Thesis (M.S.)--University of Wisconsin--Madison, 1991. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 48-53).

Proefschrift Rijksuniversiteit Groningen. / Datum laatste controle: 08-08-1996. Met lit. opg. - Met samenvatting in het Nederlands.

Thesis supervisor: Gerald F. Gebhart. Includes bibliographic references (p. 134-144).

Ketamine, widely used as an anesthetic since the 1970s, recently gained U.S. Food and Drug Administration (FDA) approval for treatment-resistant depression as a nasal spray. The use of off-label IV ketamine for pain relief, depression, and suicidal ideation has yielded promising results, but the consequences of long-term ketamine treatment have not received adequate attention. The dramatic, irreversible changes to the bladder seen in ketamine abusers and animal models should raise red flags, but the urgent need for effective depression medications prompted expedited FDA approval. Therefore, it is of the upmost importance to understand the deleterious effect of ketamine on the bladder and potentially other organ systems before a severely vulnerable patient population is exposed to dosages of ketamine that have yet to be examined for their long-term safety. Through an evaluation of current research, a two-pronged mechanism of ketamine-induced cystitis, involving nerve hypertrophy and incomplete apoptosis, was elucidated and may serve as a valuable guide for clinical care decisions, further research, and development of efficacious treatments

Abstract not available

Thesis (M. D.)--University of Hong Kong, 2006. / Title proper from title frame. Also available in printed format.

published_or_final_version / abstract / Medicine / Master / Doctor of Medicine

Interstitial cystitis is a chronic debilitating disease that causes pain and increased frequency of micturition, amongst other symptoms, without any identifiable cause. This disease affects a large number of the population, yet the etiology is still unknown. The present study aimed to characterize BDNF and CGRP—two neuropeptides that have both been proven to play an important role in the transmission of pain as well as in hypersensitivity. The signaling pathways regulating the expression of the two neuropeptides were also examined. Results revealed that BDNF protein expression levels increased in both L1 and L6 DRG following 48 hours post CYP-induced cystitis. CGRP protein expression levels decreased in L1 DRG, but increased in L6 DRG following 48 hours post CYP-induced cystitis. Examination of mRNA levels revealed an increase in the mRNA levels of both BDNF and CGRP in L6 DRG. NGF, a member of the neurotrophin family, mRNA levels also increased following 48 hour CYP-induced cystitis in the urinary bladder. Retrograde analysis revealed NGF possibly retrograde signaled to the DRG to increase BDNF and CGRP expression. Co-localization immunohistochemistry results revealed phospho-Akt co-localized with BDNF, but not with CGRP. Thus NGF retrograde signaling may activate the PI3-K/Akt cascade which may be involved in BDNF expression. CGRP expression may be via another signaling cascade.

CoordenaÃÃo de AperfeÃoamento de Pessoal de NÃvel Superior / A cistite hemorrÃgica (CH) Ã um evento inflamatÃrio frequentemente associado ao uso das oxazafosforinas. NÃs demonstramos que amifostina (AMF) pode prevenir o dano tecidual provocado pela ifosfamida (IFO). Sabendo-se que IFO tambÃm altera a funÃÃo motora do trato urinÃrio inferior, o presente trabalho foi realizado com o objetivo de investigar se AMF protege os animais contra as alteraÃÃes da funÃÃo vesical provocadas por IFO, e se este efeito ocorre atravÃs de mecanismos dependentes do Ãxido nÃtrico (NO) e dos canais de potÃssio sensÃveis ao ATP (KATP). Camundongos Swiss machos (25-30g, n=8) receberam salina (CTR)ou IFO (400mg/kg, ip) para induÃÃo de CH. Outro grupo recebeu, 30min antes de IFO, AMF (50mg/kg, sc), aminoguanidina (AMG, 50 mg/kg, ip), ODQ (2 mg/kg, vo) ou glibenclamida (GLI, 10 mg/kg, ip). Outros grupos receberam, 30min antes de AMF, L-arginina (L-ARG, 600 mg/kg, ip), ODQ ou diazÃxido (DIAZ, 2mg/kg, ip). Em outra seÃÃo, os grupos que receberam AMG foram prÃ-tratados com L-arginina e os que receberam GLI foram prÃ-tratados com diazÃxido, ambos com intervalos de 30 mim. O peso Ãmido vesical (PUV) e os parÃmetros macroscÃpicos e histopatolÃgicos foram analisados 12h apÃs a injeÃÃo de IFO. Em experimentos ex vivo, preparaÃÃes de mÃsculo liso vesical foram mantidas em soluÃÃo fisiolÃgica aerada com 95% de O2 â 5% CO2, pH 7.4 e a 37&#8304;C para registro isomÃtrico das contraÃÃes musculares a soluÃÃes despolarizantes de cloreto de potÃssio (KCl) e carbacol (CCh). Para o registro de pressÃo intravesical (PIV) por cistometrograma contÃnuo (CC), foi realizada uma laparatomia e um catÃter de polietileno fixado na bexiga e exteriorizado pela regiÃo abdominal foi conectado a um sistema de infusÃo contÃnua de salina (0.04mL/min) e a um transdutor de pressÃo acoplado a um sistema de aquisiÃÃo de sinais biolÃgicos. Nos animais tratados com AMF o aumento PUV provocado por IFO foi inibido em 83%. L-ARG e DIAZ nÃo preveniram tal efeito de IFO no PUV (1.1% e 11.4%, respectivamente). Os escores macro e microscÃpicos foram significativamente menores em AMF, comparados ao grupo IFO. L-ARG e DIAZ inibiram os escores de AMF. IFO diminuiu a contratilidade de tiras de bexiga ao CCh em relaÃÃo ao grupo CTR (1.36 Â 0.24 Vs 0.18 Â 0.02 g forÃa/mg de tecido seco; p<0.01). AMF preveniu a hipocontratilidade provocada por IFO ao estÃmulo com CCh (1.47 Â 0.16 g forÃa/mg de tecido seco; p<0.01). L-ARG e DIAZinibiram o efeito de AMF (0.6 Â 0.08 e 0.79 Â 0.12 g forÃa/mg de tecido seco, respectivamente; p<0.01 em relaÃÃo a AMF). Na anÃlise por CC, AMF reverteu o aumento da frequÃncia miccional (FM) provocada por IFO (18 Vs 5.6 micÃÃes/15 min, IFO e CTR, respectivamente; p<0.01. AMF â 6.5 micÃÃes/15 min; p<0.01 em relaÃÃo a IFO). L-ARG e DIAZ reverteram as FMs de AMF (p<0,01) (L-ARG: 14.5 e DIAZ: 11.2 micÃÃes/15 min). Os traÃados cistometrogrÃficos de CTR e AMF mostraram ciclos miccionais regulares com contraÃÃes evidentes associadas ao esvaziamento da bexiga. Nas anÃlises de CC de animais tratados com IFO, os traÃados mostraram ciclos irregulares de micÃÃo e nÃo foram observadas contraÃÃes evidentes associadas ao evento da micÃÃo. DIAZ tambÃm apresentou traÃados com este padrÃo. O tratamento com ODQ nÃo alterou o efeito sobre a disfunÃÃo vesical in vitro e in vivo promovida por IFO e nem sobre a proteÃÃo pela AMF. AMF inibe as alteraÃÃes motoras vesicais promovidas por IFO atravÃs de processos mÃltiplos que provavelmente incluem o NO e KATPs, sem envolver, no entanto, a geraÃÃo de GMPc. / Hemorrhagic cystitis (HC) is an inflammatory event often associated with the use of oxazafosforins. We have demonstrated that amifostine (AMF) may prevent tissue damage caused by ifosfamide (IFO). Considering that IFO also changes the motor function of the lower urinary tract, the present study aimed to investigate whether AMF protects animals against IFO-related bladder dysfunction, and if this effect occurs through anitric oxide (NO) and ATP-sensitive potassium channels (KATP) dependent mechanism. Male Swiss mice (25-30g, n = 8) were given saline or IFO (400mg/kg, ip) to induce HC. Another group received, 30min before IFO, AMF (50mg/kg, sc), aminoguanidine (AMG, 50 mg/kg, ip), ODQ (2 mg/kg, po) or glibenclamide (GLI, 10 mg/kg, ip ). Other groups received 30min before AMF, L-arginine (L-ARG, 600 mg/kg, ip), ODQ or diazoxide (DIAZ, 2mg/kg ip). In another experimental setting, the groups that received AMG were pretreated with L-arginine and those receiving GLI were pretreated with diazoxide each drug administered at intervals of 30 min. Bladder wet weight (BWW) and macroscopic and histopathological parameterswere analyzed 12h after IFO injection. Inin vitro assays, bladder smooth muscle preparations were kept in saline solution aerated with 95% O2 - 5% CO2, pH 7.4 and at 37 &#8304; C for isometric muscle contractions record the depolarizing solutions of KCl and carbachol (CCh). For the record of intravesical pressure (IVP) by continuous cystometrogram (CC), laparotomy was performed and a polyethylene catheter attached to the bladder and exteriorized through the abdominal region was connected to a system of continuous infusion of saline (0.04mL/min) and a pressure transducer coupled to an acquisition system biological signals. In animals treated with AMF,BWW was reduced by 83% when compared with IFO-injected mice. L-ARG and DIAZ did not preventIFO-induced BWW effect (1.1% and 11.4%, respectively). Macroscopic and microscopic criteria were significantly reduced in AMF injected mice versus IFO group. L-ARG and DIAZ failed to prevent such criteria in comparison to IFO group. IFO decreased bladder strips contractility response to CCh versus control group (1.36 Â 0.24 Vs 0.18 Â 0.02 g force / mg of dry tissue, p <0.01). AMF prevented the IFO-related decrease in contractility response (1.47 Â 0.16 g force / mg of dry tissue, p <0.01). L-ARG and DIAZ did not alter IFO effect bladder contractility (0.6 Â 0.08 and 0.79 Â 0.12 g force / mg dry tissue, respectively, p <0.01 compared to saline control). In CC analysis, AMF reversed the increased voiding frequency (VF) caused by IFO (18 Vs 5.6 micturition/15 min, IFO and CTR, respectively, p <0.01. AMF â 6.5 micturition/15min; p <0.01 compared to IFO). The VFs in L-ARG and DIAZ (14.5 and 11.2 micturition/15min, respectively) were significantly different from AMF group, p <0.01. Cystometrography recordings of control and AMF groups showed regular micturition cycles with evident contractions associated with bladder emptying, which as markedly different from IFO-injected animals that presented an irregular trace concerning micturition cycles and no evident contractions associated with the urination event. DIAZ also showed similar patterns to that of IFO. Treatment with ODQ did not alter either the in vitro and in vivo effects on bladder dysfunction promoted by IFO or upon protection by AMF. AMF inhibited IFO-related functional alterations in bladders through multiple processes that probably include NO and KATPs without involvingthe generation of cGMP.

Ketamine is a short-acting dissociative anesthetic and its hallucinogenic side effects have led to increased illicit use among night clubs and party goers. Clinically, ketamine abuse is associated with severe lower urinary tract dysfunction and reduced bladder capacity and hemorrhagic cystitis with irreversible pathological changes which may develop in some cases of long-term drug abuse. Up to now, the mechanisms causing these severe side-effects are still not clear. Herein, a novel ketamine addiction rat model was used to examine the pathological changes and explore the mechanisms of urinary bladders destruction. Rats were divided into groups of control, ketamine injection 14 days and 28 days. Ketamine injection (25 mg/kg/day) was given intraperitoneally while normal saline was given for control group. In vivo isovolumetric cystometrography studies were performed, bladder stiffness parameters were measured, and the bladder tissues were collected for protein analysis and immunohistochemical staining. Ketamine treatment significantly increased micturition pressure but decreased bladder capacity in rats. Ketamine treatment also significantly decreased bladder compliance and increased bladder non-voiding contraction during storage phase. Immunofluorescence studies showing significantly decreased neurofilament staining after ketamine injection 28 days confirmed the neurotoxicity of ketamine. TUNEL staining also showed multiple degenerating cells diffusely distributed in urothelium, suburothelium, and smooth muscle layers in ketamine injected rats. Western blotting demonstrated ketamine injection increased bladder iNOS, eNOS and COX-2 expression. It is concluded that chronic exposure to low, subanesthetic concentrations of ketamine could affect cell survival and impair neuronal morphology which subsequently led to dysfunction of neural networks and altered bladder micturation reflex.