Adrenergic and Cholinergic Innervation of the Rat Urinary Bladder

The autonomic innervation of the rat urinary bladder was studied using histochemical methods and nerve stimulations. A sparse adrenergic innervation of the detrusor muscle was found. It was supposed to originate from long adrenergic neurones. The trigonum area had a rich supply of adrenergic fibres, probably derived from short adrenergic neurones. A uniformly rich supply of acetylcholine-esterase (AChE)-positive nerves was found in the whole bladder. Postganglionic sympathetic denervation caused no detectable change of adrenergic or AChE-positive nerves in the bladder, while parasympathetic decentralization or denervation produced a total disappearance of adrenergic fibres. The AChE-positive nerves were appreciably reduced in number after parasympathetic decentralization and not detectable after postganglionic denervation. Neither adrenergic nor AChE-positive ganglion cells could be demonstrated in the bladder wall. Electrical stimulation of the hypogastric nerves or the pelvic nerves distal to the pelvic ganglia elicited contraction of the detrusor muscle. The responses were not affected by hexamethonium, dihydroergotamine or propranolol but were slightly reduced by guanethidine, reduced to about 40% by atropine and potentiated by eserine. Stimulation of the pelvic nerve proximal to the pelvic ganglion was partially blocked by hexamethonium. It is concluded that the urinary bladder of the rat is supplied by postganglionic adrenergic fibres mainly via the pelvic nerves and only to a lesser extent via the hypogastric nerves. Probably cholinergic fibres pass to the bladder mainly via the pelvic nerves but also via the hypogastric nerves, having their cellbodies outside the bladder wall, partly proximal to the pelvic ganglia.     

Effects of Myocardial Infarction on Adrenergic Nerves of the Rat Heart Muscle,a Histochemical Study

The anterior branch of the left coronary artery of the rat heart was ligated and the effects of anoxia on adrenergic nerves were studied histochemically using formaldehyde-induced fluorescence for localization of norepinephrine. Greenish catecholamine fluorescence was associated in the normal or infarcted myocardium only with adrenergic nerves. Constant but not prominent changes were seen in adrenergic nerve fibers 2 or 4 h after ligation of the coronary artery; the number of delicate adrenergic fibers was reduced and some diffusion of the histochemical reaction was seen in small areas of the infarcted myocardium. Strong effects of anoxia were seen 8 h or more after ligation of the coronary artery. These were characterized by a prominent diffusion of the histochemical reaction and gradual disappearance of adrenergic structures in 2 to 4 days of anoxia. During the healing phase the appearance of numerous adrenergic nerve fibers was closely connected with the ingrowth of a new vascular bed into the infarction area. The observations indicate that adrenergic nervous structures of the myocardium resist the effects of anoxia, which may indicate the viability of sympathetic nerves in the infarcted area during long periods of anoxia.     

Effects of Prostaglandins on the Isolated Human Bladder and Urethra

The effects of prostaglandins F_2α (PGF_2α), E₂ (PGE₁) and E₂ (PGE₂) on the human lower urinary tract were studied in vitro in preparations obtained from patients undergoing total cystourethrectomy because of bladder malignancy. Tissue specimens were taken from different parts of the urethra, the urethrovesical junction, and the bladder. From these specimens, smooth muscle preparations were dissected and mounted in organ baths, that were filled with Krebs solution (37°C) and bubbled with carbogen. Isometric tension was recorded. Preparations from the bladder and all parts of the urethra were contracted by PGF_2α. This effect was not affected by tetrodotoxin, phenoxybenzamine, or atropine; isoprenaline relaxed the PGF_2α induced contractions. PGE₁ and PGE₂ both contracted strips from the bladder. However, urethral preparations contracted by PGF_2α or noradrenaline were relaxed by these agents. This relaxing effect was at least as pronounced as that produced by isoprenaline; it was not affected by propranolol.     

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.     

人胎儿膀胱发育中肥大细胞的组织化学研究

目的：研究人胎儿膀胱的肥大细胞的组织化学性质的变化。材料和方法：取４３例不同胎龄的人胎儿膀胱切片做ＨＥ染色和ＡＢ－Ｓ染色并测定肥大细胞的临界电解质浓度值偏低，其颗粒的糖胺多糖的硫酸化和度偏低；６月龄后肥大细胞数量则明显增多，颗料经ＴＢ染色呈深紫红色，ＡＢ－Ｓ染色出现红色出现红色及红蓝混合色，临界电解质浓度值偏高，颗粒的糖的硫酸化程度出偏高，可含肝素。结论：在人胎儿膀胱发育中肥大细胞的组化性质发生了     

Suppression of the Excitatory Adrenergic Neurotransmission; a Possible Role of Cholinergic Nerves in the Retractor Penis Muscle

The excitatory adrenergic response to transmural nerve stimulation of the isolated retractor penis (rp) of dog, rat, cat, horse, boar, elk, bull, ram and goat, as well as the evoked release of ³H from dog rp preloaded with ³H-noradrenaline were studied. In untreated preparations a low concentration of scopolamine could markedly increase the excitatory adrenergic response. On the contrary, physostigmine per se suppressed this response and so did acetylcholine. Scopolamine or atropine totally prevented these suppressions. They also immediately restored the suppressed responses in spite of continuous presence of physostigmine and/or acetylcholine. In the rat rp there was no suppression of the response by physostigmine. Physostigmine decreased the evoked release of ³H and this effect was counteracted by scopolamine. The rp of dog, gelding, boar, hog, bull and ram contained considerable amounts of noradrenaline and also of acetylcholine. It is suggested that one action of cholinergic nerves in the rp is muscarinic suppression of the excitatory adrenergic neurotransmission.     

Connections between Adrenergic Nerves and other Tissue Components in the Eye

The connections between adrenergic nerve fibres and other ocular structures were studied in normal embryonic material (man, dogs, cats, guinea-pigs, and rats) as well as with a special vessel injection technique (adult rats, guinea-pigs, and rabbits). It was established that adrenergic fibres are a normal constituent of the cornea. The adrenergic nerves were more numerous in the embryo than in the adult, and also occurred within the embryonic corneal epithelium. These intraepithelial fibres disappear shortly after birth. Adrenergic fibres running in the connective tissue without connection to vessels were further found in the iris, the limbus region, the chamber angle (of the guinea-pig predominantly) and in the chorioid. It cannot be excluded that these fibres innervate some connective tissue component. In the sphincter pupillae, only a few adrenergic fibres were connected to the vessels, such as was the case also in the ciliary muscle of the guinea-pig. Under the ciliary epithelium of the ciliary body and the ciliary processes there was a thick and dense plexus of adrenergic fibres. Only a restricted number of them was associated with the vessels. The “capillaries” of the ciliary processes were remarkable in that they seemed to possess adrenergic fibres. No adrenergic innervation to the melanophores was apparent.     

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.     

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.     

Detection of Immune Responses in Sentinel Nodes Draining Human Urinary Bladder Cancer

Being the first lymph node to receive drainage from the tumour area, the sentinel node offers a unique possibility to obtain tumour-reactive lymphocytes. We investigated antitumour immune responses in sentinel nodes from patients with bladder cancer, by assaying tumour-specific proliferation and TCR Vβ repertoires. During tumour surgery, sentinel lymph nodes were identified by peri-tumoural injection of blue dye. Fresh specimens of tumour, sentinel and nonsentinel lymph nodes were obtained, and single-cell suspensions were prepared. Cells were assayed for reactivity against autologous tumour extract in [³H]-thymidine incorporation assays and characterized by flow cytometry. Parallel analyses of the expression of Vβ gene families were performed with padlock probes, linear oligonucleotides which upon target recognition can be converted to circular molecules by a ligase. Probes were reacted with cDNA prepared from magnetically separated CD4⁺ cells, and the TCR repertoire was determined by hybridizing the products to oligonucleotide microarrays. Dose-dependent proliferation in response to tumour extract could be detected in sentinel lymph nodes. Common clonal expansions were detected among tumour-infiltrating lymphocytes and in sentinel lymph nodes. Nonsentinel lymph nodes displayed a divergent TCR Vβ repertoire. These results indicate an ongoing immune response against tumour antigens in sentinel nodes, draining urinary bladder cancer. Identification of sentinel lymph nodes makes it possible to obtain tumour-reactive lymphocytes for use in adoptive immunotherapy.     

Pleomorphic Lymphoepithelioma-like Carcinoma of the Urinary Bladder

Lymphoepithelioma-like carcinoma (LELC) of the urinary bladder is often mixed with conventional transitional cell carcinoma and/or other histotypes. The pathologist’s determination of the morphologic purity of a given LELC at the biopsy stage is a clinically relevant endeavour, because there is some anecdotal evidence suggesting that pure or predominant LELC may be comparatively chemosensitive and have a favorable prognostic profile, which may potentially offer the possibility of effective therapy without bladder resection. The precise degree of cellular pleomorphism that is allowed in a pure LELC is unclear. We describe herein an otherwise conventional and pure LELC that showed, in a localized area that constituted approximately 25% of the overall tumor volume, a two to six fold variation in nuclear size, including multinucleated tumor cells. These pleomorphic areas were set in the same lymphoplasmacytic infiltrate as their conventional counterparts, and similarly displayed cellular syncytia. We performed a detailed immunophenotypic comparison between the conventional areas and the pleomorphic areas. No significant differences were found between the 2 areas in overall lymphoplasmacytic or histiocytic density, lymphocytic CD4/CD8 ratio, and lymphoplasmacytic kappa/lambda ratio. Similarly, both displayed similar qualitative and quantitative staining indices for p53, Ki67, cytokeratin AE1/AE3 and p16^INKa. Scattered cells were cytoplasmically beta-catenin positive exclusively in the pleomorphic areas; however these cells were not notably larger than the cells in the conventional areas. Both components were immunohistochemically negative for HMB-45, CD1a, the estrogen receptor, Epstein-Barr virus, CD117, D2-40, CD56, cytokeratin 20 and chromogranin. Clinicopathologic analysis of a series of cases is required to establish if there is any significance to nuclear pleomorphism in LELC. However, the phenotypic similarity between the 2 areas in this case, the intimate admixture of the pleomorphic cells with the lymphoplasmacytic infiltrate, and their syncytial pattern of growth, all suggest that pure LELC may display marked nuclear pleomorphism, and that this finding may not, in of itself, be a valid basis for removing a case from the “pure” group.     

Transmural Pressure of the Urinary Bladder Wall

Intragastric, perivesical and intravesical pressures were registered during slow filling of the urinary bladder in nine healthy men in the supine and sitting positions. Intragastric pressure was fairly constant in both positions, but intravesical pressure rose and there was also a slight rise of perivesical pressure. In both body positions transmural pressure, i.e. the pressure difference between the inside and the outside of the tbladder, rose during bladder filling. In both body positions at bladder volumes ^ 300 ml, in this material, transmural pressure, determined as the difference between intravesical and perivesical pressures, did not differ statistically significantly from transmural pressure calculated as the difference of intravesical and intragastric pressures minus a hydrostatic component. At maximal bladder volumes transmural pressure determined in the first way was statistically significantly lower than that calculated in the second way. In the supine position the transmural pressure at bladder volume 300 ml, calculated as the difference of intravesical and perivesical pressures, was lower than in the upright position.