Structural changes of smooth muscle in congenital ureteropelvic junction obstruction |
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Authors: | Hosgor Munevver Karaca Irfan Ulukus Cagnur Ozer Erdener Ozkara Erdem Sam Bulent Ucan Basak Kurtulus Senay Karkiner Aytac Temir Gunyuz |
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Affiliation: | a Department of Pediatric Surgery, Dr Behcet Uz Children's Hospital, Izmir, 35210 Turkey b Department of Pathology, Dokuz Eylul University, Izmir, 35300 Turkey c Department of Forensic Medicine, Dokuz Eylul University, Izmir, 35300 Turkey d Ministry of Justice, The Council of Forensic Medicine, Istanbul, 34301 Turkey |
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Abstract: | Background/PurposeUreteropelvic junction (UPJ) obstruction is the most common cause of congenital hydronephrosis. Previous studies have reported that the excess amount of collagen restricting mobility and resiliency of the UPJ is the result of an impaired collagen production by anomalous smooth muscle cells (SMCs). Our purpose was to evaluate the role of SMC differentiation in the pathogenesis of UPJ obstruction.MethodsSurgical specimens of UPJ from 21 patients (8 girls/13 boys) who were subjected to dismembered pyeloplasty were examined immunohistochemically using monoclonal antibodies against smooth muscle (SM) myosin heavy chain isoforms including SM1, SM2, and SMemb. The age ranged from 1 month to 13 years. Ureteropelvic walls taken from 14 forensic autopsy cases, with no urological abnormalities, served as age-matched control group.ResultsThe immunohistochemical expression of SM1 and SM2 in UPJ obstruction was significantly increased when compared with controls (P < .05). In contrast, there was no statistical difference of expression of SMemb.ConclusionOur findings supported the hypothesis that the primary anomaly in UPJ obstruction may be attributed to a malfunction of SMCs in the ureter. |
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Keywords: | Myosin heavy chains Smooth muscle Ureteropelvic junction obstruction |
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