats in two of these three groups were oophorectomized, and the rats of the remaining group underwent a sham operation on the day before the start of the four-week treatment period. One of the two oophorectomized groups was then administered a supplementation of female sex hormones (0.1 mg of estrogen and 2.5 mg of progesterone 3 times per week for 4 weeks). On the first day of the fifth week of the experimental period, the degree of crystal deposition was determined histologically, and the calcium content in renal tissue was measured. We also investigated the level of osteopontin (OPN) mRNA in renal tissues by Northern blot analysis. OPN is a matrix protein thought to be a promoter of stone formation. RESULTS: The urinary oxalate excretion, crystal deposition and calcium content in renal tissue and the expression of OPN-mRNA were greater in the oophorectomized rats compared with the controls, and the same parameters were inhibited by the female sex hormone supplementation. CONCLUSIONS: These results suggest that female sex hormones can inhibit renal crystal deposition in EG-treated rats by suppressing the urinary oxalate excretion and the expression of OPN.
Asunto(s)
Estradiol/sangre , Cálculos Renales/química , Cálculos Renales/metabolismo , Animales , Northern Blotting , Calcio/sangre , Calcio/orina , Ácido Cítrico/orina , Cristalización , Modelos Animales de Enfermedad , Glicol de Etileno , Femenino , Cálculos Renales/inducido químicamente , Médula Renal/química , Túbulos Renales Distales/química , Magnesio/orina , Osteopontina , Ovariectomía , Oxalatos/sangre , Oxalatos/química , Oxalatos/orina , Fosfoproteínas/genética , ARN Mensajero/análisis , Ratas , Ratas Wistar , Sialoglicoproteínas/genética , Vitamina DRESUMEN
Because human urine contains various substances which can affect each other, it is quite difficult to clarify the mechanism of formation of calcium oxalate (CaOx) crystal in urine. The authors recently determined CaOx crystalline content and the concentrations of other substances in urine specimens from patients with urolithiasis and healthy volunteers, and subjected the data to multi-regressive analysis for the purpose of assessing the effect of these urinary substances on CaOx crystal formation. 1. In analysis of urine from patients with urolithiasis, the partial correlation coefficients of CaOx crystal formation with oxalic acid, sodium, calcium, uric acid magnesium were 0.67, 0.28, 0.18, and -0.10, respectively. The formula of regression was as follows: Amount of CaOx crystal (X 10(6) microns3/ml) = 3.59 X 10(-2) Ox (mM/L) + 4.72 X 10(-3) Ca (mM/L) + 4.52 X 10(-3) Na (mM/L) + 2.51 X 10(-4) UA (mM/L) -2.39 X 10(-2) Mg (mM/L) -1.65. The multiple correlation coefficient was 0.759. Thus, in patients with urolithiasis, urinary crystal formation was most dependent on the oxalic acid level, sodium, calcium, and uric acid were found to promote crystal formation, while magnesium to suppress it. 2. In analysis of urine from healthy volunteers, the partial correlation coefficients of CaOx crystal formation with oxalic acid and inorganic phosphorus were 0.51 and -0.24, respectively. The formula of regression was as follows: Amount of CaOx crystal (X 10(6) microns3/ml) = 1.91 X 10(-2) Ox (mM/L) -3.43 X 10(-4) P (mM/L) +0.29 The multiple correlation coefficient was 0.525.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Oxalato de Calcio/orina , Cálculos Urinarios/orina , Calcio/orina , Cristalización , Humanos , Magnesio/orina , Masculino , Oxalatos/orina , Ácido Oxálico , Fósforo/orina , Análisis de Regresión , Sodio/orina , Ácido Úrico/orina , Cálculos Urinarios/etiologíaRESUMEN
A patient with testicular cancer (non-seminoma, stage IIB) who had undergone resection for primary disease and retroperitoneal lymph node dissection as well as chemotherapy and radiotherapy 6 years before developed iatrogenic retrograde ejaculation. The infertility was treated by oral medications, including herbal medicine and injections of a hormone preparation as well as artificial insemination of husband (AIH). After 24 sessions of AIH for 4 years, his spouse gave birth to a healthy baby girl. We believe that for patients with iatrogenic retrograde ejaculation AIH is an effective method of increasing fertility to be employed more often.
Asunto(s)
Infertilidad Masculina/terapia , Inseminación Artificial Homóloga/métodos , Escisión del Ganglio Linfático/efectos adversos , Adulto , Terapia Combinada , Eyaculación , Humanos , Masculino , Calidad de Vida , Neoplasias Testiculares/terapiaRESUMEN
With respect to prostatectomies carried out in clinic since the opening of the Kinki University Hospital in 1975, incontinence after prostatectomy was investigated with 470 patients as subjects for whom a follow-up study after the operation was possible. Also, the usefulness of the urodynamic tests for diagnosing underlying diseases was investigated. 1) Overall incidence of incontinence after transurethral resection of the prostate (TUR-P), retropubic prostatectomy (RPP) and cryoprostatectomy was 5.7 percent. 2) The incidence of incontinence was 7.1 percent of the patients with TUR-P and 3.5 percent of patients with RPP. The incidence of incontinence after cryoprostatectomy was none. 3) There was no clear differences among the incidence of incontinence after prostatectomy and the weight of resected tissues. 4) There was no clear differences among various types of incontinence after each procedures of prostatectomies. 5) The incontinence was satisfactorily treated and disappeared in 18 patients within one year after the operation. In patients who failed to get continence within a year, the incontinence was likely to persist furthermore. 6) The cure rate was low in patients with abnormal findings in a cystometrogram performed prior to the operation. Associated diseases which could cause disorders in nervous system were frequently encountered in such patients. 7) Drugs and functional electrical stimulation (FES) were introduced for the treatment of incontinence after prostatectomy. FES was effective in 36.4 percent in which drug therapy was not effective. Since multiple drug regimen was administered in most of the patients, it was difficult to make a precise evaluation of judgement for effect of each of drugs.