Showing papers on "Urinary bladder published in 1976"

Reflex activation of sympathetic pathways to vesical smooth muscle and parasympathetic ganglia by electrical stimulation of vesical afferents.

Abstract: 1. Activation of the sympathetic input to the urinary bladder by electrical stimulation of afferent fibres in the pelvic nerve evoked three responses: (1) an initial transient rise in intravesical pressure, (2) an inhibition of neurally evoked bladder contractions and (3) an inhibition of transmission in vesical parasympathetic ganglia. Similar responses were elicited by stimulation of the hypogastric nerve. 2. The reflex responses were observed in acute spinal preparations (T10-T12) and in cats with intact spinal cords, but were abolished by bilateral transection of the hypogastric nerves. 3. The inhibition of bladder contractions was antagonized by the administration of propranolol (200-400 mug, I.A.), a beta-adrenergic blocking agent. The inhibition of ganglionic transmission was antagonized by dihydroergotamine (30-75 mug, I.A.), an alpha-adrenergic blocking agent. The initial rise in intravesical pressure was not antagonized by either agent. 4. Electrical stimulation of other afferents (carotid sinus nerve and sciatic nerve) did not consistently elicit responses in the urinary bladder. However, stimulation of these afferents as well as pelvic nerve afferents evoked reflex firing in nerve filaments on the surface of the urinary bladder. The firing was abolished by transection of the ipsilateral hypogastric nerve. 5. It is concluded that stimulation of vesical afferents activates a spinal sympathetic reflex which results in closing of the internal urethral sphincter and a depression of bladder activity. The latter occurs by a direct depression of detrusor smooth muscle as well as a block of the neural input to the bladder. This vesico-sympathetic reflex represents a negative feed-back mechanism which may have an important role in the maintenance of urinary continence.

Synaptic transmission in parasympathetic ganglia in the urinary bladder of the cat.

Abstract: 1. Electrophysiological techniques were used to study the sacral para-sympathetic input to pelvic ganglia located on the surface of the urinary bladder of the cat. 2. Synaptic transmission in pelvic ganglia was mediated primarily via nicotinic receptors although muscarinic excitatory receptors were present. 3. The most prominent characteristic of transmission in pelvic ganglia was the marked recruitment elicited by increasing frequencies of preganglionic nerve stimulation. Post-ganglionic action potentials were of low amplitude at low frequencies of stimulation (0-1-0-5c/s), but commonly increased to five to twenty times control amplitudes during continuous stimulation at frequencies between 5 and 10c/s. Thus, it is proposed that vesical ganglia may act as "filters" in the micturition pathway; blocking the excitatory input to the bladder when intravesical pressure and parasympathetic firing is low and facilitating the neural input to the bladder during micturition when preganglionic activity is high. 4. Information was also obtained about the characteristics of the parasympathetic post-ganglionic neurones innervating the bladder. Stimulation of the preganglionic fibres in the pelvic nerve elicited a bimodal contraction consisting of an initial phasic response, which was atropine-resistant and a tonic response which was blocked by atropine. This suggests that two types of neurones, cholinergic and non-cholinergic, may mediate the sacral input to the vesical smooth muscle.

Naturally Occurring and Bracken-Fern-Induced Bovine Urinary Bladder Tumors Clinical and Morphological Characteristics

Abstract: Clinical and morphological characteristics of 139 naturally occurring and 20 braken-fern-induced urinary bladder tumors of cows were studied. Hematuria was prominent and occurred as early as 60 days after braken fern feeding began. Anemia and changes in leukocytes were late manifestations. Papillomas appeared as early as 1 year, whereas invasive carcinomas did not develop until 2.6 years after initiation of feeding. Twenty of 30 cows fed braken fern developed bladder tumors within 5.3 years. None of eight untreated control cows that lived 4 years or six that lived 10 years developed neoplasms. Naturally occurring and fern-induced bladder tumors were epithelial (35%) or mixed epithelial and stromal (55%). Papillomas occurred in 24% and carcinomas in 61% of naturally occurring cases, whereas there were papillomas (40%) and carcinomas (50%) in fern-fed cows. Naturally occurring tumors were metastatic to regional lymph nodes and lung. No metastases were detected in fern-fed cows.

Effect of avitaminosis A and hypervitaminosis A on urinary bladder carcinogenicity of N [4 (5 nitro 2 furyl) 2 thiazolyl]formamide

Abstract: Summary The effect of vitamin A deficiency and hypervitaminosis A on the urothelial carcinogenicity of N-[4-(5-nitro-2-furyl)-2-thiazolyl]formamide (FANFT) was determined in female weanling Sprague-Dawley rats. Vitamin A deficiency resulted in squamous metaplasia of the urinary bladder and high incidences of cystitis, ureteritis, and pyelonephritis. Administration of FANFT to vitamin A-deficient rats appeared to accelerate the carcinogenic process, with earlier appearance of urinary bladder tumors and the development of ureteral and renal pelvic carcinomas. Most of these tumors were squamous cell, occasionally with transitional cell foci. Hypervitaminosis A prevented the appearance of squamous metaplasia and squamous cell neoplasia in rats fed FANFT, but it did not inhibit the formation of transitional cell hyperplasia or neoplasia in comparison to rats receiving normal levels of vitamin A and FANFT.

Histological classification of urinary bladder cancers in rats induced by N-butyl-n-(4-hydroxybutyl)nitrosamine.

Abstract: Histological types and grades of 613 urinary bladder cancers induced in rats by N-butyl-N-(4-hydroxybutyl) nitrosamine(BBN) were analyzed. Most of them (95.1%) were transitional cell carcinomas, the remainder being squamous cell carcinomas (3.3%), undifferentiated carcinomas (2.5%), and carcinosarcomas (0.3%). Among the transitional cell carcinomas, 23.3% were Grade I anaplasia, 55.2% Grade II, and 21.5% Grade III. Among the squamous cell carcinomas, 20% each were Grade I and II, and 60% Grade III. Most of the undifferentiated carcinomas were Grade III. Some of the cases of transitional cell carcinoma had areas of squamous metaplasia and/or glandular metaplasia, and the incidence of metaplasia increased with the grade of anaplasia. Approximately 36% of the cases of transitional cell carcinoma were of the invasive type. Invasive types were twice as numerous among cases of squamous cell carcinoma as among those of transitional cell carcinoma and all of undifferentiated carcinomas were invasive. The incidence of invasive type was closely related to the grade of anaplasia. These results show that the morphological characteristics of urinary bladder carcinomas induced by BBN in rats are similar to those seen clinically in humans.

Primary malignant melanoma of the urinary bladder.

Abstract: A melanin-synthesizing tumor of the urinary bladder was studied by light and electron microscopy. Careful clinical evaluation did not reveal evidence for a primary melanoma elsewhere in the patient. The clinical presentation, course of the disease, and demonstration of melanocytes in the bladder epithelium and malignant melanocytes comprising the tumor by light and electron microscopy indicated that the neoplasm was a primary malignant melanoma arising in the bladder.

A cell line (SCABER) derived from squamous cell carcinoma of the human urinary bladder.

Abstract: An established cell line derived from a documented squamous cell carcinoma of human urinary bladder is described. The cultured cells retained the characteristic morphology of the tumor of origin for 40 in vitro passages. Numerous desmosomes were found between cultured cells. Chromosome analysis showed hypotetraploidy with no obvious modal number, while distinctive marker chromosomes and a male karyotype were present.

The effects of drugs and anaesthetic agents on the urinary bladder and sphincters.

Abstract: Summary Many patients undergoing urodynamic investigations have pressure studies performed under sedation or general anaesthesia. Some of the agents used are known to have effects on smooth muscle (Curreri and Gale, 1950; Burn and Epstein, 1959) and could, therefore, invalidate the results obtained. The purpose of this investigation was to determine the effect of these agents on urethral resistance and bladder capacity. The influence of sedative, anaesthetic and neuromuscular blocking drugs on diagnostic urethral pressure profiles and cystometrograms has been investigated. These agents have marked effects on the results obtained; in particular, the urethral pressure profile was raised by opiates and lowered by anaesthetic induction agents. Bladder capacity as measured by the cystometrogram was greatly increased by halothane. These findings indicate that urodynainic studies should be performed only on conscious unsedated patients.

Canine bladder cancer: epidemiologic features

Abstract: A retrospective study of medical records from 13 veterinary university hospital clinics yielded 114 dogs with microscopically confirmed primary malignancy of the bladder. When matched to controls, there was no increased frequency to suggest an association of urogenital tumors or anomalies with neoplasms of the bladder. The majority of tumors seen in this study were transitional cell carcinomas. Four breeds were identified with excessive risk for bladder cancer and may serve as models for further research into genetic determinants, such as abnormal tryptophan metabolism. The epidemiologic features of canine bladder cancer were compared with the disease in man. An excess among female dogs may be the result of less frequent urination as compared to male dogs. Assuming an etiology from urine-borne carcinogens applies to spontaneously occurring bladder cancer in dogs, then monitoring the frequency of occurrence of canine bladder cancer may provide an early warning of emerging environmental hazards to man.

Heterotopic urinary bladder with a communicating reservoir.

Abstract: A heterotopic bladder attached to an Ommaya reservoir was transplanted to the back of a syngeneic rat. Following transplantation, the mucosa underwent ischemic necrosis. However, it was rapidly reepithelialized in 2 weeks as a result of spreading of the epithelium originating from the ureterotrigonal region. By light microscopy the regenerated epithelium was indistinguishable from the normal transitional epithelium, and the cannula connecting the reservoir to the bladder remained patent throughout the observation period of 22 weeks. One bladder, when examined at 22 weeks, contained a transitional cell papilloma with squamous metaplasia. Although further study is needed, this model is potentially useful in studies related to bladder carcinogenesis.

Kidneys, Extrarenal Salt Excretion, and Urine

Abstract: The urinary organs consist of paired symmetrical kidneys and the ureters, which transport urine to the urodeum of the cloaca. A urinary bladder and a renal pelvis are absent in birds. The kidneys are located in the bony depressions of the fused pelvis. Each kidney is made up of three divisions, often called lobes, designated as cranial, middle, and caudal (Siller and Hindle, 1969). Each division is made up of lobules, comprised of a large cortical mass of tissue and a smaller medullary component (Figures 14–1, 14–2, and 14–3). It is more correct to consider the avian lobe as the total complement of lobules drained by a single uretral branch (Siller, 1971).

Structure and function of the rabbit bladder altered by chronic obstruction or cystitis.

Abstract: Decreased muscle contractility has been observed in association with intercellular collagen deposition after acute urinary obstruction. Chronically induced (2 months) bladder neck obstruction in rabbits produced similar marked changes in the ultrastructure of the bladder wall, with widening of the intercellular spaces and formation of collagen. Resting intravesical pressure was greater in animals with bladder neck obstruction than in the controls, yet response to stimulation was not impaired. Bacterial cystitis, in contrast, produced no consistent change in ultrastructure but the response of intravesical pressure to pelvic nerve stimulation was reduced. It is concluded that intercellular collagen deposition is not responsible per se for impaired conduction of nerve stimuli; perhaps discrete conduction pathways exist in the detrusor and the intercellular electrotonic spread of action potentials is not essential for contraction.

Pelvic exenteration as palliation of malignant disease.

Abstract: It has been traditional to exclude patients with radiation-recurrent carcinoma of the uterine cervix or other pelvic neoplasms, incapacitating pelvic pain, postirradiation fistulas, hemorrhage, or malodorous draining tumor necrosis from pelvic exenteration if cure of the malignant disease is not achievable. This negative attitude is a direct result of the reported high morbidity, prohibitive mortality, and low salvage rate previously associated with pelvic exenteration, the only acceptable surgical approach to these diseases. A recent experience with eighteen patients who underwent pelvic exenteration for advanced primary or recurrent carcinoma of the cervix, urinary bladder, or rectum has led us to challenge several traditional concepts regarding this operative procedure. We have observed but one operative death and our morbidity has been minimal. This may reflect our belief that an aggressive pelvic lymphadenectomy in those patients with direct visceral involvement from radiation-recurrent carcinoma of the pelvic viscera is not advantageous since no significant survival has ever been documented for patients with pathologic visceral involvement and positive lymph nodes. In addition, significant morbidity has always been associated directly with pelvic lymphadenectomy in the irradiated pelvis, and elimination of this phase of the operation in selected patients with radiation-recurrent carcinoma is indicated. Moreover, the considerable decrease in morbidity and the minimal mortality observed have led us to adopt a very liberal attitude toward preoperative selection criteria, and we regularly now use pelvic exenteration not only for cure but as intentional palliation in selected patients. We strongly believe that elimination of pain, fistulas, pelvic sepsis, hemorrhage, and malodorous areas of tumor necrosis are important for improving the quality of life for both the patient and family.

Lumbar spondylosis and neuropathic bladder: investigation of 73 patients with chronic urinary symptoms.

Abstract: Seventy-three patients presented with either chronic urinary symptoms such as incontinence, retention, and recurrent urinary infection or chronic low back pain and neurogenic claudication. Lumbar spondylosis was considered to be the major cause of the urological and skeletal symptoms; the diagnosis of a neuropathic bladder depended as much on features in the history as on the results of urological and neurological investigations. The preoperative demonstration of significant lumbar spondylosis was often difficult, but decompressive laminectomy in 34 patients produced relief of urinary symptoms and improvement in bladder function in 75%.

Urinary-bladder toxicity following pelvic irradiation and simultaneous cyclophosphamide therapy.

Abstract: The frequency and severity of urinary-bladder toxicity were determined retrospectively in a large series of childhood cancer patients treated with either pelvic irradiation and simultaneous cyclophosphamide or cylclophosphamide with extrapelvic irradiation. Of 50 patients who received the first combination, 17 (34%) developed urinary-bladder toxicity. Eight of the 17 had transient hematuria and dysuria with complete clearing clinically after cessation of treatment; nine had chronic or intermittent hematuria which persisted after treatment was stopped and often resulted in demonstrable fibrosis and telangiectasia of the bladder. By contrast, of 60 children who received cyclophosphamide and radiotherapy outside the pelvic region, only five (8%) developed hematuria and in all instances it was transient. This comparative study demonstrates a significantly increased frequency and severity of urinary-bladder toxicity in cancer patients receiving pelvic irradiation with simultaneous cyclophosphamide.

Urinary bladder complications with cyclophosphamide therapy.

Abstract: The use of cytotoxic drugs in rheumatic diseases is attended by many potential side-effects, including infection, bone marrow depression, gastrointestinal toxic reactions, infertility, teratogenesis, and neoplasia.1In addition, individual drugs have rather specific side-effects. The urinary bladder complications that have been reported with the use of cyclophosphamide include acute hemorrhagic cystitis, chronic cystitis, urine cytologic abnormalities, mucosal telangiectasia, interstitial fibrosis, and transitional cell carcinoma.2We report the occurrence of severe and prolonged hemorrhagic cystitis, bladder calculi, and eosinophilic cystitis in a patient with systemic lupus erythematosus (SLE) who was treated with cyclophosphamide. PATIENT SUMMARY An 18-year-old man was admitted to a neighboring hospital with acute psychosis, epilepsy, and pericarditis in November 1968. The result of an antinuclear factor (ANF) test was reported to be positive. A diagnosis of SLE with cerebral vasculitis was made, and the patient was treated with corticotropin and cyclophosphamide, intravenously. During the next ten

Early Detection of Diabetic Visceral Neuropathy: An Electrophysiologic Study of Bladder and Urethral Innervation

Abstract: The segmental and supraspinal innervation of the detrusor muscle and periurethral striated musculature was studied in 27 patients with diabetes mellitus by gas cystometry, integrated sphincter electromyography, and spinal evoked-response latency measurements. Slowing of neural conduction velocities was a consistent finding in all the patients, even when cystometry did not show abnormalities. Thus, neuropathy in the segmental innervation of the bladder and urethra was documented.

The continent ileostomy and the isolated ileal bladder.

Abstract: The histories of 19 patients operated on by Kock's technique are reported. Follow-up extended from 3 years 4 months for the first case to 2 weeks for the last. There was one fatality. Some details of technique, contraindications, and complications and their treatment are discussed. Seventeen patients had a total proctocolectomy for ulcerative colitis and 2 had urinary diversion into an isolated ileal reservoir for inoperable carcinoma of the urinary bladder.