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Inhibition by papaverine of calcium movements and tension in the smooth muscles of rat vas deferens and urinary bladder.

Papaverine, up to 150 micron, was without effect on resting tension of vas deferens and urinary bladder smooth muscle strips, but caused a dose-dependent inhibition of the phasic component of the 100 mM-K contracture. At 150 micron, papaverine caused an 80 and 60% inhibition of phasic tension in vas deferens and urinary bladder muscle respectively. Papaverine caused a marked dose-dependent reduction in the tonic component of 100 mM-K contractures in both preparations. At 150 micron, papaverine often relaxed preparations below initial starting tension. Addition of 150 micron-papaverine to incubation media caused a fall of 25-30% in 45Ca uptake by both preparations. Papaverine at 150 micron caused a small fall in resting 45Ca efflux from vas deferens and a larger fall in efflux from bladder muscle. However, this papaverine concentration caused a large inhibition of the 45Ca uptake by and 45Ca efflux from both preparations when stimulated by high-K depolarization. Papaverine at 150 micron was without significant effect on Ca binding by either microsomes or mitochondria isolated from both vas deferens and urinary bladder smooth muscle. The main site of papaverine action appears to be on the Ca-influx mechanism responsible for regulating Ca entry during prolonged K depolarization.

Animals↗

Neurosecretory granules in small cell invasive carcinoma of the urinary bladder.

A 69-year-old man showed symptoms of urinary bladder irritability and hematuria. Cystoscopy and radiographic studies revealed a tumor within a bladder diverticulum. The tumor shared histologic and ultrastructural features with oat cell carcinoma of the lung, including the presence of small numbers of neurosecretory type granules. In spite of conservative surgical treatment, there has been no evidence of recurrent or metastatic tumor over 14 months of follow-up. Hypophosphatemia was present preoperatively, but resolved spontaneously after tumor resection. In regard to histogenesis, a metaplastic origin is favored. This appears to be the first reported case of a neoplasm of Kultschitzky-type cells arising in the urinary bladder.

Aged↗

Flat intraepithelial lesions of the urinary bladder.

BACKGROUND: In the 1998 World Health Organization and International Society of Urologic Pathology (WHO/ISUP) classification system for bladder neoplasms, flat intraepithelial lesions of the urinary bladder were categorized as reactive atypia, atypia of unknown significance, dysplasia, and carcinoma in situ. The clinical outcomes of patients diagnosed with these atypical urothelial proliferations are uncertain. METHODS: The authors studied a series of patients who were diagnosed with reactive atypia of the urinary bladder (25 patients), urothelial atypia of unknown significance (35), or urothelial dysplasia (26) between 1985 and 1993. All histologic slides were reviewed and classified according to the 1998 World Health Organization and International Society of Urologic Pathology classification system. Patients with a concomitant or prior history of carcinoma in situ or urothelial carcinoma were excluded. RESULTS: Patient age at diagnosis ranged from 24 to 88 years (mean, 65 years). The male-to-female ratio was 3:1. The mean follow-up was 3.9 years (range, 0.1-13.4 years; median, 3.5 years). None of the patients with reactive atypia or atypia of unknown significance developed dysplasia, carcinoma in situ, or urothelial carcinoma. Four patients (15%) with urothelial dysplasia developed biopsy-proven cancer, including 3 patients with muscle-invasive cancer. The mean interval from the diagnosis of urothelial dysplasia to the development of cancer was 4.5 years. CONCLUSIONS: Patients with a diagnosis of urothelial atypia of unknown significance or reactive atypia do not have adverse clinical outcomes, whereas patients with urothelial dysplasia of the bladder have an increased risk for the development of carcinoma in situ and urothelial carcinoma.

Adult↗

[Injuries of the urinary bladder].

The authors analyse 32 patients with injuries of the urinary bladder treated in Clinical Hospital Centre "Firule" in the period from 1976 to 1988 (Figure No 1). There were: 10 contusions of the bladder (31%), 5 extraperitoneal ruptures (16%), 16 intraperitoneal ruptures (50%), and 1 combined extra and intraperitoneal rupture (3%). The isolated injuries of the bladder are rare. Extraperitoneal ruptures most of them are connected with the pelvic fractures. The intraperitoneal ruptures of the bladder were connected with splenic rupture in 7 cases, with the rupture of the rectum in 1 case, with the vaginal rupture in 1 case, with the rupture of the aorta in 1 case, with the rupture of the ovarian cyst in 1 case and with the rupture of the ileum in 1 case. All the patients with the urinary bladder rupture were operated, what got sufficient drainage of the urine, and drainage of the perivesical space and closure of the defect of the bladder.

Adolescent↗

Carcinosarcoma of the urinary bladder following cyclophosphamide therapy: evidence for monoclonal origin and chromosome 9p allelic loss.

We report a case involving a 45-year-old man with a 12-year history of Wegener granulomatosis, who developed a carcinosarcoma of the urinary bladder after long-term cyclophosphamide therapy. Cyclophosphamide is well recognized as an etiologic agent for urothelial carcinoma of the urinary bladder. However, only 5 cases of carcinosarcoma of the urinary bladder following cyclophosphamide therapy have been reported. We used loss of heterozygosity studies and microsatellite markers to define the molecular basis of this rare neoplasm. These studies revealed evidence supporting a monoclonal origin for the 2 components of this tumor. We also demonstrated allelic loss of chromosome 9p. This loss associated with carcinosarcoma of the urinary bladder is in agreement with previous studies, suggesting a possible role for the tumor suppressor gene p16 in the pathogenesis of this tumor.

Carcinosarcoma↗

Structure of the toad's urinary bladder as related to its physiology.

The structure of the urinary bladder of the toad Bufo marinus was studied by light and electron microscopy. The epithelium covering the mucosal surface of the bladder is 3 to 10 microns thick and consists of squamous epithelial cells, goblet cells, and a third class of cells containing many mitochondria and possibly representing goblet cells in early stages of their secretory cycle. This epithelium is supported on a lamina propria 30 to several hundred microns thick and containing collagen fibrils, bundles of smooth muscle fibers, and blood vessels. The serosal surface of the bladder is covered by an incomplete mesothelium. The cytoplasm of the squamous epithelial cells, which greatly outnumber the other types of cells, is organized in a way characteristic of epithelial secretory cells. Mitochondria, smooth and rough surfaced endoplasmic reticulum, a Golgi apparatus, "multivesicular bodies," and isolated particles and vesicles are present. Secretion granules are found immediately under the plasma membranes of the free surfaces of the epithelial cells and are seen to fuse with these membranes and release their contents to contribute to a fibrous surface coating found only on the free mucosal surfaces of the cells. Beneath the plasma membranes on these surfaces is an additional, finely granular component. Lateral and basal plasma membranes are heavily plicated and appear ordinary in fine structure. The cells of the epithelium are tightly held together by a terminal bar apparatus and sealed together, with an intervening space of only 0.02 mmicro near the bladder lumen, in such a way as to prevent water leakage between the cells. It is demonstrated in in vitro experiments that water traversing the bladder wall passes through the cytoplasm of the epithelial cells and that a vesicle transport mechanism is not involved. In vitro experiments also show that the basal (serosal) surfaces of the epithelial cells are freely permeable to water, while the free (mucosal) surfaces are normally relatively impermeable but become permeable when the serosal surface of the bladder is treated with neurohypophyseal hormones. The permeability barrier found at the mucosal surface may be represented, structurally, either by the filamentous layer lying external to the plasma membrane, by the intracellular, granular component found just under the plasma membrane, or by both of these components of the mucosal surface complex. The polarity of the epithelial sheet is emphasized and related to the physiological role of the urinary bladder in amphibian water balance mechanisms.

Animals↗

Primary adenocarcinoma of urinary bladder. Clinicopathologic study of 16 cases.

The clinicopathologic and immunohistochemical features of 16 pure adenocarcinomas primary in the urinary bladder were reviewed. Only 3 patients were found to have disease confined to the urinary bladder. Of 13 cases with follow-up only 3 are free of disease. Histologically, the tumors were classified as signet ring cell (3), colloid (3), colonic type (5), clear cell (1), and not otherwise specified (NOS, 4). Immunohistochemically, all tumors but one colloid carcinoma were immunoreactive for cytokeratin and epithelial membrane antigen, and most tumors were likewise immunoreactive for carcinoembryonic antigen. Eight cases were immunoreactive for Leu M1 antigen. Prostate specific antigen, S-100 protein, and placental alkaline phosphatase were uniformly negative. No correlation between immunohistochemical profile and histologic type or clinical outcome was found. The utility of immunohistochemistry and other pathologic findings is reviewed.

Adenocarcinoma↗

N-butyl-N-(4-hydroxybutyl)nitrosamine-induced urinary bladder cancer in C57BL/6 X DBA/2 F1 mice as a useful model for study of chemoprevention of cancer with retinoids.

Highly invasive carcinomas of the urinary bladder were induced in male C57BL/6 X DBA/2 F1 (hereafter called B6D2F1) mice by gastric intubation of N-butyl-(4-hydroxybutyl)nitrosamine (OH-BBN) using a quantitative dosing schedule. Animals received either 5 or 10 mg OH-BBN per intubation, two times each week, for 9 weeks for a total dose of either 90 or 180 mg, and they were killed 6 months after the first carcinogen intubation. Seven days after the final intubation of OH-BBN, animals were fed either a placebo diet or diet supplemented with either 150 or 200 mg 13-cis-retinoic acid per kg of diet. A 41 and 43% incidence of urinary bladder cancer was observed in mice given the low and high dose of carcinogen, respectively, and fed a placebo diet. Sixty-seven % of the carcinomas induced in these animals invaded either into or through the urinary bladder wall. Varying degrees of transitional and either squamous or glandular or both squamous and glandular differentiation were observed in the carcinomas. Feeding of diet supplemented with 13-cis-retinoic acid reduced cancer incidence; the degree of reduction was proportional to the dose of retinoid administered. The highly invasive nature of the carcinomas induced by quantitative administration of OH-BBN in B6D2F1, mice provides a useful animal model of the highly invasive variant of human transitional cell urinary bladder cancer in which to study chemoprevention by retinoids as well as other compounds.

Animals↗

Staging of urinary bladder neoplasms with MR imaging: is Gd-DTPA helpful?

This study was performed to investigate whether intravenous administration of Gd-DTPA can improve the accuracy of MR imaging in the detection and staging of bladder neoplasms. In 68 patients with suspected urinary bladder neoplasms, MR examinations were performed with T1-weighted SE sequences before and after intravenous administration of Gd-DTPA. The findings were compared with surgical staging using the TNM classification. Overall staging accuracy of contrast enhanced MR was 46%; if stages Ta-T3a were combined into one group, the accuracy was 69%. Accuracy was low (19%) in tumors without muscular bladder wall invasion (Ta). In cases with extravesical spread (greater than or equal to T3b), the accuracy of staging was 87%. Contrast enhanced MR detected extravesical extension of tumor with a sensitivity of 93% and a specificity of 95%. Contrast enhancement increased the sensitivity for detection of urinary bladder neoplasms from 70% on precontrast T1-weighted scans to 79% on postcontrast scans. In comparison with T2-weighted scans, the Gd-DTPA enhanced T1-weighted scans had better image quality and lower acquisition times.

Adult↗

Urinary bladders of freshwater turtles as a renal physiology model potentially biased by monogenean infections.

Because the urinary bladder of the freshwater red-eared slider turtle, Trachemys scripta elegans, is analogous to the collecting and distal tubules of the mammalian kidney, it is used frequently as an experimental model in renal physiology. The urinary bladders of 41% of these turtles obtained over a 1 year period from a commercial supplier were infected with the monogenean parasite Neopolystoma orbiculare. Macroscopically, the infected bladders appeared normal, aside from the presence of adult parasites (means = 2.3 +/- 0.3 monogeneans/turtle). However, there were distinct histological lesions associated with the deposition of masses of monogenean eggs in the bladder wall. Clusters of the eggs in varying stages of development in the mucosa and tunica muscularis were surrounded by granulomas with an inflammatory infiltrate of histiocytes, lymphocytes and occasional multinucleate giant cells. These often formed granulomatous polyps projecting into the bladder lumen. Eggs containing a mature oncomiracidium are apparently extruded into the bladder lumen. In general, the bladder walls of infected turtles were infiltrated with eosinophils and lymphocytes. Considering the extent of the inflammatory lesions, it is recommended that turtle bladders infected with these parasites not be used as models for renal physiology until the effects of these infections on the various physiological measurements are determined.

Animals↗

Minimizing urinary bladder radiation dose during brachytherapy for carcinoma of the cervix using balloon inflation technique.

PURPOSE: Radiotherapy is effective in treating cancer of the cervix. However, its success is associated with significant morbidity of the urinary bladder. This study has been designed to reduce the radiotherapy dose from the brachytherapy component of cervical cancer treatment to the urinary bladder to minimize radiation-induced morbidity. MATERIALS AND METHODS: By inflating the balloon of a Foley catheter at the anterior fornix region, attempts were made to displace the urinary bladder in patients undergoing gynecological intracavitary brachytherapy. The radiation dose to the urinary bladder was then studied in 12 insertions without and 31 insertions with balloon inflation. RESULTS: The increase in the distance from the intrauterine tandem source to a reference point in the base of the bladder and the resultant decrease in the radiation dose have been determined. A highly significant reduction in the radiation dose with an increase in distance between the source applicator and bladder base were achieved (p < 0.01 in both cases). CONCLUSION: A significant reduction in radiation dose to the bladder base can be achieved by the technique described in this study. A three-dimensional plan generated using CT images can demonstrate the drawback of ICRU-38 bladder reference point. The technique is simple consistent and reproducible within an acceptable range.

Brachytherapy↗

Regulation of the substance P-induced contraction via the release of acetylcholine and gamma-aminobutyric acid in the guinea-pig urinary bladder.

1. The action of substance P (SP) on the release of gamma-aminobutyric acid (GABA) and acetylcholine (ACh) and on contraction were studied in strips of the guinea-pig urinary bladder. Substance P induced a dose-dependent contraction of strips of guinea-pig urinary bladder (EC50 = 1.2 x 10(-9) M). This contraction was not altered by tetrodotoxin, but with a dose of 10(-9) M and less, there was a complete inhibition by 10(-6) M) atropine. Contractions initiated by 3 x 10(-9) M) SP or more were partly inhibited by atropine. The EC50 value of substance P in the presence of atropine was 7.0 x 10(-9) M. 2. Substance P induced a Ca2+-dependent and tetrodotoxin-resistant release of [3H]-acetylcholine (ACh) from strips of urinary bladder preloaded with [3H]-choline (EC50 = 4.9 x 10(-10) M), and this release was antagonized by [D-Pro2,D-Trp7,9] substance P. 3. Bicuculline increased the substance P-induced contraction and the release of [3H]-ACh from the strips. 4. Substance P induced a Ca2+-dependent and tetrodotoxin-sensitive release of [3H]-gamma-aminobutyric acid (GABA) from strips preloaded with [3H]-GABA (EC50 = 2.6 x 10(-9) M), and this release was antagonized by [D-Pro2,D-Trp7,9] substance P. 5. Therefore, substance P appears to exert excitatory effects on the contractility of urinary bladder predominantly by stimulating its own receptor located on the cholinergic nerve terminals. GABA released by substance P inhibits stimulation of the cholinergic neurone. However, the direct action of substance P on the cholinergic neurone is more potent that the indirect action via GABA release.

Acetylcholine↗

Rectal prolapse associated with urinary bladder neoplasia in a cat.

A case of feline rectal prolapse which appeared to be secondary to transitional cell carcinoma of the urinary bladder is described. The cat was reported to be incontinent and treatment was declined by the owners. Euthanasia was performed and necropsy revealed an extensive nodular thickening of the entire urinary bladder wall. A diagnosis of urinary bladder transitional cell carcinoma was made on histopathological examination.

Animals↗

Reduction of integrin beta4 and enhanced migration on laminin in association with intraepithelial spreading of urinary bladder carcinomas.

PURPOSE: The aim of the present study was to investigate the biological and molecular basis of intraepithelial spreading (IES) of carcinomas in situ (CIS) of the urinary bladder, which were considered to be precursors of nodular invasive carcinomas. MATERIALS AND METHODS: The propensity for IES of human transitional carcinoma cells was examined by inoculation into murine renal pelvis and urinary bladder, and the biological character of the cells with a high propensity for IES was explored in vitro. RESULTS: Three of 6 cell lines exhibited a high propensity for IES. When cultured on laminin, these IES cells scattered, whereas 3 non-IES cells and 2 immortalized transitional epithelial cells did not. IES cells showed strong adhesiveness, haptotaxis and enhanced migration on laminin compared with both non-IES and immortalized transitional epithelial cells. In IES cells, expression of the integrin beta4 subunit was markedly reduced and the integrin alpha6beta1 complex was predominant compared with the integrin alpha6beta4 complex. Transfection of IES cells with integrin beta4 subunit cDNA inhibited their ability to migrate on laminin and their propensity for IES. In addition, expression of the integrin beta4 subunit was reduced in surgically resected specimens of CIS of the urinary bladder. CONCLUSION: The results indicate that a reduction in integrin beta4 plays a role in IES of CIS of the urinary bladder through enhanced migration on laminin.

Antigens, CD↗

Primary adenocarcinoma of the appendix invading the urinary bladder.

We report a case of adenocarcinoma of the appendix invading the urinary bladder in a 75-year-old man. Although cystoscopic examination and computed tomography suggested a primary or secondary bladder tumor, repeated transurethral bladder biopsy could not confirm the neoplasm. At operation a primary neoplasm of the appendix invading the bladder was discovered and en bloc resection of the urinary bladder with the adherent cecum followed by an ileocolonic anastomosis and ureterocutaneostomy was performed. The patient died of carcinoma 13 months later.

Adenocarcinoma↗

[Benign cystic teratoma (dermoid cyst) of the ovary perforated into the urinary bladder].

In a 25-year-old female patient with right-sided adnex tumour and inveterate infection on the urinary tract a benign cystic teratoma (dermoid cyst) perforated into the lumen of the urinary bladder could diagnosed cystoscopically. As therapeutic method of choice the tumour with the adjacent part of the wall of the urinary bladder was operatively removed. The histological investigation confirmed the right ovary as starting point of the tumour. Pathogenetic and etiologic points of view of the perforation of dermoid cysts of the small pelvis into adjacent hollow organs are discussed in short. When a perforation into the lumen of the urinary bladder is present, among others the clinical symptoms of the flux of hair and fatty paste with the urine belonging to this give good diagnostic references.

Adult↗