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At least 379 records · Page 21Linked to original sources
PubMed1994

Dysfunctional voiding syndromes and vesicoureteral reflux.

Micturition disorders simulating neurogenic bladder disease have been loosely termed "dysfunctional voiding". No underlying neuropathy can be found. A variety of voiding disturbances have been identified since the early 1970s, each with its own characteristics and clinical relevance. We have classified voiding dysfunctions into mild, moderate and severe, according to their potential impact on the upper tracts. Bladder instability, the Hinman syndrome and the Ochoa syndrome are the only dysfunctional voiding syndromes that are associated with reflux or ureterovesical obstruction. Each syndrome is briefly described.

Child↗
PubMed2006

Assessment of the health status and risk factors of Kham Tibetan pastoralists in the alpine grasslands of the Tibetan plateau.

The health status of Tibetan herders in the Sanjiangyuan region of the Tibetan Plateau, in southwest Qinghai Province, is assessed in this paper. The field study was conducted in 2002 in the context of a broader community development and research framework, the ultimate goal of which is to achieve an effective region-specific programme of preventative health care and training for Tibetan pastoralists. Specifically, the authors analysed the impact of a number of potentially health-related environmental and lifestyle risk factors on self-reported health indicators, with a special emphasis on mother and child health. Several health status indicators were used, including a general morbidity index and a measurement of functional incapacity due to illness in the sample households. Maternal and child health findings were alarming with high rates of miscarriage and infant loss, with no traditional midwives to assist in pregnancy and delivery. Preventable childhood illnesses were also common. Other debilitating diseases included hepatitis, tuberculosis, arthritis (gout), gall bladder disease, peptic ulcers and back pain. Finally, binary logistic regression analysis showed a significant link between general morbidity and the time it takes to obtain water. The survey findings, validated by the focus groups, indicate a real need for increased accessibility and quality of health service provision to women and men and effective preventative health strategies.

Adolescent↗
PubMed1978

Nonvalue of neomycin instillation after intermittent urinary catheterization.

This study evaluated weekly urine cultures of patients with neurogenic bladder disease who underwent intermittent urinary catheterization for bladder retraining. One group of 53 patients in 1974 received regular instillations of 0.1% neomycin after each catheterization. A similar group of 55 patients in 1975 did not receive neomycin and constituted a control group. Distribution of age, sex, diagnosis, and duration of bladder retraining was comparable in both groups. Quantitative bacterial colony counts of 10(4) to 10(5) or greater per ml of urine were considered significant. There was no difference in the incidence of bacteriuria between the neomycin-treated group and the control group (53 versus 49%, respectively), and most patients in each group had colony counts >10(5)/ml. Escherichia coli was seen less frequently in neomycin-treated patients (43.4 versus 62.5%), but a greater percentage of infections due to Pseudomonas aeruginosa, group D streptococci, and yeasts was noted in the neomycin-treated group than in the control group (41.5 versus 22.5%).

Bacteriuria↗
PubMed1978

Visualization of the cystic artery after injection of Pancreozymin.

In 84 patients selective angiography of the common hepatic artery before and after injection Pancreozymin was performed. The results prove that: 1. Pancreozymin produces visualization of the cystic artery and its branches and of the gall-bladder wall in the majority of these normal gall-bladders that are not visualized during angiography without Pancreozymin. 2. Pancreozymin improves visualization of many normal and pathological gall-bladders seen only faintly on angiography without Pancreozymin. 3. In a patient with an angiographically normal liver the non-visualization of the branches of the cystic artery or of the gall-bladder wall after injection of Pancreozymin is a reliable sign of organic gall-bladder disease, or of a collapsed gall-bladder seen sometimes in patients with bile duct or pancreatic tumour.

Cholecystokinin↗
PubMed1986

Nontraumatic spontaneous rupture of the urinary bladder.

Rupture of the urinary bladder without a history of recent trauma or instrumentation is rare; it is usually associated with bladder disease or outlet obstruction. The patient is usually seen as an emergency case and has an atypical clinical picture. The four patients in this report were initially seen and treated by a general surgeon; in only two was the diagnosis established preoperatively and confirmed by retrograde cystography. Awareness on the part of the consulting surgeon that bladder rupture is possible in a predisposed patient may lead to a correct preoperative diagnosis. In this series, early operation--removing urine from the peritoneal cavity or retropubic space, closing the rupture and securing good vesical drainage--resulted in resumption of vesical function in all four patients and there were no deaths.

Adult↗
PubMed2005

Inhibition of substance P activity prevents stress-induced bladder damage.

Substance P is a neuropeptide involved in inflammation, immune regulation and stress response. Stress may induce bladder damage by stimulating inflammatory response such as mast cell activation. We here examined the role substance P during stress-induced mast cell degranulation and urothelial injury in rat bladder. Adult Sprague-Dawley rats (200-270 g) were either exposed to cold-immobilization stress or substance P (SP) intracerebroventricularly. Different doses of substance P receptor (NK1R) antagonist CP 99994 were administered peripherally or centrally before the stress exposure. From each group, samples of the bladder were examined with light and electron microscope. Stress- and SP-injected centrally, increased the number of both granulated and degranulated mast cells. Ultrastructurally, urothelial degeneration with vacuolization in the cytoplasm and dilated intercellular spaces were seen. Both central and peripheral injection of CP 99994 prevented stress-induced urothelial degeneration as well as stress-induced mast cell degranulation. In conclusion, centrally and peripherally released substance P is involved in stress-induced bladder damage. Inhibition of NK1R prevents stress-induced pathological changes of urinary bladder and NK1R antagonist can be considered for the treatment of inflammatory bladder diseases.

Animals↗
PubMed2001

Distribution of DT-diaphorase and reduced nicotinamide adenine dinucleotide phosphate: cytochrome p450 oxidoreductase in bladder tissues and tumors.

PURPOSE: We previously showed that mitomycin C activity in human bladder tumors is inversely related to tumor stage and muscle invasive tumors are less sensitive than superficial tumors. Because DT-diaphorase and reduced nicotinamide adenine dinucleotide phosphate:cytochrome P450 oxidoreductase (P450R) have a role in mitomycin C bioactivation, we investigated the distribution of these enzymes as a function of depth in the bladder wall and in human bladder tumors located at different parts of the bladder. MATERIALS AND METHODS: Gene expression of DT-diaphorase and P450R relative to the expression of beta-actin was measured by reverse transcriptase-polymerase chain reaction in 4 dog and 8 human bladder tissue specimens, and in 46 human bladder tumors. DT-diaphorase activity was measured by enzymatic assay in dog and human bladders. RESULTS: Data showed decreasing expression of DT-diaphorase and P450R from urothelium to muscle layer in the normal bladder wall with higher interindividual variation in humans than in dogs (greater than 40-fold versus approximately 3-fold). The expression of DT-diaphorase and P450R in bladder tumors correlated inversely with tumor stage (p <0.05) and was significantly higher in superficial than in muscle invasive bladder disease. DT-diaphorase and P450R expression in bladder tumors was approximately 6-fold higher than in normal bladder tissue. In normal and tumor tissues DT-diaphorase expression correlated significantly with P450R (r2 = 0.33, p <0.01), while DT-diaphorase expression correlated with its enzyme activity (r2 = 0.84, p <0.01). CONCLUSIONS: Our results indicate a higher distribution of DT-diaphorase and P450R in superficial bladder tumors and tissues. Preferential enzyme distribution in superficial tumors may be a cause of the higher efficacy of intravesical mitomycin C therapy for superficial versus muscle invasive disease.

Animals↗
PubMed1994

A model for the function of glycosaminoglycans in the urinary tract.

Investigations into the antibacterial defense mechanisms of the urinary tract revealed an important function for cell surface glycosaminoglycans (GAG), that of a generalized antiadherent activity. This activity was found to prevent bacterial, protein, and ionic adherence to the cell membrane. A model was developed to explain mechanically the activity of sulfated polysaccharides at the bladder surface. The model predicted injurious effects of quaternary amines and also that the mucus would be the so-called blood-urine barrier. It also led to the hypothesis that exogenous polysaccharides may be important in treating bladder disease such as infection and interstitial cystitis. For the first clinical test of these concepts, a polysaccharide was employed in several double-blind studies and was shown to ameliorate significantly the symptoms of interstitial cystitis. These discoveries suggest new methods to manipulate the microenvironment between the transitional cell surface and the urine, leading to novel therapies in regulating disease of the genitourinary tract. They also stress the importance of understanding the mechanisms by which GAGs exert their effect in the urinary tract and how they are produced, maintained, and even inactivated (e.g., by urinary substances such as protamine).

Animals↗
PubMed1976

Spontaneous bladder rupture: rare cause of peritonitis.

Spontaneous rupture of the urinary bladder is an uncommon, but important, cause of generalized peritonitis. It is a surgical emergency which may be rapidly fatal if diagnosis and treatment are delayed. Bladder disease or obstruction, coupled with a sudden increase in intra-abdominal pressure usually accounts for the rupture. Characteristic symptoms are acute lower abdominal pain followed by generalized peritonitis. In most cases, the rupture is intra-peritoneal.

Emergencies↗
PubMed1986

Advanced transitional cell bladder cancer: a treatable disease.

Although metastatic bladder cancer is difficult to treat effectively, chemotherapy combinations and schedules have emerged recently that can result in long-lasting complete responses in some patients. Response rates, response durations, and survival patterns of the entire patient population are, however, unsatisfactory. Whereas survival times of these patients following therapy with cisplatin alone or in combination with other drugs are not significantly different, complete response rates are higher and disease-free survival is longer when combinations are used. Higher dosages are associated with better response rates but also with substantial toxicity. Extensive local pretreatment or prior systemic chemotherapy reduces the likelihood of clinically meaningful disease response. Several adjuvant studies have demonstrated an advantage in length of disease-free survival for chemotherapy-treated patients when compared to those who are observed following operation. Metastatic transitional cell bladder cancer is a chemotherapeutically treatable malignancy. Locally advanced disease may be most effectively treated by aggressive surgery followed by cisplatin-based combination chemotherapy. The highest response rates and longest disease-free survivals are uniformly associated with aggressive and prolonged multidrug therapy.

Aged↗
PubMed2001

The action of cysteinyl-leukotrienes on intracellular calcium mobilization in human detrusor myocytes.

OBJECTIVE: To investigate the presence of leukotriene D4 receptors in fura-2-loaded human detrusor smooth muscle cells (DSMCs) by examining the ability of leukotriene D4 to raise intracellular-free Ca2+ concentration ([Ca2+]i), to determine the origin of the leukotriene D4-mediated rise in [Ca2+]i and to investigate whether the specific leukotriene D4 receptor antagonist montelukast inhibits the Ca2+ response induced by leukotriene D4. MATERIALS AND METHODS: Detrusor muscle biopsies were obtained from patients with benign noninvasive bladder diseases undergoing cystoscopy. DSMCs were isolated using an explant technique and maintained in culture. Only primary cultures or cells passaged up to three times were used for experiments. DSMCs were characterized with immunohistochemical staining and their identity confirmed by transmission electron microscopy. [Ca2+]i was measured in single DSMCs using the Ca2+ probe fura-2 and fluorescence-ratio microscopy. RESULTS: Immunohistochemical staining showed that 80-99% of the cells were positive for smooth muscle alpha-actin. The ultrastructural features of the cultured cells were those of smooth muscle cells and showed no differentiation in a fibroblastic or myofibroblastic direction. Leukotriene D4 increased the level of [Ca2+]i in a dose-dependent manner. Calcium was mobilized almost exclusively from intracellular Ca2+ stores. There was a dose-dependent inhibition of the increase in [Ca2+]i by montelukast. CONCLUSION: The present study is the first to show the presence of specific leukotriene D4 receptors in human detrusor myocytes. This may have implications for a potential pathophysiological role of leukotriene D4 in patients with interstitial cystitis and other functional or inflammatory bladder disorders.

Calcium↗
PubMed2002

[Primary bladder osteosarcoma treated with hemicystectomy].

Primary osteosarcoma of the bladder is an extremely rare type of tumour, and less than 30 adequately documented cases have been registered. From a clinical and radiological point of view, it is impossible to distinguish from other types of bladder tumours, since despite the fact that calcification of the bladder wall is common in osteosarcoma, other bladder diseases exist which may also present calcification. Prior to primary bladder osteosarcoma diagnosis, it is vital to first rule out the existence of an skeletal origin. Differential diagnosis must be carried out essentially with other bone-forming tumours, such as carcinosarcoma and transitional cell carcinoma with bone metaplasia. Prognosis for bladder osteosarcoma is extremely pessimistic, as the majority of patients do not survive beyond 6 months, regardless of the treatment carried out. We present a case of bladder osteosarcoma treated by right hemi-cystectomy, which remains disease free after a follow-up period of one year.

Aged↗
PubMed2006

[Utilizing optical coherence tomography (OCT) for visualization of urothelial diseases of the urinary bladder].

PURPOSE: The technique of optical coherence tomography (OCT) has significantly improved over the last few years. This new diagnostic procedure allows imaging of tissue structure of the bladder wall during cystoscopy with high resolution. MATERIALS AND METHODS: The penetration depth of OCT is limited to 2.5 mm. The resolution is approximately 15 microm. Fifty patients with different clinical conditions of the bladder were examined. Altogether 488 OCT images were generated. RESULTS: OCT of normal bladder mucosa clearly shows a differentiation between urothelium, lamina propria, and smooth muscle. Cystitis and metaplasia are characterized by blurring of the laminated structure and thickening of the epithelial layer. In malignant areas there is complete loss of the regular layered tissue structure. CONCLUSION: OCT improves the diagnosis of flat lesions of the urothelium. It has the potential for facilitating intraoperative staging of malignant areas in the bladder.

Aged↗
PubMedDate not supplied

Efficacy of plain abdominal radiography in patients with biliary tract disease.

A retrospective review was performed to determine the usefulness of plain abdominal radiographs in patients presenting to the emergency department with gallbladder disease. Patients with the clinical diagnosis of biliary tract disease were divided into two groups: those with confirmed biliary tract disease and those who did not have gall bladder disease. There were no major radiologic findings (pneumoperitoneum, pneumobilia, or bowel obstruction) in any patient with biliary tract disease. No significant difference was noted in the incidence of minor radiologic findings (right upper quadrant calcification, mild ileus and right basilar atelectasis) in patients with biliary colic and acute cholecystitis. Additionally, there was no significant difference in minor findings between patients with biliary tract and nonbiliary tract disease. Plain abdominal radiographic findings were found to be nonspecific in patients with gallbladder disease and not useful in differentiating between patients with biliary colic and acute cholecystitis. Our results also suggest that plain abdominal radiographic findings are not useful in differentiating between patients with and without biliary tract disease, although the selection of patients without biliary tract disease may have biased this finding.

Acute Disease↗