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1.
Rev. esp. patol ; 57(2): 116-119, Abr-Jun, 2024. ilus
Artículo en Inglés | IBECS | ID: ibc-232415

RESUMEN

A 62-year-old male presented with pain and haematuria starting 3 months before. The computed tomography showed focal and mural bladder thickening with ureteropelvic dilatation. The following transurethral bladder resection revealed a high-grade muscle-invasive urothelial carcinoma. In the subsequent cystoprostatectomy we found the same tumour, but adding focal tumour-associated stromal osseous metaplasia. Ossifying metaplasia is an extremely rare feature in urothelial carcinoma, with a few reported cases and represents a diagnostic challenge, mimicking radiotherapy-induced sarcoma or sarcomatoid carcinoma. (AU)


Varón de 62 años que consulta por dolor y hematuria desde hace 3 meses. En la tomografía computarizada se observó un engrosamiento focal y mural de la vejiga con dilatación ureteropélvica. La resección vesical transuretral reveló un carcinoma urotelial infiltrante de alto grado músculo-invasivo. En la cistoprostatectomía posterior encontramos el mismo tumor, pero añadiendo focos de metaplasia ósea estromal asociada al tumor. La metaplasia osificante es una característica extremadamente rara en el carcinoma urotelial, con algunos casos informados, y representa un desafío diagnóstico, ya que simula un sarcoma inducido por radioterapia o un carcinoma sarcomatoide. (AU)


Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Osteoma Osteoide , Carcinoma de Células Transicionales , Vejiga Urinaria , Metaplasia , Tomografía Computarizada por Rayos X
2.
Infect Dis Clin North Am ; 38(2): 241-253, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38729665

RESUMEN

This article discusses the urinary microbiome in relation to urinary tract infection (UTI) in women. It makes biologic sense that the microbiota of different niches (bladder, vagina, and gut) interact with each other in health, as well as during a UTI event; however, these relationships remain poorly understood. Future research should close knowledge gaps regarding the interactions between the urinary microbiota and the host, amongst the microbiota of adjacent niches, and between the microbes within the same microbiota. The new knowledge should result in improved UTI treatment in the age of antibiotic stewardship.


Asunto(s)
Microbiota , Infecciones Urinarias , Humanos , Infecciones Urinarias/diagnóstico , Infecciones Urinarias/microbiología , Infecciones Urinarias/tratamiento farmacológico , Femenino , Adulto , Antibacterianos/uso terapéutico , Sistema Urinario/microbiología , Vagina/microbiología , Vejiga Urinaria/microbiología
3.
Pediatr Surg Int ; 40(1): 131, 2024 May 10.
Artículo en Inglés | MEDLINE | ID: mdl-38730091

RESUMEN

PURPOSE: To evaluate the urodynamic changes in patients who have undergone colocystoplasty (CCP), gastrocystoplasty (GCP) and ileocystoplasty (ICP) in a retrospective study. Changes in urinary continence, incidence of pathologic contractions before and after augmentation, alterations of urodynamic parameters were also examined. METHODS: Eighty-four patients were included in the study who underwent bladder augmentation between 1987 and 2017. Group I: 35 patients with CCP. Group II: 18 patients with GCP. Group III: 31 patients with ICP. Cystometry was performed at 3, 6, and every 12 months, then biannually after augmentation. Pre- and postoperative urodynamic changes were analysed statistically. RESULTS: In Group I, two patients and in Group III, one patient remained incontinent after CCP and ICP. Bladder capacity increased significantly, maximal intra-vesical pressure decreased and compliance improved in all groups (p < 0.001). Postoperative studies showed pathologic contractions in the augmented bladder in half of the patients with GCP, in 43% of patients after CCP and 26% of patients with ICP. CONCLUSION: From the urodynamic point of view, ileum is the most adequate option in the long term. Contractions after augmentation might be caused by the remaining peristalsis of the detubularised segment. Further investigations are needed to evaluate pathologic contractions that remained after detubularisation.


Asunto(s)
Íleon , Vejiga Urinaria , Urodinámica , Humanos , Estudios Retrospectivos , Femenino , Masculino , Vejiga Urinaria/fisiopatología , Vejiga Urinaria/cirugía , Niño , Íleon/cirugía , Íleon/fisiopatología , Adolescente , Colon/cirugía , Colon/fisiopatología , Preescolar , Estómago/cirugía , Estómago/fisiopatología , Procedimientos Quirúrgicos Urológicos/métodos , Lactante
4.
Int J Mol Sci ; 25(9)2024 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-38732143

RESUMEN

This study explores low-intensity extracorporeal shock wave therapy (LiESWT)'s efficacy in alleviating detrusor hyperactivity with impaired contractility (DHIC) induced by ovarian hormone deficiency (OHD) in ovariectomized rats. The rats were categorized into the following four groups: sham group; OVX group, subjected to bilateral ovariectomy (OVX) for 12 months to induce OHD; OVX + SW4 group, underwent OHD for 12 months followed by 4 weeks of weekly LiESWT; and OVX + SW8 group, underwent OHD for 12 months followed by 8 weeks of weekly LiESWT. Cystometrogram studies and voiding behavior tracing were used to identify the symptoms of DHIC. Muscle strip contractility was evaluated through electrical-field, carbachol, ATP, and KCl stimulations. Western blot and immunofluorescence analyses were performed to assess the expressions of various markers related to bladder dysfunction. The OVX rats exhibited significant bladder deterioration and overactivity, alleviated by LiESWT. LiESWT modified transient receptor potential vanilloid (TRPV) channel expression, regulating calcium concentration and enhancing bladder capacity. It also elevated endoplasmic reticulum (ER) stress proteins, influencing ER-related Ca2+ channels and receptors to modulate detrusor muscle contractility. OHD after 12 months led to neuronal degeneration and reduced TRPV1 and TRPV4 channel activation. LiESWT demonstrated potential in enhancing angiogenic remodeling, neurogenesis, and receptor response, ameliorating DHIC via TRPV channels and cellular signaling in the OHD-induced DHIC rat model.


Asunto(s)
Modelos Animales de Enfermedad , Tratamiento con Ondas de Choque Extracorpóreas , Contracción Muscular , Canales Catiónicos TRPV , Vejiga Urinaria , Animales , Femenino , Ratas , Canales Catiónicos TRPV/metabolismo , Canales Catiónicos TRPV/genética , Tratamiento con Ondas de Choque Extracorpóreas/métodos , Vejiga Urinaria/fisiopatología , Vejiga Urinaria/metabolismo , Vejiga Urinaria Hiperactiva/terapia , Vejiga Urinaria Hiperactiva/metabolismo , Vejiga Urinaria Hiperactiva/fisiopatología , Vejiga Urinaria Hiperactiva/etiología , Ovariectomía , Ratas Sprague-Dawley , Ovario/metabolismo
5.
Int J Med Sci ; 21(6): 1144-1154, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38774757

RESUMEN

Objectives: To examine time-dependent functional and structural changes of the lower urinary tract in streptozotocin-induced diabetic rats with or without low-dose insulin treatment and explore the pathophysiological characteristics of insulin therapy on lower urinary tract dysfunction (LUTD) caused by diabetes mellitus (DM). Methods: Female Sprague-Dawley rats were divided into five groups: normal control (NC) group, 4 weeks insulin-treated DM (4-DI) group, 4 weeks DM (4-DM) group, 8 weeks insulin-treated DM (8-DI) group and 8 weeks DM (8-DM) group. DM was initially induced by i.p. injection of streptozotocin (65 mg/kg), and then the DI groups received subcutaneous implantation of insulin pellets under the mid dorsal skin. Voiding behavior was evaluated in metabolic cages. The function of bladder and urethra in vivo were evaluated by simultaneous recordings of the cystometrogram and urethral perfusion pressure (UPP) under urethane anesthesia. The function of bladder and urethra in vitro were tested by organ bath techniques. The morphologic changes of the bladder and urethra were investigated using Hematoxylin-Eosin and Masson's staining. Results: Both 4-and 8-weeks diabetic rats have altered micturition patterns, including increased 12-h urine volume, urinary frequency/12 hours and voided volume. In-vivo urodynamics showed the EUS bursting activity duration is longer in 4-DM group and shorter in 8-DM group compared to NC group. UPP change in 8-DM were significantly lower than NC group. While none of these changes were found between DI and NC groups. Organ bath showed the response to Carbachol and EFS in bladder smooth muscle per tissue weights was decreased significantly in 4- and 8-weeks DM groups compared with insulin-treated DM or NC groups. In contrast, the contraction of urethral muscle and maximum urethral muscle contraction per gram of the tissue to EFS stimulation were significantly increased in 4- and 8-weeks DM groups. The thickness of bladder smooth muscle was time-dependently increased, but the thickness of the urethral muscle had no difference. Conclusions: DM-induced LUTD is characterized by time-dependent functional and structural remodeling in the bladder and urethra, which shows the hypertrophy of the bladder smooth muscle, reduced urethral smooth muscle relaxation and EUS dysfunction. Low-dose insulin can protect against diuresis-induced bladder over-distention, preserve urethral relaxation and protect EUS bursting activity, which would be helpful to study the slow-onset, time-dependent progress of DM-induced LUTD.


Asunto(s)
Diabetes Mellitus Experimental , Insulina , Ratas Sprague-Dawley , Uretra , Vejiga Urinaria , Micción , Animales , Diabetes Mellitus Experimental/complicaciones , Diabetes Mellitus Experimental/fisiopatología , Diabetes Mellitus Experimental/tratamiento farmacológico , Diabetes Mellitus Experimental/inducido químicamente , Femenino , Insulina/administración & dosificación , Ratas , Vejiga Urinaria/efectos de los fármacos , Vejiga Urinaria/fisiopatología , Vejiga Urinaria/patología , Uretra/efectos de los fármacos , Uretra/fisiopatología , Uretra/patología , Micción/efectos de los fármacos , Estreptozocina/toxicidad , Factores de Tiempo , Humanos , Síntomas del Sistema Urinario Inferior/tratamiento farmacológico , Síntomas del Sistema Urinario Inferior/etiología , Síntomas del Sistema Urinario Inferior/fisiopatología
6.
Gulf J Oncolog ; 1(45): 94-99, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38774938

RESUMEN

PURPOSE: We report the use of online adaptive radiotherapy (OART) aiming to improve dosimetric parameters in the prostate cancer patient who had lower urinary tract symptoms that caused him not to adhere to the standard bladder filling protocol. METHODS AND MATERIALS: The reference treatment plan for adaptive radiotherapy plan was generated for the pelvis and the solitary bony lesion using the Ethos treatment planning system. For each treatment session, high-quality iterative reconstructed cone beam CT (CBCT) images were acquired, and the system automatically generated an optimal adaptive plan after verification of contours. Image-guided RT (IGRT) plans were also created using the reference plan recalculated on the CBCT scan and were compared with adaptive plans. RESULTS: The reference bladder volume in the planning CT scan was 173 cc, and the mean bladder volume difference over the course was 25.4% ± 16.6%. The ART offered superior target coverage for PTV 70 Gy over online IGRT (V95: 90.5 ± 3.2 % Vs 97.3 ± 0.4%; p=0.000) and the bladder was also better spared from the high dose (V65 Gy: 17.9 ± 9.1% vs 14.8 ± 3.6%; p=0.03). However, the mean rectum V65 doses were very similar in both plans. CONCLUSION: Managing the inconsistent bladder volume was feasible in the prostate cancer patient using the CBCT-guided OART and our analysis confirmed that adaptive plans offered better target coverage while sparing the bladder from high radiation doses in comparison to online IGRT plans. KEY WORDS: radiotherapy, CBCT, online adaptive radiotherapy, image-guided RT.


Asunto(s)
Neoplasias de la Próstata , Planificación de la Radioterapia Asistida por Computador , Vejiga Urinaria , Humanos , Masculino , Neoplasias de la Próstata/radioterapia , Neoplasias de la Próstata/patología , Planificación de la Radioterapia Asistida por Computador/métodos , Vejiga Urinaria/patología , Radioterapia Guiada por Imagen/métodos , Tomografía Computarizada de Haz Cónico/métodos , Dosificación Radioterapéutica , Radioterapia de Intensidad Modulada/métodos , Anciano
7.
Radiat Oncol ; 19(1): 54, 2024 May 03.
Artículo en Inglés | MEDLINE | ID: mdl-38702761

RESUMEN

BACKGROUND: Stereotactic ablative body radiotherapy (SABR) is an emerging treatment alternative for patients with localized low and intermediate risk prostate cancer patients. As already explored by some authors in the context of conventional moderate hypofractionated radiotherapy, focal boost of the index lesion defined by magnetic resonance imaging (MRI) is associated with an improved biochemical outcome. The objective of this phase II trial is to determine the effectiveness (in terms of biochemical, morphological and functional control), the safety and impact on quality of life, of prostate SABR with MRI guided focal dose intensification in males with intermediate and high-risk localized prostate cancer. METHODS: Patients with intermediate and high-risk prostate cancer according to NCCN definition will be treated with SABR 36.25 Gy in 5 fractions to the whole prostate gland with MRI guided simultaneous integrated focal boost (SIB) to the index lesion (IL) up to 50 Gy in 5 fractions, using a protocol of bladder trigone and urethra sparing. Intra-fractional motion will be monitored with daily cone beam computed tomography (CBCT) and intra-fractional tracking with intraprostatic gold fiducials. Androgen deprivation therapy (ADT) will be allowed. The primary endpoint will be efficacy in terms of biochemical and local control assessed by Phoenix criteria and post-treatment MRI respectively. The secondary endpoints will encompass acute and late toxicity, quality of life (QoL) and progression-free survival. Finally, the subgroup of high-risk patients will be involved in a prospective study focused on immuno-phenotyping. DISCUSSION: To the best of our knowledge, this is the first trial to evaluate the impact of post-treatment MRI on local control among patients with intermediate and high-risk prostate cancer undergoing SABR and MRI guided focal intensification. The results of this trial will enhance our understanding of treatment focal intensification through the employment of the SABR technique within this specific patient subgroup, particularly among those with high-risk disease, and will help to clarify the significance of MRI in monitoring local responses. Hopefully will also help to design more personalized biomarker-based phase III trials in this specific context. Additionally, this trial is expected to be incorporated into a prospective radiomics study focused on localized prostate cancer treated with radiotherapy. TRIAL REGISTRATION: Clinicaltrials.gov identifier: NCT05919524; Registered 17 July 2023. TRIAL SPONSOR: IRAD/SEOR (Instituto de Investigación de Oncología Radioterápica / Sociedad Española de Oncología Radioterápica). STUDY SETTING: Clinicaltrials.gov identifier: NCT05919524; Registered 17 July 2023. TRIAL STATUS: Protocol version number and date: v. 5/ 17 May-2023. Date of recruitment start: August 8, 2023. Date of recruitment completion: July 1, 2024.


Asunto(s)
Neoplasias de la Próstata , Radiocirugia , Radioterapia Guiada por Imagen , Anciano , Humanos , Masculino , Persona de Mediana Edad , Imagen por Resonancia Magnética/métodos , Tratamientos Conservadores del Órgano/métodos , Órganos en Riesgo/efectos de la radiación , Estudios Prospectivos , Neoplasias de la Próstata/radioterapia , Neoplasias de la Próstata/diagnóstico por imagen , Neoplasias de la Próstata/cirugía , Neoplasias de la Próstata/patología , Calidad de Vida , Radiocirugia/métodos , Dosificación Radioterapéutica , Planificación de la Radioterapia Asistida por Computador/métodos , Radioterapia Guiada por Imagen/métodos , Vejiga Urinaria/efectos de la radiación , Ensayos Clínicos Fase II como Asunto
8.
Asian J Endosc Surg ; 17(3): e13318, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38716571

RESUMEN

INTRODUCTION: As bladder diverticula in older adults are often secondary to bladder outlet obstruction, bladder diverticulectomy is often performed with prostate treatment. Cases of sequentially performed robot-assisted bladder diverticulectomy and prostatectomy have been reported; however, performing cystotomy for each procedure may increase the risk of complications and prolong operative time. MATERIALS AND SURGICAL TECHNIQUE: We reported the cases of three patients who underwent diverticulectomy without additional cystotomy via the bladder opening during robot-assisted laparoscopic radical prostatectomy in our hospital. DISCUSSION: This technique corresponds to a transvesical approach through the bladder neck opening. Hence, it is especially useful for well-visualized diverticula close to the ureteral orifice or on the posterior wall. Although other approaches may be better depending on the location of the diverticulum, it is considered a reasonable approach that does not require an additional cystotomy.


Asunto(s)
Divertículo , Prostatectomía , Procedimientos Quirúrgicos Robotizados , Vejiga Urinaria , Humanos , Masculino , Prostatectomía/métodos , Procedimientos Quirúrgicos Robotizados/métodos , Divertículo/cirugía , Anciano , Vejiga Urinaria/cirugía , Vejiga Urinaria/anomalías , Persona de Mediana Edad
9.
World J Urol ; 42(1): 300, 2024 May 06.
Artículo en Inglés | MEDLINE | ID: mdl-38710872

RESUMEN

OBJECTIVE: To observe the effect of acupuncture Zhibian (BL54) on the function of the bladder in controlling urine in women under ultrasound. METHOD: 74 healthy subjects were randomly divided into deep acupuncture group of 37 cases and shallow acupuncture group of 37 cases. Under the guidance of ultrasound, the two groups of subjects were acupunctured at bilateral BL54. The deep acupuncture group was acupunctured to the pudendal nerve, and the shallow acupuncture group was acupunctured to the superficial fascia. Ultrasound was used to observe the peak systolic velocity (PSV), time average maximum velocity (TAMX), end diastolic velocity (EDV), pulsation index (PI), resistance index (RI) of the pudendal arteries, and bladder volume of two groups of subjects before and after acupuncture. The anatomical hierarchical structure of bilateral BL54 and score of Chinese version of the Massachusetts General Hospital Acupuncture Sensation Scale (C-MASS) of all subjects was measured. RESULT: After acupuncture, the PSV, TMAX of the pudendal artery, bladder volume, and the Score of C-MASS Scale in the deep acupuncture group were higher than in the shallow acupuncture group (P < 0.05). The RI of the pudendal arteries in the shallow acupuncture group decreased compared to before acupuncture (P < 0.05). CONCLUSION: Acupuncture at the BL54 can increase the blood flow velocity of the pudendal artery, improve the function of the bladder in controlling urine in women, and different depths of acupuncture will have different therapeutic effects.


Asunto(s)
Terapia por Acupuntura , Vejiga Urinaria , Humanos , Femenino , Terapia por Acupuntura/métodos , Vejiga Urinaria/diagnóstico por imagen , Adulto , Ultrasonografía Intervencional , Adulto Joven , Persona de Mediana Edad , Puntos de Acupuntura
10.
Pediatr Surg Int ; 40(1): 124, 2024 May 07.
Artículo en Inglés | MEDLINE | ID: mdl-38713441

RESUMEN

PURPOSE: Megacystis-microcolon-intestinal hypoperistalsis syndrome (MMIHS) is a well described clinical condition, but reports are focused on microcolon and intestinal hypoperistalsis, while data on bladder management are scant. Aim of the study is to present urological concerns in MMIHS. METHODS: Retrospective evaluation of clinical data on urological management of MMIHS patients treated in the last 10 years. RESULTS: Six patients were enrolled (3 male, 3 female). Three girls had prenatal diagnosis of megacystis (1 vesicoamniotic shunt was placed). All patients had genetic diagnosis: 5 had ACTG2 gene mutations and 1 MYH11 mutation. All patients were addressed to our attention for urinary symptoms, such as urinary retention, urinary tract infections, acute renal injury. Two patients presented frequent stoma prolapses. All children underwent a complete urological evaluation, and then started a bladder management protocol (clean intermittent catheterization, via urethra or cystostomy-tube placement), with improvement of urinary infections, upper urinary tract dilation and stoma prolapses, if present. All patients had good renal function at last follow-up. CONCLUSION: We believe that MMIHS patients must be addressed soon and before onset of symptoms for a multidisciplinary evaluation, including an early assessment by a pediatric urologist expert in functional disorder, to preserve renal function at its best.


Asunto(s)
Anomalías Múltiples , Colon , Colon/anomalías , Seudoobstrucción Intestinal , Vejiga Urinaria , Vejiga Urinaria/anomalías , Humanos , Femenino , Estudios Retrospectivos , Masculino , Anomalías Múltiples/cirugía , Colon/cirugía , Vejiga Urinaria/cirugía , Lactante , Seudoobstrucción Intestinal/cirugía , Seudoobstrucción Intestinal/diagnóstico , Recién Nacido , Preescolar , Mutación
11.
Asian J Endosc Surg ; 17(3): e13317, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38692582

RESUMEN

INTRODUCTION: Robot-assisted nephroureterectomy (RANU) for upper urinary tract urothelial carcinoma is typically performed via the transperitoneal approach because of limited surgical space. However, a retroperitoneal approach may be preferable in patients with a history of abdominal surgery or in those in whom pelvic lymph node dissection is unnecessary. MATERIALS AND SURGICAL TECHNIQUES: RANU via the retroperitoneal approach was selected for two patients diagnosed with high-grade upper urothelial carcinoma with a history of abdominal surgery. Nephrectomy was performed in the 90° flank position, and the bed was tilted at 20°. The retroperitoneal space was extended, and the robot trocar was subsequently repositioned in the left lower quadrant. After redocking the robot, the distal ureter was dissected, and the bladder cuff was resected en bloc along with the kidney and the ureter. Neither patient had any complications within 3 months postoperatively. DISCUSSION: By devising a new technique for trocar placement, total retroperitoneal RANU without repositioning was possible, even in a small patient.


Asunto(s)
Nefroureterectomía , Procedimientos Quirúrgicos Robotizados , Humanos , Procedimientos Quirúrgicos Robotizados/métodos , Espacio Retroperitoneal/cirugía , Nefroureterectomía/métodos , Masculino , Anciano , Neoplasias Ureterales/cirugía , Carcinoma de Células Transicionales/cirugía , Carcinoma de Células Transicionales/patología , Vejiga Urinaria/cirugía , Neoplasias Renales/cirugía , Neoplasias Renales/patología , Persona de Mediana Edad , Femenino
12.
Asian J Endosc Surg ; 17(3): e13315, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38689524

RESUMEN

INTRODUCTION: Despite a potential risk of bladder injury in laparoscopic hysterectomy (LH) and robot-assisted LH (RaLH), an intraoperative method for delineating the entire bladder with indocyanine green (ICG) has not been established. METHODS: We conducted a preliminary experiment using porcine bladders to verify the appropriate amount of ICG for intraoperative bladder visualization. Afterward, intraoperative bladder visualization was tried in LH and RaLH in two patients suspected of having adhesions around the bladder after previous abdominal surgery. RESULTS: Although near-infrared (NIR) fluorescence was well observed through the wall of the porcine bladder filled with ICG solution at a concentration of 0.024 mg/mL, the subsequent replacement of the ICG solution with saline made the NIR fluorescence brighter. In both patients, the bladder was successfully delineated by NIR fluorescence after filling the bladder with ICG solution and the subsequent washout with saline. CONCLUSION: The ICG-Washout method for locating the bladder by NIR fluorescence could be useful in LH and RaLH.


Asunto(s)
Colorantes , Histerectomía , Verde de Indocianina , Vejiga Urinaria , Femenino , Animales , Porcinos , Histerectomía/métodos , Vejiga Urinaria/cirugía , Humanos , Laparoscopía/métodos , Persona de Mediana Edad , Procedimientos Quirúrgicos Robotizados
14.
Mymensingh Med J ; 33(2): 461-465, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38557526

RESUMEN

Urothelial carcinoma (UC) is the most common malignancy of urinary bladder. It is the 9th leading cause of death worldwide and second most common genitourinary malignancy among male. Incidence is increasing in developing countries like Bangladesh. About 80% of patients are found between 50 to 80 years of age. It is 3-4 times more common in male than in female. Determination of therapeutic strategy and prediction of progression of urothelial carcinoma is a major clinical challenge. Treatment of urothelial carcinoma still now mostly depends on pathological stages. Amplification or genomic alteration of Cyclin D1 (a proto-oncogene) may cause protein overexpression which is frequently realized as a clonal pathology in various human neoplasms including bladder cancer. Evaluation of Cyclin D1 expression is promising for guiding therapeutic strategies, risk stratification and prediction of tumor progression. The aim of the study was to determine the expression of Cyclin D1 in urothelial carcinoma of urinary bladder and its association with tumour grade. This cross-sectional observational study was conducted in Department of Pathology, Dhaka Medical College, Dhaka, Bangladesh from July 2019 to June 2021. Histomorphologically diagnosed 51 urothelial carcinomas were included. Sections were stained with hematoxylin and eosin. Immunostaining with Cyclin D1 antibody was also done. Relevant information was collected and recorded in a predesigned data sheet. Statistical analysis was carried out as required. Mean age ±SD was 57.8±10.55 years. Male female ratio was 4.6:1. In this study 39(76.5%) patients were smoker. Regarding clinical presentations 36(70.6%) patients presented with painless hematuria alone. Lateral wall (64.7%) was the most frequent tumor location. Among 51 cases, 38(74.5%) cases were high grade urothelial carcinoma (HGUC) and 13(25.5%) cases were low grade urothelial carcinoma (LGUC). Considering Cyclin D1 expression, most of the LGUC cases showed high level of expression by both percentage (84.6%) and intensity (84.6%). Most of the HGUC cases showed low level of expression by both percentage (63.2%) and intensity (60.5%). Cyclin D1 showed significant inverse association with HGUC (p<0.05). In urothelial carcinoma of urinary bladder, Cyclin D1 expression was decreased with increasing grade of the tumor. Cyclin D1 expression was inversely associated with tumour grade.


Asunto(s)
Carcinoma de Células Transicionales , Neoplasias de la Vejiga Urinaria , Femenino , Humanos , Masculino , Bangladesh/epidemiología , Carcinoma de Células Transicionales/metabolismo , Carcinoma de Células Transicionales/patología , Estudios Transversales , Ciclina D1/metabolismo , Vejiga Urinaria/metabolismo , Vejiga Urinaria/patología , Neoplasias de la Vejiga Urinaria/metabolismo , Neoplasias de la Vejiga Urinaria/patología
15.
J Acoust Soc Am ; 155(4): 2492-2502, 2024 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-38587431

RESUMEN

The swim bladder in some teleost fish functions to transfer the sound energy of acoustic stimuli to the inner ears. This study uses the auditory evoked potential tests, micro-computed tomography scanning, reconstruction, and numerical modeling to assess the contribution of the swim bladder to hearing in crucian carp (Carassius carassius). The auditory evoked potential results show that, at the tested frequency range, the audiogram of fish with an intact swim bladder linearly increases, ranging from 100 to 600 Hz. Over this frequency, the sound pressure thresholds have a local lowest value at 800 Hz. The mean auditory threshold of fish with an intact swim bladder is lower than that of fish with a deflated swim bladder by 0.8-20.7 dB. Furthermore, numerical simulations show that the received pressure of the intact swim bladders occurs at a mean peak frequency of 826 ± 13.6 Hz, and no peak response is found in the deflated swim bladders. The increased sensitivity of reception in sound pressure and acceleration are 34.4 dB re 1 µPa and 40.3 dB re 1 m·s-2 at the natural frequency of swim bladder, respectively. Both electrophysiological measurement and numerical simulation results show that the swim bladder can potentially extend hearing bandwidth and further enhance auditory sensitivity in C. carassius.


Asunto(s)
Carpas , Animales , Vejiga Urinaria , Microtomografía por Rayos X , Audición , Pruebas Auditivas
16.
Zoolog Sci ; 41(1): 124-131, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38587525

RESUMEN

For adult anuran amphibians, the kidney and urinary bladder play important osmoregulatory roles through water reabsorption. In the present study, we have examined ontogenetic expression of aquaporins, i.e., AQP2, AQPamU (AQP6ub, AQPa2U), and AQP3, in these organs using the Japanese tree frog, Dryophytes japonicus. Immunohistochemistry using the metamorphosing larvae at stages 40-43 localized AQP2 protein to the collecting ducts in the dorsal zone of the mesonephric kidney. At prometamorphic stages 40 and 41, labelling of AQP2 protein was observed in the apical/ subapical regions of the collecting duct cells. At climax stages 42 and 43, labels for AQP2 and AQP3 became observed in the apical/subapical regions and basolateral membrane of the collecting duct cells, respectively, as seen in the adults. As for the urinary bladder, immuno-positive labels for AQPamU were localized to the apical/subapical regions of granular cells in the mucosal epithelium at stages 40-43. On the other hand, AQP3 immunoreactivity was hardly observed in the urinary bladder at stage 40, and weakly appeared in many granular cells at stage 41. Thereafter, labels for AQP3 became evident along the basolateral membrane of granular cells at stages 42 and 43, together with AQPamU in the apical/subapical regions. These results suggest that the kidney and urinary bladder might be capable of water reabsorption, via AQP2, AQPamU, and AQP3, at stage 42, contributing to the acclimation of the tree frogs to terrestrial environments.


Asunto(s)
Acuaporina 2 , Vejiga Urinaria , Animales , Japón , Anuros , Riñón , Agua
17.
PLoS One ; 19(4): e0301778, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38598450

RESUMEN

The urinary collecting system (UCS) consists of organized ducts that collect urine from the nephrons and transport it to the ureter and bladder. Understanding the histogenesis of the UCS is critical. Thirty human embryos between the Carnegie stages (CS) 18 and 23 were selected from the Congenital Anomaly Research Center, Kyoto, Japan. Epithelia of the UCS, ureter, and bladder of each sample were randomly selected. Histological findings of the epithelia were analyzed according to the following criteria: type of epithelium, presence or absence of glycogen, percentage of migrated nuclei, percentage of cells in mitosis, and the surrounding mesenchyme. A thickened epithelium lining a narrow luminal cavity was observed in the pre-expanded pelvic specimens at CS18-CS23. At CS23, after pelvic expansion, the UCS showed a thin epithelium with a large luminal cavity mainly located on the early branches, whereas the epithelium covering the subsequent branches had medium thickness. Histological characteristics differed depending on the UCS part and sample stage. The degree of differentiation was evaluated, revealing that in CS18-CS23 pre-expanded pelvis specimens, the undifferentiated epithelium was found in the zeroth to third/fifth generation, whereas at CS23, after pelvic expansion, a differentiated epithelium covered the UCS zeroth to seventh generation. In a comparison of the urothelial epithelium between the UCS, ureter, and bladder, we found that urinary tract differentiation may be initiated in the bladder, followed by the ureter, UCS zeroth to seventh generations, and finally, UCS eighth to end generations. An understanding of the histogenesis of embryonic stage UCS can aid in the clinical management of congenital urinary tract defects and other diseases.


Asunto(s)
Uréter , Sistema Urinario , Humanos , Embrión de Mamíferos , Vejiga Urinaria , Urotelio/patología
18.
Rev Esp Patol ; 57(2): 116-119, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38599730

RESUMEN

A 62-year-old male presented with pain and haematuria starting 3 months before. The computed tomography showed focal and mural bladder thickening with ureteropelvic dilatation. The following transurethral bladder resection revealed a high-grade muscle-invasive urothelial carcinoma. In the subsequent cystoprostatectomy we found the same tumour, but adding focal tumour-associated stromal osseous metaplasia. Ossifying metaplasia is an extremely rare feature in urothelial carcinoma, with a few reported cases and represents a diagnostic challenge, mimicking radiotherapy-induced sarcoma or sarcomatoid carcinoma.


Asunto(s)
Carcinoma de Células Transicionales , Neoplasias de la Vejiga Urinaria , Masculino , Humanos , Persona de Mediana Edad , Neoplasias de la Vejiga Urinaria/patología , Carcinoma de Células Transicionales/patología , Vejiga Urinaria/patología , Cistectomía , Metaplasia/patología
19.
Acute Med ; 23(1): 37-42, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38619168

RESUMEN

Nursing staff, healthcare assistants (HCAs) and other healthcare professionals on the Acute Medical Unit (AMU) at Royal Berkshire Hospital (RBH) were taught a Point of Care Ultrasound (POCUS) skill during a twenty minute session. Practitioners learned how to take bladder volume measurements with the Butterfly iQ, a portable ultrasound device which provides a visually-aided method of volume measurement. A Likert scale was used to measure the confidence that staff had in performing volume measurements with the AMU automated scanners, and with the semi-automated Butterfly iQ. After the teaching session, confidence reported by practitioners in using the semi-automated visual method was significantly higher than confidence reported in using the automated non-visual scanners (t < 0.001). Minimal time and expense was required to teach practitioners how to perform this skill. Training nurses in POCUS for bladder visualisation and bladder volume calculation is easy and practicable.


Asunto(s)
Sistemas de Atención de Punto , Vejiga Urinaria , Humanos , Vejiga Urinaria/diagnóstico por imagen , Aprendizaje , Hospitales , Pruebas en el Punto de Atención
20.
J Pak Med Assoc ; 74(3): 513-518, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38591289

RESUMEN

Objective: To evaluate long-term outcomes in patients homogenously treated with radical cystectomy and ileal conduit for muscle invasive bladder cancer. METHODS: The retrospective study was conducted at the Urology Department of Pakistan Kidney and Liver Institute and Research Centre, Lahore, Pakistan, and comprised data from December 25, 2017, to January 16, 2023, related to patients who underwent radical cystectomy with ileal conduit with or without neo-adjuvant and adjuvant radiation, chemotherapy, or immunotherapy for papillary urothelial carcinom of the bladder. Clinical trajectory, histopathological characteristics and long-term clinical outcomes were noted. Data was analysed using SPSS 20. RESULTS: In our study of 40 patients with muscle invasive bladder cancer, males predominated (32, 80%), with a median age of 57.4 years (IQR: 29-80). Diagnosis was early in 5 (12.5%) patients with varying haematuria durations, while 34 (85%) patients had a smoking history. Comorbidities included hypertension in 17 (42.5%) patients, diabetes in 1 (2.5%) patient, both hypertension and diabetes in 9 (22.5%) patients and a combination of hypertension, diabetes, and ischaemic heart disease in 3 (7.5%) patients. Transurethral resection was performed once in 13 (32.5%) patients and multiple times in 27 (67.5%) patients. Additionally, 5 (12.5%) patients received immunotherapy, 11 (27.5%) patients underwent non-adjuvant radiation, and 14 (35%) patients received non-adjuvant chemotherapy. Papillary urothelial carcinoma was the predominant histological subtype among 37 (92.5%) patients. Patients receiving chemotherapy had significantly better overall survival (p=0.02). No significant differences were noted in recurrence or survival by therapy modality (p>0.05). These findings highlight the significance of early diagnosis, tailored treatments, and comorbidity management in muscle invasive bladder cancer patients. Age stratification revealed significant survival differences across groups (χ²=10.923, df=3, p= 0.012). Analysis by complications did not show age-related survival variations (χ² =3.978, df = 3, p=0.264). Conclusion: Achieving excellent long-term survival in MIBC patients requires a multidisciplinary approach, emphasizing early diagnosis, tailored treatment, and adherence to guidelines and protocols.


Asunto(s)
Carcinoma de Células Transicionales , Diabetes Mellitus , Hipertensión , Neoplasias de la Vejiga Urinaria , Derivación Urinaria , Masculino , Humanos , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Neoplasias de la Vejiga Urinaria/cirugía , Neoplasias de la Vejiga Urinaria/diagnóstico , Cistectomía/métodos , Vejiga Urinaria/patología , Carcinoma de Células Transicionales/cirugía , Estudios Retrospectivos , Músculos/patología , Resultado del Tratamiento , Invasividad Neoplásica/patología
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