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PubMed1990

[Reconstruction of urinary bladder].

Reconstruction of the urinary tract was reviewed. Reconstruction of the ureter dealt with end to end ureteroureterostomy, transureteroureterostomy, bladder flap procedure, psoas hitch procedure, ureterovesiconeostomy, ileal inter position and autotransplantation of the kidney. Bladder augmentation concerned with use of the ileum, ileocecal segment and sigmoid colon, together with artificial material. Reconstruction of the bladder included urinary diversion such as ileal, jejunal, sigmoid, transverse and ileocecal conduit, ureterureterostomy, continent urinary reservoir such as Kock, Mainz and Indiana pouch, and total replacement of the bladder using various segments of intestine anastomosed to the urethra. Surgical endeavor performed by urologists during the past 100 years from 1890 to 1990 was tremendous and it was mainly reviewed from the standpoints of surgical technique and complications.

Female↗
PubMed2000

Distension of urinary bladder induces exaggerated coronary constriction in smokers with early atherosclerosis.

Distension of the urinary bladder causes an increase in efferent sympathetic activity, which can precipitate myocardial ischemia. Smoking has been shown to modulate activities of afferent nerves from the distended urinary bladder and to impair endothelial function in response to sympathetic activation. To assess the effect of bladder distension on coronary dynamics in smokers, we measured epicardial and microvascular responses in 24 patients with early atherosclerosis (< 50% diameter stenosis). Patients were classified into habitual smokers (group 1, n = 14) and nonsmokers (group 2, n = 10). Habitual smokers were randomized into two subgroups on the basis of the use of doxazosin, as follows: subgroup 1A (n = 7), without administration of doxazosin before catheterization; subgroup 1B (n = 7), with dosing doxazosin. In response to bladder distension (mean intravesical pressure 21.5 mmHg), bladder distension significantly decreased coronary diameter at the stenotic segments, coronary blood flow, and increased coronary resistance compared with baseline values, in subgroup 1A patients. In subgroup 1B patients during bladder distension, coronary diameter, coronary blood flow, and coronary resistance did not show significant changes compared with baseline values. There were significant differences of coronary diameter at the stenotic segments, coronary blood flow, and of changes of coronary vascular resistance between subgroup 1A and group 2 during bladder distension, despite similar changes in rate-pressure product. The present study showed that urinary bladder distension caused an abnormal vasomotor response of epicardial vasoconstriction and a concomitant increased coronary resistance, which leads to reduction in coronary blood flow in patients with early atherosclerosis. Smoking may further impair the response, implying that smoking has exaggerated response to sympathetic stimulation of conduit and resistance vessels. The abnormal response was abolished by pretreated administration of doxazosin, suggesting that the involved mechanisms are related to alpha(1)-adrenoceptors.

Aged↗
PubMed2003

Effect of nefiracetam, a neurotransmission enhancer, on primary uroepithelial cells of the canine urinary bladder.

Repeated oral treatment of dogs with a high dose of nefiracetam is reported to induce hemorrhagic lesions in the urinary bladder. To delineate its pathogenesis, we established the primary culture of uroepithelial cells of the canine urinary bladder, and then explored the effect of nefiracetam on the cultured cells. Uroepithelial cells scraped from the connective tissues of the urinary bladder of naive dogs were suspended in the minimum essential medium containing dispase, and then resuspended in the keratinocyte medium to be 6.0-7.0 x 10(5) cells/ml. Afterward, they were added to an apical chamber with a 12-mm transwell filter, cultured for three days, and recultured in the keratinocyte medium containing 1 mM CaCl(2) for 20 days. Microscopically, these cultured cells consisted of three cell layers with high transepithelial electric resistance (TER; > 10,000 ohm-cm(2)). Immunofluorescence observations revealed ZO-1 and E-cadherin bands, and electron microscopic examinations displayed the superficial cells with the assembly of tight junctions. When the effect of nefiracetam and its five main metabolites (M-3, M-10, M-11, M-18, and M-20) on TER and the ZO-1 band was assessed using cultured cells, only M-18 significantly reduced TER in the coculture for 48 h or more. Both M-10 and M-18 exhibited a deformation of uroepithelial cells and a slight reduction of the ZO-1 band from 120 h later. In conclusion, this culture system possesses both functional and morphological features of the uroepithelium reflected in vivo, and M-18 may play a pivotal role in the impairment of uroepithelial cells, leading to the onset of the urinary bladder lesion in dogs due to nefiracetam.

Animals↗
PubMed1986

The postganglionic excitatory innervation of the mouse urinary bladder and its modulation by prejunctional GABAB receptors.

Field stimulation produced reproducible contractions of the mouse isolated urinary bladder whose amplitude was frequency-related. These contractions were partially sensitive to atropine (3 microM), unaffected by hexamethonium (10 microM) and almost abolished by tetrodotoxin (0.5 microM). Atropine (3 microM) suppressed contractions produced by exogenous acetylcholine thereby indicating atropine-resistance of the nerve-mediated contractions. Nerve-mediated contractions of the mouse urinary bladder were enhanced by physostigmine (0.1-0.5 microM) and inhibited by hemicholinium-3 (0.5 mM) thus confirming the presence of a cholinergic component in the excitatory postganglionic innervation. Atropine (3 microM) inhibition of the nerve-mediated contractions increased with increasing duration and strength of the train of stimulation. The nerve-mediated contractions of the mouse bladder were unaffected by phentolamine (0.2 microM), propranolol (0.3 microM) or indomethacin (5 microM). ATP (1mM) the major candidate for the role of nonadrenergic-noncholinegic (NANC) excitatory neurotransmitter in the mammalian urinary bladder produced a contraction of the mouse isolated bladder. Exposure to the stable ATP analogue alpha, beta-methylene ATP (APCPP) or beta, gamma-methylene ATP (APPCP) produced a partial desensitization of the nerve-mediated response which, for APCPP, was greater in the presence than in the absence of atropine (3 microM). In the presence of atropine (3 microM) and after APCPP desensitization the amplitude of the response to field stimulation amounted to about 20% of the original response and was sensitive to tetrodotoxin, indicating that it is nerve-mediated. GABA (0.001-0.3 mM) inhibited the amplitude of field stimulation induced contractions of mouse urinary bladder. This effect was mimicked by the selective GABAB receptor agonist, (+/-)-baclofen, but not by the selective GABAA receptor agonist, homotaurine. GABA and (+/-)-baclofen exhibited cross-desensitization. The GABA-or (+/-)-baclofen-induced inhibition of the nerve-mediated contractions were reduced by previous exposure to homotaurine (1 mM) or to 5-aminovaleric acid (2 mM), two GABAB receptor antagonists. On the other hand the inhibitory effects of GABA or (+/-)-baclofen were unaffected by picrotoxin (0.1 mM), a selective GABAA receptor antagonist. The inhibitory effect of GABA on nerve-mediated contractions was reduced in the presence of atropine or hemicholinium-3 as well as following desensitization of P2-purinoreceptors.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1987

Structural requirements for affinity and efficacy of N-(4-amino-2-butynyl)succinimides at muscarinic receptors in the guinea-pig ileum and urinary bladder.

The muscarinic activities on the isolated guinea-pig ileum and urinary bladder of some N-(4-amino-2-butynyl)succinimides, modified only in the amino group, were resolved into receptor affinity and efficacy components. The structural requirements for high affinity and high efficacy were quite different. Cyclic tertiary amino moieties generally favoured high affinity, while small acyclic amino and ammonium groups favoured high efficacy. On the ileum, dissociation constants and relative efficacies of the succinimides were highly correlated (r = 0.94-0.97) with those of the identically modified N-(4-amino-2-butynyl)-2-pyrrolidones. This observation suggests that N-(4-amino-2-butynyl)succinimides and 2-pyrrolidones bind to and activate muscarinic receptors in a similar fashion. In spite of their agonist properties on the ileum, the succinimides studied were agonists, partial agonists or competitive antagonists on the urinary bladder. However, dissociation constants and relative efficacies of the compounds showed good agreement in the two tissues. It therefore appears that muscarinic receptors in the guinea-pig ileum and urinary bladder are pharmacologically similar. The large differences observed in agonist potency and relative maximal responses between the two tissues were explained by a greater receptor reserve for muscarinic agonists in the ileum than in the bladder.

Animals↗
PubMed2000

Developmental expression of urinary bladder neurotrophic factor mRNA and protein in the neonatal rat.

These studies were performed to determine the developmental expression pattern of neurotrophic factor (NTF: nerve growth factor (betaNGF), brain-derived neurotrophic factor (BDNF), glial-derived neurotrophic factor (GDNF), ciliary neurotrophic factor (CNTF), neurotrophin-3 (NT-3) and NT-4 mRNA and NGF, NT-3 and NT-4 protein in the urinary bladder of the postnatal Wistar rat. It was hypothesized that NTFs may contribute to the development of the spinobulbospinal micturition reflex that represents the adult micturition pattern. Changes in NTF mRNA or protein expression in the urinary bladder at the time of development of the mature micturition reflex (postnatal days (P) 16-18) may suggest an involvement of target-derived NTFs in this maturation process. Developmental ages, prior to (P5, P10, P15) or following (P20, P30, adult P90) the development of the spinobulbospinal micturition reflex were selected and the urinary bladder was analyzed for levels of neurotrophic factor mRNA or protein. Results from ribonuclease protection assays demonstrated a similar developmental pattern among each neurotrophic factor examined. Neurotrophic factor mRNA levels increased by P10 and reach a maximum by P15. Subsequently, NTF mRNA levels declined to adult levels that were less than the earliest postnatal time examined (P5). NTF mRNA expression was significantly (p</=0.05-0.001) greater at P10, P15, P20 and P40 (NT-4 mRNA) compared to adult levels for each NTF examined except GDNF mRNA. In general, NGF, NT-3 and NT-4 urinary bladder protein levels in early postnatal development, as determined by ELISA, were similar when compared to the corresponding mRNA expression. Differences in the correlation between NT-3 and NT-4 mRNA and protein expression were demonstrated in the adult urinary bladder where significantly (p</=0. 001) greater levels of protein were revealed despite relatively low abundance of NT-3 and NT-4 mRNA. The developmental expression pattern (maximum expression at the second to third postnatal week) of NTFs in the urinary bladder is consistent with a potential role in the development of the spinobulbospinal reflex. Relatively high expression of NT-3 and NT-4 protein in the adult urinary bladder suggests a potential importance of these factors in the adult lower urinary tract.

Animals↗
PubMed2006

Enhanced urinary bladder and liver carcinogenesis in male CD1 mice exposed to transplacental inorganic arsenic and postnatal diethylstilbestrol or tamoxifen.

Pregnant CD1 mice received 85 ppm arsenite in the drinking water from gestation day 8 to 18, groups (n = 35) of male offspring were subsequently injected on postpartum days 1 through 5 with diethylstilbestrol (DES; 2 microg/pup/day) or tamoxifen (TAM; 10 microg/pup/day), and tumor formation was assessed over 90 weeks. Arsenic alone increased hepatocellular carcinoma (14%), adenoma (23%) and total tumors (31%) compared to control (0, 2 and 2%, respectively). Arsenic alone also increased lung adenocarcinoma, adrenal cortical adenoma and renal cystic tubular hyperplasia compared to control. Compared to arsenic alone, arsenic plus DES increased liver tumor incidence in mice at risk 2.2-fold and increased liver tumor multiplicity (tumors/liver) 1.8-fold. The treatments alone did not impact urinary bladder carcinogenesis, but arsenic plus TAM significantly increased formation of urinary bladder transitional cell tumors (papilloma and carcinoma; 13%) compared to control (0%). Urinary bladder proliferative lesions (combined tumors and hyperplasia) were also increased by arsenic plus TAM (40%) or arsenic plus DES (43%) compared to control (0%) or the treatments alone. Urinary bladder proliferative lesions occurred in the absence of any evidence of uroepithelial cytotoxic lesions. Urinary bladder lesions and hepatocellular carcinoma induced by arsenic plus TAM and/or DES overexpressed estrogen receptor-alpha, indicating that aberrant estrogen signaling may have been a factor in the enhanced carcinogenic response. Thus, in male CD1 mice, gestational arsenic exposure alone induced liver adenoma and carcinoma, lung adenocarcinoma, adrenal adenoma and renal cystic hyperplasia. Furthermore, DES enhanced transplacental arsenic-induced hepatocarcinogenesis. In utero arsenic also initiated urinary bladder tumor formation when followed by postnatal TAM and uroepithelial proliferative lesions when followed by TAM or DES.

Animals↗
PubMed1988

[A case of pheochromocytoma of the urinary bladder].

A case of pheochromocytoma of the urinary bladder is reported. A 17-year-old male was admitted to our hospital because of gross hematuria and urinary retention on Nov. 10, 1985. There was no history of hypertension. Intravenous pyelography and cystogram demonstrated a filling defect in the bladder. Transabdominal sonography disclosed a solid mass in the anterior wall and bladder neck. Cystoscopic examination revealed a non-papillary and broad based tumor in the anterior wall and bladder neck. Partial resection of the bladder wall was performed under the diagnosis of bladder tumor. The histological diagnosis was pheochromocytoma of the urinary bladder.

Adolescent↗
PubMedDate not supplied

Urinary bladder and rectal temperature monitoring during clinical hypothermia.

Three methods of temperature monitoring were studied in 55 adult hypothermic postcardiac surgery patients using the pulmonary artery, rectum, and urinary bladder as measurement sites. Pulmonary artery temperature served as the standard for core body temperature. Measurements in the rectum were recorded with a disposable plastic temperature probe and in the urinary bladder with a thermistor-tipped Foley catheter. Patients were studied within one hour of admission to the cardiac surgical intensive care unit and on an hourly basis until they reached normothermia (37 degrees C). Although mean temperatures did not vary greatly for any group, there was a significant difference between measures over time. Correlations of pulmonary artery and urinary bladder temperatures ranged from .78 to .94, pulmonary artery and rectal temperature from .49 to .82, and urinary bladder and rectal temperature from .46 to .85. The results of this study indicate that the urinary bladder is a reliable indicator of core temperature during rewarming following cardiac surgery.

Adult↗
PubMed1996

Comparisons of neurotransmitter concentrations in the synaptosomal preparation of the normotensive and hypertensive rat urinary bladder.

Synaptosome-rich fractions were prepared from tissue homogenate of the urinary bladder of the spontaneously hypertensive rat and normotensive Wistar-Kyoto rat by differential centrifugation (1000 x g, 17 000 x g and 100 000 x g) with discontinuous sucrose gradient. Synaptosomal acetylcholine, norepinephrine, epinephrine and dopamine were measured by the method of high-performance liquid chromatography. The respective neurotransmitter concentrations for the normotensive rats were 300.4 +/- 30.1, 962.8 +/- 58.5, 617.3 +/- 59.8, and 1354.8 +/- 144.2 pmol/mg synaptosomal protein. For the hypertensive rats, the acetylcholine concentration (203.8 +/- 23.0 pmol/mg protein) was significantly lower (P < 0.05), while the norepinephrine, epinephrine and dopamine concentrations (1459.0 +/- 180.3, 971.3 +/- 62.2, and 2161.0 +/- 243.4 pmol/mg protein, respectively) were significantly higher (P < 0.05 for all) than those of the normotensive rats. In conclusion, it has been demonstrated that the vesicle-bound catecholamines in the synaptosome-rich fraction of the urinary bladder were significantly increased in hypertensive rats. On the contrary, the synaptosomal acetylcholine concentration was significantly decreased. These findings are suggestive of increased sympathetic innervation and decreased parasympathetic innervation in the urinary bladder of the spontaneously hypertensive rat.

Acetylcholine↗
PubMed2001

Ileal neobladder for urinary bladder replacement following total pelvic exenteration for rectal carcinoma.

OBJECTIVE: The aim of this study was to determine the feasibility of using the ileal neobladder as a substitute for the urinary bladder following total pelvic exenteration for rectal carcinoma. PATIENTS AND METHODS: Between 1992 and 1998, we performed total pelvic exenteration with ileal neobladder in 5 men with rectal carcinoma. Four patients had primary tumors, and one had recurrent disease after low anterior resection for rectal carcinoma. Histological types were adenocarcinoma in 4 and squamous cell carcinoma in 1. Invaded organs were: the urinary bladder in 1, the urinary bladder and prostate in 2, the prostate and seminal vesicle in 1, and the prostate in 1. RESULTS: There was no operative death. In 1 patient, an ileal conduit was needed because of partial necrosis of the neobladder. Minor leakage on the dorsal wall of the neobladder occurred in 2 patients, which was successfully stopped with simple closure and a gluteus maximus fasciocutaneous flap, respectively. All except one patient with the ileal conduit could void via the urethra. Complete daytime urinary continence was achieved, but nocturnal continence was maintained with voiding once or twice per night. As the urodynamic state, the mean maximum flow rate was 20.9 ml/s (range 9.0-34.1), the mean average flow rate was 7.7 ml/s (range 3.0-11.0), and the mean voided volume was 285.5 ml (range 160-432). The mean length of follow-up was 47.8 months. One patient died of local recurrence 38 months postoperatively, and 1 died of pneumonia 10 months postoperatively. Both patients could void via the urethra until death. The other three patients are currently alive without any evidence of recurrence. CONCLUSIONS: Although total pelvic exenteration is a laborious surgical procedure, an ileal neobladder could be a good alternative to the urinary bladder enabling the patients to void via the urethra with urinary continence.

Adenocarcinoma↗
PubMed1995

Analysis of the mechanisms underlying the contractile response induced by the hydroalcoholic extract of Phyllanthus urinaria in the guinea-pig urinary bladder in-vitro.

The hydroalcoholic extract of Phyllanthus urinaria (Euphorbiaceae), substance P and substance P methyl ester all caused graded contractions in the guinea-pig urinary bladder. Responses to hydroalcoholic extract and substance P were markedly inhibited in calcium-free Krebs solution, this effect being reversed by reintroduction of calcium in the medium. The contraction in response to hydroalcoholic extract was unaffected by atropine, propranolol, prazosin, yohimbine, tetrodotoxin, w-conotoxin, nicardipine, HOE 140, guanethidine, staurosporine, phorbol ester or indomethacin, excluding the involvement of nervous mediated responses, or action via cholinergic, adrenergic, kinins, cyclo-oxygenase metabolites, protein kinase C or activation of L or N-type calcium channels. The selective NK1 tachykinin antagonist (FK 888), but not NK2 (SR 48968) antagonized substance P-induced contraction, but both drugs failed to effect Phyllanthus urinaria-induced contraction. Prolonged desensitization of guinea pig urinary bladder with capsaicin (10 microM) or preincubation of guinea-pig urinary bladder with capsazepine did not affect contraction caused by hydroalcoholic extract. Ruthenium red almost completely abolished capsaicin-induced contraction, but had no effect on hydroalcoholic extract-mediated contraction. Substance P and the hydroalcoholic extract caused marked potentiation of the twitch response in the preparations field stimulated. The facilitatory effect of substance P, but not that of hydroalcoholic extract, was prevented by the NK1 (FK 888), but not by NK2 (SR 48968) antagonist. We concluded that contraction induced by hydroalcoholic extract of Phyllanthus urinaria in the guinea pig urinary bladder involves direct action on smooth muscle and relies on the mobilization of extracellular calcium influx unrelated to activation of L- and N-type calcium channels or activation of protein kinase C mechanisms. In addition contraction caused by the hydroalcoholic extract of Phyllanthus urinaria in guinea-pig urinary bladder does not involve the activation of tachykinin or vanilloid receptors.

Adrenergic alpha-Antagonists↗
PubMed2000

New biochemical mechanisms of the anticancer effect of Ukrain in the treatment of cancer of the urinary bladder.

The aim of this study was to elucidate the mechanisms of the anticancer effect of Ukrain by comparing the processes of formation of the pool of free amino acids and their derivatives in the blood plasma and tumor biopsy specimens and unchanged bladder tissue in 28 patients with T1N0M0 bladder cancer. The examination was carried out before and after Ukrain treatment (10 mg i.v./day, for 20 days), which was combined with systemic chemotherapy for bladder cancer. Twenty-eight patients served as controls and received systemic chemotherapy only. Compared with healthy donors, the blood plasma of patients with urinary bladder cancer showed decreased concentrations of thiol-containing free amino acids and glutamine (Gln) and increased levels of nonessential (glutamic acid, proline, alanine) and aromatic (phenylalanine) free amino acids. In contrast to conventional chemotherapy, treatment with Ukrain eliminated the blood plasma amino acid imbalance in patients with bladder cancer, concomitantly enriching the pool of free amino acids and their derivatives in unchanged urinary bladder tissue and decreasing concentrations of Gln and leucine (Leu), regulators of malignant cell proliferation and differentiation, by 30-50%. In this situation, the concentrations of Gln and Leu in tumor tissue and the surrounding healthy urinary bladder tissue correlated highly significantly and negatively (r = -0.95). In conclusion, Ukrain prevents active free amino acid transport into urinary bladder tumor tissue, inhibiting the activities of protein biosynthesis, gluconeogenesis and energy production. The combined decrease in Gln and Leu levels in urinary bladder tumor tissue is a specific sign of the antitumor effect of Ukrain and a mechanism of its cancerostatic action by controlling the processes of amino acid pool formation in the tumor.

Alkaloids↗
PubMed1982

Arylazido aminopropionyl atp (ANAPP3) antagonism of cat urinary bladder contractions.

ANAPP3 produces a transient contraction of the urinary bladder of the cat similar to that produced by ATP and hypogastric nerve stimulation. 2 ANAPP3 partially antagonizes the inhibition of pelvic nerve-evoked bladder contractions induced by adenosine, possibly by blocking P1 receptors. 3 ANAPP3 antagonizes contractions of the cat urinary bladder induced by ATP, beta, gamma-methylene ATP, pelvic nerve stimulation and hypogastric nerve stimulation. 4 ANAPP3 produces no antagonism of either noradrenaline-induced inhibition of pelvic nerve-evoked bladder contractions or acetylcholine-induced bladder contractions, thereby substantiating the specificity of the effect of ANAPP3 against purines.

Adenosine Triphosphate↗
PubMedDate not supplied

Urinary bladder mural hemorrhage associated with systemic bleeding disorders in three dogs.

The sonographic appearance of three dogs with diffuse bladder wall thickening due to mural hemorrhage is described. Two dogs were diagnosed with immune-mediated thrombocytopenia and the third dog with vitamin K antagonist toxicity. Urinary bladder wall thickening ranged from 5 to 12 mm on initial sonographic examination. In the two surviving dogs, the bladder wall returned to normal thickness. One dog, euthanatized for refractory hematuria, had submucosal hemorrhage in the urinary bladder at necropsy. Urinary wall thickening sonographically resolved at a rate of approximately 1 mm per day. Mural hemorrhage should be considered in patients with concurrent bleeding disorder and urinary bladder wall thickening.

Animals↗
PubMed1989

Investigations on organ-specific metabolism and genotoxic effects of the urinary bladder carcinogen N-nitrosobutyl-3-carboxypropylamine (BCPN) and its analogs N-nitrosodibutylamine (NDBA) and N-nitrosobutyl-4-hydroxybutylamine (4-OH-NDBA).

N-Nitrosodibutylamine (NDBA) and its omega-oxidized metabolites N-nitrosobutyl-4-hydroxybutylamine (4-OH-NDBA) and N-nitrosobutyl-3-carboxypropylamine (BCPN) are potent urinary bladder carcinogens. To study putative organ specific activation of BCPN, its alpha-oxidation by liver and urinary bladder microsomal fractions was investigated in comparison to NDBA and 4-OH-NDBA. Additionally, induction of DNA single strand breaks (SSB) was monitored in hepatocytes and in a human lymphoblastoid cell line (Namalva) in the presence and absence of external metabolic activation, including N-nitroso-t-butyl-n-butylamine as a negative control. BCPN was alpha-hydroxylated and dealkylated at both alkyl chains in small rates (about 1 nmol x mg protein-1 x 60 min-1) by microsomes from rat liver and pig urinary bladder epithelium. NDBA and 4-OH-NDBA were dealkylated at similarly low rates by pig urinary bladder microsomes, in strong contrast to the high debutylation rates observed for rat liver microsomes. Correspondingly, SSB induction by NDBA and 4-OH-NDBA was observed in Namalva cells with NDBA and 4-OH-NDBA in the presence of PB-induced rat liver microsomes but not with urinary bladder microsomes or without external activation. BCPN did not induce DNA-damage in Namalva cells (with or without external activation) or in rat hepatocytes. Significant induction of sister chromatid exchanges (SCEs) and micronuclei, however, was observed in Namalva cells after incubation with NDBA and BCPN. Our data suggest activation of BCPN via alpha-oxidation in the urinary bladder, even though activation rate in-vitro is so low that a positive response is not detectable by several short-term tests.

Animals↗
PubMed1993

Percutaneous gallbladder and urinary bladder rotational lithotripsy and a model for gallbladder sclerotherapy after lithotripsy. Clinical and experimental studies.

In experiments in pigs, fragmentation of stones implanted into the gallbladder and the urinary bladder, respectively, was successfully achieved by mechanical rotational lithotripsy with the Rotolith lithotriptor. The stones could be fragmented into pieces about 1 mm in diameter. Ten patients were selected for percutaneous rotational lithotripsy of gallbladder stones. The procedure was completed in 7 of these 10 patients. Employing a suprapubic approach, the instrument was also used for lithotripsy of urinary bladder stones in 6 male patients. Percutaneous rotational lithotripsy is well suited for elderly patients with symptomatic gallbladder stones and concurrent disease making them high-risk patients for surgery and general anesthesia. Fragmentation of urinary bladder stones in the clinical setting was not as successful as in our experimental series, probably due to the larger volume of the human urinary bladder and the high specific weight of the bladder stones. The feasibility of rotational lithotripsy of urinary bladder stones is conceivable, but when compared with current methods, the use of the Rotolith lithotriptor did not yield any advantage. Ablation of the gallbladder is of great interest to prevent recurrence of cholecystolithiasis after lithotripsy. Rotational lithotripsy of gallbladder stones was performed in an experimental model in 42 pigs to study chemical and thermal sclerotherapy with various agents in edematous gallbladders. A total ablation of the gallbladder mucosa was difficult to effect. Remnants of mucus-producing epithelium persisted in a high percentage of the histologic specimens. Sclerotherapy cannot be considered an effective method for "nonsurgical cholecystectomy."

Adult↗
PubMed1991

Elevated expression of P-glycoprotein in kidney and urinary bladder cancers.

A monoclonal antibody, MRK16, recognizing specifically an epitope of P-glycoprotein (P-GP), a highly active efflux transporter of chemotherapeutic agents, was used to determine the degree of expression of P-GP in the normal human kidney and urinary bladder, and in kidney and urinary bladder cancers. P-glycoprotein was localized in the microvilli of the epithelial cells of the proximal renal tubules by immunoelectron microscopy, and detected immunohistochemically in 6 of 20 untreated kidney cancers and 11 of 31 untreated urinary bladder cancers. Some of the cancerous tissues were further examined with regard to P-GP expression by immunoprecipitation. In urinary bladder cancers, the degree of P-GP expression seemed to be somewhat correlated with tumor grading. These results indicate that our method to detect the degree of expression of P-GP by MRK16 may be applicable for the diagnosis of clinical multidrug resistant urinary cancers.

ATP Binding Cassette Transporter, Subfamily B, Mem↗