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PubMedDate not supplied

Ovarian metastases from carcinoma of the bilharzial urinary bladder.

A pathologic study of 135 cases of carcinoma of the bilharzial urinary bladder treated with radical anterior pelvic exenteration, including 60 cases examined by subserial sections of both ovaries, did not reveal a single incidence of ovarian metastases from bladder carcinoma. The same observation has been reported by some investigators examining the more aggressive forms of bladder carcinoma seen in Western countries. Based on these findings, we recommend that at least one ovary, the one away from the tumors, should be retained with an intact blood supply to avoid the distressing symptoms of menopausal syndrome. This is especially advisable in our patients where carcinoma of the bladder occurs at a younger age.

Age Factors↗

PubMed1987

[The problem of urinary bladder cancer--an attempt at a therapeutic standard].

The particular uncertainties of the carcinoma of the urinary bladder results from diagnostic and therapeutic deficiencies the causes of which are to be found in the dignity and inclination to dissemination of tumours of the bladder. At present with the help of diagnostic methods which are at our disposal it is difficult to establish an exact clinical staging. Nevertheless it was tried to set certain therapeutic central points. For this purpose malignant tumours of the urinary bladder were subdivided into three groups, taking into consideration the tumour infiltration as well as the tumour grading and adequate therapeutic measures were discussed under a curative, adjuvant and palliative aim.

Combined Modality Therapy↗

PubMed1991

Stereological estimates of nuclear volume in the prognostic evaluation of primary flat carcinoma in situ of the urinary bladder.

Primary, flat carcinoma in situ of the urinary bladder is rare and its behaviour is unpredictable. The aim of this retrospective study was to obtain base-line data and investigate the prognostic value of unbiased, stereological estimates of the volume-weighted mean nuclear volume, nuclear vv, in 78 bladder biopsies from 22 patients with primary flat carcinoma in situ (Bergkvist grades III-IV). On average, nuclear vv was 77 microns 3 in nine biopsies with morphologically normal urothelium, 292 microns 3 in 56 isolated primary lesions and 266 microns 3 in lesions of luminal urothelium in 13 biopsies with co-existing invasive carcinoma. No recognizable developmental pattern of nuclear vv in relation to the time course of disease was found. Nuclear volume in the first biopsy was of the same magnitude in lesions with and without co-existing invasive carcinoma (2P = 0.55), and in lesions with short and long duration of invasion-free period (2P greater than 0.20). Nuclear vv in the first biopsy did not differ between patients who survived and those who died from their primary flat carcinoma in situ (2P = 0.07). Dividing the patients on the basis of the group median of the first biopsy showing flat carcinoma in situ (nuclear vv = 261 microns 3), the survival was the same in patients with nuclear vv above and below the cut-off point (2P = 0.16). However, the survival curves showed a tendency to differ in the first 2-8 years of observation. Stereological estimates of nuclear vv provide objective, quantitative information, but their prognostic value in patients with primary flat carcinoma in situ of the bladder needs further clarification in larger data bases.

Aged↗

PubMed2002

Cold- and menthol-sensitive C afferents of cat urinary bladder.

Cold-sensitive C afferents of the urinary bladder were studied in adult cats anaesthetised with alpha-chloralose. The bladder was catheterised for fluid instillations and bladder pressure recordings. Pelvic nerve branches were stimulated electrically close to the bladder. Evoked afferent activity was recorded from dissected filaments of the ipsilateral S1-S2 dorsal roots. Responsive afferents were identified using the 'marking technique', based on activity-dependent decrease in C fibre conduction velocity. Of 108 examined bladder C afferents, 14 were activated by innocuous cooling of the bladder wall. Their conduction velocities ranged from 0.6 to 1.7 ms(-1) and their activity dependent decrease in conduction velocity was <10 %. All nine cold-sensitive afferents tested responded to menthol exposure. Cold-sensitive C afferents failed to respond to bladder filling with body-warm saline and to active bladder contractions. These characteristics indicate that the cold-sensitive C afferents of the bladder resemble cutaneous cold receptors rather than cold-sensitive mechanoreceptors or nociceptors. It is concluded that the bladder wall is endowed with cold receptors with unmyelinated C afferents in the pelvic nerves and that these afferents are responsible for the bladder cooling reflex.

Action Potentials↗

PubMed2003

Lymphoepithelioma-like carcinoma of the urinary bladder.

Lymphoepithelioma-like carcinomas (LELCAs) of the urinary bladder are rare. We report 2 such cases presenting with painless gross hematuria. The first case occurred in a 73-year-old man. Bladder sonography revealed a 2 x 3 cm well-defined tumor beneath the bladder mucosa. Radical cystoprostatectomy revealed lymphoepithelioma-like carcinoma with perivesical soft tissue invasion. Cisplatin-based chemotherapy was given. Computed tomography scan demonstrated no evidence of recurrence 26 months postoperatively. The second case occurred in a 63-year-old man. Cystoscopy revealed a solid tumor at the bladder dome. Transurethral resection of bladder tumor (TUR-BT) demonstrated lymphoepithelioma-like carcinoma with lamina propria invasion. Tumor cells were positive for cytokeratin but negative for leukocyte common antigen. The patient received adjuvant chemotherapy due to suspicious extravesical tumor spread and high-grade tumor characteristics. After tumor recurrence was identified, TUR-BT was performed again and the surgical specimen showed superficial high-grade LELCA. After bacillus Calmette-Guerin instillation, follow-up cystoscopy revealed no recurrence at 10 months postoperatively. Pure LELCA is morphologically different from transitional cell carcinoma and has a more favorable prognosis than high-grade, invasive bladder carcinoma if managed appropriately.

Aged↗

PubMed1988

Conversion from low grade to high grade of rat urinary bladder carcinomas.

The present study was conducted to test if low-grade carcinomas induced by a single dose of N-methyl-Nitrosourea (MNU) can be converted to high-grade carcinomas by a second identical dose of the carcinogen. The heterotopically transplanted rat urinary bladder system was used. Four wk after heterotopic bladder transplantation, the recipient male Fischer 344 rats were divided into 2 groups. The first group received 0.25 mg of MNU into heterotopically transplanted rat urinary bladder; the second group (controls) received 0.9% NaCl solution. At week 29 of the experiment, 1/3 of the animals from each group were killed for histological examination of the heterotopically transplanted rat urinary bladders. The remaining animals from each group were divided into 2 subgroups, the first receiving 0.25 mg MNU and the second, 0.9% NaCl solution. All animals were killed at 50 wk of the experiment. MNU-induced carcinomas at week 29 were all of low histological grade and were noninvasive. Longer follow-up without a second carcinogen administration resulted in both an increase in tumor incidence (P less than 0.005) and more tumors per bladder (P less than 0.001), but high-grade invasive carcinomas were rare. The second dose of MNU administered at the stage when low-grade carcinomas were prevalent (week 29) resulted in a significant increase in invasive high-grade carcinomas (P less than 0.01). Our data are consistent with the view that the second carcinogen administration induces a new mutation(s) within low-grade carcinomas which leads to invasive carcinomas.

Animals↗

PubMed2005

Nephrogenic adenoma of the urinary bladder.

INTRODUCTION: The nephrogenic adenoma (NA) is a benign metaplastic lesion of the urothelium and is attributed to chronic irritation of the mucosa, by injury, infection, stone disease or intravesical instrumentations. We present our experience on this morbid entity, its clinical appearance in the urinary bladder, its frequency and relapses. Furthermore we reviewed the related recent literature and focused on its potential to neoplastic degeneration and the value of the new diagnostic modalities. PATIENTS AND METHODS: Four patients with NA of the urinary bladder are presented. The papilloid or polypoid formations observed by the cystoscopy were identified after the TUR, as NA of the urinary bladder. Their mean follow-up was 3.5 years. RESULTS: Remission of the symptoms was observed after TUR in all patients. Three out of four patients presented 1-7 relapses, while in one case, after seven NA relapses, a urothelial carcinoma of the bladder was diagnosed. CONCLUSIONS: Unlike histological features, the clinical - endoscopic characteristics of NA are non-specific. Even if it is not definitely considered like a premalignant condition, NA has to be followed up frequently and long lasting, because of its high recurrence rate. The combination of Cytology, Flow cytometry, DNA image analysis and Fluorescence in situ hybridization of bladder washings or voided urine, are of high value in monitoring NA of the urothelium.

Adenoma↗

PubMed2005

Urinary levels of soluble e-cadherin in the detection of transitional cell carcinoma of the urinary bladder.

OBJECTIVE: To test the hypothesis that elevated urinary levels of soluble E-cadherin (sE-cadherin) would aid in the detection of transitional cell carcinoma (TCC) of the urinary bladder. METHODS: We performed sE-cadherin staining of one murine (MBT2) and four human (RT4, 5637, T24, and TCCSUP) bladder cancer cell lines. sE-cadherin levels were also determined in voided urine of 188 consecutive subjects at risk for TCC recurrence, 31 patients with other uro-pathologic conditions, and 10 healthy subjects using a commercially-available ELISA kit. sE-cadherin was analyzed continuously and categorically on the basis of its median distribution. RESULTS: Moderately and poorly differentiated bladder cancer cell lines had decreased cellular E-cadherin expression, whereas RT4, a well differentiated cell line, had preserved expression. All cell lines had measurable sE-cadherin levels in their conditioned media. The area under the ROC curve of sE-cadherin for the detection of TCC was 0.719 (95%CI, 0.637-0.801; p<0.001). Higher levels of sE-cadherin were associated with positive cytology results (p=0.012) and muscle invasive tumor stage (p=0.009). Urinary sE-cadherin was more sensitive, but less specific than urinary cytology for the detection of bladder TCC. In a multivariable logistic regression analysis, higher sE-cadherin and positive cytology were both associated with an increased risk of bladder TCC (p=0.048 and p<0.001, respectively). Combination of cytology and sE-cadherin allowed categorization of patients into three significantly different risk groups for bladder cancer. Adjustment of sE-cadherin for urinary creatinine levels did not affect any of the outcomes. CONCLUSIONS: Urinary level of sE-cadherin may add information to cytology in the detection of bladder TCC.

Adult↗

PubMed2002

Regulation of Na+ channel density at the apical surface of rabbit urinary bladder epithelium.

We have investigated the effects of various manipulations on Na(+) transport across the rabbit urinary bladder epithelium. After bladders were mounted in Ussing chambers there was a spontaneous and significant (>4-fold) increase in amiloride-sensitive short-circuit current (equivalent to net Na(+) transport) over a 6-h period. The increase in current was almost abolished by brefeldin A, an inhibitor of anterograde vesicular transport, and reduced after a 3-h delay by cycloheximide, an inhibitor of protein synthesis. The spontaneous increase in short-circuit current was potentiated by treatment of bladders with either forskolin, which causes an elevation in cAMP levels, or aldosterone. Acting together, these two agents produced a significant synergistic effect on short-circuit current. The short-circuit current recovered rapidly after reduction in intracellular Na(+) levels, achieved either by lowering the extracellular Na(+) concentration or blockade of epithelial Na(+) channels with the sulphydryl modifying reagent p-chloromercuribenzenesulphonic acid (PCMBS). Recovery after PCMBS treatment was partially sensitive to brefeldin A. Short-circuit current saturated as the extracellular Na(+) concentration was increased (EC(50) = 51 mM). Saturation occurred over a range of Na(+) concentrations in which single channel permeability is known to remain constant, indicating that it depends on a reduction in epithelial Na(+) channel density at the apical plasma membrane. Exposure of bladders to a high Na(+) concentration caused an increase in endocytotic activity, detected through an increase in the uptake of the fluid-phase marker fluorescein isothiocyanate (FITC)-dextran into vesicles located beneath the apical plasma membrane. We conclude that the urinary bladder epithelium is able to respond rapidly and efficiently to changes in its environment by regulating the density of epithelial Na(+) channels in its apical surface.

Animals↗

PubMed1990

Content and contractile effect of arginine vasopressin in rat urinary bladder.

The contractile response of normal male rat urinary bladders to exogenous arginine vasopressin (AVP) and the AVP content of normal and denervated bladders were investigated. In isolated detrusor strips, the maximal response to AVP was about 12% of the contraction elicited by KCl (124 mM), and the EC50 value was 1.03 +/- 0.13 x 10(-8) M. The response to transmural nerve stimulation was not affected by the presence of AVP. Addition of an AVP receptor antagonist strongly reduced the response to exogenous AVP, but did not affect contractions in response to nerve stimulation. In normal bladders, the concentration of immunoreactive (ir) AVP was 29 +/- 6.0 x 10(-15) mol/g. Three days after denervation the bladders had increased 2.4-fold in weight. At this time, the concentration of irAVP was not different from the control value, but the total content had increased significantly. Characterization of bladder irAVP by reverse-phase HPLC revealed that 66.5% of the total immunoreactivity eluted in the position of synthetic AVP. The results suggest a non-neuronal localization of bladder irAVP.

Animals↗

PubMedDate not supplied

Serial bone scintigrams demonstrating obstructive uropathy and nephropathy due to transitional cell carcinoma of the urinary bladder.

Serial 99mTc diphosphonate bone scintigraphic studies of two patients with transitional cell carcinoma of the urinary bladder demonstrated gradually progressive renal dysfunction. The abnormalities in the last bone scan of each patient were compatible with the findings of the concurrent 131I hippuran and 99mTc-DTPA studies, and were presumably secondary to obstruction of the ureteral orifices by tumor in the urinary bladder. Progressive renal dysfunction may be reliably demonstrated by serial 99mTc diphosphonate bone scintigraphy.

Aged↗

PubMed1993

Representation of the urinary bladder in the lateral thalamus of the cat.

1. In alpha-chloralose-anesthetized cats the region surrounding the ventral posterolateral nucleus (VPL) of the thalamus was investigated to locate foci with input from the urinary bladder stimulated by application of intravesical pressure. The locations of the recording sites were verified in Nissl-stained histological sections with reference to electrolytic lesions. 2. Of the 23 visceroceptive thalamic neurons identified, 4 (17%) were located in the periphery of the VPL (VPLp) and 19 (83%) in the lateral and dorsal aspects of the posterior complex (POl and POd, respectively) adjoining VPLp. 3. The neurons responded to noxious intensities of intravesical pressure in the range of 50-100 mmHg. Excitatory responses were elicited in 8 (35%) neurons, "inhibitory" responses in 13 (57%) neurons, and 2 (9%) neurons responded with an increase and a decrease of their discharge to subsequent stimuli. 4. Of the 22 visceroceptive thalamic neurons tested for this parameter, 73% had low-threshold cutaneous receptive fields (RFs). These were located in the region of the lower back, the hip, the thigh, and the proximal tail (12 PO neurons), or covered the entire postcranial contralateral part of the body (3 PO neurons). For only one of the VPLp neurons, a somatic RF was found and this was located on the distal tail. The neurons responded to tap stimuli applied at a low repetition rate. None of the 11 neurons tested with noxious pinching of the skin was activated by this kind of stimulus. 5. It is concluded that the cat's lateral thalamic region, around but not within VPL proper, contains neurons that play a role in the processing of information about noxious events in the urinary bladder. A comparison with results from experiments in the monkey indicates differences in the organization of the visceroceptive systems between both species, regarding the thalamic localization of visceroceptive neurons, the occurrence of convergent low-threshold somatic RFs, and the association of excitatory and inhibitory effects of urinary bladder stimulation with the location of somatic RFs.

Afferent Pathways↗

PubMed1975

Angiography in urinary bladder tuberculosis.

Angiography was performed in 6 cases of bacteriologically and microscopically verified tuberculosis of the urinary bladder. As a rule, general or locally accentuated hypervascularization in the bladder wall could be demonstrated in the arterial phase but no venous abnormalities were observed. The circulation time was usually not changed. Thus the angiographic appearances were non-specific. Angiographically it is impossible to differentiate between tuberculous cystitis, cystitis of other genesis or even tumour of the bladder.

Adult↗

PubMed1978

Reversible papillary hyperplasia of the rat urinary bladder.

A rapid reproducible method for the production of ulcers and reversible regenerative hyperplasia of the urinary bladder of rats is described. This method does not involve administration of a toxic chemical or retention of a foreign body. Ulceration was produced by means of applying a steel rod, 5 mm in diameter, frozen at -78 C, to the serosal surface of the bladder for 2 seconds, twice, with a 5-second interval between each application. Sequential histologic observations showed that ulcers were accompanied by necrosis of the entire thickness of the bladder at the site of freezing with extensive acute inflammation. Regenerative hyperplasia was evident at the edge of the ulcer by the second day, with greatest severity at 5 days when papillary and nodular hyperplasia were present. At 15 days the bladders were normal or had only minimal hyperplasia. The labeling index by autoradiography was highest in the mildly hyperplastic area near the ulcer at 2 days and remained relatively high through 5 days. The hyperplastic epithelium surrounding the ulcer observed by scanning electron microscopy had numerous degenerative cells on the surface, and small epithelial cells with numerous short, uniform microvilli on their luminal surface were also observed. The numerous short, uniform microvilli on their luminal surface were also observed. The microvilli had a symmetric luminal membrane, as observed on trasmission electron microscopy. More peripherally the cells had microridges only or microvilli and microridges on their luminal surface. Neither pleomorphic microvili nor a structured glycocalyx fuzz on microvilli was observed during the process of regenerative hyperplasia, distinguishing it from neoplastic bladder proliferations.

Animals↗

PubMedDate not supplied

Direct invasion of urinary bladder from sigmoid colon cancer: CT findings.

Radiological findings in three cases of sigmoid colon carcinoma invading the urinary bladder are reported. An irregular spiculated margin or nodular indentations in region of bladder dome were seen on intravenous urography. A soft tissue mass contiguous with an irregularly thickened urinary bladder wall and a circumferentially thickened sigmoid colon wall were demonstrated on CT and sonography and led to the correct diagnosis.

Adenocarcinoma↗

PubMed1975

ATP-ase activity of lymphocytes from patients with carcinomas of the urinary bladder.

In 13 out of 26 patients with urinary bladder carcinomas in various stages of malignancy, the ATP-ase activity of circulating lymphocytes was found significantly elevated. A decline in the ATP-ase activity was demonstrated in 14 of 17 patients re-investigated after treatment, while the activity remained unchanged in 2 and rose in 1 patient. No correlation between the clinical tumour stage and the lymphocyte ATP-ase activity was found, but the activity was closely correlated to the histological grade of malignancy. In 11 of the 17 patients the clinical effect of the treatment was closely correlated to a decline in ATP-ase activity. Determination of lymphocyte ATP-ase activity is suggested as an additional and simple help in the diagnosis of bladder carcinoma and in the follow-up control after treatment of patients with this disease.

Adenosine Triphosphatases↗

PubMed2001

Fetal urine production and accuracy when estimating fetal urinary bladder volume.

OBJECTIVES: The volume of the fetal urinary bladder can be estimated by measuring bladder diameters on an ultrasound image. The calculated urine production rate might reflect the fetal status in compromised pregnancies. The aim of this study was to assess the fetal urine production rate and the accuracy of measurements of diameters and volumes of the bladder. DESIGN: Urine production rate and the variability in volume measurement error were assessed by ultrasound examinations of fetal bladder images documented on videotapes. In material comprising 101 longitudinal and 90 transverse bladder images, the variability (SD) in distance measurement error was estimated for the bladder diameters. Using this SD, the variability in volume measurement error in the selected bladder image was also calculated. RESULTS: The urine production rate for fetuses of 20, 25, 30, 35 and 40 weeks is 4.2, 12.1, 22.7, 36.1 and 52.2 mL/h, respectively. The SD for volume measurement error when selecting bladder images with a volume of 5, 10, 20, 30 and 40 mL is 17.3%, 13.6%, 11.8%, 11.2% and 10.9% of the actual volume, respectively. The corresponding SD when measuring the volume of selected bladder images accounted for 3.7-2.0%. CONCLUSIONS: The urine production rate presented here is in parity with recent previous reports. We distinguish between different kinds of measurement error. The variability was mostly related to the selection of appropriate bladder image, whereas measurement of the selected bladder image accounted for only a minor part of the resulting variability.

Cross-Sectional Studies↗

PubMed2002

[HER-2 and TOP 2A gene amplifications in urinary bladder carcinoma].

The HER-2/neu gene is frequently amplified in bladder cancer. Topoisomerase 2 Alpha (TOP2A) which is located nearby the HER-2/neu gene is an important molecular target for several anti cancer drugs. The frequency of TOP2A amplification in urinary bladder cancer is unknown. It was the aim of this study to determine the frequency of HER-2 and TOP2A amplification in urinary bladder cancer and to evaluate the association of these amplifications with tumor phenotype. For this purpose a tissue microarray containing 768 pTa, 425 pT1 and 571 pT2-4 carcinomas was analyzed by fluorescence in situ hybridization (FISH). Amplifications of both genes were significantly associated with advanced tumor stage and high grade. HER-2 amplification was found in 1.6% of pTa, 7.2% of pT1 and 13.8% of pT2-4 carcinomas (p < 0.0001). HER-2 amplification was present in only 1.1% of grade 1 and 0.8% of grade 2 tumors but in 14.2% of grade 3 tumors (p < 0.0001). TOP2A amplification was present in 0.7% pTa, 1.8% pT1 and 3.4% pT2-4 carcinomas (p < 0.0001). TOP2A was found in none of the grade 1, in 0.2% of grade 2 and 3.8% of grade 3 tumors (p < 0.0001). 1% of all analyzed tumors had simultaneously high level amplification of TOP2A and HER-2. Amplification of both genes were significantly associated with tumor specific survival if all tumors were analyzed together. Given the high frequency of HER-2 amplification in urinary bladder cancer, some of these tumors may respond favorable to Herceptin therapy. The TOP2A amplification status may influence response to anthracyclin treatment.

Antigens, Neoplasm↗