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Urinary bladders from Fischer rats organ cultured in a chemically defined medium, Ham's F12, underwent transitional cell hyperplasia which persisted for the duration of the culture period (10 days). The hyperplastic response was initiated at 2 days of culture in basal epithelial cells as evidenced by [3H]thymidine autoradiography. After 2 days, cells classified as intermediate cells were observed replicating DNA in increasing numbers, whereas the frequency of basal cells replicating DNA decreased. The peak periods of basal and intermediate cell DNA replication were at 2 and 5 days, respectively. The total increase in the number of cells in the epithelium during a 10-day culture period was approximately 2.6-fold. The appearance of DNA-replicating cells before the appearance of mitotic figures indicated that the cells of the transitional epithelium are primarily G1 cells, The hyperplastic response in the transitional epithelium was significantly inhibited by hydrocortisone. Epithelia cultured in the presence of hydrocortisone also displayed less atypia than those epithelia cultured in its absence. Hydrocortisone concentrations of 2.1 and 21 micronM inhibited hyperplasia by 75 and 84%, respectively, Cells replicating DNA at 2 days of culture were considerably less sensitive to the hydrocortisone inhibition of [3H]thymidine incorporation into DNA than cells replicating DNA at 4 days of culture. The possibility is discussed that basal and intermediate cells may have different sensitivities to hydrocortisone.
The effects of propiverine hydrochloride (P-4, CAS 60569-19-9), a new drug to treat pollakiuria, was investigated on the spontaneous contractions of isolated guinea-pig urinary bladder strip and rhythmic urinary bladder contractions of anesthetized dog. At 10(-6)-10(-5) mol/l P-4 raised the base line of an isolated guinea-pig urinary bladder strip and accelerated its spontaneous contraction. At 10(-4) mol/l P-4 raised, and then lowered the baseline, and accelerated then suppressed its spontaneous contractions. Papaverine at 10(-6)-10(-4) mol/l also showed a similar action as P-4 in the isolated guinea-pig urinary bladder strip. Flavoxate at 10(-6)-10(-4) mol/l raised its base line and accelerated its spontaneous contractions. Those of P-4 at 10(-5) mol/l were not inhibited by tetrodotoxin 10(-6) mol/l). At doses of 50 mg/kg or more, intraduodenal administration of P-4 suppressed the frequency of rhythmic urinary bladder contractions of anesthetized dog in a dose-dependent manner. These results indicate that P-4 shows mainly an accelerating action on the endogenous spontaneous contractions of urinary bladder, but on exogenous contractions induced by the Balloon's method it shows an suppressing action and regulates the functions of the urinary bladder, so P-4 might become a useful drug for the clinical treatment of micturitional dysfunction, for example, pollakiuria.
Histopathological and angiographic findings were correlated in 6 cases of tuberculosis of the urinary bladder. The number of vessels was only slightly increased in the initial and fibrotic stages, whereas hypervascularization was observed in the exudative and productive stages. Otherwise the angiographic changes were nonspecific. Thus it was not possible to distinguish tuberculous cystitis from cystitis of other genesis, and in some instances from tumours of the urinary bladder either.
At present urologists give preference to drawing the urine by puncturing the anterior wall of. the urinary bladder by means of a trochar with introduction of a drain-tube. A set of 3 types of trochar-drain tubes of a similar construction but differing in their diameter are proposed for superpubical drawing of the urine. By using a simple in its arrangement and a little-traumatic trochar-drain tube a single-stage cystotomy can also be effected with the help of Foley, Maleko or Pezzer's catheters. Not a single of 152 patients subjected to superpubical drainage with these instruments suffered any complications.
Urinary bladder reconstruction using resin-sprayed thin paper was performed on four patients with either bladder cancer or tuberculosis. The paper was transurethrally removed after the bladder regenerated. Satisfactory results were obtained in three patients; the patient with a long standing tuberculous cicatrical contracted bladder, however, failed to regenerate the bladder with an adequate capacity.
The urinary bladder of the fresh-water turtle acidifies its contents by actively transporting H(+) ions across the luminal membrane. It is known that the H(+) transport system is dependent upon oxidative metabolism and the substrate glucose; however, the specific biochemical events resulting in H(+) translocation have not been identified. This study examines the relationship between active H(+) transport and a specific oxidative pathway of glucose metabolism, the pentose phosphate shunt. To investigate this relationship the metabolic and transport rates were simultaneously measured under several well-defined conditions. When H(+) transport was inhibited by either the application of an opposing pH gradient or by acetazolamide, glucose metabolism by the pentose phosphate shunt declined. Conversely, stimulation of H(+) transport by either imposing a more favorable pH gradient or by CO(2) addition resulted in an increase in pentose phosphate shunt metabolism. Glycolytic activity, in contrast, was invariant with the maneuvers which altered the rate of H(+) transport. Additional experiments localized pentose phosphate shunt enzyme activity to the mucosal fraction of the bladder which is the cell layer responsible for acid secretion. The finding that the rate of glucose metabolism by the pentose phosphate shunt is related to the rate of H(+) transport suggests but does not prove that the pentose phosphate shunt may be an important metabolic pathway for H(+) transport by the turtle urinary bladder.
The urinary bladder of Bufo marinus excretes H+ and NH+4, and the H+ excretion is increased after the animal is placed in metabolic acidosis. The present study was done to determine if parathyroid hormone could stimulate the bladder to increase the excretion of H+ and/or NH+4. Parathyroid hormone added to the serosal solution in a final concentration of 10 mug/ml was found to increase H+ excretion by 50 per cent above the control hemibladders, while there was no effect on NH+4 excretion. Parathyroid hormone had no effect on H+ excretion when added to the mucosal solution. We also performed experiments utilizing theophylline and dibutyryl cyclic AMP which mimicked those of the parathyroid hormone experiments. A dose-response analysis was performed and the results indicate that 1 mug/ml of parathyroid hormone was the minimal effective dose. These results suggest that parathyroid hormone can stimulate H+ excretion in the toad urinary bladder and this effect seems to be mediated by cyclic AMP. In addition, it was found that parathyroid hormone has no effect on NH+4 excretion.
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Organ-like cysts appear to develop after subcutaneous transplantation of minced tissues of fetal urinary bladder into adult syngeneic recipients. These are multilocular cysts lined with epithelium and filled with secretion. Many months later they undergo a spontaneous malignant tranformation. Transplantable strains of vesical cancer and hemangiopericytoma have been obtained.
Detection of urinary bladder tumours by cytological examination of urine was carried out on 193 patients suffering from haematuria. The patients comprised 149 new cases and 44 follow-up cases previously diagnosed as bladder cancer. Urinary bladder malignancy was detected in 72 of new cases and 20 of follow-up cases by cytological examination of urine. Reliability of the findings was checked by histopathological examination of the biopsy material removed from bladder by cystoscopy which detected malignancy in 84 of new cases and 16 of follow-up cases. Thus the sensitivity of cytological examination of urine in detecting bladder malignancy was 92% and specificity of 88%. False positive result was 4% and false negative result was 12%.
In the urinary bladder of amphibia, hypertonicity of the serosal bath (SH) evokes an increase in transepithelial water permeability, the characteristics of which resemble the response to antidiuretic hormone (ADH). The ionic dependency, in particular for Ca2+, appears very similar for SH- and ADH-induced water fluxes. In the present experiments La3+ was used as a probe to study the Ca2+-dependency of the hydrosmotic response to SH in isolated urinary bladder of the toad Bufo marinus. Addition of La3+ (5 mM) on the serosal side of the membrane produced a significant and reversible increase in basal transepithelial water flux. The hydrosmotic response elicited by adding 250 mM mannitol to the serosal Ringer's solution was inhibited by 30% in the absence of serosal Ca2+. Similarly, the hydrosmotic response to SH was inhibited by 37%, 30% and 40% when 5 mM La3+ was added to the serosal medium 30 min before, concommitantly with, or 60 min after induction of SH. The inhibition of transepithelial water flux observed in the absence of serosal Ca2+ or in the presence of serosal La3+ was reversible. The results support a critical role for Ca2+ in the modulation of transepithelial water permeability in the urinary bladder of amphibia. Ca2+ presumably exerts its effects at a post-cyclic AMP step.
Urinary lactic dehydrogenase (LDH) activity and isozyme pattern were investigated in 38 patients with bladder tumors of various stages and grades and in 10 healthy persons. Urinary LDH activity was markedly elevated and directly correlated with histologic stage and grade of tumors. The urinary LDH isozyme pattern differed significantly from that of normal urine even in early and well-differentiated tumor cases. LDH4 and LDH5 became more prominent as the degree of the histologic stage and grade of the tumor increased. In the patients with tumors more advanced than stage T2, LDH4 and LDH5 were greater than LDH1 plus LDH2, the reverse of what is found in normal urine. As analogous result was obtained in patients with tumors of grade II or higher. No appreciable difference was found in the LDH isozyme pattern of patients with single or multiple tumors although the total activity was greater with multiple tumors. A comparison between LDH isozyme pattern in urine and in tumor tissue was evaluated in 26 patients with a good correlation (r = 0.40, P less than 0.05). Comparison of the results with urine LDH and urine cytology was attempted for each stage and grade. In 5 of 16 cases having negative urine cytology, a positive isozyme index was present and 10 of 13 cases having positive urine cytology had a positive isozyme index. These data suggest that evaluation of urinary LDH combined with urinary cytology might be of value in the diagnosis of bladder tumors and for following patients who have had bladder tumors.
Urinary bladder outflow obstruction induces a myriad of structural and functional changes in the organ. Among the morphological responses to outlet obstruction is both hyperplasia and hypertrophy of specific cellular elements. The initial event which has been implicated in the initiation of the response to outflow obstruction is an initial period of high intravesical pressure and subsequent distention of the bladder. In a previous study, it was shown that at one day following partial outlet obstruction there was a marked increase in thymidine labelling of the urothelium, at 3-5 days, the labeling shifted from the urothelium to the interstitial and serosal elements. The current study was designed to determine if acute distention of the urinary bladder can induce an increase in DNA synthesis (3H-thymidine incorporation), and localize the increased DNA synthesis via autoradiography of 3H-thymidine. In this study, the bladders of adult male New Zealand white rabbits were mounted in isolated in vitro baths. Each control bladder was filled to either 5 or 20 ml. with saline, or distended to 120% of capacity. The bladders were incubated for 7 hours at which time 3H-thymidine was placed both within and outside the bladder for an additional one hour. At the end of the time the bladder was divided at the ureteral orifices into bladder body and base, and each body and base divided into two sections. One section of bladder body and base was quantitatively analyzed for both labelled and unlabelled DNA; the second section was fixed and prepared for autoradiography. The results can be summarized as follows: 1) Acute overdistention for 8 hours induced a slight decrease in the DNA concentration which was mediated by edema of the bladder wall. 2) Acute overdistention induced a 5-fold increase in 3H-thymidine incorporation in the bladder body and a 3-fold increase in the bladder base. Radioautoradiography of the overdistended bladders showed significant and substantial labelling which was confined to the urothelial basal cells. The control bladders showed little or no labelling. These results are consistent with the theory that acute distention following partial outlet obstruction initiates the proliferative response of the bladder to outlet obstruction, and the urothelium is the initial target of the proliferative response. Functionally, the proliferative response may serve to maintain the structural as well as functional integrity of the bladder.
Frog urinary bladder epithelium has been examined by freeze-fracture electron microscopy of preparations previously fixed by glutaraldehyde either at rest or during antidiuretic challenge. All the agonists tested were observed to induce membrane particle clustering in the A face of the apical plasma membrane of granular cells. This was the case for the natural hormone (hypophysical extracts) and its presumed cellular mediator, adenosine 3',5'-monophosphate. Particle clustering was observed both in the presence and in the absence of water net flow and is thus independent of these movements. Clusters were also observed during hydrosmotic challenge by hypertonic serosal media, a condition which depresses transepithelial sodium transport. No complementary patterns of these A face clusters could be found on the B face. The significance of these membrane-associated particle clusters is discussed in terms of membrane structure and function.
Urinary tract symptoms and signs may result from secondary involvement of the urinary bladder in patients with Crohn's disease. In a small but significant proportion of these individuals, urinary tract symptoms represent the initial or predominant mode of presentation. Such patients may be erroneously treated for primary infection of the lower urinary tract for prolonged periods before the intestinal origin of the disease process is discovered. Roentgenologic abnormalities of the urinary bladder may provide early and important clues to the correct DIAGNOSIS. The various abnormalities of the urinary bladder which may occur secondary to Crohn's disease are described and illustrated, and the roentgenologic differential diagnosis is discussed.
The urinary bladder of the elderly is showing a reduced adaptability on account of morphological changes; it is therefore more prone to infections. The morphological changes consist in a reduction of muscle fibres and in an increase of collagen fibres and in elastosis, furthermore in a sklerosis of the intramural arteries. 58% of our chronically - ill patients prove to have a chronic infection of the urinary tract.
The examination of resorption from the urinary bladder had previously been restricted almost exclusively to animal research, since, as a rule, a separation of the bladder from the urinary tract is required. If this is not done, the resorbed test substance quickly finds its way back into the bladder. More than 95 per cent of the xenon which has been resorbed from the bladder becomes eliminated through the lungs. The detection and measurement of xenon in the exhaled air enables one to conduct, in a relatively simple fashion, urinary bladder resorption research using human subjects. Studies based on 141 patients showed that the xenon exhalation tests currently represent the most sensitive and exact method for detecting and determining the nature of inflammatory diseases of the urinary bladder. With a number of so-called "irritable bladder" cases it became clear that functional disorders of the bladder epithelium could be present without any evidence of associated morphologic changes. With radiogenic treatment of tumors in the lower pelvic region one experiences an increase in bladder resorption with increased exposure to radiation. There exists, as it were, a linear correlation between the radiation dosage and the degree of resorption from the urinary bladder. Three months after terminating radiotherapy one can detect, as a rule, only a negligible increase in resorption. If at this time the rate of xenon resorption still remains clearly high, one must reckon with permanent radiation damage of the bladder, insofar as it proves unsuccessful to eliminate the cause of cystitis.