膀胱癌高危乳头瘤病毒定位研究及临床意义

目的：进一步探讨高危ＨＰＶ１６、１５与膀胱癌的病因学关系。方法：运用改良的原位杂交技术对５２例福尔马林固定石蜡包理膀胱乳头状移行细胞癌组织进行高危ＨＰＶＤＮＡ定位检测。结果：ＨＰＶ ＤＮＡ的阳性信号存在于肿瘤细胞核内,呈点状,也可为点片状,位于乳头癌全层,癌旁不典型增生上皮、癌旁正常的上皮组织及Ｂｒｕｎｎ氏巢可同时有高危ＨＰＶ的点片状表达。５２例膀光乳头状移行细胞癌中高危型ＨＰＶ１６、１８ＤＮＡ阳     

男性膀胱颈挛缩32例临床分析

目的：总结对男性膀胱颈挛缩的诊治体会,方法：分析32例男性膀胱颈挛缩的临床特征及诊断要点,评价经膀胱切除颈部狭窄纤维环及前列腺的手术疗效,结果：术后平均尿流率及最大尿流率与术前比较均有显著性提高（P＜0．01）,随访3－12个月,临床症状消失,排尿满意,结论：男性膀胱颈挛缩要注意与前列腺增生症相鉴别,其中行膛胱镜检查是重要的鉴别手段。经膀胱切除颈部狭窄纤维环及前列腺是疗效可靠的治疗方法。     

Arthrogryposis,renal dysfunction and cholestasis syndrome: Report of five patients from three Italian families

We report on five patients from three families with neurogenic arthrogryposis, cholestasis and tubular renal dysfunction. Despite a similar clinical picture the liver histology showed a broad pathological spectrum, ranging from pigment storage to parenchymal giant cell transformation and ductopenia. The findings are compared with those of other cases from the literature in search of a correct nosology of the syndrome characterized by arthrogryposis, renal and liver disease.Conclusion We propose to consider the picture of arthrogryposis, renal tubular dysfunction and cholestasis as a single syndrome.     

增殖细胞核抗原在膀胱移行细胞癌中的表达及其预后评价

目的：探讨增殖细胞核抗原（ｐｒｏｌｉｆｅｒａｔｉｎｇｃｅｌｎｕｃｌｅａｒａｎｔｉｇｅｎ,ＰＣＮＡ）在膀胱移行细胞癌中的表达及其与预后的关系。方法：用抗ＰＣＮＡ的单克隆抗体ＰＣ１０免疫组化染色常规石蜡包埋的膀胱癌组织。结果：全部４８例膀胱癌标本中４６例ＰＣＮＡ显示阳性（９５８％）,正常膀胱组织均为阴性。ＰＣＮＡ指数在Ⅰ、Ⅱ、Ⅲ级肿瘤中分别为（８２８±８６８）％,（２３８２±１６０２）％,（４４６８±２４６５）％。在Ｔａ～Ｔ１和Ｔ２～Ｔ４期肿瘤中分别为（１２５８±１２３３）％和（３４５５±２１８９）％。ＰＣＮＡ指数在各病理分级和分期间均有统计意义（Ｐ＜０．０１）。为了比较ＰＣＮＡ指数与生存率,根据ＰＣＮＡ染色平均水平,将患者分为两组即高ＰＣＮＡ组,其ＰＣＮＡ指数＞２１％和低ＰＣＮＡ组,其ＰＣＮＡ指数＜２１％。我们用Ｌｏｇｒａｎｋ方法对生存率统计发现高ＰＣＮＡ组的预后明显比低ＰＣＮＡ组的预后差（Ｐ＜０．０１）。结论：ＰＣＮＡ表达与膀胱癌病理分级、临床分期和预后均有密切关系,可作为膀胱癌一个有效的预后指标。     

MR imaging of the male pelvis

Prostate and urinary bladder cancer are the most frequently encountered malignancies of the urinary tract. Appropriate use of the different imaging techniques is crucial for accurate assessment of prognosis and for the development of appropriate treatment planning. Especially determination of local tumor extension and detection of nodal or bone metastases is extremely important. In this regard MR imaging is the most promising imaging technique. Therefore, in this review its role in staging these malignancies is evaluated and compared with clinical staging, and other imaging techniques. Finally, future developments, such as new sequences, new contrast agents, the role of surface coils and MR-guided biopsy, are considered. Also, the preferred radiological approach is discussed.     

Sprouting of bladder nerves into cystoplastic cecal segment in the rat

Incorporation of bowel into the bladder (enterocystoplasty) has been widely used to increase bladder capacity. It has been reported by others that the response of smooth muscle from the cystoplastic segment of the intestine shifts from that of the intestine (relaxation to α-agonists and ATP) to that of the bladder (contraction to α-agonists and ATP). This suggests a functional integration of the intestinal muscle into the bladder; the mechanisms are unknown. The aims of the present study were (1) to elucidate if there are signs of bladder nerves sprouting across the anastomosis into the intestinal segment, and (2) to study what happens with the intrinsic innervation of the intestinal segment. As a model, we used cecocystoplasty in rats. The bladder was opened and a patch of cecum with intact vascular supply was anastomosed to the bladder. After two to 11 months the rats were sacrificed and the bladders mounted as wholemounts and stained for acetylcholinesterase-containing nerves, or embedded in paraffin for histology. A pronounced degeneration of the myenteric plexus was found in the cecal segments. In some areas, this had proceeded to the extent that the ganglia were isolated ovoid lumps of cells with no apparent connection to other ganglia. Areas lacking ganglia and nerve trunks but still with muscle could be found in all specimens. Abundant axon bundles were demonstrated sprouting from the cut bladder nerves close to the anastomosis. The bundles spread out in a fan-like pattern or were organized as fewer thicker nerves. There were many nerve bundles entering the cecal segment where they branched and the diameter decreased till they no longer became visible. Some nerves reached surviving lumps of myenteric ganglion cells. The results show that the bladder nerves sprout into the anastomosed cecal segment. It is reasonable to assume that these nerves are responsible for the changes in receptor pharmacological properties of the cecal smooth muscle towards that of bladder muscle. Received: 30 October 1998 / Accepted: 18 May 1999     

Conservative treatment of neurogenic bladder dysfunction

Summary In neurogenic bladder dysfunction conservative treatment is preferred whenever possible and preservation of renal function remains the main topic. Additionally, a patient-related form of bladder management with decreased intravesical pressure and social dryness is needed. Therefore many strategies are available and after evaluation of the underlying neurogenic bladder dysfunction an individual kind of treatment can be used. Possible options are the clean intermittent catherization, anticholinergic drugs, detrusor triggering, electrical stimulation and bladder emptying by Valsalva's manouvre.      

同种异体大鼠胰腺移植膀胱引流术式模型的建立及分析

大鼠胰腺移植模型可用于解决临床移植中常见问题的初步探索性研究．采用目前临床胰腺移植常用的膀胱引流术式,建立大鼠的同种异体胰腺移植模型30例,其中12例存活超过5d,存活超过2周者6例,超过3个月者4例。尸检及病理结果表明,手术过程中血管吻合技术的熟练程度、吻合时间过长及移植胰腺冷缺血期间保存温度超过4℃而使之活力下降是移植后动物死亡的主要原因。     

Inhibition of cardiac inward-rectifier K current by terodiline

The antispasmodic agent terodiline has cardiotoxic effects that include QT lengthening. To determine whether inhibition of inwardly-rectifying K⁺ current (I_K1) might be a factor in the cardiotoxicity, we measured I_K1 in guinea pig ventricular myocytes. Terodiline reduced outward I_K1 with an IC₅₀ of 7 μM; maximal reduction was 60% with 100–300 μM concentration. Inhibition was independent of current direction, and persisted after removal of the drug. Terodiline (3–5 μM) lengthened action potentials in guinea pig papillary muscles by ca. 10%, primarily by slowing phase 3 repolarization; higher concentrations abbreviated the plateau and markedly slowed late repolarization. Terodiline washout provoked an extra lengthening, consistent with persistent inhibition of I_K1 and rapid recovery of net inward plateau current. The results suggest that inhibition of I_K1 is a likely factor in the cardiotoxicity of the drug.     

Different pH Dependency of Mitomycin C Activity in Monolayer and Three-Dimensional Cultures

Purpose. Previous studies by other investigators have shown an enhancement of mitomycin C (MMC) activity at acidic extracellular pH (pH_e) in monolayer cultures of human cells. The goal of the present study was to determine if the efficacy of intravesical MMC therapy in patients treated for superficial bladder cancer can be enhanced by using acidified dosing solutions. We evaluated (a) the effect of pH_e on MMC activity in patient bladder tumors in vitro, and (b) the pH dependency of MMC activity in 2-dimensional monolayer and 3-dimensional multilayer cultures of human bladder RT4 tumor cells. Methods. Patient bladder tumors were maintained as 3-dimensional histocultures. RT4 cells were harvested and maintained as monolayer cultures or as 3-dimensional cell pellets on a collagen gel matrix. The cell pellets were 300–450 cell layers and 4,000–5,000 µm in diameter. Tumors or cells were incubated for 2 hr with MMC-containing media at pH_eof 5, 6, and 7.4. The drug effect was measured by the inhibition of DNA precursor (thymidine) incorporation. The stability of MMC as a function of pH_e was determined. About 24% of MMC was degraded following 2 hr exposure at pH_e 5 and 2% at pH_e 6 and 7.4. Results. The drug concentrations required to inhibit thymidine incorporation by 50% (IC₅₀) were corrected for the degraded MMC at acidic pH_e. The results showed no pH-dependent MMC activity in human patient bladder tumors nor in RT4 multilayer cultures; the IC₅₀ values were about 10 µg/ml at all three pH_e. In contrast, the monolayer RT4 cultures showed a pH-dependent MMC cytotoxicity; the IC₅₀ were 0.1, 0.8 and 1.2 µg/ ml at pH_e 5,6 and 7.4, respectively (p < 0.05). Pre-incubation of multi-layered RT4 cultures in acidic pH medium for 8 hr enhanced the MMC activity; the IC₅₀ was reduced by about 5 fold at pH_e 5 and about 3 fold at pH_e 6. Similar pH-dependent MMC activity was found when multilayers were pre-treated for 1 hr with 0.5 µml nigericin, a proton ionophore known to cause the intracellular pH (pH_i) to equilibrate with pH_e. Conclusions. These data suggest that the difference in the pH dependency of MMC activity in the monolayer and multilayer systems was due to the different experimental conditions. The time lag for pH_i to equilibrate with pH_e in the multilayer systems and the instability of MMC at low pH_e imply that the efficacy of intravesical MMC therapy is unlikely to be enhanced by using acidic dosing solution.