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PubMed1990

Effect of hyperosmotic challenge on basolateral membrane potential in rabbit urinary bladder.

In the rabbit urinary bladder, serosal hyperosmotic challenge (SHOC) with either 33 mM NaCl or 66 mM mannitol caused basolateral membrane potential (Vbl) to initially depolarize from -52.6 +/- 1.6 to -48.4 +/- 1.4 mV, followed by a recovery of Vbl to -57.5 +/- 1.3 mV after 13.7 +/- 1.0 min. The voltage recovery was dependent on both serosal HCO3- and Cl-, and in the absence of both, Vbl depolarized to -11.6 +/- 1.5 mV and the ratio of apical-to-basolateral resistance (Ra/Rbl) decreased from 21.0 +/- 3.4 to 8.3 +/- 3.1. This decrease in Ra/Rbl and consequent depolarization of Vbl is caused by a decrease in basolateral K+ conductance. Replacement of serosal Cl- with NO3- or SCN- followed by SHOC caused a sustained depolarization of Vbl to -32.5 +/- 4.4 and -40.9 +/- 0.9 mV, respectively. However, when Br- was used to replace Cl-, voltage recovery occurred but was slowed (24.0 +/- 2.7 min) and reduced in magnitude (-47.5 +/- 3.5 mV). Addition of amiloride (1 mM) or niflumic acid (100 microM), but not bumetanide (1 microM), to the serosal bathing solution inhibited voltage recovery causing Vbl to depolarize to -36.3 +/- 2.6 and -41.5 +/- 4.5 mV, respectively. Serosal addition of ouabain after SHOC caused Vbl to depolarize by 10.8 +/- 0.9 mV in 2 min. We speculate that the SHOC-induced initial depolarization of Vbl is a loss of Ba2(+)-sensitive K+ conductance caused by cell shrinkage. The subsequent repolarization/hyperpolarization of Vbl is caused by an enhanced basolateral membrane Na+ pump current and a reappearance of the Ba2(+)-sensitive K+ conductance. The parallel operation of Na(+)-H+ and Cl(-)-HCO3- exchanges will then supply Na+ for the pump current and, via cellular accumulation of Na+, K+, and Cl-, might result in a partial recovery of cell volume and thus Ba2(+)-sensitive K+ conductance.

Amiloride↗
PubMed2003

Paraganglioma of the urinary bladder--a case report.

Paragangliomas of the urinary bladder are extremely rare tumors accounting for less than 1% of all bladder tumors. Males and females are affected roughly equally with an average age of 41 years. Hypertension and headache during or immediately after voiding in association with intermittent hematuria is virtually diagnostic of urinary bladder paragangliomas. A high index of clinical suspicion is required to diagnose these tumors. We present a case of a urinary bladder paraganglioma because of its rarity.

Adult↗
PubMed2005

Thyroid transcription factor 1 expression in small cell carcinoma of the urinary bladder: an immunohistochemical profile of 44 cases.

Small cell carcinoma of the urinary bladder is a rare and aggressive tumor resembling small cell carcinoma of the lung. Thyroid transcription factor 1 (TTF-1) expression is common in small cell carcinomas arising in the lung. However, studies of its expression in extrapulmonary small cell carcinomas have yielded varying results. Because information concerning the immunohistochemical profile of small cell carcinoma of the urinary bladder is limited, we investigated the immunoreactivity of this tumor to a battery of antibodies in a series of 44 cases. Using 5-mum sections cut from paraffin-embedded tissue blocks, immunohistochemistry was performed to detect TTF-1, cytokeratin (CK) 7, CK20, and uroplakin antigenicity in 44 cases of small cell carcinoma of the urinary bladder. None of the patients had primary lung tumors. The TTF-1 immunohistochemical stain showed nuclear positivity in 17 cases (39%). Positive immunostaining for CK7 was observed in 26 cases (59%). There was no positive staining with either CK20 or uroplakin. There was no correlation between TTF-1 expression and survival (P = .27). In addition, TTF-1 expression did not correlate with clinicopathological characteristics, including age (P = .74), sex (P = .53), smoking history (P = .96), clinical stage (P = .10), pathological T stage (P = .50), lymph node metastasis (P = .40), and distant metastasis (P = .58). In summary, TTF-1 expression in small cell carcinoma of the urinary bladder was found in 39% of the tumors, demonstrating that this marker is expressed in small cell carcinomas other than those of pulmonary origin. Small cell carcinoma of the urinary bladder is positive for CK7 immunostaining in 59% of cases consistent with its origin from urothelium. Unlike urothelial carcinoma, expression of CK20 and uroplakin in small cell carcinoma of the urinary bladder is consistently negative, and thus, these stains do not appear to be useful in the diagnosis of this neoplasm. TTF-1 positivity is not a significant prognostic factor in small cell carcinoma of the urinary bladder.

Adult↗
PubMed1993

Species differences in cAMP production and contractile response induced by beta-adrenoceptor subtypes in urinary bladder smooth muscle.

The contractile activity of urinary bladder smooth muscle has been shown to be inhibited by beta-adrenoceptor agonists. beta-Adrenoceptor subtypes in the rabbit, canine, and human urinary bladder smooth muscles were studied by measuring changes in contractile forces and in intracellular cAMP concentrations on administration of beta-adrenoceptor agonists. In the rabbit bladder, only beta 2-receptors may have functional roles in the detrusor muscle, while both beta 1- and beta 2-receptors may have functional roles in the detrusor muscles of the canine bladder. Only beta 2-receptors may have functional roles in the human detrusor muscles, similar to the rabbit detrusor muscles. Thus, species differences may exist in beta-adrenoceptor subtypes in smooth muscles of urinary bladder.

Animals↗
PubMed2005

Monitoring urinary bladder volume and detecting post-operative urinary retention in children with an ultrasound scanner.

BACKGROUND: Post-operative urinary retention (PUR) is associated with a risk of over-distension and permanent detrusor damage. The prevention of PUR by routine catheterization may increase the risk of urinary tract infection. Post-operative monitoring of the bladder volume is a reliable method in adults, but has not been evaluated for reliability in children. METHODS: Forty-eight patients who, according to current clinical guidelines, required urinary bladder emptying were scanned before catheterization using the Bladderscan. Volumes estimated with ultrasound were compared with volumes measured after emptying the bladder with a catheter. Bladder emptying was controlled by concomitant fluoroscopy in 20 children. RESULTS: The mean difference between the ultrasound estimates and the catheter-emptied urine volumes was 4 ml [standard deviation (SD) = 25 ml] in 26 children above the age of 3 years and -18 ml (SD = 19 ml) in 22 younger children. In the subpopulation in whom complete bladder emptying could be confirmed by fluoroscopy (14 children; median age, 3 years; range, 1-11 years), the mean difference between the ultrasound estimates and the catheter-emptied volumes was -11 ml (SD = 24 ml). CONCLUSIONS: This study confirms agreement between the ultrasound scanner estimates of urinary bladder volume and the urine volume measured by emptying the bladder. Reliability was good in children above the age of 3 years. The volume was underestimated in younger children. Thus, routine monitoring of urinary bladder volume with an ultrasound scanner is a non-invasive, pain-free and reliable way of preventing over-distension of the urinary bladder in children after surgery and other procedures under general anaesthesia.

Adolescent↗
PubMed2006

Urinary bladder cancer risk factors in men: a Spanish case-control study.

The rising incidence of urinary bladder cancer is alarming and potential relationships with different risk factors have been postulated. The purpose of this study was to examine the possible relationship between different environmental risk factors and urinary bladder cancer. All men with urinary bladder cancer who were admitted to the Department of Urology of Reina Sofia University Hospital of Cordoba, Spain over 1 year were included in our study. Men were administered an interview questionnaire, which included data on history of known urinary bladder cancer risk factors. Comparisons between men with urinary bladder cancer (cases) and those with nonmalignant urological disease (controls) were made. The study included 74 cases and 89 controls. The variables associated with malignant lesions on univariate analysis were age, smoking and drinking alcohol. Meanwhile, fish, poultry and beef consumption were proved to be protective factors. The risk factors identified by the logistic regression analysis were age, smoking and fluid intake. The independent protective factors on the multivariate analysis were fish and poultry consumptions. Smoking was found to be the principal independent risk factors for urinary bladder cancer. Our results call for further investigation of urinary bladder cancer risk factors; future studies should preferably be performed on large prospective cohorts, to increase their validity.

Age Factors↗
PubMed2000

Genetic modeling of human urinary bladder carcinogenesis.

We developed a model of human urinary bladder cancer progression from in situ precursor lesions to invasive carcinoma using whole organ histologic and genetic mapping. The model represents a high-density and detailed analysis regarding allelic losses on chromosomes 4, 8, 9, 11, and 17 as revealed by testing of 234 samples obtained from five cystectomy specimens. The samples corresponded to microscopically identified intraurothelial precursor conditions ranging from dysplasia to carcinoma in situ and invasive cancer. The initial analysis of paired normal and tumor DNA samples disclosed allelic losses in 72 of 225 tested hypervariable DNA markers. Subsequent use of these markers on all mucosal samples revealed that 47 had alterations with a statistically significant relation to urothelial neoplasia. The allelic losses clustered in 33 distinct chromosomal regions, indicating the location of putative tumor suppressor genes involved in the development and progression of urinary bladder cancer. Some of the markers with statistically significant allelic losses mapped to the regions containing well-characterized tumor suppressor genes but many were located in previously unknown loci. The majority of statistically significant allelic losses (70%) occurred early in low-grade intraurothelial dysplasia, and some of them involved adjacent areas of morphologically normal mucosa preceding the development of microscopically recognizable precursor lesions. The remaining 30% of markers developed allelic losses in the later phases of urothelial neoplasia, implicating their involvement in progression to invasive disease. Markers exhibiting allelic losses in early phases of urothelial neoplasia could be used for detection of occult preclinical or even premicroscopic phases of urinary bladder cancer, whereas markers that showed allelic losses in the later phases of the process could serve as indicators of progression to invasive disease. The approach used in this study facilitates genome-wide modeling of cancer progression and provides important chromosomal landmarks for more specific studies of multistep urinary bladder carcinogenesis.

Aged↗
PubMed1985

[Structural features of the intrinsic venous bed of the human urinary bladder].

The intraorganic veins of the human urinary bladder have been studied in a vast sectional material. The veins within the organ make an enormous multilayered plexus which is differently organized in various layers of its wall. Abundant anastomoses, multiplicated ways for outflow from every layer, manifested interactions between the venous plexuses are specific for the intraorganic venous bed of the urinary bladder. The structures for an active regulating the hemomicrocirculatory blood stream are widely presented in the urinary bladder. In its every tunic certain specific morpho-functional features for organization and adaptation of the intraorganic venous bed are revealed.

Adolescent↗
PubMed1999

Comparative sensitivity of urinary CYFRA 21-1, urinary bladder cancer antigen, tissue polypeptide antigen, tissue polypeptide antigen and NMP22 to detect bladder cancer.

PURPOSE: We compare the individual and combined sensitivity of urinary CYFRA 21-1, urinary bladder cancer antigen, tissue polypeptide antigen and NMP22 to detect bladder cancer, evaluate the false-positive rates for different pathological conditions, and assess differential sensitivity regarding histological and clinical characteristics of disease. MATERIALS AND METHODS: A total of 267 subjects entered the study. Sensitivities of the tests were evaluated in 111 patients with active bladder cancer and 76 with no evidence of disease. False-positive rates were evaluated in 80 symptomatic and asymptomatic controls, including patients with benign urological conditions and nonbladder malignancies, and healthy subjects. CYFRA 21-1 was determined by electrochemoluminescent immunoassay in the Elecsys 2010, urinary bladder cancer antigen was quantified by enzyme linked immunosorbent assay (IDL Biotech), tissue polypeptide antigen was measured by the Prolifigen TPA-IRMA and NMP22 was assayed by enzyme linked immunosorbent assay (Matritech). Cutoffs were obtained by the 95% percentile in patients with no evidence of disease, which gave a 95% specificity for all biomarkers. Differences in sensitivity of urinary biomarkers regarding stage, grade, tumor size, pattern of growth, focality and recurrence were evaluated. RESULTS: At a specificity of 95% cutoffs were 5.4 ng./ml. for CYFRA 21-1, 15.5 microg./l. for urinary bladder cancer antigen, 760.8 U./l. for tissue polypeptide antigen and 14.6 U./ml. for NMP22. Using these cutoffs sensitivities were 75.7% for NMP22, 83.8% for CYFRA 21-1, 73.9% for urinary bladder cancer antigen quantitative and 80.2% for tissue polypeptide antigen. The additional determination of cytokeratins increased the sensitivity of NMP22. Cytokeratins did not appear to be specific for bladder cancer, and false-positives rates were between 20% for urinary bladder cancer antigen and 36% for tissue polypeptide antigen for benign urological conditions, and between 40% and 52%, respectively, for nonbladder malignancies. NMP22 showed lower false-positives rates, mainly for benign diseases. Urinary tumor markers appeared to be associated with some of the most relevant histological and clinical parameters of bladder cancer. CONCLUSIONS: Our preliminary evaluation showed the tests to be potential noninvasive adjuncts to help determine the need for cystoscopy. The combination of 2 tumor markers, NMP22 and 1 cytokeratin (CYFRA 21-1 or urinary bladder cancer antigen), seemed to be the most effective. Further comparative studies are needed to assess the promising diagnostic role of these markers.

Aged↗
PubMed1988

Primary choriocarcinoma of the urinary bladder.

A case of choriocarcinoma of the urinary bladder is presented. A 57-year-old man underwent a cystectomy for transitional cell carcinoma, grade II. Choriocarcinoma was found, in addition to the transitional cell carcinoma, in the removed urinary bladder. After the operation, metastases appeared in both lungs, evolving rapidly despite chemotherapy. The patient died five months after admission. Immunohistochemically, staining for human placental lactogen was strongly positive, and both alpha and beta subunits of human chorionic gonadotropin were weakly positive in the primary site of the removed urinary bladder and in the metastatic foci.

Carcinoma, Transitional Cell↗
PubMed1989

In situ freezing of the rat urinary bladder: DNA adduct formation in the bladder epithelium demonstrated by 32P-postlabeling assay.

In situ freezing of the urinary bladder has been demonstrated to exert tumor-initiating potential in two-stage urinary bladder carcinogenesis in the rat. In the present experiment, DNA modification was examined after in situ freezing of the whole urinary bladder performed by pinching with frozen forceps at -15 degrees C or -30 degrees C for 2 s. The 32P-postlabeling analysis revealed at least 2 DNA adducts in the epithelial cells of the urinary bladder collected 3 days after freezing. Single-strand breaks of DNA were also found by means of the alkaline elution assay in the bladder epithelium collected 10 min after freezing. Thus, the previously demonstrated tumor-initiating activity of in situ freezing in urinary bladder carcinogenesis was revealed to be associated with substantial DNA damage and adduct formation.

Animals↗
PubMed2000

Role of prostanoids in the contraction induced by a tachykinin NK2 receptor agonist in the hamster urinary bladder.

In isolated strips of the hamster urinary bladder the selective tachykinin NK2 receptor agonist [betaAla8]NKA(4-10) induced a concentration-dependent (1 nM-10 microM) contraction (EC50 104 nM) associated with significant release of prostaglandin E2 (PGE2, 50+/-17 pg/mg tissue). In mucosa-free bladder strips [betaAla8]NKA(4-10) was as potent as in the presence of mucosa (EC50 46 nM), although the evoked PGE2 release was significantly less than in controls (6+/-1.7 pg/mg tissue). Dexketoprofen (10 microM) produced a significant but limited rightward shift of the concentration/response curve to [betaAla8]NKA(4-10) both in the presence and absence of the mucosal layer: the EC50 for [betaAla8]NKA(4-10) was increased five- and threefold, respectively. The evoked PGE2 release was abolished in both cases. The selective tachykinin NK2 receptor antagonist, nepadutant (10 nM-1 microM) produced a concentration-dependent and even inhibition of both contraction and PGE2 release induced by [betaAla8]NKA(4-10). The L-type calcium channel blocker, nifedipine (1 microM) and the non-selective cationic channel blocker SKF 96365 (30 microM) both inhibited the contractile response to [betaAla8]NKA(4-10) (89+/-2 and 83+/-2% inhibition, respectively). The evoked PGE2 release was not affected by nifedipine but was almost abolished by SKF 96365. Arachidonic acid (100 microM) induced a contractile response (5.9+/-0.7 mN) associated with a large production of PGE2 (383+/-78 pg/mg tissue). The contractile response to arachidonic acid was inhibited by both nifedipine (1 microM) and SKF 96365 (30 microM) (83+/-5 and 79+/-3% inhibition, respectively). The PGE2 production induced by arachidonic acid was markedly inhibited by SKF 96365 only (about 94% inhibition). Exogenous PGE2 contracted hamster bladder strips in the presence of dexketoprofen (EC50 1 microM) and strongly potentiated the contractile response to a submaximal concentration of [betaAla8]NKA(4-10). In anaesthetized hamsters the administration of [betaAla8]NKA(4-10) (10 nmol/kg, i.v.) produced a contractile response of the urinary bladder (13+/-0.4 mmHg) that was inhibited partly by dexketoprofen (25+/-3 and 35+/-4% inhibition for 0.2 and 2 mg/kg, i.v. dexketoprofen, respectively). We conclude that activation of tachykinin NK2 receptors determines prostanoid synthesis/release in the hamster urinary bladder and that this effect is largely ascribable to structures present in the bladder mucosa. Prostanoids generated following NK2 receptor activation amplify the direct contractile effect of NK2 receptor agonists. This latter response is largely due to activation of L-type calcium channels (nifedipine-sensitive) although this source of calcium apparently is not essential for activation of prostanoid synthesis.

Animals↗
PubMed2001

Lessons to be learned: a case study approach. Paraganglioma of the urinary bladder.

Primary paraganglioma arises infrequently in the urinary bladder. We present here the clinicopathological, immunohistochemical and ultrastructural findings in a 23-year-old Saudi female. She was hospitalised because of gross haematuria over the previous seven days. The intravenous urogram revealed a filling defect in the urinary bladder. Cystoscopy disclosed a non-papillary tumour arising from the roof of the bladder neck. Transurethral resection was, accordingly, performed--but marked fluctuation in blood pressure was observed during the procedure. The histopathological findings of trabeculae and small nests of plump oval to spindle cells with a clear to acidophilic cytoplasm, forming an organoid pattern and demonstrating inconspicuous mitotic activity, were diagnostic of paraganglioma of the urinary bladder, the diagnosis was confirmed by means of immunohistochemical and ultrastructural studies. The endocrine markers chromogranin A and neuron-specific enolase were positive in chief cells; sustentacular cells at the periphery of neoplastic cell clusters were positive for S-100 protein. Neurosecretory granules were identified by electron microscopic examination. It is emphasised that, currently, there are no anatomico-pathological criteria to distinguish benign and malignant forms of the disease. Post-surgical recovery was uneventful in this case. Recurrence and metastases, though infrequent, have been reported in the literature; therefore, radiation therapy may be an important adjunct--and long-term follow-up is mandatory.

Adult↗
PubMed1978

[Clinical and morphological findings and problems in malacoplakia of the urinary bladder (author's transl)].

Malacoplakia of the urinary bladder (observations on 4 female patients, average age 47 years, longest duration 8 years) is, under light microscopy, arranged in 4 layers. Zone 1 contains inflammatory granulation tissue. Zone 2 is composed of von Hansemann cells (macrophages). In zone 3, Michaelis-Gutmann bodies appear. Finally, the deepest zone 4 contains connective tissue, blood vessels, and lymphoplasmacellular infiltrates. By electron microscopy, the gradual formation of residual bodies from the remains of phagocytosed materials in the macrophages in these layers can be observed. Through loading with calcium and iron compounds, the residual bodies take on the characteristic appearance of Michaelis-Gutmann bodies. Etiologically, the origin of malacoplakia is probably involved with coliform bacteria, but apparently additional factors are required for the development of a disease process: e.g., disturbance of macrophage function. There are certain parallels between malacoplakia and Whipple's disease. With atypical localization outside the urinary bladder, differential diagnostic difficulties can arise in separating malacoplakia from inflammatory-granulomatous processes (granulomatous orchitis, xanthogranulomatous pyelonephritis). The prognosis of malacoplakia in the urinary bladder is good in all cases, but timely treatment of recurrence and constant supervision are indicated.

Adult↗
PubMed1986

Roles of urinary sodium ion concentration and pH in promotion by ascorbic acid of urinary bladder carcinogenesis in rats.

Since the sodium salt of ascorbic acid (AA) promoted two-stage urinary bladder carcinogenesis in rats, whereas AA itself did not, the roles of the urinary sodium ion concentration and pH on urinary bladder carcinogenesis were investigated. Male F344 rats were given 0.05% N-butyl-N-(4-hydroxybutyl)nitrosamine in their drinking water for 4 weeks and then treated with basal diet containing 5% AA plus 3% sodium bicarbonate (NaHCO3), 5% AA, 3% NaHCO3 or 5% sodium L-ascorbate (SA), 5% SA plus 1% ammonium chloride (NH4Cl) or 1% NH4Cl, or no added chemical for 32 weeks. NaHCO3 significantly increased the induction of neoplastic and preneoplastic lesions of the urinary bladder. Like SA, AA plus NaHCO3 induced high incidences of neoplastic and preneoplastic lesions of the urinary bladder, whereas AA alone did not. NH4Cl reduced the promoting activity of SA in urinary bladder carcinogenesis. These results suggest important roles for urinary sodium ion concentration and pH in modulating urinary bladder carcinogenesis. Moreover, AA was found to act as a copromoter under conditions of increased urinary pH and sodium ion concentration.

Animals↗
PubMed2004

The M2 muscarinic receptor mediates contraction through indirect mechanisms in mouse urinary bladder.

We investigated the contractile role of M2 muscarinic receptors in mouse urinary bladder. When measured in the absence of other agents, contractions elicited to the muscarinic agonist oxotremorine-M exhibited properties consistent with that expected for an M3 response in urinary bladder from wild-type and M2 knockout (KO) mice. Evidence for a minor M2 receptor-mediated contraction was revealed by a comparison of responses in M3 knockout and M2/M3 double knockout mice. Treatment of wild-type and M2 knockout urinary bladder with N-2-chloroethyl-4-piperidinyl diphenylacetate (4-DAMP mustard) caused a large inhibition of the muscarinic contractile response. The residual contractions were much smaller in M2 knockout bladder compared with wild type, suggesting that M2 receptors rescue the muscarinic contractile response in wild-type bladder following inactivation of M3 receptors with 4-DAMP mustard. When measured in the presence of prostaglandin F2alpha and isoproterenol or forskolin, oxotremorine-M mediated a potent contractile response in urinary bladder from M3 KO mice. This response exhibited an M2 profile in competitive antagonism studies and was completely absent in M2/M3 KO mice. Following 4-DAMP mustard treatment, oxotremorine-M elicited a contractile response in wild-type urinary bladder in the presence of KCl and isoproterenol or forskolin, and this response was diminished in M2 KO mice. Our results show that the M2 receptor mediates contractions indirectly in the urinary bladder by enhancing M3 receptor-mediated contractions and inhibiting relaxation. We also show that it is difficult to detect M2 receptor function in competitive antagonism studies under conditions where a simultaneous activation of M2 and M3 receptors occurs.

Adrenergic beta-Agonists↗