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Biomedical subjects

R M Levin

Publications and source records attributed to R M Levin.

At least 127 records · Page 7Linked to original sources
PubMed1995

The ontogeny of bladder function in the fetal calf.

Although numerous experimental studies have addressed urinary bladder physiology and pharmacology, little information is available concerning the ontogeny of bladder function. The present in vitro study describes the developmental aspects of bladder compliance, pressure generation and emptying in bovine fetuses from early second trimester to term (280 days). The results can be summarized as follows: 1) bladder compliance increased 3-fold between early second trimester and term; 2) sustained contractile response to bethanechol was present in all bladders; 3) field stimulation produced a submaximal, nonsustained contraction and an active relaxation when the field stimulus was turned off; 4) bladder emptying in response to bethanechol was nearly 100% in mid- and late-gestational bladders but was only 50% at early gestation; 5) bladder emptying in response to field stimulation was 20% to 40% for all gestational age groups; 6) field stimulated relaxation was observed only in the fetal bladder. These studies demonstrate that bladder physiology in utero is different from postnatal bladder function. The presence of a relaxant response during the fetal period may reflect a unique and significant role of the in utero bladder in protecting the upper urinary tracts from sustained increased pressure.

Adenosine Triphosphate↗
PubMed1995

Effect of mucosal removal on the response of the feline bladder to pharmacological stimulation.

The urothelium plays an important role in the maintenance of normal bladder function. It provides a nonpermeable barrier to the contents of urine. The urothelium is directly involved in the transduction of both intravesical pressure and intravesical volume information to the afferent nerve fibers located within the lamina propria area. A third function may be to modulate bladder contractile function through local secretion of bioactive substances into the muscularis layers adjacent to the urothelium. To test this last hypothesis, the following experiments were performed: Strips of female cat bladders were isolated from the bladder body, base and urethra. The mucosa of alternate adjacent strips was removed, and the contractile response to field stimulation (FS), bethanechol (body), phenylephrine (base, urethra) and KCI was determined. For the bladder body, the strips without mucosa responded to FS, bethanechol, adenosine triphosphate (ATP) and KCI significantly greater than the strips with mucosa intact. For the bladder base and urethra, the contractile responses to FS, KCI and phenylephrine were significantly greater for the strips with mucosa removed as compared with the strips with mucosa intact. For the urethra and bladder base, FS in the presence of phenylephrine produced a relaxation. For the bladder base, the degree of FS relaxation of the isolated strips with mucosa removed was significantly greater than the strips with mucosa intact. For the urethra, FS relaxation was similar for the two groups. In conclusion, removal of the urothelium significantly and substantially increased the contractile response to FS, KCI, bethanechol and phenylephrine. Field stimulation relaxation in the bladder base was also enhanced. Thus in the cat, the mucosa has a significant inhibitory effect on the contractile response of the bladder to stimulation. The mechanism of this activity is not clear at the present time but will be the subject of further study.

Adenosine Triphosphate↗
PubMed1995

Metabolic responses of rabbit corpus cavernosum tissue to various forms of stimulation.

The present study was designed to investigate the effect of various forms of stimulation on the levels of high energy phosphates (ATP + CP) in the rabbit corpora cavernosa. Prestimulation with the alpha agonist phenylephrine (200 microM) for five minutes caused a significant decrease in both ATP and Creatine phosphate (CP) when compared with control tissue. Field stimulation (64 Hz) of the precontracted tissue induced an immediate decrease in tension by approximately 50%. The level of ATP + CP after field stimulated-relaxation was not significantly different from that from the initial prestimulation. Field stimulation (FS) from basal tone (2 g) caused a contraction and a significant decrease in both ATP and CP. Phentolamine (10 microM) (alpha-adrenergic antagonist) induced a significant decrease in the 2 g basal tension and a significant increase in the intracellular concentrations of both ATP and CP from that of control levels. In summary, the contractile response to both neuronal and pharmacologic stimulation was similar to that of other smooth muscle, producing a decrease in high energy phosphates. Field stimulated relaxation did not change the level of high energy phosphates from that of prestimulated levels. Finally, our data indicates that in the presence of the alpha blocker phentolamine (10 microM), high energy phosphate levels (ATP + CP) increase significantly. This indicates that in the corpus cavernosum, there is significant basal tone that is linked to significant tonic alpha receptor stimulation and is maintained by a net consumption of ATP.

Adenosine Triphosphate↗
PubMed1994

Alterations of mitochondrial oxidative metabolism in rabbit urinary bladder after partial outlet obstruction.

Previous studies demonstrated that one of the most significant cellular responses of the rabbit urinary bladder to partial outlet obstruction is a 50% decrease in the activities of the mitochondrial enzymes citrate synthase and malate dehydrogenase, when calculated as either activity per unit mass or activity per mg protein. A major question arose from these studies: Are the mitochondrial enzyme activities per mitochondrion reduced, or is the number of mitochondria per unit tissue mass reduced? The current experiments were designed to study the sequential changes in the activities of mitochondrial oxidative enzymes following partial outlet obstruction. The activities of NADH-cytochrome c reductase (NCCR), cytochrome oxidase (CO), citrate synthase (CS) and malate dehydrogenase (MDH) were measured in whole tissue homogenates and in mitochondrial preparations of separated bladder mucosa and muscle, from normal bladders, and, from hypertrophied bladders at 1, 3, and 7 days following partial outlet obstruction. The results can be summarized as follows: 1) Whole tissue homogenates: Activities of all enzymes were reduced to approximately 50% of control at 1 day following partial outlet obstruction. NCCR and CO activities returned to 75 and 85% of control respectively by 7 days post-obstruction; CS activity did not show any significant recovery over the 7 day period. 2) Mucosal and smooth muscle mitochondrial preparations: Activities of all enzymes were decreased significantly by 50% or greater at 1 day following partial outlet obstruction. The cytochrome (NCCR and CO) enzyme activities returned to control levels by 7 days post-obstruction; CS activity showed only a minor recovery over this time period. These results show that mitochondrial enzyme activity is significantly impaired immediately following partial outlet outlet obstruction, and whereas the activity of the cytochrome enzymes NCCR and CO recover to control levels (in the mitochondrial preparations) within 7 days post obstruction, the Krebs cycle enzymes (CS and MD) show no significant recovery. Thus, the regulatory mechanisms for the cytochromes is significantly different from that for the enzymes of the krebs cycle.

Animals↗
PubMed1994

Partial outlet obstruction of the rabbit bladder results in changes in the mitochondrial genetic system.

In the rabbit, partial outlet obstruction of the urinary bladder results in significant changes in the physiology, cellular structure, and cellular metabolism of that organ. One of the most striking changes observed is a 50% decrease in oxidative metabolism. Here we investigate whether the function of the mitochondrial (mt) genetic system is altered in rabbit bladder tissue following partial outlet obstruction. Southern analyses of total DNA prepared from bladder tissue excised as a function of time after initiation of partial outlet obstruction showed that the relative number of copies of the mt genome decreases as much as 10-fold during the first 7 d after obstruction, and that this attenuated mt genome copy number is maintained until at least 14 d post-obstruction. Northern analyses, in contrast, showed that mt COII and cytochrome b transcript levels initially decrease but recover to control levels by about 5 d after obstruction; that level is maintained through 14 d post-obstruction. Enzymatic analysis of cytochrome oxidase and NADH cytochrome c reductase activities in obstructed bladder tissue gave results which paralleled the pattern in the mt RNA analyses. Surprisingly, transcript levels for the mt-related nuclear COIV gene rapidly decreased to about 50% of control levels following obstruction and remained there until 14 d post-obstruction. These results indicate that partial outlet obstruction of the rabbit bladder leads to significant changes in the status and expression of the mt genetic system in bladder tissue.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

Ontogeny of the ryanodine receptor in rabbit urinary bladder smooth muscle.

Bladder smooth muscle contraction is mediated by both direct calcium entry through the cell membrane, and by calcium induced calcium release (CICR) from the sarcoplasmic reticulum (SR) storage sites. Ryanodine is a neutral plant alkaloid which binds to an ion channel located on the SR membrane. Its effects in cardiac skeletal muscle are well characterized where it inhibits the efflux of intracellular calcium stores, and thus it serves as a negative inotrope. It has also been shown that in the developing rabbit myocardium, there is a gradual increase in the expression of this ion channel. Little has been written about the expression and function of the ryanodine sensitive ion channel in smooth muscle. Recently we have shown that neonatal rabbit bladder smooth muscle is not very sensitive to ryanodine, while that from mature rabbits is extremely sensitive. This leads us to quantify the expression of the ryanodine sensitive ion channel. In this paper we demonstrate that the Kd values do not change to any significant degree with normal rabbit bladder development. However the Bmax values for 3 day, 2, 4, 6, and 8 week rabbit bladder smooth muscle are 7, 10, 15, 29, and 44 fmol specifically bound ryanodine/mg protein. The differences between the neonatal groups and the mature groups are significant (P < 0.5). This increase in ryanodine sensitive ion channel expression with normal growth would suggest that with normal maturation, the bladder smooth muscle cell acquires an increased pool of sequestered intracellular calcium. This would follow a similar pattern of development that has already been described in rabbit myocardium.

Aging↗
PubMed1994

An early molecular response induced by acute overdistension of the rabbit urinary bladder.

In the rabbit, partial urinary bladder outlet obstruction rapidly increases bladder mass and alters several parameters of normal bladder function. Previous experiments on this animal model (Buttyan et al. Neurourol. Urodyn. 11:225-238, 1992) had identified an early molecular response to partial outlet obstruction that involved the profound induction of mRNA encoding a heat-shock gene, hsp-70, as well as induced expression of mRNA for basic fibroblast growth factor and certain protooncogenes. Numerous physiological studies of the hypertrophied rabbit bladder indicate that the primary stimulus for bladder growth may be the initial overdistension that occurs as the bladder fills following partial outlet obstruction. The present study was undertaken to determine if the sequence and characteristics of gene activation during the recovery following a brief period of overdistension of the rabbit bladder are comparable with the gene activity previously described in association with partial outlet obstruction. Rabbit bladders were overdistended to 20% above capacity for 1 hr and then relieved. Bladders were recovered from control (untreated) rabbits and from rabbits at 1 hr or at 1, 3 or 5 days following relief of overdistension. RNAs extracted from these tissues were examined by Northern blot assays for a number of different mRNA transcripts previously shown to be altered by partial outlet obstruction. By 1 hr following the relief from acute overdistension, there was already a greater than 10-fold increase in the expression of hsp-70 related transcripts as well as a marked increase in the expression of mRNA encoding bFGF and decreased expression of TGF-beta 1.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

Alterations in the expression of the beta-cytoplasmic and the gamma-smooth muscle actins in hypertrophied urinary bladder smooth muscle.

The obstruction of the bladder outlet induces a marked increase in bladder mass, and this is accompanied by reduced contractility of bladder smooth muscle and alteration in the cellular architecture. In this study, we show that the composition of various isoforms of actin, a major component of the contractile apparatus and the cytoskeletal structure of smooth muscle, is altered in response to the obstruction-induced bladder hypertrophy. Northern blot analysis of the total RNA isolated from hypertrophied urinary bladder muscle, using a cDNA probe specific for smooth muscle gamma-actin, shows over 200% increase in the gamma-actin mRNA. However, the estimate of the amount of actin from the 2D gel reveals only a 16% increase in gamma-actin, since the 2D gel electrophoresis does not distinguish gamma-smooth muscle actin from gamma-cytoplasmic actin. The bladder smooth muscle alpha-actin and the smooth muscle alpha-actin mRNA are not altered in response to the hypertrophy. The obstructed bladder also reveals a decrease in the beta-cytoplasmic actin (37%) and a concomitant diminution in the beta-cytoplasmic actin mRNA (29%). Hence, the composition of the actin isoforms in bladder smooth muscle is altered in response to the obstruction-induced hypertrophy. This alteration of the actin isoforms is observed at both the protein and mRNA levels.

Actins↗
PubMed1994

Expression of stress proteins (HSP-70 and HSP-90) in the rabbit urinary bladder subjected to partial outlet obstruction.

Partial obstruction of the rabbit bladder outlet induces a rapid hypertrophy characterized by increased bladder mass, increased smooth muscle content, and increased collagen deposition. In addition, partial outlet obstruction induces decreased contractile responses to both field stimulation and postsynaptic receptor stimulation. Although the morphological and contractile responses to partial outlet obstruction have been well characterized, there is little information on the cellular and molecular mechanisms of these changes. In a previous study, we demonstrated that one of the earliest genes to be expressed following partial outlet obstruction in rabbits was the gene expressing stress protein-70 (HSP-70). In order to further define the genetic and molecular basis of these responses, the expression of stress gene products HSP-70 and HSP-90 in rabbit urinary bladder subjected to partial outlet obstruction has been quantitatively evaluated by Western blot coupled with laser densitometry using anti-HSP-70 and -90 monoclonal antibodies. The data show that stress gene products HSP-70 and HSP-90 are constitutively expressed in control rabbit bladder tissue and transiently increased following partial outlet obstruction. Increased content of HSP-70 was detected at 6 hr after obstruction and reached a maximum (2.7-fold over the control level) at 24 hr. Increased HSP-90 was also detected at 6 hr but reached a maximum (4.5-fold over the control level) at 12 hr. By 7 day post-obstruction, the content of these two proteins returned to the control levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

Effect of partial outflow obstruction on rat detrusor contractility and intracellular free calcium concentration.

Partial outlet obstruction induces significant alteration in detrusor contractility. A mild obstruction can result in increased contractile force, whereas severe obstruction results in marked contractile dysfunction. The cellular mechanisms mediating these alterations in the contractile response are presently not known. In the current study, we have investigated the effect of both mild and severe partial outlet obstruction on detrusor contractility and correlated the contractile response to field stimulation, bethanechol, adenosine triphosphate (ATP), and KCl with the level of intracellular free calcium using FURA-2 fluorescence. Our results are as follows. Severe obstruction induced a significantly greater increase in bladder weight than mild obstruction. In general, mild outlet obstruction induced an increase in the contractile responses to field stimulation, bethanechol, ATP, and KCl, whereas severe outlet obstruction induced a decrease to field stimulation and ATP. In general, the stimulated increase in intracellular free calcium paralleled the contractile response. The results indicate that the alterations in the contractile response to field stimulation and pharmacological stimulation induced by partial outlet obstruction may be mediated by altered calcium translocation and intracellular release.

Animals↗
PubMed1994

Comparative biochemical characteristics of the cat and rabbit urinary bladder.

The cat and the rabbit are two of the most popular models for the study of lower urinary bladder function. The cat has been used extensively for in vivo studies of spinal and supra-spinal micturition reflexes. In contrast, the rabbit has been used extensively for the in vitro study of bladder function. Although the cat and rabbit bladders are approximately the same mass, the cat bladder can generate approximately 6 times the intravesical pressure than the rabbit bladder at the same volume (in vitro response to field stimulation). In order to determine if the increased pressure generation is related to increased cellular energetics, we compared the intracellular concentrations of ATP and creatine phosphate (CP), and the enzyme activities of three enzymes which have important functions in cellular energetics: creatine kinase, citrate synthase, and malic dehydrogenase between the cat and rabbit urinary bladder. The results can be summarized as follows: (1) The bladder weight of the cat and rabbit are similar. (2) The isolated cat bladder can generate approximately 6 times the intravesical pressure of the isolated rabbit bladder. (3) The ATP and CP concentrations of the rabbit are significantly greater than the concentrations in the cat bladder. (4) The hydroxyproline concentration is significantly greater in the cat than the rabbit. (5) The maximum activities of creatine kinase, citrate synthase, and malic dehydrogenase are significantly lower in the cat than the rabbit. In general, it is clear that the ability of the cat to generate high intravesical pressures is not correlated with increased tissue high energy phosphate concentrations, or high enzymatic activities of three specific cytosolic or mitochondrial enzymes.

Adenosine Triphosphate↗
PubMed1994

Stimulation of DNA synthesis in rabbit bladder wall after partial outlet obstruction and acute overdistension.

Partial outlet obstruction of the rabbit urethrovesical junction (UVJ) has been used to induce pathology in the urinary bladder characteristic of obstructive damage observed in humans. The purpose of the experiments reported here was to compare the 3H-thymidine (3H-TdR) labelling of DNA in urinary bladders of male New Zealand White (NZW) rabbits subjected to partial outlet obstruction or overdistension. A total of 18 animals was used. Two normal controls, and 12 partially obstructed animals (at 1 day [D], 3D, 5D, 7D, 14D, and 21D) were injected (i.v.) with 3H-TdR at a dose of 0.5 microCi/g body weight. An additional 4 were overdistended to volumes 120% of maximum intravesical pressure, immediately emptied via the catheter, and injected with 3H-TdR 24 hr (1D) later. All animals were sacrificed up to 3.5 hr after injection of the label. DNA-associated radioactivity reached a peak at 3D after obstruction and was reduced substantially by 5D, although the level of incorporation remained well above control levels out to 21D. Levels of 3H-TdR incorporation 1D after overdistension bladders were about half of that found 1D following partial obstruction. The distribution of 3H-TdR labelled DNA in tissues was demonstrated by radioautography of histologic sections. One day following obstruction, 3H-Tdr incorporation was localized in the urothelium. Labelling of urothelium subsequent to 1D was reduced but remained above control levels until 21D. Labelled smooth muscle nuclei were observed only in control and 3D bladders, and they were measured at similar frequencies. Labelling of both intrinsic connective tissue (ICT) (mucosal, submucosal, and mural) and extrinsic connective tissue (ECT) (serosal) peaked at 3D after obstruction and declined thereafter but not to control levels. Labelling of ECT was, of course, limited to those bladders in which ECT was present (i.e., 3-21D). While the distribution of labelled cells in radioautograms was more variable 1D after obstruction than 1D after overdistension, the general cellular and biochemical responses to overdistension, as measured by DNA synthesis, are similar to those observed after partial outlet obstruction. Since the first sequela of obstruction is acute distension, these data support the assertion that the initial overdistension of the bladder initiates the cellular response to obstruction.

Animals↗
PubMed1994

3H-thymidine uptake by the rat urinary bladder after partial outflow obstruction.

Partial outflow obstruction induces marked changes in detrusor contractile function and morphology. One common finding in all experimental animal models of outflow obstruction is a significant increase in bladder mass. It is not clear which tissue compartments undergo hypertrophy, hyperplasia, or both. The present study was designed to evaluate the time-related changes in 3H-thymidine uptake and distribution within each tissue compartment induced by partial outflow obstruction using autoradiography. Partial outlet obstruction in rats induced a mild 2-fold increase in mass over a 14 day period. DNA synthesis increased significantly at 1 day following surgery, and remained increased through 7 days. DNA synthesis returned to control levels by 14 days. Distribution studies (using autoradiography) demonstrated a marked increase in the number of labelled urothelium cells at 1 and 3 days after obstruction. Sham surgery also initiated an increase in the number of labelled cells in the urothelium at 1 day. Although both sham and obstructive surgeries induced substantial increases in the labelling of cells within the connective tissue components, the magnitude of the increase in labelled connective tissue cells of the obstructed bladders was greater than that of the sham group. The number of labelled smooth muscle cells of the obstructed bladder increased significantly at 3, 5, and 7 days. However, there were no changes in smooth muscle incorporation of 3H-thymidine by the sham groups. In conclusion, partial outflow obstruction induced time-dependent increases in bladder wall proliferation. The urothelium and connective tissue were the compartments first affected, followed by smooth muscle.

Animals↗
PubMed1994

Rabbit as a model of urinary bladder function.

Micturition is a complex neuromuscular process. Although control mechanisms have been identified at several levels of the central nervous system and spinal cord, the final pathway in the control of micturition is the autonomic innervation of the urinary bladder and related structures. Following this line of reasoning further, micturition is ultimately dependent on the ability of the urinary bladder to both contract and generate intravesical pressure, and to modify its shape in such a way as to efficiently expel its contents without leaving a high residual volume. In order to understand the various elements of micturition, a wide variety of both in vivo and in vitro animal models has been developed. In many cases, animal models have been utilized to describe the effect of specific experimental pathologies on the lower urinary tract. The current review of the use of the rabbit in urological research is not meant to be a comprehensive treatise on the topic, but should provide a rational description of the how this species can be utilized to study both normal and pathological function.

Aging↗
PubMed1994

Ultrasound diagnosis of bladder outlet obstruction in rabbits.

One of the primary characteristics of partial outlet obstruction secondary to BPH is an increase in bladder mass commonly referred to as bladder hypertrophy. This condition has been simulated in rabbits by the partial ligation of the catheterized urethra. Ultrasonography has been utilized in both adult and pediatric urology to visualize the bladder and diagnose specific bladder disorders. The aim of the present study is to determine if ultrasonography can visualize bladder wall hypertrophy induced by obstruction. Partial outlet obstructions were created in NZW rabbits using standard methodologies, and then 5 to 7 days later, sonography was performed. The films were read by both the principal investigator and blinded investigators instructed to determine bladder wall thickness and from this predict the bladder weight. Then results were correlated with cystometrograms (CMGs) and whole bladder weights. Both the principal investigator and the blinded investigators were consistently able to distinguish obstructed from control bladders based solely on sonographic depictions of relative bladder wall thickness. In addition, the investigators were able to distinguish between low (control), medium, and high bladder weights based on sonography. The accuracy of predicting the bladder weights increased when cystosonograms were correlated with CMG studies. Thus, the degree of bladder hypertrophy can be accurately estimated by the combination of cmg and ultrasonography.

Animals↗
PubMed1994

Comparative studies on intracellular calcium and NADH Fluorescence of the rabbit corpus cavernosum.

Erectile function (erection and detumescence) involves the complex interaction of direct neuronal stimulation of corporal smooth muscle, neurohumoral release of specific endothelial contractile and relaxant factors, and secondary modulation by a variety of putative neuropeptides and vasoactive modulators. Using surface spectrofluorometry, we have correlated spontaneous contractile activity and the contractile response to field and pharmacological agents with intracellular calcium and NADH metabolism. The results demonstrate that the corpus cavernosal tissue has very unusual properties. Spontaneous contractile activity is correlated with a phasic increase in intracellular calcium. However, spontaneous contractile activity is most often correlated with a bi-phasic effect on the ratio of NADH/NAD. At the start of the spontaneous contraction, there is a sharp phasic increase in NADH/NAD; peak contractile force occurs simultaneous with a phasic decrease in this ratio showing that at peak force generation, there is a decrease in the level of intracellular energy. Phenylephrine stimulation results in an increase in intracellular calcium in proportion to the increase in tension; however, phenylephrine stimulation at low concentrations results in a net increase in the NADH/NAD ratio whereas high concentrations of phenylephrine result in a net decrease in the NADH/NAD ratio. In general, field stimulation results in a decrease in tension at low frequencies, a biphasic response at midfrequencies, and a contraction at high frequencies. These contractile responses are directly directly related to alterations in the intracellular concentration of calcium. That is, a decrease in tension is preceded by a decrease in intracellular calcium while an increase in tension is preceded by an increase in intracellular free calcium. Field stimulation results in a rapid and phasic alteration in the NADH/NAD ratio; however, the NADH/NAD response can be either an increase, decrease, or biphasic response. There does not appear to be a consistent relationship between the contractile/relaxant response to field stimulation and altered NADH/NAD ratio. Finally, ATP, bethanechol, and nitroprusside induce a decrease in the basal tension of the corpus cavernosal strips which corresponds with a decrease in the NADH/NAD ratio. However, whereas nitroprusside relaxation is correlated with a decreased intracellular calcium level, both ATP and bethanechol stimulate an increase in intracellular free calcium. These studies indicate that the response of the corpus cavernosal tissue to both field stimulation and pharmacological agents is complex and may involve both direct and indirect actions of a variety of cellular mediators on the corporal smooth muscle.

Animals↗
PubMed1994

Update on bladder smooth-muscle physiology.

The urinary bladder responds to distension induced by a number of different stresses with rapid and substantial increases in bladder mass and concomitant alterations in the contractile responses to neuronal stimulation, pharmacological simulation by autonomic agonists, and membrane depolarization. Furosemide, sucrose, or diabetes-induced diuresis, as well as outlet obstruction and overdistension all produce similar effects on the bladder. Accompanying the increases in bladder mass and contractile changes are increases in DNA synthesis and [3H]-thymidine uptake. Autoradiographic studies have localized the increased DNA synthesis following bladder distension initially to the urothelium, followed by slower increases in labelling of the lamina propria and extramural connective tissue. The net result of these compartmental differences in DNA synthesis is a reorganization of the structural relationships between smooth-muscle cells, the connective-tissue matrix, and the extrinsic connective-tissue lamina. This may contribute to the functional changes which occur after severe overdistension. Increases in the expression of heat-shock protein-70, basic fibroblast growth factor, N-ras, and c-myc, and decreases in transforming growth factor-beta occurred acutely after obstruction, suggesting that these changes may play a role in obstruction-induced bladder hypertrophy. Removal of the obstruction induces apoptosis of urothelial and connective tissue elements in the bladder, accompanied by increases in transforming growth factor-beta and decreases in basic fibroblast growth factor genes, and a reversal of the bladder dysfunction. Therefore the bladder hyperplasia after outlet obstruction and the regression following removal of the obstruction seem to be directly opposing processes governed by gene expression.

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