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Biomedical subjects

R J Garden

Publications and source records attributed to R J Garden.

4 recordsLinked to original sources

Laparoscopic excision of a urachal cyst.

OBJECTIVES: To determine the role of laparoscopic surgery in the treatment of urachal disorders. METHODS: A case report and literature review of laparoscopic urachal cyst procedures. RESULTS: A 21-year-old man presented with a draining sinus at the umbilicus. A diagnosis of a urachal sinus was made. The patient underwent a laparoscopic excision of the sinus and cyst. CONCLUSIONS: Minimally invasive techniques such as laparoscopic surgery are the preferred means of managing urologic diseases such as the urachal cyst.

Adult↗

Covered exstrophy with sequestered colonic remnant.

We report on a woman who presented with urinary incontinence, covered exstrophy and an abdominal mass. Radiographic studies and cystoscopy confirmed that the anterior abdominal mass did not communicate with the bladder or colon and that the gastrointestinal tract was normal. Subsequent surgical resection of the mass and Young-Dees-Leadbetter bladder neck reconstruction were performed. Histological examination of the mass revealed colonic mucosa. The etiology of the covered exstrophy and sequestered colonic remnant is discussed.

Abnormalities, Multiple↗

Isograft bladder mucosal transplantation for hypospadias repair in identical twins.

Urethral reconstruction with a bladder mucosal free graft offers several advantages for patients with complex hypospadias. We report a case in which identical twins circumcised at birth presented with mid-shaft hypospadias and chordee. A bladder mucosa graft was harvested from 1 twin, divided and used to form 2 neourethras. The donor twin underwent hypospadias repair, followed immediately by repair in the second twin with the isograft neourethra. To our knowledge this is the first reported case of bladder mucosal transplantation for hypospadias repair.

Child, Preschool↗

Bacillus Calmette-Guerin abrogates in vitro invasion and motility of human bladder tumor cells via fibronectin interaction.

Intravesical bacillus Calmette-Guerin (BCG) has been shown to be an effective treatment for superficial transitional cell carcinoma of the bladder (TCC). The mechanisms by which BCG limits tumor cell activity have thus far been unclear. We investigated the interaction between BCG and invasive human TCC cell line EJ in an in vitro invasion assay. We observed that BCG inhibited the invasion of EJ cells through an artificial basement membrane. In terms of the steps involved in tumor cell invasion, i.e. attachment, proteolysis, and motility, BCG was found to limit tumor cell motility. Attachment and proliferation of tumor cells were not affected by BCG. The effects of BCG on tumor cell migration were mediated by fibronectin (FN), a basement membrane glycoprotein component. Abrogation of BCG-FN-tumor cell interactions with anti-FN antibodies eliminated the ability of BCG to block tumor cell invasion. Fibronectin appears to link BCG and tumor cells via independent FN binding receptors to separate domains of the FN molecule. The molecular mechanism by which BCG may limit tumor cell motility may be its ability to protect against the formation of specific FN sequences as a result of protease cathepsin B digestion. A 31 kD and 27 kD FN band were absent from purified or tumor cell associated cathepsin B digestion when incubated in the presence of BCG, but present in the absence of BCG. Furthermore when purified from SDS polyacrylamide gel electrophoresis, the fragments were shown to have motility stimulating activity for the invasive EJ cells. These findings suggest that BCG functions as a potent inhibitor of tumor cell invasion. We conclude that BCG-fibronectin-tumor cell interactions may have a direct influence on the invasive mechanisms, such as motility, of tumor cells.

BCG Vaccine↗