摘要:

Morphometric analysis of the innervation pattern of the stromal layer of the urinary bladder was done on biopsies from 88 patients with definite multiple sclerosis (MS). The biopsies were stained for acetylcholinesterase and for S100 protein, and a semiquantitative score was assigned. Nearly 30% of the samples showed increased immunoreactivity for S100, indicating Schwann cell hyperplasia. In 16% a decreased S100 immunoreactivity was found, the significance of which is unclear. More than 90% had normal acetylcholinesterase activity. No correlation could be demonstrated for age, sex, severity and duration of the disease, the presence of cystitis and the type of detrusor dysfunction. The finding of altered S100 immunoreactivity in MS bladders could indicate that MS also affects the peripheral nervous system and is not limited to the central nervous system as classically described. This finding warrants further investigation.

ISSN:0042-1138    

DOI:10.1159/000281534

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Painful bladder disease is an ill-defined disease presenting with chronic cystitis symptoms, despite sterile urine. This report includes only patients with painful bladder diseases of unknown etiology and pathogenesis. We have chosen to classify these patients pathoanatomically as follows: interstitial cystitis, detrusor myopathy, chronic unspecific cystitis and eosinophilic cystitis. The pathoanatomical appearance of the four groups of patients are described in details and certain clinical differences appear between the groups. The etiology and pathogenesis to the inflammatory reactions and muscle changes found in the detrusor biopsies are unknown, but many theories exist. It is suggested that something in the urine gains access to the bladder wall and initiates the pathoanatomical changes through a defective urothelium and glycosaminoglycans layer. In the interstitial cystitis patients, the inflammatory process and mast cell degranulation might be monitored by the urinary excretion of 1,4-methyl-imidazole-acetic acid and eosinophil cationic protein. It is concluded that no specific therapy for the disease exists, since etiology and pathogenesis are still unknown and therefore future research in this field is very important.

ISSN:0042-1138    

DOI:10.1159/000281535

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

The present investigation was conducted to examine the effect of neoadjuvant PVB and CAP regimens for locally invasive bladder cancer and consisted of two studies: (1) a retrospective nonrandomized study of neoadjuvant PVB therapy, and (2) a well-controlled randomized study of neoadjuvant CAP therapy. A total of 25 patients with primary locally invasive bladder cancer were entered into the PVB study between January 1981 and December 1985. Since 1986, 31 patients have been randomized into the CAP study. In the PVB-treated group, a 71.4% complete response (CR) plus partial response (PR) rate and a 71.4% downstaging were noted. On the other hand, in the CAP-treated group, a 50.0% CR plus PR rate and a 88.9% downstaging were noted. The 2- and 5-year survival rates of neoadjuvant PVB were 78.6 and 60.6%, respectively. In contrast, the 2-year survival rate of the neoadjuvant CAP-treated group was 100% at a mean follow-up of 15.8 months. No statistical significance was achieved in the survival rates. These results indicated that neoadjuvant PVB and CAP would be useful in the management of invasive bladder cancer.

ISSN:0042-1138    

DOI:10.1159/000281536

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

A review of 36 cytotoxic agents used singly in over 1,900 patients with renal cancer between 1983 and 1988 finds marginal antitumor activity, < 5–10%. The future role of monoclonal antibodies for therapy of this disease may offer some hope with the recent description of rather specific phenotypic expression, URO 10+/URO 8+, suggesting the cell origin of most renal tumors from the distal portion of the proximal tubule.

ISSN:0042-1138    

DOI:10.1159/000281537

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

The dynamics of major histocompatibility complex (MHC) class-II (DR) antigen products in renal tubular cells and cellular infiltrations in the interstitium of the kidney following renal transplantation without immunosuppressive therapy are presented. DR antigen in 27 normal kidneys and in 18 of 19 kidneys transplanted as autograft showed no DR-antigen expression on their tubular cells. These DR-antigen-negative tubular cells could be induced to express the antigen during courses of untreated rejection both in primary (n = 6) and repeat (n = 4) allografts. Parallel to the increasing DR-antigen expression in the allograft, the autologous kidney expressed this antigen with the same time dependency and with the same intensity. Graft infiltrating cells were evaluated by daily fine-needle aspiration biopsy and core biopsy. Induction of DR antigen was associated with a significant infiltration of blastogenic ceils and monocytes/macrophages in the allograft. During rejection of the allograft no cellular infiltrate was noted in the autograft, but during an initial time period after allograft removal cellular infiltrates were seen. Following both courses of rejection DR antigen returns to negative by 6–8 days as did blastogenic cells and monocytes/macrophages in the autograft interstitium. Inducible antigen expression in normally DR-antigen-negative allograft parenchymal cells during rejection is shown to depend on inflammatory cells in the graft. The antigen expression is not restricted to the tissue transplanted, but also affects autologous tissue of the host organism.

ISSN:0042-1138    

DOI:10.1159/000281538

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

The regional distribution of peptidergic nerves in the juvenile and adult human prostate has been studied immunohistochemically using highly specific polyclonal antibodies. Nerves displaying immunoreactivity of Met-enkephalin, Leu-enkephalin, heptapetide and octapeptide were detected in the dorsolateral stroma closely related to smooth muscle predominantly of juvenile glands. A less strong immunoreactivity was present around stromal vessels and periurethral. Subepithelial periacinar nerves showing Leu-enkephalin, Met-enkephalin, octa- and heptapetide immunoreactivity were found in a few instances. The most prominent immunoreaction was achieved with octapeptide antiserum, followed in decreasing order by Met-enkephalin, Leu-enkephalin and heptapeptide. Their density decreased with age. Antisera against β-endorphin, α-neoendorphin, β-neoendorphin and dynorphin A gave to positive immunoreaction with prostatic nerves. The regional distribution pattern described is in favor of a postsynaptic peptidergic sympathetic innervation of prostatic stroma acting with classical neurotransmitters.

ISSN:0042-1138    

DOI:10.1159/000281539

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

In 15 adult dogs, the possible role of acetylcholine as a parasympathetic neurotransmitter in canine penile erection was investigated. Intracavernous injection of increasing dosages of acetylcholine (0.1–100 μg) induced a dose-dependent erectile response with increased arterial flow, cavernous smooth muscle relaxation, and venous occlusion. This erectile response was completely abolished after muscarinic blockade by intracavernous injection of 0.1 mg atropine. After cavernous nerve stimulation, atropine injection significantly reduced the pudendal arterial flow (by 25%) and likewise caused a significant reduction in cavernous outflow restriction. Histologic staining showed acetylcholinesterase-positive fibers around the cavernous arteries and within the cavernous erectile tissue.

ISSN:0042-1138    

DOI:10.1159/000281540

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

On the basis of a standardized in vitro irrigation model, the incrustation behavior of catheters was investigated using collected urine with controlled contamination (Proteus mirabilis). Irrigation treatment with a NaCl solution did not effectively reduce incrustation compared to the control experiment. On the other hand, incrustations were definitively prevented or existing crystal deposits were largely dissolved with a citrate solution of pH 4.0 (Suby G). Analytical investigations (infrared spectroscopy, scanning electron microscopy) of the deposits on the catheter revealed the presence of struvite (MgNH4PO4 × 6H2O), brushite (CaHPO4 × 2H2O) and carbonate apatite (Ca10[PO4] [CO3OH]6[OH]2).

ISSN:0042-1138    

DOI:10.1159/000281541

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

A case of spontaneous urinary peripelvic extravasation secondary to an obstructing squamous cell carcinoma of the ureter is presented. A review of the literature reveals that peripelvic extravasation caused by tumor obstruction of the ureter is rare and most of its underlying lesions are metastatic retroperitoneal adenopathy.

ISSN:0042-1138    

DOI:10.1159/000281542

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

A case report of large-bowel perforation after intravesical neodymium-yttrium aluminum garnet laser irradiation is presented. Recommendations to prevent bowel injury are discussed.

ISSN:0042-1138    

DOI:10.1159/000281543

出版商:S. Karger AG    

年代:1989

数据来源: Karger