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Evidence that action potential generation is not the exclusive determinant to trigger spontaneous myogenic contraction of guinea-pig urinary bladder smooth muscle.

Urinary bladder smooth muscle (UBSM) exhibits spontaneous contraction. This spontaneous mechanical activity is myogenic and can be closely related to the UBSM cell action potential to facilitate Ca2+ influx through voltage-gated Ca2+ channels. In the present study, to know whether this membrane electrical event is the exclusive mechanism to trigger spontaneous smooth muscle contraction, we compared the inhibitory effects of Ca2+ channel blockers on the spontaneous action potential and mechanical activity in the isolated guinea-pig UBSM. Both action potential and rhythmic contraction were generated spontaneously in the presence of atropine (1 microM), phentolamine (1 microM), propranolol (1 microM), suramin (10 microM) and tetrodotoxin (1 microM), which suggest that both phenomena were myogenic in origin. Nisoldipine (100 nM) and diltiazem (10 microM) completely eliminated the generation of action potential whereas its frequency was dramatically increased by a dihydropyridine Ca2+ agonist, BayK 8644 (1 microM). In contrast to disappearance of action potential in the presence of Ca2+ channel blockers, spontaneous contraction of UBSM was inhibited only partly by nisoldipine or diltiazem and most of the mechanical components persisted in these channel blockers. These results indicate that spontaneous action potential in UBSM cell is generated through the activation of L-type voltage-gated Ca2+ channels. The subsequent elevation of intracellular Ca2+ concentrations during a burst of action potentials can be partly responsible for the induction of UBSM mechanical activity. In addition, the present study provides evidence that UBSM spontaneous mechanical activity is also attributable to the mechanism(s) other than the generation of Ca2+ spike.

Action Potentials↗

[The tolerance dose of the urinary bladder].

The tolerance dose of the urinary bladder was estimated by studying the late injury of the urinary bladder in 79 cases of the carcinoma of the urinary bladder treated by external irradiation, in 253 cases of the uterine cervix treated by conformation radiotherapy technique or two-axes arc therapy combined with low-dose rate intracavitary irradiation of small doses, and 55 cases of the carcinoma of the uterine cervix treated by low-dose rate intracavitary irradiation combined with whole pelvic irradiation with the center splitter. As a result, the tolerance dose in case of radiotherapy of the carcinoma of the urinary bladder was revealed to be as low as TDF 100. The tolerance dose in case of radiotherapy of the carcinoma of the uterine cervix treated mainly by conformation radiotherapy technique or two-axes arc therapy was proved to be TDF 110-120, and treated mainly by intracavitary irradiation 120 or over.

Brachytherapy↗

Study on the contraction and oxygen consumption induced by high K, Na-deficient solution in the urinary bladder and gall bladder of guinea-pig.

In urinary bladder and gall bladder of guinea-pig, the application of hyperosmotic 65.4 mM K solution induced a tonic contraction and increased the rate of oxygen consumption two or three times. The increased O2 consumption maintained steady level during 120 min. In isosmotic 154 mM K, Na-deficient solution, the tonic contraction gradually decreased and oxygen consumption also showed a transient increase followed by a small one. In the urinary bladder, the addition of pyruvic acid completely prevented the decline of the tonic contraction by iso-154K solution at 120 min, but this addition partially prevented it in the gall bladder. Hyperosmotic application of sucrose partially prevented it in the urinary bladder, but completely recovered it in the gall bladder. When NaCl was applied to iso-154K solution, the decrease of tonic contraction was prevented by half in both the muscles. The application of pyruvic acid and NaCl prevented the reduction of oxygen consumption by iso-154K solution in the urinary bladder, but in the gall bladder, this had little effect. There was a close correlation (r = 0.950) between the muscle tension and the rate of oxygen consumption in the urinary bladder at 120 min under various conditions. In the gall bladder, a correlation (r = 0.875) was also found between both when the results by hyperosmotic addition of NaCl and sucrose were omitted. In the urinary bladder, tension cost, a ratio of O2 consumption rate (mumol O2/g/min) to developed tension (kg force/cm2), was large (0.206) and similar to that of taenia coli; and that of gall bladder was small (0.130) and almost similar to that of vascular smooth muscle.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Roentgenologic abnormalities of the urinary bladder secondary to Crohn's disease.

Urinary tract symptoms and signs may result from secondary involvement of the urinary bladder in patients with Crohn's disease. In a small but significant proportion of these individuals, urinary tract symptoms represent the initial or predominant mode of presentation. Such patients may be erroneously treated for primary infection of the lower urinary tract for prolonged periods before the intestinal origin of the disease process is discovered. Roentgenologic abnormalities of the urinary bladder may provide early and important clues to the correct DIAGNOSIS. The various abnormalities of the urinary bladder which may occur secondary to Crohn's disease are described and illustrated, and the roentgenologic differential diagnosis is discussed.

Adult↗

The effect of partial outlet obstruction on prostaglandin generation in the rabbit urinary bladder.

Partial outlet obstruction of the urinary bladder has been demonstrated to induce specific dysfunctions in cellular and sub-cellular membrane structures within the bladder's smooth muscle and mucosal compartments. Recent studies have linked these membrane dysfunctions to alterations in phospholipid metabolism leading to mobilization of free arachidonic acid, the precursor for synthesis of prostaglandins (PG). The purpose of this study was to determine if partial outlet obstruction of the urinary bladder induces changes in the capacity of bladder smooth muscle and mucosa to generate PG. PG were isolated from control and partially obstructed urinary bladder smooth muscle and mucosa of male New Zealand White (NZW) rabbits. PG concentrations (PGE2, PGF2alpha and PGI2, as its stable metabolite 6-keto-PGF1alpha) were determined after 30 minute incubations using enzyme-linked immunoassay (ELISA) kits. In both control and obstructed rabbit urinary bladders, PG generation was significantly higher in isolated mucosa than muscle tissues. A significantly higher concentration of PGF2alpha, and 6-keto-PGF1alpha was measured in obstructed muscle tissue relative to controls. The concentration of 6-keto-PGF1alpha was also significantly higher than the concentrations measured for PGE2 and PGF2alpha in both control and obstructed smooth muscle samples. The generation of PGE2 was significantly higher in rabbit urinary bladder mucosa than either PGF2alpha or 6-keto-PGF1alpha in both control and obstructed samples. The capacity of obstructed mucosal tissue to generate 6-keto-PGF1alpha was significantly higher than control tissue, while no significant differences in PGE or PGF2alpha generation were noted. These data suggest obstruction of the urinary bladder induce specific elevations in PG in both smooth muscle and mucosal tissues.

6-Ketoprostaglandin F1 alpha↗

Role of ultrasonography and urinary cytology in diagnosing recurrence of superficial urinary bladder cancer compared to cystoscopy.

Urinary cytology, ultrasonogram of the urinary bladder and cystoscopy were done in 99 cases of urinary bladder cancer patients in the department of urology of Dhaka Medical College Hospital (DMCH), Dhaka, during the period from January 1997 to December 1998. Pre transurethral resection of bladder tumour (TURBT), urinary cytology was positive in 20.20% cases and ultrasound scan was positive in 96.9% cases. Histopathological examination revealed 95.96% as transitional cell carcinoma:- Grade I (3.0%), Grade II (62.6%) and Grade III (34.4%). During follow-up urinary cytology was positive in only one case whereas ultrasound scan was positive in 53.5% cases of whom only 21.6% patients had actual recurrent bladder tumours proved by cystoscopy. Statistical analysis of the three tests and histopathology showed significant variation though by Chi-square test the ultrasound scan is found superior to urinary cytology. We conclude when ultrasonography of the urinary bladder shows any suspected lesion it should be examined by cystoscope and biopsy should be taken from the suspected area for confirmation. Neither urinary cytology nor ultrasound scan can replace cystoscopic examination.

Adult↗

The addition of coaching to cognitive strategies: interventions for persons with compromised urinary bladder syndrome.

Compromised urinary bladder syndrome (CUBS) is defined as urinary frequency (UF) and/or urinary incontinence (UI) sufficient to be a problem. This term is an expansion of separate mainstream concepts referring to UF and UI, because the new term entails both phenomena considered at one time. Cognitive strategies (CS) offer one way to enhance the effectiveness and implementation of behavioral interventions directed to assist persons with CUBS. Two hypotheses predicted that persons receiving bladder health information would show less improvement on the outcomes than those receiving CS only or those receiving CS plus coaching after adjusting for type of UI. Secondly, persons receiving CS only would show less improvement on the outcomes than those receiving CS plus coaching. Data were collected at 3 time points, and the outcomes measured were comfort, bladder function, incidents of UF/UI (as recorded by participants in a diary), and perception of health. Neither hypothesis was fully supported. However, persons receiving information and information with CS plus coaching improved on comfort and UI/UF; all groups increased on bladder function; and perception of health did not change in any of the groups. Explanations for the mixed findings are proposed. In general, these findings support the application of conservative, noninvasive cognitive interventions innovatively applied through the use of pamphlets and audiotapes to help persons with CUBS experience increased comfort and improved bladder function. Implications for clinical practice are to provide a two-tiered intervention: education followed by CS with coaching if needed to enhance bladder function. A nursing role (as coaching) to augment specific interventions for CUBS is supported and should be differentiated for persons with symptoms of urgency.

Adult↗

Acute effects of full urinary bladder and full caecal urinary reservoir on regional renal function. A study with scintillation camera renography.

Scintillation camera renograms were recorded in six patients without a history of bladder function disturbances and in eight patients with caecal urinary reservoir. Each patient was studied once with empty bladder/reservoir and once with full bladder/reservoir. Renograms were obtained from parenchyma, pelvis and whole kidney. Time was measured from injection of isotope to peak of the renogram curve (Tmax) and to the point corresponding to the centre of gravity of the area under the curve (Tg). A full reservoir gave longer Tmax and Tg for both parenchyma and pelvis than an empty reservoir. With full bladder the only significant change was Tg increase for renal pelvis. In the patients with full caecal reservoir, the elimination of radioisotope from the renal pelvis was significantly slower, reflected as longer Tmax and Tg, than in the subjects with full bladder. In comparisons between empty and full bladder/reservoir, Tg permitted clearer separation between the groups than did Tmax. The higher Tmax and Tg values for full than for empty reservoir indicated obstruction to urinary flow and could be ascribed to the high intrareservoir pressure. Regularly occurring pressure waves with amplitudes of 30-65 cm H2O were recorded in the reservoirs, sometimes reflected as transient increases in radioisotope activity in the renograms. In some patients the two kidneys differed considerably in their response to a full urinary bladder or reservoir. The cause may have been difference in the dynamics of the two ureterovesical junctions or of the ureterointestinal anastomoses.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Ileocoecal augmentation and orthotopic bladder replacement in the management of urinary bladder injury following multiple trauma.

The authors offer their experience with the use of the ileocoecal segment for orthotopic bladder replacement (in 7 patients) or augmentation (in 2 patients) in contracted bladders after multilpe trauma. The group of patients was followed up for 6-35 months. In no case did replacement result in adverse metabolic changes, and it was invariably instrumental in normalization of the upper urinary tract, if dilated. By virtue of its hypotonic nature, replacement was not associated with incontinence, with urge incontinence persisting only in patients undergoing augmentation, probably in view of the remaining spacious lower urinary bladder segment with inadequate neurogenic signalization. As both intervention provided patients with a sufficiently long intermicturition intervals thus giving them relative comfort, the response by patients was most favourable.

Cecum↗

Xanthoma of the urinary bladder.

Xanthomas of the urinary bladder are rare lesions of reactive nature. They present as yellow-white mucosal plaques that may be mistaken for a neoplastic process. A biopsy displays stromal accumulation of lipid macrophages without accompanying inflammatory component. This article presents a 78-year-old woman who had a tumour-suspect xanthoma of the urinary bladder occurring subsequent to several resections of non-invasive carcinomas.

Aged↗

Phaeochromocytoma of the urinary bladder.

The occurrence of urinary bladder paragangliomas is rare. A 12-year-old Chinese girl who presented with history of blurring of vision was found to have grade IV hypertensive retinopathy. Investigations revealed a phaeochromocytoma on the posterior wall of the urinary bladder. A partial cystectomy with right ureter reimplantation was undertaken and her hypertension was promptly controlled. The diagnosis and management of this rare tumour is discussed.

Child↗

[Two cases of small cell carcinoma of the urinary bladder].

Small cell carcinoma of the urinary bladder is a rare entity, and is considered to be of neurosecretary origin. Its prognosis is generally poor even with aggressive therapy. In Japan, 19 cases of small cell carcinoma of the urinary bladder have been reported including our cases. We herein report two cases of small cell carcinoma of the urinary bladder. One patient was an 80-year-old male. Cystoscopy revealed a large tumor centered on the posterior wall of the urinary bladder. The biopsy specimen of the tumor revealed small cell carcinoma. Intraarterial infusion chemotherapy was performed. He died of multiple liver metastasis 8 months after chemotherapy. The other patient was a 80-year-old male. Cystoscopy revealed a bladder tumor on the left lateral wall. The biopsy specimen of the tumor revealed small cell carcinoma. Irradiation and partial cystectomy were performed. He has been well without any evidence of recurrence 6 months after surgery. Our cases and a review of the literature indicate that a multidisciplinary treatment may improve prognosis of small cell carcinoma of the urinary bladder.

Aged↗

Evaluation of an ultrasonographic score for urinary bladder morbidity in Schistosoma haematobium infection.

An ultrasonographic urinary bladder morbidity score was developed and tested in 510 patients with schistosomiasis haematobia, and then evaluated for screening 1,134 randomly selected children from villages endemic for Schistosoma haematobium. The ultrasonographic urinary bladder morbidity score had four grades ranging from normal to marked thickening of the urinary bladder wall or any polyps or masses. Among both patients and randomly screened subjects, the ultrasonographic score was greater (P = 0.01 and P < 0.01) in males than in females. Children examined in the clinic had higher (P = 0.03) ultrasonographic scores than adults. Infected subjects in communities were more likely (P < 0.001) to have urinary bladder morbidity than uninfected subjects, and clinic patients with egg counts > or = 20 eggs/10 ml of urine had higher (P = 0.03) ultrasonographic urinary bladder morbidity scores than those with lighter infections. The geometric mean egg count was higher (P = 0.04) in clinic patients with grade II and III lesions than in those with grade 0 and I lesions. There was progressive improvement of the grade of urinary bladder morbidity scores in patients treated with praziquantel at each follow-up examination (P < 0.001) and there was a positive relationship (P < 0.01) between urinary bladder morbidity scores and ultrasonographic-detected renal back pressure changes. The ultrasonographic urinary bladder morbidity score objectively measured the severity of urinary bladder morbidity and correlated with intensity of S. haematobium infection in our subjects. It can be used in evaluating both morbidity in patients and in community surveys and in following the outcome of chemotherapy.

Adolescent↗

Intracellular potentials of toad urinary bladder.

Short-circuited urinary bladders of Bufo marinus were impaled with microelectrodes. Intracellular potentials in the order of -80 mV were recorded. On inhibition of apical Na entry they hyperpolarized by about 15 mV and the fractional resistance of the apical membrane increased to near 1.0. These patterns are similar to those of other tight Na transporting amphibian epithelia. On two occasions, stable recordings from a single cell were obtained before and after oxytocin. Intracellular potential and fractional resistance of the apical membrane remained constant despite doubling of Na transport and cellular conductance. This finding suggests that oxytocin stimulates conductive pathways in both, apical and basolateral cell membranes of the toad urinary bladder.

Action Potentials↗

Immunohistomorphologic and molecular cytogenetic analysis of a carcinosarcoma of the urinary bladder.

Carcinosarcomas of the urinary bladder are malignant biphasic tumors with an epithelial and a spindle cell component. For the histogenesis of the two components, a biclonal and a monoclonal origin are discussed. We present the immunomorphology and molecular cytogenetics of such a case. The immunohistology of biopsies of the urinary bladder revealed a poorly differentiated urothelial carcinoma (GIII) and a co-existing pleomorphic, spindle cell leiomyosarcoma (GIII). The two components were microdissected and further analyzed for gains and losses of chromosomal material using comparative genomic hybridization. In addition, loss of heterozygosity analyses were included. The tumor components revealed as overlapping core aberrations losses on the short arm of chromosome 9 and on the long arm of chromosome 11. However, both components showed additional aberrations exclusively detected in one of the components. The occurrence of overlapping aberrations strongly argues for a monoclonal origin of this tumor with a common ancestor. The additional aberrations of the components point to an independent and divergent course of tumor progression in both components.

Aged↗