[Occupational cancer of the urinary bladder: the diagnostic value of urinary cytology in dyestuff workers exposed to aromatic amine].
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Adult↗
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[Value of exfoliative cytology of the urinary bladder in occult bladder cancer and in the control of treated cancers].
The exfoliative cytology of the urinary bladder is helpful in the detection of occult bladder carcinoma, which in according to definition is not recognizable without magnification, as well as in the follow-up of treated bladder carcinoma. Within a period of 5 years 23 occult bladder carcinomas were detected by cytological studies alone. The degree of malignancy of the established transitional cell carcinoma varied between G2 and G3. The latent period between the found cytological result and the histological confirmation amounted to 14 months. In our experience the diagnosis of occult bladder carcinoma can be established by exfoliative cytology of the urinary bladder, if invisible parts of tumor with moderate and high degree of malignancy communicate with the mucosa of the bladder. The cytological recognition of malignant cells of urothelium offers valuable support for further therapeutic procedures, if there is no cystoscopic evidence of tumor in the bladder. In addition to clinical diagnosis of bladder cancer exfoliative cytology of the urinary bladder should also be part of the follow-up of treated bladder cancer.
Biopsy↗
Involvement of opioid and nicotinic receptors in rectal and anal reflex inhibition of urinary bladder motility in cats.
The present study was performed to investigate mechanisms involved in urinary bladder relaxation during reflex activation of the pelvic nerves in the cat. Electrical stimulation of the pelvic nerves produced a contraction of the urinary bladder (P less than 0.05) and colon (P less than 0.05). Reflex activation of the pelvic nerves by rectal distension or mechanical stimulation of the anus induced relaxation of the bladder (P less than 0.05), while a colonic contraction was elicited (P less than 0.05). Naloxone (1.5 mg kg-1, i.v.) abolished the reflex inhibition of bladder motility elicited by rectal distension or mechanical stimulation of the anus (P less than 0.05). However, the urinary bladder and colonic contraction produced by electrical stimulation of the pelvic nerves were not affected. Hexamethonium (10 mg kg-1, i.v.) or severing of the pelvic nerves completely abolished the responses of the urinary bladder and colon to electrical stimulation or reflex activation of the pelvic nerves. The results indicate that inhibitory reflexes from the rectum and anal canal to the urinary bladder are conveyed via efferents of the pelvic nerves, and involve both nicotinic and opioid receptor mechanisms.
Anal Canal↗
Changes in intracellular calcium concentration and P2X1 receptor expression in hypertrophic rat urinary bladder smooth muscle.
AIMS: Contractile responses to purinergic activation in the urinary bladder are altered in outflow obstruction (O). We determined if the lowered contractile response to adenosine triphosphate (ATP) in obstructed rat urinary bladder was due to changes in calcium handling or in P2X1 purinoceptor density. MATERIALS AND METHODS: O was created in rat by partial ligature of the urethra, with non-obstructed rats as controls (C). Force and intracellular calcium were measured in bladder strips activated with ATP. Tissue was sectioned for light and electron microscopy and analyzed with Western blot using a P2X1 antibody. RESULTS: Bladder weight increased from 66 +/- 3 (C) to 206 +/- 17 mg (O) (n = 6). ATP gave a transient contractile response which was decreased in the obstructed strips (C: 161 +/- 20; O: 63 +/- 16% of high-K+ force). Intracellular calcium concentration after ATP activation in the obstructed bladder muscle was about 50% of that in the control preparations (C: 669 +/- 110; O: 335 +/- 59 nM). Half-time for calcium influx was increased in the O group. P2X1 immunoreactivity per unit bladder weight was similar in the two groups. Cell membrane area per unit wet weight was decreased in the O group. CONCLUSIONS: Attenuated contractile responses to ATP in obstructed rat urinary bladder are due to a lowered rate of calcium influx and maximal peak calcium concentration. This change in Ca2+transients is not due to a decrease in P2X1 receptor density in the smooth muscle cell membranes. Possibly, the increase in cell volume buffers the rapid and transient influx of Ca2+ following purinoceptor activation in the obstructed bladder.
Adenosine Triphosphate↗
Submucosal mesenchymal tumors of the mouse urinary bladder.
A unique morphologic change has been described in the submucosa of the urinary bladder of mice since the 1950s. These lesions, variously referred to as vegetative changes, reactive lesions, submucosal granulomas, leiomyosarcomas, atypical hemangiosarcomas, or submucosal mesenchymal tumors have been considered rare and of questionable etiology. Although the morphologic criteria are fairly well defined, the pathobiology of the lesion is not well characterized and the previously listed nomenclature reflects this uncertainty. The lesion may not be limited to the urinary bladder, the cell of origin is controversial, the biology is unknown, and whether the lesion is granulomatous, hypertrophy, hyperplasia, metaplasia, or a benign or malignant neoplasm is not well defined. Data compiled from multiple sources are discussed to review the strain of mouse most often affected, sex, age at diagnosis, anatomic location, incidence, descriptive morphology, immunohistochemical staining results, and other features of the submucosal mesenchymal tumor of the mouse urinary bladder. Presented are suggested terminology for the lesion, submucosal mesenchymal tumor of the mouse urinary bladder; the relevance of the tumor for human risk assessment; and discussion of the possible histogenesis of this lesion from primitive mesenchymal cells of the submucosa (lamina propria) of the urinary bladder of mice.
Actins↗
Acute abdomen--remember spontaneous perforation of the urinary bladder.
Spontaneous perforation of the urinary bladder is a rare clinical condition presenting as an acute abdomen. It should be suspected in patients with a past history of radiotherapy to the pelvis, enterocystoplasty and those suspected of having a tumour in the bladder. Disproportionately elevated serum urea and creatinine should raise the index of suspicion. A case of spontaneous perforation of the bladder, five years following successful treatment of a bladder tumour by radiotherapy, is reported.
Abdomen, Acute↗
Inhibitors of peptidases: how they influence the biological activities of substance P, neurokinins, bradykinin and angiotensin in guinea pig, hamster and rat urinary bladders.
Neurokinins, bradykinin and angiotensins were tested in isolated urinary bladder of the guinea pig, the hamster and the rat, in the absence and in presence of a variety of peptidase inhibitors in order to establish if peptide degradation interferes with the bladder contractions elicited by the three types of peptides. Indeed, the effects of neurokinins, bradykinin and angiotensin I in the guinea pig bladder were significantly enhanced by captopril (4.6 x 10(-6) mol/l), chymostatin (1 mg/l), phosphoramidon (4.6 x 10(-6) mol/l) and thiorphan (1.0 x 10(-6) mol/l), while only captopril was found to potentiate the effects of the same peptides in the rat bladder. The four peptidase inhibitors, as well as bacitracin were found to modify the responses of the hamster urinary bladder to one or another or to all three groups of peptides and to DiMeC7. The present results suggest that the urinary bladders of various species have different types of active proteolytic enzymes: only the angiotensin-converting enzyme appears to be present in the rat bladder, while the same enzyme and possibly two additional endopeptidases interfere with the myotropic effects of neurokinins, kinins and angiotensins in the guinea pig and the hamster bladder.
Angiotensin II↗
Antibacterial mechanisms of the urinary bladder.
THE DISAPPEARANCE OF BACTERIA FROM THE NORMAL URINARY BLADDER IS APPARENTLY A FUNCTION OF TWO HOST DEFENSE MECHANISMS: the mechanical clearance of organisms by voiding, and the antibacterial activity of the bladder wall. This study quantified the relative contribution of each of these mechanisms to the resistance of the bladder to bacterial infection.(32)Phosphorus-labeled E. coli. S. aureus, and P. mirabilis were each injected into the urinary bladders of unanesthetized female guinea pigs. At intervals after voiding, the bladders were removed, washed, homogenized, and assayed for residual radioactivity and viable bacteria. Mechanical clearance was measured by the changes in total radioactive count. Antibacterial activity was quantified by comparing the bacterial to radioactive ratios of the original bacterial inoculum with similar ratios in the bladder homogenates. More than 99.9% of the bladder inoculum was rapidly excreted and about 0.1% (10(4)-10(5)) organisms remained attached to the bladder wall. Of those E. coli attached to the bladder, rapid sequential reduction in viability occurred and reached a level of 85% loss at 30 min after inoculation. 4 hr after challenge, less than 10% of those organisms still attached to the bladder mucosa remained viable. P. mirabilis was handled with equal facility, but S. aureus showed a reduction in viability of only 46% at 1 hr and 67% at 4 hr after inoculation. 6 hr after infection with S. aureus, 6 of 12 guinea pig bladders showed multiplication of the organisms still attached to the bladder wall; only 1 of 12 animals challenged with E. coli had comparable multiplication. The mechanism whereby the bladder wall kills bacteria is unclear, but it did not appear to be related to an antibacterial activity of urine, clumping of organisms on bladder mucosa, phagocytosis by leukocytes, or serum levels of bactericidal antibody. Although it is clear that the bladder exhibits intrinsic antibacterial properties, the role of this defense mechanism in the pathogenesis of urinary tract infection requires further clarification.
Agglutination Tests↗
Relationship between calculus formation and carcinogenesis in the urinary bladder of rats administered the non-genotoxic agents thymine or melamine.
Urinary bladder lesions induced by administration of thymine or melamine were investigated in male F344 rats. Animals, 6 weeks old at the beginning of the experiment, received either 3.0 or 1.0% thymine or 3.0, 1.0 or 0.3% melamine in the diet for 36 weeks followed by a 4 week period without chemicals, the total observation time being 40 weeks. Carcinomas of the urinary bladder were observed in 1/20 (5%) rats in each of the 3.0% thymine and 1.0% melamine groups, and in 15/19 (79%) animals given the 3.0% melamine treatment. Papillomas were induced in 9/20 (45%), 12/19 (63%) and 1/20 (5%) among rats receiving the 3.0% thymine, 3.0% and 1.0% melamine treatments respectively. Exploratory laparotomy at the end of week 36 revealed calculus formation in 9/10 (90%), 10/10 (100%) and 7/10 (70%) rats in these groups. In the ureter of the 3.0% melamine treated group, a carcinoma and papillomas were induced in 1/19 (5%) and 3/19 (16%) animals respectively. However, no tumors were observed in the renal pelvis in any of the other treated groups. Thus, administration of 3.0% thymine in the diet results in calculus formation in the urinary bladder of F344 rats, and is associated with development of tumors. It was also confirmed that a 3.0% dose level of melamine in the diet induces tumors in both the urinary bladder and the ureter.
Animals↗
[Innervation of the urinary bladder of Ovis aries L].
The authors have extended a preliminary study about the innervation of urinary bladder, confirming the previous results pointing out the presence of metasympathetic ganglions in the wall of urinary bladder. Therefore nine urinary bladders of Ovis aries of different age and both sexes have been studied by Ruffini, Bodian and Bielschowsky's staining methods. It's possible summarize the data on the innervation of urinary bladder in the following way: in the tunica adventitia there are motor and sensitive bundles of myelinated nervous fiber. The formers, after many divisions, penetrate into the tunica muscularis contacting bundles of smooth muscle fibers, while the latters after several divisions after giving rise to thinner bundles, produce Pacini-like and Ruffini-like sense corpuscles and free nervous terminations. Furthermore, some metasympathetic ganglions of different size have been detected throughout the running of the bundles. In the tunica submucosa a diffuse and peculiar non myelinated network is observed, arising from the vegetative nervous fibers.
Age Factors↗
[Intestinal replacement of the urinary bladder with creation of continent cutaneostomy].
Continent urine derivation with creation of cutaneous urine-retaining catheter mechanism was conducted in 28 patients. Indications for surgery were the following: contracted urinary bladder in combination with long obliteration of the urethra, urinary bladder extrophy (the condition after ureterosygmostomy), urinary bladder cancer, arteriosclerotic urinary bladder. Creation of cutaneous urine-retaining cather mechanism was performed according to the following methods: urine derivation by Minez pouch I (with creation of appendistoma) was made in 14 patients; extending intestinoplasty by Minez pouch (creation of intestinal reservoir from ileocecal angle with catheter appendicostoma) was made in 8 patients; extending ileoplasty with catheter ileostoma by Huder--2 patients; creation of a reservoir of the ileum with catheter ileocutaneostoma by extramural technique of Ald-Enein--2 patients; extending intestinoplasty with catheter ileostoma--2 patients. Implantation of the ureters was made using principles of antireflux defense.
Adolescent↗
Low activities of glutathione-related enzymes as factors in the genesis of urinary bladder cancer.
A comparative study of reduced glutathione (GSH) concentrations and activities of GSH related-enzymes in urinary bladder transitional epithelium (UBTE), urinary bladder nontransitional tissue (UBNT), and liver of the rabbit, was carried out to investigate the reasons for the susceptibility of UBTE towards peroxidase-mediated chemical carcinogenesis. Cooxidative activation of chemical carcinogens by prostaglandin H synthase occurs at high levels in UBTE and minimally in UBNT. Other peroxidases are also likely to activate carcinogenic xenobiotics in the urinary bladder. GSH concentrations in UBTE and UBNT were low compared to that in the liver. gamma-Glutamyl transpeptidase activities were much lower in UBTE and in UBNT than those in the liver. Activities of selenium-dependent and selenium-independent glutathione peroxidases were very low in UBTE and UBNT. Cytosolic glutathione S-transferase activity towards 1,2-epoxy-(4-nitrophenoxy)propane was very low in UBTE. Microsomal glutathione S-transferase activity towards 1-chloro-2,4-dinitrobenzene was much lower in UBTE than in the liver. We propose that the low GSH concentration and diminished activities of glutathione peroxidases, gamma-glutamyl transpeptidase, and certain isozymes of glutathione S-transferase could be responsible for the vulnerability of UBTE towards chemical carcinogenesis.
Animals↗
Percutaneous rotational lithotripsy of urinary bladder stones. Clinical results with the Rotolith lithotriptor.
Mechanical rotational lithotripsy of urinary bladder stones, up to 20 mm in diameter, was performed in 6 male patients with the Rotolith lithotriptor. The lithotriptor was introduced through a 10 F (OD 3.3 mm) suprapubically inserted sheath, and the procedure was performed under intermittent fluoroscopy and inspection through a transurethral cystoscope. In 3 patients, the bladder stones were fragmented to pieces small enough to be evacuated through the cystoscope. The instrument, which is designed for lithotripsy of gallbladder stones, was less efficient for fragmentation of urinary bladder calculi, primarily due to the large volume of the human urinary bladder, and possibly because of the higher gravity of bladder stones. There was no substantial damage to the mucosa of the urinary bladder.
Aged↗
Primary signet-ring cell carcinoma of the urinary bladder.
Sixty-one cases of adenocarcinoma of the urinary bladder presenting between 1966 and 1981 were reviewed. Among the only seven cases of primary adenocarcinoma of the urinary bladder, three were classified as primary signet-ring cell carcinoma. These 3 cases were reviewed with the 11 previously reported cases in the literature. Primary signet-ring cell carcinoma of the urinary bladder occurs predominantly in men (12 men, 2 women) with age ranging from 38 to 83 years. It usually runs a rapidly fatal course despite therapy. The characteristic clinical, gross, and histomorphologic findings and pathogenesis of this rare bladder malignancy are discussed.
Adenocarcinoma↗
Time-dependent urinary bladder remodeling in the streptozotocin-induced diabetic rat model.
Urinary bladder dysfunction and remodeling are well-recognized phenomena in diabetes but detailed assessments of tissue morphological changes have not been conducted. We studied time-dependent morphological changes in bladders from diabetic rats (streptozotocin model) and evaluated the usefulness of automated digital imaging technology as an unbiased, reproducible, and convenient method for the bladder morphometric analysis. Urinary bladders were isolated from diabetic (3 days, 2 weeks or 5 weeks after single injection of streptozotocin, 65 mg/kg) or control rats (0 or 5 weeks) and were processed for histochemical evaluations (hematoxylin/eosin and Mason's trichrome staining). Digital image analysis was used to quantify equatorial cross-sectional areas of bladder tissue and lumen, as well as relative prevalence of the three primary tissue components viz. smooth muscle, urothelium, and extracellular matrix. Digital imaging and color segmentation provided reliable and unbiased evaluations of the bladder tissue sections. Progressive increases in total bladder tissue and lumen area were observed in the diabetic animals relative to controls (p<0.05), demonstrating classic hypertrophy and dilation. Prevalence of smooth muscle and urothelium (% of total tissue) both increased significantly, but collagen content decreased. Average bladder wall thickness and urothelium thickness were unchanged. Bladder remodeling during experimental diabetes is associated with time-dependent chamber dilation and increased tissue mass. Changes in bladder wall composition also occurred in a time-dependent manner, most notably increased smooth muscle and urothelium and decreased collagen prevalence. Furthermore, automated digital imaging technologies provide an unbiased, reproducible, and convenient method for detailed morphometric analysis of bladder tissues.
Animals↗
Neurofibroma of the urinary bladder.
BACKGROUND: Neurofibroma of the urinary bladder is rare. Only isolated case reports have appeared. Information regarding the long term follow-up of patients with neurofibroma is limited. METHODS: The authors studied 4 cases of neurofibroma of the bladder diagnosed at Mayo Clinic from 1965 through 1990. Immunostains for S-100 protein, neurofilament protein, epithelial membrane antigen (EMA), cytokeratin (CAM 5.2; AE 1/3), Type IV collagen, MIB-1, and p53 protein were performed in all cases, as was Alcian blue at pH 2.5. The mean follow-up was 9.6 years (range, 2-18 years). RESULTS: The mean age at diagnosis was 17 years (range, 7-28 years); the male-to-female ratio was 1:1. All four patients exhibited physical stigmata of neurofibromatosis type 1. Clinical presentations included hematuria (one patient), irritative symptoms (two patients), and pelvic mass (one patient). Long term urinary complications included bladder atony (two patients), neurogenic bladder (one patient), and recurrent urinary tract infection with hematuria (one patient). Subsequently, two patients underwent partial cystectomy and one a complete cystectomy. Involvement of the bladder was generalized in all four cases. Three tumors were transmural, showing a diffuse and plexiform pattern of growth; in the fourth case, a superficial biopsy showed only diffuse submucosal growth with conspicuous pseudo-Meissnerian corpuscle formation. An Alcian blue positive, variably collagenized matrix was present in all cases. Tumor cells displayed immunoreactivity for S-100 protein and Type IV collagen in all cases. Neurofilament protein positive axons were evident in three cases; all other immunostains were negative. The mean MIB-1 labeling index was 3.2% (range, 0.9-7.3%). No malignant transformation was observed during a mean follow-up of 9.6 years. CONCLUSIONS: Neurofibroma of the bladder presents early in life, is of the plexiform type with a diffuse component, and usually occurs in the setting of generalized neurofibromatosis type 1 rather than as isolated visceral neurofibromatosis. Malignant transformation did not occur in any of these 4 patients during a mean follow-up time of 9.6 years.
Adolescent↗
Expression of cyclooxygenase-2 in transitional cell carcinoma of the urinary bladder in dogs.
OBJECTIVE: To evaluate expression of cyclooxygenase (COX)-1 and COX-2 in the urinary bladder epithelium of clinically normal dogs and in transitional cell carcinoma cells of dogs. ANIMALS: 21 dogs with transitional cell carcinoma of the urinary bladder and 8 dogs with clinically normal urinary bladders. PROCEDURE: COX-1 and COX-2 were evaluated by use of isoform-specific antibodies with standard immunohistochemical methods. RESULT: COX-1, but not COX-2, was constitutively expressed in normal urinary bladder epithelium; however, COX-2 was expressed in neoplastic epithelium in primary tumors and in metastatic lesions of all 21 dogs and in new proliferating blood vessels in 3 dogs. Also, COX-1 was expressed in the neoplastic cells. CONCLUSIONS AND CLINICAL RELEVANCE: Lack of expression of COX-2 in normal bladder epithelium and its substantial expression in transitional cell carcinoma cells suggest that this isoform may be involved in tumor cell growth. Inhibition of COX-2 is a likely mechanism of the antineoplastic effects of non steroidal antiinflammatory drugs.
Animals↗
Preoperative diagnosis of urinary bladder involvement in adenocarcinoma of colon and rectum.
OBJECTIVE: Objective of the study was to compare urinary symptoms, urinalysis, computed tomography, intravenous pyelography, ultrasonography between colorectal adenocarcinoma with urinary bladder involvement and without urinary bladder involvement. MATERIAL AND METHOD: Patients with adenocarcinoma of the colon and rectum who had the first operation between January 1999 and October 2004 were included in the present study. All patients were divided into the bladder adhesion group and nonadhesion group. Sex, sites of tumor, urinary symptoms and preoperative investigations were compared. RESULTS: 453 patients were included in the present study with 264 males and 189 females (sex ratio M:F = 1.4:1). 26 cases (5.7%) had bladder adhesion. Males had more chance of having bladder involvement. Sigmoid and rectum were the most common sites of bladder adhesion. All cases with urinary symptoms had bladder involvement. Urinalysis and computed tomography had a sensitivity of 59% and 61%, respectively. All cases whose computed tomography showed bladder involvement had bladder adhesion during surgery. Cystoscopy had a sensitivity of 75%. Ultrasonography and IVP did not help in detection of bladder invasion. CONCLUSION: History of urinary symptoms, urinalysis, computed tomography should be routinely performed in patients with adenocarcinoma of the sigmoid and rectum to detect urinary bladder involvement and to inform modes of urinary tract diversion to patients before surgery.
Adenocarcinoma↗