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Biomedical subjects

M Caine

Publications and source records attributed to M Caine.

At least 19 recordsLinked to original sources
PubMed1996

Functional antagonistic activity of Rec 15/2739, a novel alpha-1 antagonist selective for the lower urinary tract, on noradrenaline-induced contraction of human prostate and mesenteric artery.

The aim of this study was to compare with known reference standards the functional in vitro alpha-1 antagonistic activity of Rec 15/2739 on noradrenaline-induced contractions of human prostate and mesenteric artery. We also characterized these tissues with regard to the alpha-1 adrenoceptor subtypes present. Comparing the apparent pKB values revealed Rec 15/2739 to be one of the most potent compounds action on the prostate. Its potency was slightly lower than that of tamsulosin and was higher than the potencies of prazosin, terazosin and 5-methylurapidil. On the mesenteric artery, tamsulosin was the most potent compound. Comparing the results from the functional studies with those obtained from radioreceptor binding studies, we found that the potency (pKB value) in inhibiting the contraction of prostatic tissue showed a close and significant correlation with the affinity for native and recombinant alpha-1A adrenoceptors. No significant correlation was found with affinity for either the native or the recombinant alpha-1B adrenoceptor subtype, or for recombinant alpha-1d receptors. Similar results were obtained for mesenteric artery. In order to characterize further the alpha-1 adrenoceptor subtypes present in the examined tissues, we investigated the functional effects of chloroethylclonidine, an alpha-1B-D subtypes selective alpha-1 adrenoceptor irreversible antagonist, and those of nifedipine, which antagonizes the extracellular calcium influx primarily mediated by alpha-1A adrenoceptor stimulation. The results indicate the presence of both chloroethylclonidine-sensitive and -insensitive alpha-1 adrenoceptor subtypes in the human prostate, whereas in mesenteric artery the alpha-1A subtype seems to be present exclusively. The possibility that the functionally relevant alpha-1 adrenoceptor subtype could be classified as alpha-1L in both tissues shoul also be considered.

Adrenergic alpha-1 Receptor Antagonists↗
PubMed1993

[Terazosine in the treatment of benign prostatic hypertrophy].

A review is presented of the current status of terazosin in the treatment of BPH. The results of many clinical trials indicate a definite and significant improvement in both subjective and objective parameters. Attention is drawn to certain possible problems and limitations of placebo controlled trials with alpha-adrenergic blockers for BPH. Parameter improvements appear to be dose-related, and the importance of dose titration is stressed. The pharmacokinetic properties of the drug enables a once daily administration. Long term treatment for more than two years indicates that efficacy is maintained.

Administration, Oral↗
PubMed1991

Antispasmodic effects of flavoxate, MFCA, and REC 15/2053 on smooth muscle of human prostate and urinary bladder.

The antispasmodic effects of the flavone compounds flavoxate hydrochloride, 3-methylflavone carboxylic acid (MFCA), and REC 15/2053 (and in the case of the detrusor, oxybutynin), on the human detrusor, prostatic adenoma, prostatic capsule, and bladder neck, were studied by the in vitro isometric method. All the compounds inhibited, in different orders of potency, potassium-induced contractions of the tissues. Flavoxate showed a slightly greater activity than the other two compounds in the prostatic and bladder neck tissues. However, REC 15/2053 displayed greater activity in the detrusor than in the other tissues. The relaxant effect on the prostatic tissues suggests a potential use for these compounds in benign prostatic obstruction.

Adenoma↗
PubMed1990

Place of extracorporeal shock-wave lithotripsy (ESWL) in management of cystine calculi.

We treated 12 patients with sixteen renal and one ureteral cystine stones primarily with extracorporeal shock-wave lithotripsy (ESWL). Among the stones thirteen were greater than 25 mm. In four stones less than 25 mm, three stones completely disappeared and 1 was reduced to small fragments, following ESWL. In thirteen stones greater than 25 mm, twelve were treated by ESWL initially, and one by surgery. Of the 12 cases treated initially by ESWL, 4 became stone-free, 4 remained with small fragments, and 1 remained with large fragments. Two patients were operated on because of poor response to ESWL and 1 patient lost kidney function because of prolonged obstruction. Disintegration of cystine stones greater than 25 mm required an average of 8,522 shock-waves in 4.33 sessions. The problems associated with application of ESWL monotherapy to cystine stones are presented.

Adolescent↗
PubMed1990

Triorchidism--a reconstructive approach.

Testicular duplication is a relatively rare condition. A case is described in which conservative surgery was performed with reconstruction to produce a single testis.

Adult↗
PubMed1990

Alpha-adrenergic blockers for the treatment of benign prostatic hyperplasia.

There seems little doubt that alpha-adrenergic blockers can afford a measure of relief to many sufferers from BPH. The exact role this treatment has to play in the overall management of these patients has yet to be clearly defined. A continuing search is being made for more effective drugs, with the hope of finding one that will be more specific in its action on the prostate and produce fewer generalized effects. Whether this will prove possible may depend on whether any further subgroup of alpha receptors more specific to the prostate can be found or whether some method of targeting the drugs to the required region can be devised. If a drug treatment that reduces the size of the prostate can be found, perhaps a combination of the two forms of medical treatment will have a place. At present, it seems reasonable to conclude that there is good justification for using the alpha-blocking drugs available when employed in the manner and for the indications outlined herein.

Adrenergic alpha-Antagonists↗
PubMed1988

Treatment of complete staghorn calculi by extracorporeal shock wave lithotripsy monotherapy with special reference to internal stenting.

Extracorporeal shock wave lithotripsy monotherapy was used to treat 41 patients with complete staghorn calculi. In 20 patients polyethylene angiographic pigtail catheters were inserted prophylactically as ureteral stents and the other 21 patients did not receive stents. Prophylactic stenting reduced the incidence of complications and the need for percutaneous nephrostomy tubes to relieve subsequent ureteral obstruction. Internal stenting maintained the sterility of the urinary tract and reduced the average hospital stay by a third. Residual stone fragments representing less than 5 per cent of the original stone mass remained in 56 per cent of the patients, particularly in those with hydronephrotic kidneys. We suggest that extracorporeal shock wave lithotripsy monotherapy with prophylactic stenting is the preferred treatment for noninfected complete staghorn calculi.

Adult↗
PubMed1988

Vesicouterine fistula: a rare complication of cesarean section.

Vesicouterine fistula is a rare complication of cesarean section. Most patients present early postoperatively, while others are seen months later with urinary incontinence. Recurrent urinary infections, menstruation through the bladder (menouria), secondary infertility and amenorrhea are less common reasons for consultation. Although more than 100 such cases have been described, there have been few reports on fertility after surgical cure of the fistula. We report 4 cases of a vesicouterine fistula after cesarean section. The first patient was treated nonoperatively and the other 3 patients were treated surgically. Three patients had normal pregnancies after resolution of the problem. The clinical features, etiological factors and treatment modalities are discussed.

Adult↗
PubMed1988

Alpha-adrenergic mechanisms in dynamics of benign prostatic hypertrophy.

Smooth muscle tone in the enlarged prostate is directly related to stimulation of the alpha-adrenergic receptors present in prostatic tissue. Variations in tone produce corresponding alterations in the degree of prostatic obstruction. Such variations can explain the spontaneous symptomatic variations seen clinically in benign prostatic hypertrophy (BPH), and represent a "dynamic component" in obstruction which is superimposed on the underlying basic "mechanical component." The obstructive symptoms posed by the dynamic component can be reduced to a minimum by pharmacologic blockade of the alpha-adrenergic receptors. Alpha-blockade can also reduce irritative symptoms. Acute obstruction due to overstimulation of alpha-receptors can be relieved or prevented by alpha-blockade.

Adrenergic alpha-Antagonists↗
PubMed1987

Physostigmine and naloxone reverse the effect of intrathecal morphine on the canine urinary bladder.

Cystometrograms and urethral pressure profiles were used in 11 anaesthetized dogs to study the urodynamic effects of intravenously administered physostigmine (Group I--seven dogs) and intravenously administered naloxone (Group II--four dogs) following intrathecal morphine. In four of these dogs (Group III) intravenous physostigmine preceded the intrathecal morphine injection. In Groups I and II, intrathecal morphine 0.03 mg kg-1 caused a significant relaxation of the detrusor P less than 0.05), as expressed by a fall of 34.2 +/- 4.4% (SE) in mean intravesical pressure and a rise of 57 +/- 12.7% (SE) in calculated detrusor compliance at 90 min. Both physostigmine, 0.1 mg kg,-1 and naloxone, 0.025 mg kg,-1 given at this time completely abolished the influence of the narcotic on the bladder without changing urethral pressures. In Group III, physostigmine produced a marked rise in intravesical pressure (P less than 0.01) that was reversed by subsequent morphine. It is of interest that physostigmine, a potent cholinergic agent, and naloxone, a pure opiate antagonist, exert a similar action on bladder function.

Animals↗
PubMed1987

Shock-wave treatment for stones in the kidney and ureter. The Jerusalem experience.

We report on our first 6 months' experience with the extracorporeal shock-wave lithotripter (ESWL). During this period, 410 treatments were given to 350 kidneys and ureters. Our series was characterized by a particularly high proportion (40%) of multiple and large calculi and included 25 complete staghorns. The latter required multiple treatments (up to five), but no adjunct percutaneous nephrolithotomies were used in this series. A percutaneous nephrostomy was inserted in 20 cases. Thirty-six ureteric calculi above the pelvic level were treated in situ, with 95% success. The presence of a ureteric catheter is useful in these cases. Posttreatment pain was graded, and 61% of the patients did not require any analgesia. High-frequency jet ventilation was used in 91% of the 172 patients receiving general anesthesia and was of great value in minimizing respiratory-stone movement. The principal complication encountered was ureteric obstruction due to impacted particles. Temperature greater than 38 C occurred in 8.5% of the cases. It is suggested that the availability of the ESWL should encourage the early treatment of both renal and ureteric calculi, as well as enable the treatment of certain patients rejected for conventional surgery.

Adolescent↗
PubMed1986

The action of intrathecal morphine and methadone on the lower urinary tract in the dog.

The effects of intrathecally administered morphine and methadone on lower urinary tract dynamics were investigated by cystometrograms and urethral pressure profiles in 16 anesthetized dogs. The examinations were performed before and 30, 60 and 90 minutes following intrathecal injection of 0.03 mg./kg. morphine or methadone. Intrathecal normal saline was used for control studies. Significant relaxation of the detrusor was noted after intrathecal morphine as expressed by a decrease in mean intravesical pressure (p less than 0.05) and by a rise in the calculated detrusor compliance. These effects were reversed by intravenously injected naloxone. As opposed to morphine, methadone caused an increase in detrusor tone. No appreciable effects were observed on the urethra after intrathecal morphine or methadone. Neither intravenous injection of the opiates nor intrathecal administration of saline caused alterations in bladder tone. The result may imply a spinal, albeit opposing, effect of the two opiates on bladder dynamics.

Animals↗