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W Artibani

Publications and source records attributed to W Artibani.

At least 19 recordsLinked to original sources
PubMed1995

Evidence for the presence of both pre- and postjunctional P2-purinoceptor subtypes in human isolated urinary bladder.

1. In order to characterize P2-purinoceptor(s) in human urinary bladder the contractile effects of ATP and its slowly-hydrolyzable analogues alpha, beta-methylene ATP (alpha, beta-MeATP) and beta, gamma-methylene ATP (beta, gamma-MeATP) were investigated on human detrusor strips taken from patients undergoing cystectomy for bladder carcinoma. 2. Serial concentration-response curves (SCRC) for ATP, alpha, beta-MeATP and beta, gamma-MeATP were constructed with an interval of 25 min between two successive doses to avoid tachyphylaxis. ATP (10 microM-10 mM) induced a phasic contraction, which was very rapid in onset. The dose-response curve to ATP appeared not to be monophasic: at the lower concentrations (10-300 microM) the curve was shallow, whilst at high concentrations (1-10 mM) the curve was steeper. The magnitude of the response obtained at the highest concentration tested (10 mM) was only 21.1 +/- 2.8% (mean +/- s.e. mean; n = 4) of the KCl (100 mM)-induced contraction. 3. alpha, beta-MeATP (0.3 microM-1 mM) and beta, gamma-MeATP (10 microM-1 mM) elicited a phasic contraction with a time course similar to that exhibited by ATP. The magnitude of the response obtained at the highest concentration tested (1 mM) was 70.3 +/- 6.3% for alpha, beta-MeATP (n = 10) and 27.9 +/- 4.5% for beta, gamma-MeATP (n = 8) of KCl (100 mM)-induced contraction. The rank order of potency was alpha, beta-MeATP > beta, gamma-MeATP > ATP. A plateau of response could not be achieved by any of these agonists. 4. The P2-purinoceptor antagonist, suramin (10-300 microM), dose-dependently antagonized only the lower part of alpha,beta-MeATP dose-response curve. Data were analysed in terms of dose-ratio estimated at two levels of response (10% and 35% of KC1 100 mM-induced contraction). At 10% of KCl response the Schild plot slope was 0.98 and the estimated pKB was 5.85, whereas using the dose-ratio at the 35% level of the KCl response, the Schild plot was not linear suggesting an interaction of alpha,beta-MeATP with a heterogeneous receptor population.5. The putative P2-purinoceptor antagonist, Coomassie Brilliant Blue G (CB-G) at 0.3 and 1 l micro M(n = 5), shifted to the left the alpha,beta-MeATP SCRC. The response at the highest concentration of agonist was potentiated, being equal to 78.8 +/- 11.7% of the KCl (100 mM) response (n = 5). CB-G at 0.3 microM also shifted to the left the beta,upsilon-MeATP SCRC and significantly potentiated the response at 1 mM up to 46.3 +/- 5.6% of KCl 100 mM response (n = 4).6. Pretreatment with terodotoxin (TTX) at 1 microM shifted to the left the alpha,beta-MeATP SCRC but the response to the highest concentration of the agonist was not potentiated, being 73.6 +/- 9.9% of the KCl(100 mM) response (n = 5). TTX (1 micro M) shifted to the left the beta,upsilon-MeATP SCRC and significantly potentiated the response at 1 mM (61.6 +/- 3.1% of KCl response; n = 4).7. The NO synthase inhibitor NG-nitro-L-arginine methyl ester (L-NAME) at 100 micro M did not modify the SCRC to either alpha, beta or beta,upsilon-MeATP.8. We conclude that in human detrusor muscle there is a heterogeneity of purinoceptors. The complex antagonism exhibited by suramin suggests the presence not only of Ph-purinoceptors but also of another contractile P2-purinoceptor subtype insensitive to suramin. Moreover, the activity of CB-G and TTX seems to support the existence of a prejunctional P2-purinoceptor subtype inducing the release of one or more inhibitor neurotransmitters.

Adenosine Triphosphate↗
PubMed1995

Bladder function in the aged rat: a functional and morphological study.

This study was designed to characterize urinary bladder function in the aged rat (27 months of age). For comparative purposes, two different control groups were included into the experimental protocol: normal 6-month old and hyperdiuretic 6-month old rats. Increased threshold volume for micturition and increased bladder mass were found in both aged and hyperdiuretic rats. No difference in the amplitude of micturition contractions was detected between groups. In the aged rat, but not in the hyperdiuretic one, augmented threshold volume and bladder mass were associated with increased intravesical pressure at micturition and structural changes of intramural bladder innervation. When activated, the vesicovesical reflex did not show any change in terms of rate of isovolumetric contractions. In the aged rat, altered sensory information on the state of maximum fullness seems to play an important role in determining abnormal cystometric findings.

Age Factors↗
PubMed1992

Urological manifestations of acute appendicitis: report of two new cases.

Clinical manifestations of acute appendicitis are variegated and urologic symptoms may be the first manifestation of the disease. In 1985 we reported on 2 cases of acute appendicitis who presented with irritative bladder symptoms. Here we describe 2 new cases come to our observation because of hematuria and irritative bladder symptoms. A brief review of the literature is also carried out.

Acute Disease↗
PubMed1992

Focal xanthogranulomatous pyelonephritis: diagnostic and therapeutic aspects.

The authors report 2 cases of localized xanthogranulomatous pyelonephritis (XGP) in which computed tomography (CT) permitted to raise a motivated clinical suspicion of inflammatory disease: the surgical exploration documented absence of neoplasm and allowed a conservative therapy implying only the removal of the mass. A literature review confirms that some CT signs in XGP permit differentiation from carcinoma. If they are present, in unifocal cases of disease, the authors suggest a limited surgical approach and a therapeutic strategy as conservative as possible.

Female↗
PubMed1992

Renal cell carcinoma with extension into the inferior vena cava: problems in diagnosis, staging and treatment.

Management of renal cell carcinoma with extension into the vena cava is one of the highest challenges in urology. The delineation of the upper level of the endocaval thrombus, its possible extension into the hepatic veins and possible involvement of the caval wall are crucial points and dictate the operative strategy. From 1978 to 1989, at the Department of Urology of the University of Padua, 29 patients with renal cell carcinoma and caval extension were submitted to surgery. Seventeen patients were staged V2 according to the UICC TNM Staging System 1983, 2 patients V3 and 10 V4. The median patient age was 57 years and the male:female ratio was 1.9:1. A complete thrombus removal was accomplished in all patients. In 2 patients, a caval resection was necessary. Five patients died during the perioperative period. The patient survival rate was comparable to that of T3N0M0-staged cases. Survival rates at 1 and 4 years were, respectively, 96.8 and 40% for V2 cases, 100 and 100% for V3, 85.7 and 40% for V4. It seems, therefore, that in patients with locoregional disease and satisfactory conditions, the presence of vascular invasion did not lead to a worst prognosis. By itself, the extent of the caval thrombus seems not to influence the prognosis.

Adult↗
PubMed1992

Video-urodynamic studies of minor voiding dysfunctions in children: an overview of 13 years' experience.

By the definition 'minor voiding dysfunctions' is understood children with a history of frequency, urgency, daytime wetting, squatting, and infrequent voiding, singly or in combination. Urinary tract infections (UTI) are often present but symptoms must also be present when the children are free of infection. The upper urinary tract is generally normal or has minor anomalies. Any evidence of infravesical obstruction, frank or occult neurogenic bladder, or emotional disturbances must be excluded. In this study we report 13 years' experience of video-urodynamic evaluation in children with minor voiding dysfunctions, with special reference to clinical information, morphofunctional correlations, relationship with recurrent UTI, vesico-ureteric reflux and dilatation of the upper urinary tract. According to our experience we estimate that about 60% of the patients evaluated in this study would not require a video-urodynamic evaluation today.

Child↗
PubMed1992

Ambulatory urodynamics: preliminary experience with vesico-urethral holter in children.

Detrusor function was evaluated by vesico-urethral holter (VUH), a computerized recording system (Urodec 500), in 17 children with lower urinary tract dysfunction. Eight had neurogenic bladders, eight had minor voiding dysfunction, and one was incontinent after posterior urethral valve ablation. VUH was technically satisfactory in, and acceptable to, all patients. It was more accurate in evaluating the type of urinary tract dysfunction than conventional urodynamics in 25% of the male patients and in 32.5% of the female patients.

Adolescent↗
PubMed1991

Results of contemporary radical cystectomy for invasive bladder cancer: a clinicopathological study with an emphasis on the inadequacy of the tumor, nodes and metastases classification.

We reviewed 261 patients who underwent a radical operation at a single institution as definitive treatment of invasive bladder cancer to evaluate the survival and accuracy of the tumor, nodes and metastasis system in characterizing the prognosis. Between January 1979 and June 1987 the 261 evaluable patients underwent 1-stage radical cystectomy with pelvic node dissection and urinary diversion. No chemotherapy and/or radiation therapy was given before or after the operation. The postoperative mortality rate was 1.8%. The over-all staging error between clinical and pathological stages was as high as 44%. The over-all actuarial 5-year survival rate was 54.5%. The 5-year survival rates were 75% for stage pT1, 63% for stage pT2, 31% for stage pT3 and 21% for stage pT4 disease. A significant difference in the survival (p less than 0.002) was observed in stage pT3 by dividing tumors confined within the bladder wall (pT3a, 50%) from those extending throughout the bladder wall (pT3b, 15%). A careful evaluation of transitional cell involvement of the prostate in stage pT4a cancer led to the identification of 2 different patterns: 1) contiguous when a bladder tumor extended directly into the prostate through the bladder wall and 2) noncontiguous when a bladder tumor and a transitional cell carcinoma of the prostate were found simultaneously. These patterns had completely different (p less than 0.05) survival rates (6 versus 37%). The patients with high grade tumors had a worse prognosis in comparison with those with grades 1 and 2 tumors (41 versus 56%, p less than 0.005). The over-all 5-year survival of patients with positive nodes was 4% in comparison with 60% of those without nodal involvement (p less than 0.001). Despite current optimal surgical treatment, nearly 50% of all patients with invasive bladder cancer continue to die. The need for a modification of the current tumor, nodes and metastasis tumor classification to provide the clinician a more reliable staging system for planning treatment modalities is indeed mandatory.

Actuarial Analysis↗
PubMed1991

Pharmacological analysis of 5-hydroxytryptamine effects on electrically stimulated human isolated urinary bladder.

1. 5-Hydroxytryptamine (5-HT) is able to potentiate the contractions induced by electrical field stimulation of pieces of human isolated urinary bladder. On the basis of available selective 5-HT agonists and antagonists, we have further investigated the receptors involved and their site of action. 2. 5-HT produced a concentration-dependent increase of the contractile response to electrical field stimulation from 0.1 nM to 1 microM. At higher concentrations (up to 100 microM) the effect decreased. These activities were mimicked by a variety of 5-HT agonists, for which the following rank order of potency was found: 5-HT greater than alpha-methyl 5-HT greater than 5-methoxytryptamine greater than 5-carboxamidotryptamine greater than 2-methyl 5-HT much greater than GR 43175. In addition the gastro-prokinetics agents metoclopramide, cisapride and the 5-HT3 antagonist ICS 205-930 behaved as 5-HT agonists, their EC50 values being 2.3, 0.3, and 0.5 (microM) respectively. 3. The 5-HT potentiating effect was resistant to antagonism by ondansetron (1 microM) and cyanopindolol (1 microM), selective 5-HT3 and 5-HT1A/1B antagonists respectively. The 5-HT2 antagonists ketanserin (1 microM), spiperone (1 microM) and methysergide (1 microM) also showed a weak inhibitory activity. Methiothepin (0.1-1 microM) antagonized only the inhibitory effect of 5-HT. Metoclopramide (0.1-1 microM), cisapride (0.01-0.1 microM) and ICS 205-930 (0.3-3 microM) all produced a rightward displacement of the 5-HT response curve with concomitant reduction of the maximum response. The pA2 values calculated were 7.4, 8.5 and 7.0 respectively. The antagonism of metoclopramide was receptor specific and was not apparently related to interactions with dopaminergic activity since domperidone showed no antagonism of 5-HT, and metoclopramide, itself, did not antagonize the potentiating effect of prostaglandin F2a.4. The receptor involved in the potentiating effect of 5-HT may be located prejunctionally because 5-HT did not potentiate responses to acetylcholine (ACh) or electrical field stimulation with the parameters of direct muscle excitation. Also, since the 5-HT potentiating effect was blocked by atropine, it may be attributed to a release of ACh.5. This study suggests that in the human urinary bladder 5-HT causes two opposite effects on the contractile response to electrical field stimulation. A potentiating effect at low concentrations due to an interaction with an atypical receptor, different from the classical 5-HT1, 5-HT2 or 5-HT3 subtypes and an inhibitory effect at greater concentrations probably due to an interaction with 5-HT1-like receptors. The possibility that this atypical receptor possesses some characteristics of those found in other isolated preparations like guinea-pig ileum, rat oesophagus and mouse embryo colliculi neurones is discussed.

Acetylcholine↗
PubMed1991

Page kidney: a curable form of arterial hypertension. Case report and review of the literature.

A case report of arterial hypertension which occurred 5 years after a blunt renal trauma is presented. The physiopathology of this type of hypertension along with the diagnostic features and the therapeutic aspects are extensively discussed. The sudden appearance of hypertension in a young patient following trauma must suggest a Page kidney as one of the diagnostic possibilities.

Adult↗
PubMed1991

Bilateral renal cell carcinoma with caval invasion in a woman with duplicated inferior vena cava.

Workup of a woman presenting with a palpable right flank mass, detected bilateral renal solid lesions, later proved to be renal cell carcinomas, and caval invasion in the presence of duplicated inferior vena cava. This association does not appear to have been previously described. The patient underwent right radical nephrectomy, cavotomy and auriculotomy with caval thrombus removal and delayed enucleation of left renal masses and left adrenalectomy. Eighteen months after surgery the patient is alive and without local and distant recurrence.

Adult↗
PubMed1990

Vescica Ileale Padovana: a technique for total bladder replacement.

A new technique for detubularized and originally reshaped ileal total bladder replacement following radical cystectomy for bladder cancer is described and named 'Vescica Ileale Padovana'. 16 patients have been clinically, radiologically and urodynamically evaluated with a follow-up ranging from 4 to 18 months (mean 10 months). The complication rate was low: 1 ureteroileal stenosis; 2 urethroileal strictures. Daytime continence was perfect in 87% (14 of 16 patients). Nighttime continence was perfect (dry sleep for 6-7 h) in 81% (13 of 16 patients). The reservoir features were: high capacity (400-650 ml); low pressure (mean pressure at capacity 17 cm H2O no pressure waves in 50% of patients 30-50 cm H2O wide pressure waves with 250-ml threshold volume in 50%); absence of reflux; complete voiding by abdominal straining, and perineal relaxation.

Cystectomy↗
PubMed1990

[Neurogenic bladder caused by meningomyelocele in childhood: urodynamic pattern and treatment regimens].

The authors reviewed the records of 160 patients with neurogenic bladder secondary to myelomeningocele (MMC) treated at the Urology Department of the University of Padua during 1977-1988. All patients had been evaluated by excretory urography, urethrocystography and videocystomannometry (VCM). Urodynamic studies are fundamental in determining vesicosphincteric dysfunction and patients who are at high risk for early renal lesions. For this reason, the authors recommend urodynamic evaluation from the first year of the infant's life in order to institute treatment early. The therapeutic approach should aim at a) preserving renal function, b) achieving a socially acceptable degree of urinary continence, and c) protecting sexual function.

Adolescent↗