The continent cecal reservoir for urine.
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Adult↗
Biomedical subjects
S Colleen
Publications and source records attributed to S Colleen.
The microbial flora of the continent cecal urinary reservoir, its stoma and the peristomal skin.
The bacteria occurring in reservoir urine, on the cutaneous stoma and on the abdominal skin were studied in 9 patients who had undergone urinary diversion via a continent cecal reservoir. Aerobic and/or facultatively anaerobic bacteria were isolated persistently from reservoir urine in 3 patients but only occasionally in the remainder. These organisms were isolated in pure culture. Anaerobic bacteria also were found, although infrequently and only in conjunction with facultative anaerobes. Most stomal cultures showed heavy growth of Staphylococcus epidermidis, while fewer microbes were isolated in the abdominal skin cultures. Propionibacterium acnes, present in most skin cultures, was absent or scantily represented on the stoma. Microbial antibiosis was demonstrated in vitro between stomal and urinary reservoir bacteria in 6 patients. However, bacteria from stomal isolates had no antagonistic effect against bacteria belonging to the family of Enterobacteriacae or against anaerobic species isolated from urine. Antibiosis may influence the microbial ecology of the urine reservoir and cutaneous stoma.
Adult↗
Cardiovascular complications of estrogen therapy for nondisseminated prostatic carcinoma. A preliminary report from a randomized multicenter study.
In a prospective multicenter study, 244 men with highly or moderately differentiated prostatic cancer in stage I, II or III (VACURG) were consecutively randomized to three groups of treatment: Group A (77 patients) received polyestradiol phosphate (Estradurin, Leo) 80 mg i.m. every fourth week + ethinyl estradiol (Etivex, Leo) 150 micrograms daily, group B (72 patients) estramustine phosphate (Estracyt, Leo) 280 mg twice daily, and group C (76 patients) no therapy. Only men without current or previous other malignancy and without cardiovascular disease were admitted to the study. After 4 1/2 years 125 of the 244 patients had left the study, 9 because of cancer progression (stage IV, VACURG). The most serious complications were cardiovascular, including ischemic heart disease, cardiac decompensation, cerebral ischemia and venous thromboembolism, which occurred in 24 patients from group A and 9 from group B as compared to only one patient in group C. The subgroup superficial or deep venous thrombosis comprised 11 group A and 2 group B patients. Estrogens (E + e) offered as palliative treatment to patients with non-generalized prostatic carcinoma is burdened with a high incidence of serious cardiovascular complications.
Aged↗
Immunoglobulins in urine from patients with ileal and colonic conduits and reservoirs.
Gel chromatography of proteins in urine from continent cecal urinary reservoirs revealed an abundance of high molecular weight proteins, especially secretory immunoglobulin A. Quantitation of immunoglobulins in urine from ileal and colonic conduits and ileal and cecal reservoirs showed secretory immunoglobulins A, G and M in amounts considerably greater than in urine from normal urinary tracts, whether or not bacteriuria was present. More secretory immunoglobulin A was found in reservoir than in conduit urine, but there was no such difference for immunoglobulin G and immunoglobulin M. In hemagglutination-inhibition tests, immunoglobulin A antibodies from cecal reservoir urine in 1 patient inhibited adherence (mannose-resistant) to human and animal erythrocytes of Escherichia coli obtained from reservoir urine from that same patient. High levels of secretory immunoglobulin A may constitute a host defense mechanism against urinary tract infection in patients with reservoirs and conduits.
Adult↗
Continent caecal reservoir in urinary diversion.
Construction of a continent urinary reservoir was attempted in 18 patients with carcinoma of the bladder. The caecum was used as the reservoir and an intussuscepted ileal nipple was created to provide continence. Fifteen patients are alive and have been observed for 7 to 68 months. The most common complication was malfunction of the nipple valve with urinary leakage and/or difficulty in catheterisation. Revision of the outlet was performed one or more times in 11 cases. The technique of nipple valve construction was successively evolved, with improvement in the functional results. Stricture of one uretero-intestinal anastomosis occurred in three patients. Construction of a continent caecal reservoir is a complex procedure and the problem of a stable, continence-ensuring mechanism in the outlet has not been conclusively solved. The enhanced quality of life offered by a successful continent reservoir nevertheless warrants continued clinical trials in selected patients.
Adult↗
Urinary tract infections in men caused by Staphylococcus saprophyticus.
Clinical data of 49 male patients, whose urine contained Staphylococcus saprophyticus (greater than 10(5) bacteria/ml), were analyzed. The median age of the patients was 70 yr (range 7-83). Of the patients, 25 had catheter à demeure. Among the remaining patients, 22 had symptoms of acute urinary tract infection, 8 of whom had symptoms suggesting engagement also of the upper urinary tract. One 17-yr-old man had acute epididymitis. One patient was symptomless. No obstructive uropathy could be revealed in 13 (54%) of the 24 patients without catheter.
Adolescent↗
Renal function after urinary diversion. A study of continent caecal reservoir, ileal conduit and colonic conduit.
Total and separate renal function, renal parenchymal thickness and dilatation of the upper urinary tract were studied in 40 patients preoperatively and 24 to 67 months after urinary diversion, using 51Cr-EDTA clearance test, scintillation camera renography and urography. In ten patients a continent caecal reservoir was used for diversion. In the other patients, an ileal or a colonic conduit (15 patients with each method) was used, one ureter being implanted with an anti-reflux method and the other with direct technique. Renal function following urinary diversion showed little or no deterioration in most patients. The functional outcome was not related to the method of diversion or, in the conduit groups, to the mode of ureteral implantation. Serum creatinine tests and urography were not adequate for determining loss of renal function. Radionuclide studies proved to be valuable for assessing renal function after urinary diversion.
Adult↗
Calcium-loading test and bone disease in patients with urolithiasis.
A group of 121 patients with a history of multiple or complicated calcium urolithiasis were divided into three subgroups: normal, absorptive and renal/resorptive calciuria by means of a calcium-loading test. Patients with renal hypercalciuria had lower bone mineral content (BMC) than the other groups but did not differ in amount of bone or TmPO4/GFR. The 24-hour urine calcium excretion was elevated in patients with renal and absorptive type of hypercalciuria but not in patients with normal calcium-loading test and there was no correlation to BMC. The c-AMP/creatinine seemed to discriminate patients with resorptive calciuria from patients with renal calciuria. It is suggested that only patients with renal hypercalciuria should be treated with calcium-retaining drugs such as thiazides.
Adult↗
A histochemical and ultrastructural study of human urethral uroepithelium.
The ultrastructure and histochemistry of the human urethral mucosa was studied. By scanning electronmicroscopy (SEM) the cover cell of the urethra was found to be polygonal and with a surface topography characterized by numerous microvilli and micro-ridges. By transmission electronmicroscopy (TEM) the cover cells were shown to be interconnected with tight junctions but to lack the asymmetric luminal membrane and the fusiform vacuoles that characterize urothelium above the bladder neck. Histochemical analyses showed the human urethral cells to harbour large amounts of glycogen, and the glycocalyx facing the urethral lumen displayed high affinity for alcian blue and colloidal iron, indicating the presence of acid mucopolysaccharides. The reactivity with alcian blue appeared at pH 2.5, but was abolished by pre-treatment with sialidase. Studies with TEM or using SEM with energy-dispersive X-ray spectrometry (EDX) confirmed the high content of acid mucopolysaccharides in the luminal glycocalyx of the cover cells by demonstrating high binding capacity for ruthenium red. The quantitative binding of ruthenium red was not influenced by pH shifts between 4.5 and 7.5. Utilizing the SEM + EDX technique, small variations in quantity of negative charge (i.e. of bound ruthenium red) were detected within individual cover cells, but considerable variations were found between cells. The significance of these physicochemical properties of the human urethral lining is discussed with special reference to the previously demonstrated liability of this mucosal surface to interact with microorganisms such as Escherichia coli, Staphylococcus saprophyticus and Neisseria gonorrhoeae.
Cell Membrane↗
Complicated infections of the male genital tract with emphasis on Chlamydia trachomatis as an etiological agent.
During the past five years, Chlamydia trachomatis has been documented to be one of the main etiological agents in urethritis, and also in acute epididymitis in men less than 35 years old. Although C. trachomatis is known to infect the urethra and the epididymidis, its etiological role in prostatitis is uncertain. In patients today, urethral stricture most often occurs after surgical manipulation such as instrumentation of the urethra. In patients who develop stricture as a sequela to a sexually transmitted infection, there is more commonly a history of nongonococcal than of gonococcal urethritis. When stricture does occur, early treatment is important for good prognosis. A case of urethral stricture is described in which acute retention appeared 2.5 years after a Chlamydia-caused urethritis was diagnosed.
Adult↗
An angiographic study of erection in the dog.
Erections were produced in dogs by stimulating the pudendal, the pelvic and the hypogastric nerves either singly or in combination and angiographic studies were then performed. During an erection an increase in blood flow to the erectile tissue could be demonstrated together with an impaired venous return.
Angiography↗
Staging of bladder carcinoma with computed tomography.
In a series of 24 patients with bladder carcinoma. 17 of whom underwent cystourethrectomy, the discriminatory power of computer tomography (CT) in staging of the tumours was compared with the clinical evaluation. In low-stage tumours the accuracy of staging was not increased by CT. In high-stage tumours CT was greatly superior to clinical examination for assessing neoplastic extension. CT is recommended in bladder carcinoma for which cystourethrectomy is planned, so as to achieve maximum accuracy of information concerning depth of infiltration.
Adult↗
Bacterial colonization of human urethral mucosa. II. Adherence tests using tissue organ cultures.
Interaction between two urinary tract pathogens, viz. Staphylococcus saprophyticus and Escherichia coli, and the mucosal lining of the human urethra was studied in a tissue organ culture system utilizing 14C-labelled organisms and scanning electron microscopy. Reduction of pH from 7.5 to 5.5 of the medium in which the organisms were suspended, significantly increased the number of staphylococci that adhered to the urethral cover cells, while no such effect was found when testing E. coli. Increasing time of incubation from 1 to 8 hours did neither effect the numbers, nor the proportions of S. saprophyticus that were bound to the urethral mucosal lining. At pH 6.5 and 7.5 a minor increase of the proportion of E coli that adhered to the urethral organ culture was found when the incubation period exceeded 4 hours, no corresponding finding could be verified at SEM. Two possible modes of the microorganisms to overcome the mutual repellent forces between the invading organism and the urethral surface cover cell are suggested--reduction of surface charge in microorganisms with high isoelectric point (S. saprophyticus) (utilizing pH-shift towards increased acidity), and attachment by means of poorly or non-charged bacterial appendices (i.e. fimbriae) (E. coli).
Adhesiveness↗
Bacterial colonization of human urethral mucosa. I. Scanning electron microscopy.
A scanning electron microscopic investigation of the urethral mucosa of altogether ten men and women subjected to cystourethrectomy because of urothelial cancer of the urinary bladder was performed. The mucosal cells were found to be polygonal and characterized by the presence of microvilli and microridges. No sex difference could be demonstrated. Although a higher number of cells carrying microridges was found in the proximal part of the urethra, no statistical difference in the number of cells with various surface topography was found in different parts of the urethra. The micrographs revealed that the number of urethral cells to which bacteria were attached, was low, also in patients with proven preoperative infection. The bacteria, mainly cocci, seemed to exhibit a preferential adherence to a subpopulation of urethral cover cells, as indicated by the observation that the organisms were not attached randomly. The possibility that different cell surface properties may explain this distribution is considered.
Female↗
Intracavitary Epodyl for multiple non-invasive, highly differentiated bladder tumours.
Multiple, recurrent cancer of the bladder grade I-II (WHO), stage T1 (UICC) was treated with regular intravesical instillation of ethoglucid (Epodyl) in 39 patients. In ten of them cystitis necessitated withdrawal of the treatment. The therapeutic schedule could be followed in 29 cases, with eradication of the tumours in 27. Nine patients who continued the treatment on a prophylactic basis were still recurrence-free after 18-60 (mean 37) months. Myelosuppression did not occur, but cystitis was a serious problem that frequently jeopardized therapy.
Aged↗
Inhibitory effect on the formation of chlamydial inclusions in McCoy cells by seminal fluid and some of its components.
Our purpose was to determine the effect of semen and some of its components upon chlamydial inclusion (CI) count and cytopathogenic effect in cycloheximide-treated McCoy cells. Semen and spermine caused a dose-related decrease in the number of CI, using a standardized infectious dose of Chlamydia trachomatis, immunotype F. Lysozyme in certain concentrations stimulated CI formation, whereas the cations Cu++ and Zn++ produced a cytopathogenic effect and a dose-related reduction of the CI count, EDTA neutralized the effects of the cations and its addition to seminal fluid experimentally infected with C. trachomatis resulted in a greater number of CI than found in control cultures containing only semen.
Adult↗
Physico-chemical properties of Staphylococcus epidermidis and Staphylococcus saprophyticus as studied by aqueous polymer two-phase systems.
The physico-chemical surface characteristics, i.e. charge, charge density and hydrophobic interaction liability, of two strains of Staphylococcus saprophyticus were studied by the partition in aqueous polymer two-phase systems and compared to that of three strains of Staphylococcus epidermidis. The two strains of S. saprophyticus, one with and one without sheep erythrocyte agglutinating ability, were found to be negatively charged at pH 7.2 and 5.5, but exhibited a charge reduction at the lower pH. The three strains of S. epidermidis were found to carry a lower charge and lost relatively more charge at pH reduction than did S. saprophyticus. All strains of both bacterial species had a poor hydrophobic interaction liability. Incubation of one strain of S. saprophyticus with specific immune serum did not influence on hydrophobicity, but reduced charge drastically. Charge reduction was found to be associated with an immune serum fraction containing IgG and IgA.
Animals↗
[Urinary tract infections caused by coagulase negative Staphylococcus].
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Adolescent↗