[Neurogenic bladder in spinal diseases].
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Child↗
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Results for “BLADDER DISEASES”
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Tumors of the bladder and prostatic diseases. Papers dedicated to Hans Wolf on the occasion of his 60th birthday.
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Animals↗
Urethral recurrence after radical radiotherapy for bladder cancer.
PURPOSE: Following cystectomy for bladder cancer, orthotopic reconstruction may result in a decreased risk of urethral recurrence compared to cutaneous diversion. We evaluate the rate of urethral recurrence after radical external beam radiotherapy. MATERIALS AND METHODS: We reviewed the records of 214 men who had received radical radiotherapy at a single center from 1990 to 1995. Patients treated with chemotherapy were excluded from study. RESULTS: A total of 214 men (median age 69 years, range 39 to 86) underwent radical radiotherapy for cure. Tumor stages were T1 in 7%, T2 in 41%, T3 in 42% and T4a in 10% of the patients. Median followup was 32 months (range 1 month to 8.4 years) and 5-year survival rate was 30%. Urethral recurrence developed in 7 (3.2%) cases and was detected within 18 months (median 10 months, range 3 months to 5 years) of followup in 5. In 2 of these 7 cases recurrence developed in the prostatic urethra, and when these 2 cases were excluded from analysis the recurrence rate decreased to 2.3%. A total of 64 men completed 5-year followup, with a 4.7% rate of urethral recurrence (3.1% excluding prostatic urethral recurrence). Multifocal disease, bladder neck involvement, prostatic disease and cis were possible risk factors for urethral recurrence. CONCLUSIONS: The risk of urethral recurrence after radical radiotherapy for transitional cell carcinoma of the bladder is comparable with that reported after orthotopic reconstruction. It is not possible to exclude completely that men at higher risk were offered cystectomy, but the data are consistent with the suggestion that continued contact with urine may be protective.
Adult↗
Recent advances in high-throughput molecular marker identification for superficial and invasive bladder cancers.
Bladder cancer is the fifth most common neoplasm in industrialized countries. Due to frequent recurrences of the superficial form of this disease, bladder cancer ranks as one of the most common cancers. Despite the description of a large number of tumor markers for bladder cancers, none have individually contributed to the management of the disease. However, the development of high-throughput techniques for simultaneous assessment of a large number of markers has allowed classification of tumors into clinically relevant molecular subgroups beyond those possible by pathological classification. Here, we review the recent advances in high-throughput molecular marker identification for superficial and invasive bladder cancers.
Biomarkers, Tumor↗
[Ultrasound in gall bladder diagnosis (author's transl)].
An analysis of the ultrasound findings in 104 selected patients with suspected gall bladder disease showed a high accuracy of 92%. Limiting factors in the use of ultrasound are anatomical variations, high position of the gall bladder, which prevents demonstration of the gall bladder. The primary use of ultrasound is in the demonstration of radiologically invisible gall bladders. In our clinical material 58% had stones, with occlusion of the cystic duct as a cause, in 29% there was malignant disease in the porta hepatis, with evidence of bile obstruction amongst those patients in whom there was no radiological opacification of the gall bladder.
Adult↗
Detection of circulating MUC7-positive cells by reverse transcription-polymerase chain reaction in bladder cancer patients.
BACKGROUND: To determine whether MUC7 gene expression can be used as a bladder cancer marker in peripheral blood. METHODS: Nested reverse transcription-polymerase chain reaction (RT-PCR) was performed on four types of bladder cancer cell lines (RT4, T24, EJ-1 and TCC) and the peripheral blood of 38 (31 superficial disease and seven invasive disease) bladder cancer patients and 18 subjects with urinary tract infections or other non-malignant conditions to determine the expression of MUC7. RESULTS: No MUC7 gene expression was detected in control subjects. MUC7-positive cells were detected in all bladder cancer cell lines and in 18 of 38 (47.4%) peripheral blood samples of bladder cancer patients. Based on the tumor stage, MUC7 was detected in 11 of 29 (37.9%) patients with superficial disease (Ta and T1) and in seven of nine (77.7%) invasive disease patients (>/=T2). There was a significant difference between superficial and invasive disease (P = 0.042). Based on tumor grade, we could not detect MUC7 in five patients with grade 1, in five of 15 patients (33.3%) with grade 2 and in 13 of 18 patients (72.2%) with grade 3. There was a significant difference between grades 1 and 3 (P = 0.007) and grades 2 and 3 (P = 0.025). CONCLUSIONS: These results suggest that MUC7 is a highly specific marker for bladder cancer and may be a useful method for the molecular staging and management of bladder cancer.
Biomarkers, Tumor↗
The short-term effect of pelvic irradiation for gynecologic malignancies on bladder function.
Urinary symptoms and urodynamic studies were evaluated prospectively in 33 women undergoing radiation therapy for cervical cancer. Patients were evaluated during treatment, after one to two months, and after five to six months. Significant reductions in peak urinary flow, volume at first desire to void, cystometric capacity, and bladder compliance were evident during and immediately after therapy. Bladder symptoms and urodynamic alteration did not correlate with age, race, or stage of disease. Bladder compliance was significantly reduced in those patients receiving more than 3000 rads to the entire bladder from external beam irradiation.
Adult↗
[Nuclear magnetic resonance in the diagnosis of diseases of the bladder, prostate and scrotal organs].
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Diagnosis, Differential↗
Double-blind study with Serocytol "Muqueuse urinaire" and "S.R.E." in patients with urological disorders.
A double-blind study with Serocytol "Muqueuse urinaire" (immune serum against mucosa of the urinary tract) and Serocytol "S.R.E." (immune serum against reticulo-endothelial system) and placebo was designed for treatment of different bladder diseases (interstitial cystitis sui generis, after radiotherapy and in connection with multiple transurethral resections of bladder tumour, cystitis granularis). Twenty-four patients (17 women and 5 men, aged 41-75, with interstitial cystitis, and 2 women, aged 42 and 75, with cystitis granularis) were included in this study. According to the procedure and after breaking the code 13 patients were treated with Serocytol and 11 patients with the placebo. Nine out of 13 patients who were treated with Serocytol showed an improvement of their condition. In 1 patient the condition was unchanged. Three patients treated with the active compound dropped out of the study during the treatment phase. In one instance the patient did not appear for further check-up; in another the therapy was discontinued after 3 weeks, and in one case a general exanthema occurred. Of the 11 patients treated with placebo, there was an improvement in 2 patients, whereas in 9 cases their status was unchanged. Serocytol and placebo were well tolerated by most of the patients. There were no side effects resulting from the almost daily suppository application over a period of 2 months. No changes in the blood counts, electrolytes, liver and renal function could be found in any of these patients.
Adult↗
Glucose regulates the expression of the farnesoid X receptor in liver.
An increased prevalence of hypertriglyceridemia and gallbladder disease occurs in patients with diabetes or insulin resistance. Hypertriglyceridemia is positively associated to gall bladder disease risk. The farnesoid X receptor (FXR) is a bile acid-activated nuclear receptor that plays a key role in bile acid and triglyceride homeostasis. The mechanisms controlling FXR gene expression are poorly understood. This study evaluated whether FXR gene expression is regulated by alterations in glucose homeostasis. FXR expression was decreased in livers of streptozotocin-induced diabetic rats and normalized upon insulin supplementation. Concomitantly with diabetes progression, FXR expression also decreased in aging diabetic Zucker rats. In primary rat hepatocytes, D-glucose increased FXR mRNA in a dose- and time-dependent manner, whereas insulin counteracted this effect. Addition of xylitol, a precursor of xylulose-5-phosphate, to primary rat hepatocytes increased FXR expression to a comparable level as D-glucose. Finally, expression of the FXR target genes, SHP and apolipoprotein C-III, were additively regulated by D-glucose and FXR ligands. This study demonstrates that FXR is decreased in animal models of diabetes. In addition, FXR is regulated by glucose likely via the pentose phosphate pathway. Dysregulation of FXR expression may contribute to alterations in lipid and bile acid metabolism in patients with diabetes or insulin resistance.
Animals↗
Decreased 3H-thymidine incorporation by human bladder epithelial cells following exposure to urine from interstitial cystitis patients.
PURPOSE: Interstitial cystitis (IC) is a chronic bladder disease of unknown etiology. We sought to determine whether a cytotoxin is present in the urine of IC patients that could cause the epithelial damage seen in this disease. MATERIALS AND METHODS: Evidence for a cytotoxin was sought using both a neutral red uptake viability assay in T24 bladder epithelial cells, and a 3H-thymidine incorporation assay in primary normal adult bladder epithelial cells and FHS 738 Bl human fetal bladder cells. RESULTS: The neutral red assay in T24 cells indicated the presence of a cytotoxin in 2 of 9 IC patient urine specimens. However, the more sensitive assay of cell proliferation (3H-thymidine incorporation) in normal adult human bladder epithelial cells revealed antiproliferative activity in urine from 10 of 13 (77%) IC patients vs. 3 of 19 (16%) controls (two-way analysis of variance, p = .019). The antiproliferative activity of IC urine specimens was confirmed using FHS 738 Bl human fetal bladder cells. The antiproliferative urinary substance(s) appeared to be a low molecular weight (< 10,000 Da), heat stable, trypsin-sensitive factor(s). CONCLUSIONS: Because a denuded or damaged bladder epithelium is a central finding in IC, it is possible that the antiproliferative protein(s) contributes to the pathogenesis of this disease.
Adult↗
The rate of drug biotransformation reactions and cellular viability in the livers of patients with biliary diseases.
The cytochrome P-450 level, the rate of o-amino-phenylglucuronide synthesis and the oxygen consumption of liver slices from female patients with various gall bladder disease were determined. The cytochrome P-450 level showed a decreasing trend in patients with chronic cholecystitis, choledocholithiasis or obstructive icterus when compared with those with uncomplicated gall bladder stones. The rate of o-aminophenylglucuronide synthesis was markedly increased in patients with obstructive icterus when compared with other groups. The oxygen consumption was also enhanced in this group. The enhanced rate of glucuronidation is suggested to be caused by endogenous induction of increased bilirubin level or by accumulation of bile acids in the liver cells. The present study proposes that the drug hydroxylation and glucuronidation activities are under separate control mechanisms.
Adult↗
[Rheumatoid polyarthritis and interstitial cystopathy].
The authors report a case of interstitial cystitis occurring in association with very active rheumatoid arthritis. Although the association of immune disorders and rheumatoid arthritis is well known, cases of concomitant vesical lesions have only been reported exceptionally. The diagnosis of interstitial cystitis is based on histology and immunofluorescence studies. The pathogenetic hypothesis remains uncertain: is this a primary bladder disease or a systemic auto-immune disease with a urinary tract expression? The success of immunosuppressant treatment in this case of cystitis is in favour of the second hypothesis.
Arthritis, Rheumatoid↗
[Clinical-functional and morphological characteristics of patients with one gallstone in the gallbladder].
Patients suffering from gallstone disease form a non-uniform group. There is variance not only in the number and localization of gallstones, but also in the clinical development of the disease (the presence or absence of typical attacks of liver colic, jaundice in the anamnesis), the condition of the contractile and concentrating functions of the gall bladder, the stone formation activity and the inflammatory component manifestation. Taking into account the anamnesis data, the functional state of the gall bladder and the stone formation activity, it seems possible to make a differentiated selection of treatment methods and techniques for a certain patient suffering from the gall-bladder disease. This approach is most suitable for patients having a single stone in the gall bladder as the approach enabling to perform organ-preserving treatment for them.
Adult↗
Men who do not drink: a report from the British Regional Heart Study.
Men who do not drink are frequently used as a baseline against which the effects of alcohol consumption are measured. The characteristics of such men have been examined in a large-scale prospective study of cardiovascular disease involving 7735 middle-aged men drawn from general practices in 24 British towns. Non-drinkers include lifelong teetotallers and ex-drinkers, both long-term and recent. Long-term ex-drinkers have many characteristics likely to increase their morbidity and mortality; recent ex-drinkers have similar characteristics but to a less marked degree. Ex-drinkers are older than the other groups and include an increased proportion of unmarried men and men in manual occupations. They have the same high percentage of current cigarette smokers as moderate/heavy drinkers and a prevalence of hypertension and obesity similar to moderate/heavy drinkers and higher than lifelong teetotallers or occasional/light drinkers. Ex-drinkers have the highest percentage of men with multiple doctor-diagnosed disorders. In particular, they have the highest prevalence rates of angina and possible myocardial infarction on standardized questionnaire, of myocardial infarction on electrocardiogram and of recall of a doctor-diagnosis of ischaemic heart disease. They also have high prevalence rates of recall of high blood pressure, peptic ulcer, diabetes, gall bladder disease and bronchitis. They have the highest rates for regular medical treatment and the highest proportion of men who consider their health to be poor. It is abundantly clear that the general category of non-drinkers, which includes a large proportion of ex-drinkers, should not be used as a baseline against which to measure the effects of alcohol consumption. Overall, it would appear that the occasional/light drinking category (less than 15 drinks/week) provides a large and satisfactory baseline group for comparative purposes in the study of cardiovascular and other organic disorders.
Adult↗
Endothelin and nitric oxide levels in cerebrospinal fluid of patients with multiple sclerosis.
In order to investigate the potential role of endothelins (ETs) and nitric oxide (NO) in the pathogenesis of multiple sclerosis (MS) we evaluated the levels of these vasoactive mediators in cerebrospinal fluid (CSF) of relapsing remitting MS patients and in a group of subjects with other neurological diseases (OND) and in a control group of subjects without neurological disease. Eighty patients affected from clinically diagnosed MS were selected, 44 of them were studied during an acute clinical attack and 36 in a stable phase. The OND group included 21 subjects affected by degenerative non inflammatory (n=9) and inflammatory (n=12) neurological disease while the control group included 22 subjects with cancer of the prostate (n=11) and with bladder disease (n=11). ET levels were significantly increased in CSF of relapsing remitting MS patients with an acute clinical attack in comparison with those in a stable phase, the OND group and the control group. Moreover significant differences were observed among the four groups with regard to the NO levels: MS patients in a stable and acute phase like OND group have high levels of NO compared to the control group. Since the blood-brain barrier index values did not differ significantly between the three groups, the data of this study suggest an important role for NO and ET in cerebral microcirculation in MS patients.
Acute Disease↗
Chemotherapy for invasive bladder tumors.
The presently reported phase II trials are not comparable but do provide leads. The need for chemotherapy is based on the original urologic assessment. Those patients requiring radical surgery can be considered, but the aim of therapy must be defined. For those with minimally advanced (T2, T3a) disease, bladder preservation is possible. For those with higher stage tumors, therapy is directed more for the treatment of micrometastases, with bladder preservation as a secondary goal. While bladder preservation is possible in selected cases, chemotherapy does not eliminate the need for definitive local therapy. The more widespread adaptation of ileo neo-bladders may eliminate the reluctance of some patients and physicians to proceed with definitive therapy. However, it must be emphasized that neo-bladders alone will not alter the natural history of this disease, but may improve quality of life. The results from advanced disease studies clearly show that selected patients can achieve long term survival using chemotherapy alone. These data make survival a valid endpoint for clinical trials recognizing the large number of patients required and that progress in cancer generally comes in comes in small steps. However, more effective systemic therapy is required before a significant impact on the natural history of invasive bladder cancer can be realized. For these reasons, neo-adjuvant chemotherapy must be considered investigational and physicians are urged - despite their reluctance to enter patients on clinical trials.
Antineoplastic Combined Chemotherapy Protocols↗
[The use of metoclopramide (Plasil) in functional changes of the bladder caused neurological diseases].
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Amides↗