Effect of urinary bladder outlet obstruction on the rabbit ureter

Ureters of mature New Zealand white male rabbits were studied at 7 and 14 days following partial bladder outlet obstruction. Muscarinic receptor density; intracellular concentrations of DNA, RNA, lipid, and hydroxyproline; and functional characteristics of the whole ureter were assessed as a means of characterizing the ureteral secondary response to partial bladder obstruction. Wet weight increased 2-fold by day 7 and almost to 3-fold by day 14. Ureteral length increased 15% by day 7 and 29% by day 14. DNA concentration varied only slightly from controls while RNA increased by 68% by day 7 but returned to near normal range by day 14. Total hydroxyproline content increased, although hydroxyproline concentration per mg tissue decreased. Total lipids increased by 73% over the first 7 days but subsequently decreased to 27% above control levels by day 14. After 1 week of obstruction, muscarinic receptor density was 35.5% of controls, and after 2 weeks of obstruction, muscarinic density was 52.5% of controls. Although muscarinic receptor density decreased significantly, the number of receptors per ureter did not substantially change. Flow studies demonstrated increased opening pressures at 7 days and decreased opening pressures by day 14. Flow as a function of constant pressure was not significantly changed by the 7th day but increased 24% by the 14th day. Bethanechol (muscarinic agonist) caused similar decreases in flow in control and 1- and 2-week obstructed ureters. These studies indicate that 1 week following partial outlet obstruction, ureters demonstrate increased protein synthesis and lipid deposition resulting in increased weight and length. By the 2nd week, protein synthesis and lipid content begin to return to normal. Weight and length remain significantly increased and the capacity for flow through the ureter improves.     

The effects of heparin on the adherence of five species of urinary tract pathogens to urinary bladder mucosa

Summary Previous studies performed in our laboratory have indicated that the primary antibacterial defense mechanism of the rabbit urinary bladder is the antiadsorptive action of the surface mucopolysaccharide. Removal of this layer with an acid rinse increases bacterial adherence up to 100 fold. Exogenous mucopolysaccharide (heparin) has been shown to restore Escherichia coli adherence to control levels. To determine whether this antiadherence action of heparin is species specific, we compared the adherence of 5 common urinary tract pathogens (Escherichia coli, Klebsiella ozonae, Proteus mirabilis, Pseudomonas aeruginosa, and Streptococcus fecalis) to both mucin intact and mucin deficient rabbit bladders with and without prior heparin exposure. Bacteria were radiolabeled by addition of ³H-adenine to the culture broth so that the number of bacteria adhering to the bladder could be determined using liquid scintillation spectrophometry. Results were as follows: 1) Acid removal of the mucin layer significantly increased the adherence approximately 10 fold for all 5 species tested. 2) Briefly exposing the mucin deficient bladders to heparin decreased the adherence of all species tested except Pseudomonas to mucin intact control levels. 3) Heparin treatment of mucin intact bladders slightly decreased adherence of all species except Pseudomonas below mucin intact controls, however, results were not statistically significant. 4) The magnitude of Klebsiella adherence was nearly 20 fold greater than all other species tested. While this non-species specific adherence inhibition of heparin may prove useful in the clinical setting, it appears to be less effective against Pseudomonas.This work was supported in part by grants from the Veterans Administration, NIH Grant#RO-1-AM-6508-01, and the McCabe fund.     

Absence of relationships between L-dopa plasma levels and therapeutic effect in Parkinson's disease treated with L-dopa.

The plasma concentration of dopa was studied in 15 parkinsonian patients after a single administration of L-dopa. The study was undertaken in order to determine if correlation between plasma dopa concentration and clinical performance as a result of the tests carried out before and after a single dose of dopa, was present. Our data confirm the absolute absence of correlation between dopa levels in plasma and clinical improvement during long-term treatment. Moreover, clinical responses to the performance tests were not related to the concentration of circulating L-dopa in the plasma. Therefore dopa levels cannot be useful in clinical practice but only for the prevention of too high concentrations of plasma L-dopa which often cause a few side-effects.     

Malignant fibrous histiocytoma of soft tissue. An analysis of 78 cases located and deeply seated in the extremities

Seventy-eight cases of malignant fibrous histiocytoma (MFH) of soft tissues are reported. All tumors were deeply located in the extremities. An analysis is presented with regard to sex, age, site, macro- and microscopic features. The staging was assessed according to Enneking's classification (IB, one case; IIA, 25 cases; IIB, 42 cases; III, 10 cases). The recurrence rate after surgical treatment was high (37.5%) with significant differences after inadequate surgery (70%), wide excision (38%), or amputation (0%). Adjunctive radiotherapy rarely was effective in preventing local recurrence. The overall 5-year survival rate was 36%. The prognosis was worse in (1) tumors larger than 5 cm in diameter, (2) tumors that recurred early (less than 1 year) after surgery, and (3) tumors that had inadequate surgical treatment (intralesional or marginal excision).     

Functional and biochemical alterations in the rabbit urinary bladder following ileocystoplasty

Although the use of ileocystoplasty has increased significantly in recent years, very little is known concerning the smooth muscle properties of the implanted bowel segment. In a previous study, preliminary evidence was presented which indicated that the pharmacological response of the cytoplastic ileal segment to autonomic agonists changed toward that of the bladder. The present study extends and expands these preliminary observations on the physiology and pharmacology of augmentation cystoplasty. Augmentation cystoplasty with detubularized ileum was carried out in 16 rabbits. In vivo and in vitro physiological and pharmacological studies were carried out one and three months after surgery. The results can be summarized as follows: 1) in-vivo CMG at one month was similar to that of the preoperative bladder, but at three months there was a 24% increase in capacity, with the presence of multiple phasic contractions beginning at a volume of approximately 65% of capacity. 2) The frequency and magnitude of spontaneous activity in the cystoplastic ileum did not significantly alter from that of the normal ileum. 3) Cystoplastic ileum responded to muscarinic stimulation differently from the normal ileum. The bladder responded with an increase in the tension whereas the ileum responded with an increase in the frequency and amplitude of phasic contractions. The cystoplastic ileum responded with a pronounced sustained contraction with phasic contractions superimposed. The tonic contraction at three months was of a significantly greater magnitude than that at one month. 4) The qualitative and quantitative response to field stimulation of the cystoplastic ileum was altered from that of the ileum towards that of the bladder. 5) The normal bladder contains greater amount of creatine phosphate and lesser amounts of creatine than the normal ileum. Cystoplasty, after three months induced a change in the ileal segment towards the bladder (increased creatine phosphate and decreased creatine). 6) The normal ileum was found to have greater number of muscarinic receptors than the normal bladder whereas the cystoplastic ileum at three months was intermediate.     

Venous flow-through flap as an external monitor for buried radial forearm free flap in head and neck reconstruction.

Postoperative monitoring of buried free flaps in head and neck reconstruction can be extremely difficult or impossible. The authors describe a series of 11 cases over a 21-month period, of buried radial forearm free flaps used in head and neck reconstruction. To monitor the main buried flap a small venous flow-through flap is supplied by and attached to the cephalic vein of a radial forearm free flap. This small venous skin flap is inset separately from the main paddle, so that it is visible at the external surface of the neck, furnishing information about the perfusion of the entire flap.     

Effect of chronic nitrofurantoin on the rabbit urinary bladder

Interstitial cystitis is a pathological condition whose symptoms mimic urinary tract infection and include urgency, frequency, and moderate to severe pain. Many more women than men are affected, with antibiotic therapy being the usual first treatment approach based on symptomology. Some clinicians believe that chronic antibiotic therapy may play an etiological role in interstitial cystitis; however neither clinical nor experimental data support their opinion. The implied pathogenesis of antibiotic injury is an alteration of the bladder mucosa and its protective mucin coating to allow urine-mediated damage to the bladder wall. The purpose of this study is to evaluate rabbit urinary bladder function and morphology during chronic nitrofurantoin administration. The results demonstrate that up to twelve months of chronic nitrofurantoin administration produce no changes in 1) bacterial adherence to the rabbit bladder mucosa, 2) specific antibacterial adherence activity of the bladder mucin, and 3) ultrastructure of the mucosa, submucosa, and muscularis.