Stimulation of Adrenergic Nerve Fibres to the Urinary Bladder of the Rat

The contraction of the rat detrusor muscle caused by electrical stimulation of the hypogastric or pelvic nerves was followed by relaxation when the nerves were stimulated for a short period. The relaxation was more pronounced when the initial contraction was reduced by atropine. It was found to be mediated by adrenergic fibres acting on inhibitory β²-receptors. Stimulation of the hypogastric or pelvic nerves at high frequencies increased the contractile response probably via adrenergic fibres activating excitatory α-receptors.     

Responses of the Denervated Rat Urinary Bladder to Alfa Adrenoceptor Stimulation

Elmér , M. Responses of the denervated rat urinary bladder to alfa adrenoceptor stimulation. Acta physiol. scand. 1976. 98. 440–444. The contractile responses of the rat detrusor muscle to noradrenaline were increased 2–3 weeks after partial denervation but had returned to control values 6–9 weeks after the denervation, probably because of reinnervation of denervated muscle cells. 6–9 weeks after partial denervation the excitatory cr-adreno-ceptor mediated response to stimulation of the remaining intact nerves was predominant, masking the subsequent inhibitory β-receptor response, which at this time was seen only after α-receptor blockade. The possibility of an outgrowth of adrenergic fibres activating a-receptors in muscle cells normally not innervated by adrenergic nerves is discussed.     

Choline Acetyltransferase Activity in the Denervated Urinary Bladder of the Rat

After extirpation of the pelvic ganglia the choline acetyltransferase activity decreased markedly indicating that most of the postganglionic cholinergic neurones of the bladder take this route. A small decrease in the activity of this enzyme was found after section of the hypogastric nerves, showing that these nerves contribute to some extent to the cholinergic innervation. The residual enzyme activity found after a combination of the two surgical procedures suggests that neurones relay distal to the level of the section of the hypogastric nerves and pass outside the pelvic ganglia and (or) that neurones pass the pelvic ganglia and relay distal to them. Electrical stimulation of the hypogastric nerves after extirpation of the pelvic ganglia and the use of blocking drugs showed on the existence of cholinergic neurones passing outside the pelvic ganglia, some of them relaying distal to the point of stimulation.     

Atropine Sensitivity of the Rat Urinary Bladder during Nerve Degeneration

The pressure response of the rat urinary bladder to electrical stimulation of the pelvic nerve at a low stimulation frequency was found to be almost completely atropine resistant. However, the response to stimulation of the degenerating pelvic nerve 20–30 h after section of the nerve postganglionically using maximal stimulation frequency was totally abolished by atropine or the parasympatholytic agent Hoechst 9980. The responses were not affected by hexamethonium or dihydroergotamine, but were potentiated by eserine. The non-adrenergic portion of the bladder response to stimulation of the degenerating hypogastric nerves was also abolished by atropine or Hoechst 9980. It is concluded that the transmitter activating the detrusor muscle at stimulation of the pelvic nerve or the non-adrenergic part of the hypogastric nerve probably is acetylcholine.     

Comparative Study of Urinary Bladder Carcinomas in Japanese and Egyptians

One hundred six Japanese and 169 Egyptian cases of urinary bladder carcinoma treated by total cystectomy were analyzed histopathologically. Urinary bladder carcinomas in Egypt were encountered at an earlier age than those in Japan. The proportion of carcinomas in Egyptian males was higher than in Japanese males. Squamous cell carcinomas (SCCs) predominated in Egyptian cases whereas transitional cell carcinomas predominated in Japanese cases. The pathological stage of Egyptian cancers was more advanced than in Japanese cases; even grade 1 SCCs showed invasion into the muscular layer. Most carcinomas in Egypt were associated with Schistosoma haematobium infections. Acta Pathol. Jpn. 32: 176∼179, 1989.     

A Case Report of Inflammatory Pseudosarcoma of the Urinary Bladder

A case of inflammatory pseudosarcoma of the urinary bladder in a 35 year-old Japanese male is presented. This benign lesion can easily be mistaken for spindle cell sarcoma since it consists of rhabdomyoblast like elongated strap cells showing infiltrative growth, and whether it is benign or malignant is difficult to determine by microscopic examination. In this case, spindle cell proliferation extended among bundles of the superficial muscle layer. However, no abnormal mitoses, severe nuclear atypia or cellular pleomorphism could be seen, thus indicating inflammatory pseudosarcoma. Although the lesion was not completely resected, no recurrent disease has been clinically observed for two years following transurethral resection. Urologists and surgical pathologists must be able to detect this lesion in order to avoid unnecessary surgical procedures. Acta Pathol Jpn 42: 760 765,1992.     

尿膀胱癌抗原作为膀胱肿瘤标志物的临床评价

为评价尿膀胱癌抗原(urinary bladder cancer antigen,UBC)在膀胱移行细胞癌(BTCC)中的诊断价值,采用ELISA法对53例BTCC患者、25例泌尿系统良性疾病患者和13例健康志愿者进行UBC检测,并同时行尿细胞学检查.结果显示:(1)BTCC患者UBC平均含量为26.26±28.49μg/L,与泌尿系统良性疾病患者和健康志愿者相比(9.41±9.63μg/L、1.73±0.79μg/L),均有显著性差异(P均＜0.01).(2)以7.5μg/L为最适临界值时,UBC诊断BTCC的敏感性和特异性分别为86.8%、76.3%,与尿细胞学检查(32.1%、97.4%)相比,均有显著性差异(P均＜0.01).结论:UBC具有简便、敏感和无创的特点,可作为辅助诊断BTCC的尿肿瘤标志物.     

Adrenergic and Cholinergic Nerves of the Human Urethra and Urinary Bladder. A Histochemical Study

The occurrence and distribution of adrenergic and acetylcholine esterase (AChE) positive nerves in the human urethra and urinary bladder were studied histochemically with the fluorescence method of Falck and Hillarp, and the copper thiocholine method of Koelle and Friedenwald. Both types of nerves were mainly confined to the layers of smooth muscle cells in the walls of the organs. In all parts of the urethra, there was a scanty supply of adrenergic nerves. Few adrenergic nerves were also found in the urinary bladder, except in the trigone area, where they were abundant. AChE-positive nerves were uniformly and richly distributed in the urinary bladder. Throughout the urethra the distribution of AChE-positive nerve fibres was uniform, but the number was clearly less than in the urinary bladder. No intramurally located adrenergic or AChE-positive ganglion cells could be demonstrated.     

神经生长因子对大鼠心肌梗塞后胆碱能神经的保护作用

目的　观察神经生长因子(NGF)对大鼠心肌梗塞后胆碱能神经的影响,探讨NGF对心肌梗塞的可 能治疗作用。方法　SD大鼠20只制心梗模型,其中10只心梗后给予NGF为实验组,2天后取材,同时取正常心肌 作对照。以Karnovsky Roots法,显示胆碱能神经纤维,应用多功能真彩色病理图像分析系统分析胆碱能神经纤维 密度。结果　心梗左心室心肌梗塞区及梗塞周围区存活心肌中胆碱能神经纤维密度比正常组明显降低(P<0. 01);实验组应用NGF后胆碱能神经纤维密度较心梗组升高。结论　神经生长因子能增加大鼠心肌梗塞后胆碱能 神经纤维的密度,可能对心梗有治疗作用。     

Primary Malignant Lymphoma of the Urinary Bladder A Case Report

A patient with primary malignant lymphoma of the urinary bladder is presented. Grossly, the bladder showed multiple submucosal masses. Histologically and immunohisto-chemically, diffuse B-cell lymphoma of the medium-sized cell type was revealed. On the basis of clinicopathological features, the present case resembled previously recorded cases of bladder lymphoma. The pathogenesis of this primary bladder lymphoma was presumably associated with follicular or chronic cystitis. Primary lymphoma of the bladder is a condition that is very rarely included in series of extranodal lymphomas, and there is a curious sex difference in its occurrence rates between Japan and Western countries. Primary lymphoma of the bladder may be considered a lymphoma that originates from mucosa associated lymphoid tissue. Acta Pathol Jpn 40: 764-769, 1990.     

直肠和膀胱的盆丛神经支配

为了配合盆腔脏器手术保护脏器神经支配的需要,作者在20具男性成人盆腔标本上观测了直肠和膀胱神经支的分布。直肠盆段神经支穿入点集中分布在该段自身长度10等份的Ⅳ—Ⅶ段和Ⅹ段。膀胱神经支穿入点集中分布在输尿管穿入膀胱处的外下方。讨论了与盆腔手术保护脏器神经支配有关的应用要点。     

Innervation patterns of the inferior glenohumeral ligament: anatomical and biomechanical relevance

Although the Inferior Glenohumeral Ligament (IGHL) has a well known mechanical and proprioceptive relevance in shoulder stability, the interrelation of the ligament's anatomical disposition/innervation has not actually been described previously. The purpose of the study was to determine the IGHL innervation patterns and relate them to dislocation. Forty-five embalmed and 16 fresh-frozen human cadaveric shoulders were studied. Masson's Trichrome staining detailed the intraligamentous nerve fiber arrangements. The effect on the articular nerves of an anteroinferior dislocation of the shoulder joint and the position of 60 degrees abduction and 45 degrees external rotation was studied dynamically. The axillary nerve provided IGHL innervation in 95.08% of the cases. We saw two distinct innervation patterns originating from the axillary nerve. In Type 1, one or two collaterals diverged later from the main trunk to enter the ligament. Type 2 showed innervation to the ligament provided by the posterior branch for three to four neural branches. In both cases, these branches enter the ligament near the glenoid rim and at the 7 o'clock position (right shoulder). The radial nerve (Type 3 innervation pattern) provided IGHL innervation in 3.28% of the cases. Microscopic analysis revealed wavy intraligamentous neural branches. The articular branches relaxed and separated from the capsule at the apprehension position and stayed intact after dislocation. These results showed a special predisposition to avoid possible denervation and suggested that the neural arch probably remains unaffected after most dislocations. Knowledge of the neural anatomy of the shoulder will clearly help in avoiding its injury in surgical procedures.     

低频电刺激对脊髓损伤后膀胱过度活动抑制的仿真研究

目的 探讨低频脉冲（0～10Hz）刺激时,不同刺激波形对脊髓损伤后逼尿肌反射亢进诱发的膀胱过度活动症的结果,以寻求抑制膀胱过度活动的最优刺激波形.方法 首先根据McNeal的神经纤维电缆模型,基于Frankenhaeuser-Huxley （FH） 方程建立有髓神经纤维的膜外点电极刺激的仿真系统,评价低频电刺激中的四种波形,即正向脉冲、负向脉冲、双向对称脉冲、双向不对称脉冲的效果.通过电刺激脊髓损伤犬的阴部神经实验,验证仿真条件下最优刺激波形的临床效果.结果 仿真实验表明双向不对称脉冲的抑制效果最佳;动物实验表明以3V、0.1ms的正向脉冲为起始脉冲,结合1V、0.3ms的负向脉冲的双向不对称波形的抑制效果为最优.结论 低频脉冲刺激脊髓损伤犬阴部神经时,正向脉冲在前的双向不对称脉冲的刺激波形仿真效果最佳,并适用于临床实验,能够有效抑制膀胱过度活动,保护神经避免电化学损伤.     

18F-FDG PET/CT盆部延迟显像在原发性膀胱癌诊断和局部分期中的临床价值

目的观察18F-FDG PET/CT盆部延迟显像在原发性膀胱癌的诊断和局部分期中的价值。方法 27例疑似膀胱癌患者,术前均行增强CT及18F-FDG PET/CT常规加盆部延迟显像进行诊断和分期,以手术病理结果作为金标准,观察盆部延迟显像在原发性膀胱癌诊断和局部分期上的价值,并与增强CT作比较。结果 27例患者中,增强CT、盆部延迟显像诊断原发肿瘤的灵敏度分别为77.27%、90.90%;特异度分别为60.00%、40.00%;准确度分别为74.07%、81.48%;盆部延迟显像和增强CT诊断准确度比较无统计学差异（P=0.263）。12例患者接受了膀胱癌根治术,其中10例有盆腔淋巴结或邻近组织转移,增强CT、盆部延迟显像局部分期准确度分别为33.33%、91.67%,盆部延迟显像优于增强CT（P=0.018）。结论18F-FDG PET/CT盆部延迟显像在原发性膀胱癌的诊断上与增强CT具有同等价值,局部分期准确度优于增强CT,具有更高的临床价值。     

Sympathetic innervation of the urinary bladder and urethral muscle in the pig

Larsen , J.-J., J. Nordling and B. Christensen , Sympathetic innervation of the urinary bladder and urethral muscle in the pig. Acta physiol. scand. 1978. 104. 485–490. The sympathetic innervation of the lower urinary tract was studied in the female and male pig using a specific histochemical technique for visualization of noradrenaline containing nerves. In smooth muscle from the detrusor few evenly distributed adrenergic nerve terminals were found. A greater number of terminals were observed in the trigone, bladder neck and urethra. There was no sex difference. In smooth muscle specimens from pig detrusor and trigone sympathetic nerve terminals were more abundant than in corresponding tissue from humans.     

Immunohistochemical Analysis of c-erbB-2 Oncogene Product and Epidermal Growth Factor Receptor Expression in Human Urinary Bladder Carcinomas

Expression of the product of the c- erb 6–2 gene, a protooncogene related to, but distinct from c- erb B-1 encoding the epidermal growth factor receptor (EGF-R), was investigated in human urinary bladder carcinomas. In addition, levels of EGF-R and transferrin receptor were also analyzed using an immunohistochemical approach, and the results compared with histological pattern and grading, and tumor staging. Increased expression of c- erb B-2 product was found in 32% of cases (7/22), a positive reaction being observed in 60% of transitional cell carcinoma (TCC) Grade 3 lesions (3/5), 20% of Grade 2 TCCs (2/10) and 100% of adenocarcinomas (AC) (2/2), but in none of the cases of squamous cell carcinoma (SCC). Although no statistical correlation with staging was evident, TCCs or SCCs of high grade and stage often showed EGF-R-positive staining, whereas other well differentiated lesions and normal bladder epithelium were generally negative. Most cases of urinary bladder carcinoma were positive for the transferrin receptor, which was not detected in normal bladder. The results thus suggested that a positive reaction for c- erb B-2 product is correlated with TCC histological grading or AC morphology. A high intensity of EGF-R staining in human bladder carcinomas may be associated with poor differentiation and invasion, whereas transferrin receptor expression might reflect tumor growth.     

Febrile Urinary Tract Infection after Radical Cystectomy and Ileal Neobladder in Patients with Bladder Cancer

Urinary tract infection (UTI) is one of the most common complications after radical cystectomy and orthotopic neobladder reconstruction. This study investigated the incidence and implicated pathogen of febrile UTI after ileal neobladder reconstruction and identify clinical and urodynamic parameters associated with febrile UTI. From January 2001 to May 2015, 236 patients who underwent radical cystectomy and ileal neobladder were included in this study. Fifty-five episodes of febrile UTI were identified in 46 patients (19.4%). The probability of febrile UTI was 17.6% and 19.8% at 6 months and 24 months after surgery, respectively. While, Escherichia coli was the most common implicated pathogen (22/55, 40.0%), Enterococcus spp. were the most common pathogen during the first month after surgery (18/33, 54.5%). In multivariate logistic regression analysis, ureteral stricture was an independent risk factor associated with febrile UTI (OR 5.93, P = 0.023). However, ureteral stricture accounted for only 6 episodes (10.9%, 6/55) of febrile UTI. Most episodes of febrile UTI occurred within 6 months after surgery. Thus, to identify risk factors associated with febrile UTI in the initial postoperative period, we assessed videourodynamics within 6 months after surgery in 38 patients. On videourodyamic examination, vesicoureteral reflux (VUR) was identified in 16 patients (42.1%). The rate of VUR presence in patients who had febrile UTI was not significantly different from those in patients without febrile UTI (50% vs. 39.3%, P = 0.556). Patients with febrile UTI had significantly larger residual urine volume (212.0 ± 193.7 vs. 90.5 ± 148.2, P = 0.048) than those without. E. coli and Enterococcus spp. are common pathogens and ureteral stricture and residual urine are risk factors for UTI after ileal neobladder reconstruction.     

不同骶神经根对膀胱逼尿肌的支配作用及临床意义

目的 :确定不同骶神经根对膀胱的支配频率和支配效能。方法 :总结在 10例圆锥上脊髓损伤患者 ,从马尾骶神经根途径进行膀胱功能重建时术中骶神经根电刺激的膀胱测压结果。结果 :对膀胱的支配频率 ,S3 占 10 0 % ,S4占 90 % ,S2 占 2 5 % ;对膀胱的支配效能 ,S3 占 5 2 .2 % ,S4占 44 .9% ,S2 占 2 .5 %。 (S3 S4)提供了膀胱压力的 97% ,S2 无论在支配频率和支配效能方面 ,作用均很小。结论 :膀胱逼尿肌的神经支配主要由S3 和S4提供。     

Motor and Secretory Effects of Nerves on the Parotid Gland of the Rat

The influence of parasympathetic and sympathetic nerves on the parotid gland of the rat was investigated. It was found that both divisions of the autonomic nerves evoke secretion and probably also motor effects in this gland. Secretion elicited on sympathetic stimulation was mediated both via α- and β-adrenoceptors, while motor effects were mediated via α-adrenoceptors. On stimulation of the autonomic nerves a lower duct pressure was reached in the parotid than in the submaxillary gland, and on sympathetic nerve stimulation the flow of saliva always started later from the parotid than from the submaxillary gland. These findings are discussed in the view of the different arrangement of the myoepithelial cells in the 2 glands.