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Sample records for bladder replacement clinical

  1. Detublarized Sigmoid Colon for Total Urinary Bladder Replacement: Clinical Outcome in 51 Patients

    International Nuclear Information System (INIS)

    The technique and results of a detublarized sigmoid neo bladder for total urinary bladder substitution after radical cystectomy is described. Methods: Fifty one patients (44 men and 7 women) having a mean age of 46 (range, 32-61 years). Radical cysto prostatectomy was performed for the male patients and anterior pelvic exenteration for the female patients. This was followed by total replacement of the bladder with a detubularized sigmoid colon. They were selected to have invasive bladder cancer away from the bladder neck. The mean follow-up period was 38.8 months (range 8-96). Blood chemistry was analyzed periodically every month during the follow-up period. Early and late complications, continence and voiding pattern were recorded. Urodynamic studies were performed every 6 months. Early postoperative complications included, urinary leakage in 7 patients (14%); wound infection in II patients (22%), deep venous thrombosis of the lower extremities in one patient (2%). Late complications included stenosis of the ureterointestinal anastomosis in one patient (2%), stenosis of urethral anastomosis in one patient (2%). A reservoir stone occurred in one patient (2%). No metabolic acidosis nor vitamin B 12 deficiency was reported. The upper urinary tract function was either improved or stable in 96% of cases. However, deterioration occurred in only 4% of cases. All patients could void voluntery without catheterization. Patient satisfaction for continence, by daytime and nighttime (nocturnal continence), was 86% and 72%, respectively. The mean neo bladder capacity and mean residual urine volume was 463.8 ml (range, 275-603) and 93.7 ml (range 50-189), respectively. Pressure flow analysis showed that the mean basal pressure was 5.1 cm H2O (range, 1-18) and the mean pressure at maximal capacity was 37.4 cm H2O (range, 1-73). The mean maximal flow rate was 17.8 ml/sec (range 3.1-24.5), the mean average flow rate was 11.4 ml/sec. (range 1.9-14.6). The mean first sensation volume

  2. Interstitial cystitis/bladder pain syndrome and glycosaminoglycans replacement therapy

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    Cervigni, Mauro

    2015-01-01

    Interstitial cystitis/bladder pain syndrome (IC/BPS) is a debilitating chronic disease characterized by discomfort or recurrent abdominal and pelvic pains in the absence of urinary tract infections. Its symptomatology includes discomfort, increased bladder pressure, sensitivity and intense pain in the bladder and pelvic areas, increased voiding frequency and urgency, or a combination of these symptoms. For these reasons, this pathology has a very negative impact on quality of life. The etiolo...

  3. Interstitial cystitis/bladder pain syndrome and glycosaminoglycans replacement therapy.

    Science.gov (United States)

    Cervigni, Mauro

    2015-12-01

    Interstitial cystitis/bladder pain syndrome (IC/BPS) is a debilitating chronic disease characterized by discomfort or recurrent abdominal and pelvic pains in the absence of urinary tract infections. Its symptomatology includes discomfort, increased bladder pressure, sensitivity and intense pain in the bladder and pelvic areas, increased voiding frequency and urgency, or a combination of these symptoms. For these reasons, this pathology has a very negative impact on quality of life. The etiology of IC/BPS is still not well understood and different hypotheses have been formulated, including autoimmune processes, allergic reactions, chronic bacterial infections, exposure to toxins or dietary elements, and psychosomatic factors. The finding of an effective and specific therapy for IC/BPS remains a challenge for the scientific community because of the lack of a consensus regarding the causes and the inherent difficulties in the diagnosis. The last recent hypothesis is that IC/BPS could be pathophysiologically related to a disruption of the bladder mucosa surface layer with consequent loss of glycosaminoglycans (GAGs). This class of mucopolysaccharides has hydrorepellent properties and their alteration expose the urothelium to many urinary toxic agents. It has been hypothesized that when these substances penetrate the bladder wall a chain is triggered in the submucosa. In order to improve the integrity and function of the bladder lining, GAG layer replenishment therapy is widely accepted as therapy for patients with IC/BPS who have poor or inadequate response to conventional therapy. Currently, Chondroitin sulfate (CS), heparin, hyaluronic acid (HA), and pentosan polysulphate (PPS), and combinations of two GAGs (CS and HA) are the available substances with different effectiveness rates in patients with IC/BPS. There are four different commercially available products for GAG replenishment including CS, heparin, HA and PPS. Each product has different concentrations and

  4. Expression of VEGF and collagen using a latex biomembrane as bladder replacement in rabbits

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    André Luís Alonso Domingos

    2012-08-01

    Full Text Available OBJECTIVE: To investigate the VEGF expression and collagen deposition using a latex biomembrane as bladder replacement in rabbits. MATERIALS AND METHODS: After partial cystectomy, a patch of a non-vulcanized latex biomembrane (2 x 2 cm was sewn to the bladder of rabbits with 5/0 monofilament polydioxanone sulfate sutures in a watertight manner. Groups of 5 animals were killed at 15, 45 and 90 days after surgery and the bladder was removed. Sections of 5µm were cut and stained with picrosirius-red in order to estimate the amount of extracellular matrix in the graft. To confirm the presence of VEGF in tissues, protein expression was determined by immunohistochemistry. RESULTS: No death, urinary leakage or graft extrusion occurred in any group. All bladders showed a spherical shape. A progressive reduction in the amount of collagen occurred in the graft area and was negatively and linearly correlated with time (p < 0.001. VEGF expression was higher in grafted areas when compared to controls at 15 and 45 days after surgery and decreased with time (p < 0.001. CONCLUSION: The latex biomembrane as a matrix for partial bladder replacement in rabbits promotes temporary collagen deposition and stimulates the angiogenic process.

  5. Use of gastric segment in urinary bladder replacement after total cystectomy

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    Stijelja Borislav

    2006-01-01

    Full Text Available Drainage of urine by abnormal way is urinary derivation. Various forms of urinary derivations are available for urinary bladder replacement after radical cystectomy for invasive bladder tumor. Construction of continent urinary reservoir, so called pouch, from different bowel segments is named continent urinary derivations. If such urinary reservoir is connected with urethra, then it is about orthotopic derivation and reservoir is defined as neobladder. Upon satisfactory results of introduction of continent urinary derivations with Mainz pouch I and Orthotopic Mainz pouch, we performed continent orthotopic urine derivation with isolated gastric segment in 74-year old male patient who had previously undergone radical cystoprostatectomy because of the invasive urothelial cancer of the urinary bladder. Even though there were no major surgical complications in the near postoperative course, the patient had to be operated ten months later for ileus; 20 months after the procedure, significant loss of neobladder capacity, bilateral vesicoureteral reflux, persistent urinary infection and incipient renal failure were manifested. In the further course, reoperation was needed and neobladder augmentation by ileal pouch along with both ureteral reimplantations into the pouch wall was carried out. After this reintervention, the patient was alive in the following three years with satisfactory quality of life and preserved renal function. Our conclusion is that gastric neobladder should not be the first method of choice for urinary bladder replacement after radical cystectomy in older patients.

  6. [Follow-up after surgical replacement of the urinary bladder (urinary diversion)].

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    Ubrig, B; Kories, C; Roth, S

    2013-01-01

    Surgical replacement of the urinary bladder is usually necessary after radical cystectomy for muscle invasive bladder cancer. Besides uro-oncological follow-up (local, urethral, and systemic recurrence; tumor in the upper tract) functional follow-up of the urinary diversion is indicated. Guidelines are still scarce. Long contact time and large surface area in continent pouches made from long intestinal segments lead to absorption of contents of urine and thus to acidosis and imbalances in serum electrolytes. Compensation depends on renal function. Exclusion of long ileal segments out of the intestinal passage may lead to malabsorption of Vitamin B12 and bile acids. 30 % and more of long-term survivors with continent pouches take Vitamin B12 and sodium bicarbonate. Special attention has to be paid to obstruction of the upper urinary tract, total renal function and to secondary malignancy in the bladder substitute. For the latter, sigma-rectum pouches, augmentation cystoplasties and continent pouches with incorporation of colonic segments are at special risk. Functional follow-up affords good understanding of the specific complications of the different types of urinary diversions. PMID:23386377

  7. Whyever bladder tissue engineering clinical applications still remain unusual even though many intriguing technological advances have been reached?

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    ALBERTI, C.

    2016-01-01

    To prevent problematic outcomes of bowel-based bladder reconstructive surgery, such as prosthetic tumors and systemic metabolic complications, research works, to either regenerate and strengthen failing organ or build organ replacement biosubstitute, have been turned, from 90s of the last century, to both regenerative medicine and tissue engineering. Various types of acellular matrices, naturally-derived materials, synthetic polymers have been used for either “unseeded” (cell free) or autologous “cell seeded” tissue engineering scaffolds. Different categories of cell sources – from autologous differentiated urothelial and smooth muscle cells to natural or laboratory procedure-derived stem cells – have been taken into consideration to reach the construction of suitable “cell seeded” templates. Current clinically validated bladder tissue engineering approaches essentially consist of augmentation cystoplasty in patients suffering from poorly compliant neuropathic bladder. No clinical applications of wholly tissue engineered neobladder have been carried out to radical-reconstructive surgical treatment of bladder malignancies or chronic inflammation-due vesical coarctation. Reliable reasons why bladder tissue engineering clinical applications so far remain unusual, particularly imply the risk of graft ischemia, hence its both fibrous contraction and even worse perforation. Therefore, the achievement of graft vascular network (vasculogenesis) could allow, together with the promotion of host surrounding vessel sprouting (angiogenesis), an effective graft blood supply, so avoiding the ischemia-related serious complications. PMID:27142819

  8. Clinical pitfalls in diagnosis of nonmuscle-invasive bladder cancer.

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    Serretta, Vincenzo; Scalici Gesolfo, Cristina

    2015-10-01

    Current global economic crisis imposes healthcare system to reduce unnecessary investigations and increase early detection of tumors, to decrease the costs of an advanced disease. Several diagnostic pitfalls may occur dealing with bladder cancer (BC), particularly in nonmuscle-invasive (NMIBC) one. Hematuria, the commonest sign in NMIBC, is often underestimated. Urinary cytology is highly specific for high-grade tumors, but has a low sensitivity for low-grade BC, is operator dependent, and not always obtainable in clinical practice. Numerous urinary tests are available to ameliorate the accuracy of cytology, but none of them is routinly used in urological practice. Ultrasound could hardly detect a small bladder tumor, especially if located in the bladder neck or in the anterior wall. Computed tomography (CT) is widely adopted as an alternative to conventional urography, but its usefulness in patients with hematuria is still debated. MRI has a higher accuracy than CT for staging BC and evaluate the bladder-wall invasion. A negative cystoscopy cannot exclude Tis and should be accompanied by urinary cytology in patients with suspected Tis or high-risk NMIBC; however, new techniques such as narrow band imaging (NBI) and photodynamic (PDD) increase the detection rate of BC and flat lesions. Nearly half of all diagnostic resections present omission of muscle in the specimen or its mention in the pathology report, which is associated with an increased mortality. An adequate muscle sampling during endoscopic resection is mandatory, particularly in patients with high-grade disease. Recognition of pitfalls in diagnosis and management of BC represents the first step for a correct approach. PMID:26481718

  9. Clinical guidelines for interstitial cystitis and hypersensitive bladder updated in 2015.

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    Homma, Yukio; Ueda, Tomohiro; Tomoe, Hikaru; Lin, Alex Tl; Kuo, Hann-Chorng; Lee, Ming-Huei; Oh, Seung-June; Kim, Joon Chul; Lee, Kyu-Sung

    2016-07-01

    Clinical guidelines for interstitial cystitis and hypersensitive bladder have been updated as of 2015. The guidelines define interstitial cystitis by the presence of hypersensitive bladder symptoms (discomfort, pressure or pain in the bladder usually associated with urinary frequency and nocturia) and bladder pathology, after excluding other diseases explaining symptoms. Interstitial cystitis is further classified by bladder pathology; either Hunner type interstitial cystitis with Hunner lesions or non-Hunner type interstitial cystitis with mucosal bleeding after distension in the absence of Hunner lesions. Hypersensitive bladder refers to a condition, where hypersensitive bladder symptoms are present, but bladder pathology or other explainable diseases are unproven. Interstitial cystitis and hypersensitive bladder severely affect patients' quality of life as a result of disabling symptoms and/or comorbidities. Reported prevalence suggestive of these disorders varies greatly from 0.01% to >6%. Pathophysiology would be an interaction of multiple factors including urothelial dysfunction, inflammation, neural hyperactivity, exogenous substances and extrabladder disorders. Definite diagnosis of interstitial cystitis and hypersensitive bladder requires cystoscopy with or without hydrodistension. Most of the therapeutic options lack a high level of evidence, leaving a few as recommended therapeutic options. PMID:27218442

  10. Clinical significance of transurethral tru-cut biopsy in confirmation of bladder tumor invasive character

    International Nuclear Information System (INIS)

    The objective of this study was to evaluate the feasibility of resection (TURBT) replacement in patients with strong suspicion of invasive bladder tumor by transurethral tru-cut biopsy carried out during cystoscopy. Fifty-eight patients (52 men and six women; mean age 65 years, range 43-79) presenting with extensive bladder tumor suggested by ultrasound and computed tomography were included in the study. Each patient was submitted to transurethral, cystoscopically-guided tru-cut biopsy of bladder tumor before the planned TURBT. Comparison of histopathological assessment of tissue cores, resection and radical cystectomy specimens was carried out. Histopathological analysis of resection specimens and tissue cores were in complete accordance with previous tissue cores assessment in terms of type and grade of bladder cancer. Histological type of bladder tumor revealed by tru-cut biopsy and radical cystectomy was identical in 56 (96.6%) cases. Tumor grade was the same in biopsy cores and radical cystectomy specimens in 55 (95%) cases. Endoscopic tru-cut bladder tumor biopsy allows us to collect sufficient amounts of tissue material for histopathological confirmation of detrusor muscle infiltration in patients presenting with bladder tumors suspected to cause muscle invasiveness. The procedure is carried out under cystoscopic control and is fast, efficient, safe, easy to perform and less invasive than standard TURB in cases of an extensive bladder tumor. (author)

  11. Cool and menthol receptor TRPM8 in human urinary bladder disorders and clinical correlations

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    Benham Christopher D

    2006-03-01

    Full Text Available Abstract Background The recent identification of the cold-menthol sensory receptor (TRPM8; CMR1, provides us with an opportunity to advance our understanding of its role in the pathophysiology of bladder dysfunction, and its potential mediation of the bladder cooling reflex. In this study, we report the distribution of the cool and menthol receptor TRPM8 in the urinary bladder in patients with overactive and painful bladder syndromes, and its relationship with clinical symptoms. Methods Bladder specimens obtained from patients with painful bladder syndrome (PBS, n = 16, idiopathic detrusor overactivity (IDO, n = 14, and asymptomatic microscopic hematuria (controls, n = 17, were immunostained using specific antibodies to TRPM8; nerve fibre and urothelial immunostaining were analysed using fibre counts and computerized image analysis respectively. The results of immunohistochemistry were compared between the groups and correlated with the Pain, Frequency and Urgency scores. Results TRPM8-immunoreactive staining was observed in the urothelium and nerve fibres scattered in the suburothelium. The nerve fibre staining was seen in fine-calibre axons and thick (myelinated fibres. There was marked increase of TRPM8-immunoreactive nerve fibres in IDO (P = 0.0249 and PBS (P Conclusion This study demonstrates increased TRPM8 in nerve fibres of overactive and painful bladders, and its relationship with clinical symptoms. TRPM8 may play a role in the symptomatology and pathophysiology of these disorders, and may provide an additional target for future overactive and painful bladder pharmacotherapy.

  12. Prospective Clinical Trial of Bladder Filling and Three-Dimensional Dosimetry in High-Dose-Rate Vaginal Cuff Brachytherapy

    International Nuclear Information System (INIS)

    Purpose: To investigate the effect of bladder filling on dosimetry and to determine the best bladder dosimetric parameter for vaginal cuff brachytherapy. Methods and Materials: In this prospective clinical trial, a total of 20 women underwent vaginal cylinder high-dose-rate brachytherapy. The bladder was full for Fraction 2 and empty for Fraction 3. Dose-volume histogram and dose-surface histogram values were generated for the bladder, rectum, and urethra. The midline maximal bladder point (MBP) and the midline maximal rectal point were recorded. Paired t tests, Pearson correlations, and regression analyses were performed. Results: The volume and surface area of the irradiated bladder were significantly smaller when the bladder was empty than when full. Of the several dose-volume histogram and dose-surface histogram parameters evaluated, the bladder maximal dose received by 2 cm3 of tissue, volume of bladder receiving ≥50% of the dose, volume of bladder receiving ≥70% of the dose, and surface area of bladder receiving ≥50% of the dose significantly predicted for the difference between the empty vs. full filling state. The volume of bladder receiving ≥70% of the dose and the maximal dose received by 2 cm3 of tissue correlated significantly with the MBP. Bladder filling did not alter the volume or surface area of the rectum irradiated. However, an empty bladder did result in the nearest point of bowel being significantly closer to the vaginal cylinder than when the bladder was full. Conclusions: Patients undergoing vaginal cuff brachytherapy treated with an empty bladder have a lower bladder dose than those treated with a full bladder. The MBP correlated well with the volumetric assessments of bladder dose and provided a noninvasive method for reporting the MBP dose using three-dimensional imaging. The MBP can therefore be used as a surrogate for complex dosimetry in the clinic

  13. Postmenopausal hormone replacement therapy--clinical implications

    DEFF Research Database (Denmark)

    Ravn, S H; Rosenberg, J; Bostofte, E

    1994-01-01

    The menopause is defined as cessation of menstruation, ending the fertile period. The hormonal changes are a decrease in progesterone level, followed by a marked decrease in estrogen production. Symptoms associated with these hormonal changes may advocate for hormonal replacement therapy. This...... review is based on the English-language literature on the effect of estrogen therapy and estrogen plus progestin therapy on postmenopausal women. The advantages of hormone replacement therapy are regulation of dysfunctional uterine bleeding, relief of hot flushes, and prevention of atrophic changes in...... the urogenital tract. Women at risk of osteoporosis will benefit from hormone replacement therapy. The treatment should start as soon after menopause as possible and it is possible that it should be maintained for life. The treatment may be supplemented with extra calcium intake, vitamin D, and maybe...

  14. A study of brain MRI findings and clinical response of bladder empting failure in brain bladder

    Energy Technology Data Exchange (ETDEWEB)

    Miyakoda, Keiichi (Yamashina Aiseikai Hospital, Kyoto (Japan)); Watanabe, Kousuke

    1993-02-01

    In 45 patients (38 males and 7 females; average age:78 years) with brain bladder, who did not have any peripheral neuropathies and spinal disturbance, cerebral findings of MRI (1.5 T) T[sub 2] enhanced image were analyzed in comparison with those of 7 control patients with normal urination after BPH operations. Patients with neurogenic bladder were divided into three groups as follows: 33 patients with a chief complaint of urinary disturbance (Group I), 9 patients with urinary incontinence (Group II) and 3 patients with balanced bladder (Group III). High frequency of lacune (24%) of the globus pallidus and low signalling of the corpus striatum (30%) was found in Group I patients, but low frequency in other Group patients and control patients. Furthermore, pathologic changes with various grades in the globus pallidus were observed in 91% of Group I patients. In the treatment of urinary disturbance, a high improvement rate of micturition disorder (77%) was obtained in patients treated with a combination of dantrolene and TURp (TUIbn for females). However, patients who had clear lacune of the globus pallidus showed the low improvement rate. It should be possible that the globus pallidus contributes to control the movement of the external sphincter and the pelvic base muscles as well as other striated muscles. Moreover, lacune was rarely found in the urination center of the brain-stem on MRI. (author).

  15. [Inhibitory effect of Chinese herb medicine zhuling on urinary bladder cancer. An experimental and clinical study].

    Science.gov (United States)

    Yang, D A

    1991-06-01

    Inhibitory effect of Zhuling (Grifola umbellata pilat) on urinary bladder cancer was determined experimentally and clinically. The results showed that zhuling inhibited significantly the induction of bladder cancer in rats exposed to N-butyl-N-(4-hydroxybutyl) nitrosamine (BBN), decreasing from 100% (18/18) in control group to 61.1% (11/18) in zhuling (P less than 0.01). Zhuling was given to 22 patients with recurrent bladder cancer after TUR or partial cystectomy. The patients were followed up for 12 to 38 months (average 26.5 months). Bladder cancer recurred in seven of the patients with a longer recurrence interval (19.2 months) after medication than before medication (P less than 0.05). The remaining 15 patients had no recurrence. The mechanism of Zhuling is discussed. PMID:1935440

  16. Clinical outcome of primary small cell carcinoma of the urinary bladder

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    Hou CP

    2013-08-01

    Full Text Available Chen-Pang Hou,1,2 Yu-Hsiang Lin,1,2 Chien-Lun Chen,1,2 Phei-Lang Chang,1,2 Ke-Hung Tsui1,2 1Department of Urology, Chang Gung Memorial Hospital-Linko, Taiwan, Republic of China; 2College of Medicine, Chang Gung University, Taiwan, Republic of China Purpose: Primary small cell carcinoma of the urinary bladder is a rare malignant disease. It accounts for less than 1% of all urinary bladder carcinomas. The purpose of this study is to review the clinical features, the treatment modalities, and the overall survival of these patients. We also compare the clinical outcomes between patients of bladder small cell carcinoma (SCC and bladder urothelial carcinoma (UC. Materials and methods: We reviewed the charts of patients with bladder tumors from January 1995 to December 2012 in the Chang Gung Memorial Hospital. A total of 2421 malignant bladder tumor patients were reviewed and there were 18 patients who were diagnosed with primary bladder SCC. The patients' characteristics, including age, gender, smoking history, presented symptoms, tumor size, locations, clinical stages, treatment modalities, pathology appearance, recurrence conditions, and survival conditions were all recorded. We also compared the clinical outcomes and the overall survival rates between patients with bladder SCC and those with UC. Results: Bladder SCC accounted for about 0.74% of all bladder malignancies in our institution. The mean age at diagnosis was 70.67 years, and the male-to-female ratio was 2.6:1. Thirteen patients had a history of cigarette smoking. All patients presented with symptoms of gross hematuria, and three of them had bladder tamponade requiring blood clot evacuation by cystoscopy. Only one patient had T1 disease, ten patients had stage III disease, and seven patients had lymph node or distant metastasis (stage IV disease. The mean tumor size was 4.29 cm in diameter. For the majority (61.11% of patients, SCC coexisted with UC components. The average survival time

  17. Agonist Replacement for Stimulant Dependence: A Review of Clinical Research

    OpenAIRE

    Stoops, William W.; Rush, Craig R.

    2013-01-01

    Stimulant use disorders are an unrelenting public health concern worldwide. Agonist replacement therapy is among the most effective strategies for managing substance use disorders including nicotine and opioid dependence. The present paper reviewed clinical data from human laboratory self-administration studies and clinical trials to determine whether agonist replacement therapy is a viable strategy for managing cocaine and/or amphetamine use disorders. The extant literature suggests that ago...

  18. Overactive bladder, differential diagnosis, and clinical utility of fesoterodine

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    Wyndaele J-J

    2012-11-01

    Full Text Available Jean-Jacques WyndaeleDepartment of Urology, Antwerp University, Antwerp, BelgiumAbstract: Overactive bladder is a symptom syndrome with urgency, frequency and, in many cases, nocturia. Urge incontinence is not present in all. There is no direct correlation with detrusor overactivity, an objective finding during urodynamic testing where involuntary contractions can be noticed. In the pathophysiology, much more attention has been given to the afferent/sensory arm of the micturition reflex in the last decade. Anatomical and infectious causes have to be diagnosed or ruled out. Diagnosis of overactive bladder is made mostly by history-taking, but other tests can be necessary in specific patients. Treatment consists of behavioral measures, a good explanation of the condition, training, and pelvic floor physiotherapy. Drugs are often used. Until recently, antimuscarinic drugs have been the mainstay of pharmacological therapy. Fesoterodine is a newer antimuscarinic agent which is more pharmacodynamically stable then tolterodine. Fesoterodine has been extensively researched using different dosages and compared with placebo and tolterodine, in different age groups, and under different conditions. Fesoterodine is superior to placebo and to tolterodine in the short term and long term. Its safety is very acceptable.Keywords: overactive bladder, fesoterodine, incontinence, urgency, lower urinary tract

  19. Bladder Carcinoma Data with Clinical Risk Factors and Molecular Markers: A Cluster Analysis

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    Enrique Redondo-Gonzalez

    2015-01-01

    Full Text Available Bladder cancer occurs in the epithelial lining of the urinary bladder and is amongst the most common types of cancer in humans, killing thousands of people a year. This paper is based on the hypothesis that the use of clinical and histopathological data together with information about the concentration of various molecular markers in patients is useful for the prediction of outcomes and the design of treatments of nonmuscle invasive bladder carcinoma (NMIBC. A population of 45 patients with a new diagnosis of NMIBC was selected. Patients with benign prostatic hyperplasia (BPH, muscle invasive bladder carcinoma (MIBC, carcinoma in situ (CIS, and NMIBC recurrent tumors were not included due to their different clinical behavior. Clinical history was obtained by means of anamnesis and physical examination, and preoperative imaging and urine cytology were carried out for all patients. Then, patients underwent conventional transurethral resection (TURBT and some proteomic analyses quantified the biomarkers (p53, neu, and EGFR. A postoperative follow-up was performed to detect relapse and progression. Clusterings were performed to find groups with clinical, molecular markers, histopathological prognostic factors, and statistics about recurrence, progression, and overall survival of patients with NMIBC. Four groups were found according to tumor sizes, risk of relapse or progression, and biological behavior. Outlier patients were also detected and categorized according to their clinical characters and biological behavior.

  20. Clinical outcome of primary small cell carcinoma of the urinary bladder

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    Hou CP; Lin YH; Chen CL; Chang PL; Tsui KH

    2013-01-01

    Chen-Pang Hou,1,2 Yu-Hsiang Lin,1,2 Chien-Lun Chen,1,2 Phei-Lang Chang,1,2 Ke-Hung Tsui1,2 1Department of Urology, Chang Gung Memorial Hospital-Linko, Taiwan, Republic of China; 2College of Medicine, Chang Gung University, Taiwan, Republic of China Purpose: Primary small cell carcinoma of the urinary bladder is a rare malignant disease. It accounts for less than 1% of all urinary bladder carcinomas. The purpose of this study is to review the clinical features, the treatment modalities, and th...

  1. Clinical outcome of primary small cell carcinoma of the urinary bladder

    OpenAIRE

    Tsui, Ke-Hung

    2013-01-01

    Chen-Pang Hou,1,2 Yu-Hsiang Lin,1,2 Chien-Lun Chen,1,2 Phei-Lang Chang,1,2 Ke-Hung Tsui1,2 1Department of Urology, Chang Gung Memorial Hospital-Linko, Taiwan, Republic of China; 2College of Medicine, Chang Gung University, Taiwan, Republic of China Purpose: Primary small cell carcinoma of the urinary bladder is a rare malignant disease. It accounts for less than 1% of all urinary bladder carcinomas. The purpose of this study is to review the clinical features, the treatment modalities, and t...

  2. SOX4 expression in bladder carcinoma: clinical aspects and in vitro functional characterization

    DEFF Research Database (Denmark)

    Jensen, Mads Aaboe; Birkenkamp-Demtröder, Karin; Wiuf, Carsten;

    2006-01-01

    The human transcription factor SOX4 was 5-fold up-regulated in bladder tumors compared with normal tissue based on whole-genome expression profiling of 166 clinical bladder tumor samples and 27 normal urothelium samples. Using a SOX4-specific antibody, we found that the cancer cells expressed the...... strongly impaired cell viability and promoted apoptosis. To characterize downstream target genes and SOX4-induced pathways, we used a time-course global expression study of the overexpressed SOX4. Analysis of the microarray data showed 130 novel SOX4-related genes, some involved in signal transduction (MAP...

  3. Clinical impact of bladder biopsies with TUR-BT according to cytology results in patients with bladder cancer: a case control study

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    Matsumoto Kazuhiro

    2010-06-01

    Full Text Available Abstract Background There seems to be no consensus concerning taking bladder biopsies during transurethral resection of bladder tumor (TUR-BT. We investigate the clinical significance of bladder biopsy with TUR-BT and the relationship between urinary cytology and the biopsy results. Methods We reviewed a total of 424 patients with non-muscle invasive bladder cancer treated with TUR-BT between 1998 and 2005. Of the total, 293 patients also underwent a bladder biopsy. Biopsies from suspicious-appearing urothelium (N = 59 and those from normal-appearing urothelium (N = 234 were evaluated separately. Results Bladder cancer was observed in 23 cases (39.0% who underwent a biopsy of suspicious-appearing urothelium. Among these 23 cases, 9 cases with visible tumor resection had carcinoma in situ (CIS only in the biopsies from suspicious-appearing urothelium. Urinary cytology was negative in 3 of the 9 cases. Bladder cancer was observed in 26 cases (11.1% who underwent a biopsy of normal-appearing urothelium. Of them, 5 cases with visible tumors had CIS only in the multiple biopsies from normal-appearing urothelium. Urinary cytology was positive in all of the 5 cases. No upstaging or upgrading cases were found in these patients by the addition of these two types of biopsy. Furthermore, therapy was not altered in these patients. With or without bladder biopsy was not a significant factor for tumor recurrence in either the univariate or multivariate analysis. Conclusions Based on the results, it is concluded the multiple biopsies from normal-appearing urothelium are not necessary in patients with negative cytology results because of the low detection rate and lack of influence on therapeutic decisions. Meanwhile, biopsy of suspicious-appearing urothelium is needed in patients with negative cytology results in order to detect CIS due to staging properties. This result supports a recent EAU guideline.

  4. Physical and clinical implications of radiotherapy treatment of prostate cancer using a full bladder protocol

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    Cambria, Raffaella; Cattani, Federica; Luraschi, Rosa; Pedroli, Guido [Istituto Europeo di Oncologia, Milan (Italy). Dept. of Medical Physics; Jereczek-Fossa, Barbara A.; Orecchia, Roberto [Istituto Europeo di Oncologia, Milan (Italy). Dept. of Radiation Oncology; Univ. degli Studi of Milano, Milan (Italy); Zerini, Dario [Istituto Europeo di Oncologia, Milan (Italy). Dept. of Radiation Oncology; Serafini, Flavia [Unita operativa di radioterapia, Azienda Ospedaliera Sant' Anna, Como (Italy)

    2011-12-15

    To assess the dosimetric and clinical implication when applying the full bladder protocol for the treatment of the localized prostate cancer (PCA). A total of 26 consecutive patients were selected for the present study. Patients underwent two series of CT scans: the day of the simulation and after 40 Gy. Each series consisted of two consecutive scans: (1) full bladder (FB) and (2) empty bladder (EB). The contouring of clinical target volumes (CTVs) and organs at risk (OAR) were compared to evaluate organ motion. Treatment plans were compared by dose distribution and dose-volume histograms (DVH). CTV shifts were negligible in the laterolateral and superior-inferior directions (the maximum shift was 1.85 mm). Larger shifts were recorded in the anterior-posterior direction (95% CI, 0.83-4.41 mm). From the dosimetric point of view, shifts are negligible: the minimum dose to the CTV was 98.5% (median; 95%CI, 95-99%). The potential advantage for GU toxicity in applying the FB treatment protocol was measured: the ratio between full and empty bladder dose-volume points (selected from our protocol) is below 0.61, excluding the higher dose region where DVHs converge. Having a FB during radiotherapy does not affect treatment effectiveness, on the contrary it helps achieve a more favorable DVH and lower GU toxicities.

  5. Pain during ice water test distinguishes clinical bladder hypersensitivity from overactivity disorders

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    Bountra Chas

    2006-12-01

    Full Text Available Abstract Background The Bladder cooling reflex (BCR i.e. uninhibited detrusor contractions evoked by intravesical instillation of cold saline, is a segmental reflex believed to be triggered by menthol sensitive cold receptors in the bladder wall, with the afferent signals transmitted by C fibres. The BCR is a neonatal reflex that becomes suppressed by descending signals from higher centres at approximately the time when the child gains full voluntary control of voiding. It re-emerges in adults with neurogenic detrusor overactivity as a consequence of loss of central descending inhibition, resulting from conditions such as spinal cord injury or multiple sclerosis. We have recently shown an increase of nerve fibres expressing the cool and menthol receptor TRPM8 in both overactive (IDO and painful bladder syndrome (PBS, but its functional significance is unknown. We have therefore studied the bladder cooling reflex and associated sensory symptoms in patients with PBS and overactivity disorders. Methods The BCR, elicited by ice water test (IWT was performed in patients with painful bladder syndrome (PBS, n = 17, idiopathic detrusor overactivity (IDO, n = 22, neurogenic detrusor overactivity (NDO, n = 4 and stress urinary incontinence (as controls, n = 21. The IWT was performed by intravesical instillation of cold saline (0 – 4°C. A positive IWT was defined as presence of uninhibited detrusor contraction evoked by cold saline, associated with urgency or with fluid expulsion. Patients were asked to report and rate any pain and cold sensation during the test. Results A positive IWT was observed in IDO (6/22, 27.3% and NDO (4/4, 100% patients, but was negative in all control and PBS patients. Thirteen (76.5% PBS patients reported pain during the IWT, with significantly higher pain scores during ice water instillation compared to the baseline (P = 0.0002, or equivalent amount of bladder filling (100 mls with saline at room temperature (P = 0.015. None

  6. DEVELOPMENT OF THE NOMOGRAM THAT PREDICTS PATHOLOGICAL LYMPH NODE INVOLVEMENT IN BLADDER CANCER PATIENTS BASED ON CLINICAL VARIABLES

    OpenAIRE

    L. V. Mirylenko; O. G. Sukonko; A. V. Pravorov; A. I. Rolevich; A. S. Mavrichev

    2014-01-01

    Objective: to develop nomogram based on clinical variables, that predicts pathological lymph node involvement (рN+) in bladder cancer patients.Material and methods: We used data of 511 patients with bladder cancer, that have undergone radical cystectomy between 1999 and 2008 at N.N. Alexandrov National Cancer Centre. Mono- and multivariate logistic regression analyses were used for pN+ prediction on preoperative data. Coefficients from logistic regression equation were used to construct the n...

  7. Microsatellite instability as prognostic marker in bladder tumors: a clinical significance

    OpenAIRE

    Mittal RD; Mandhani Anil; Vaish Minal; Mittal Balraj

    2005-01-01

    Abstract Background Carcinoma of urinary bladder is one of the leading causes of death in India. Successful treatment of bladder cancer depends on the early detection & specific diagnostic approaches. In the present study, microsatellite instability (MSI) has been evaluated as a prognostic marker in patients with superficial urinary bladder cancer in lower urinary tract for determining risk of recurrence. Methods A total of 44 patients with bladder tumors diagnosed with Transitional Cell Carc...

  8. Clinical and pathological implications of miRNA in bladder cancer

    Directory of Open Access Journals (Sweden)

    Braicu C

    2015-01-01

    important practical applications, taking into account that they modulate essential biological processes such as epithelial to mesenchymal transition, which is a mechanism relevant in bladder cancer. miRNAs collected from biological specimens can furnish valuable evidence with regard to bladder cancer oncogenesis, as they also have been linked to clinical outcomes in urothelial carcinoma. Therefore, a single miRNA or a signature of multiple miRNAs may improve risk stratification of patients and may supplement the histological diagnosis of urological tumors, particularly for bladder cancer.Keywords: bladder cancer, miRNA, prognostic, diagnostic

  9. Oxybutynin extended release for the management of overactive bladder: a clinical review

    Directory of Open Access Journals (Sweden)

    AM Arisco

    2009-05-01

    Full Text Available AM Arisco, EK Brantly, SR KrausUniversity of Texas Health Science Center at San Antonio, Department of Urology, San Antonio, Texas, USAAbstract: Overactive bladder (OAB is a common condition which negatively impacts the quality of life of afflicted patients. This can result in alterations in social interactions at home, in the workplace and in the community, often leading to depression and poor self esteem as well as loss of productivity. Traditional mainstays of treatment include both behavioral therapy and pharmacotherapy. Oxybutynin immediate release (IR represents the first such medication approved by the FDA specifically for treatment of OAB in 1975. Nevertheless, bothersome side effects in addition to thrice daily dosing often led to treatment cessation which raised the question that patients may actually prefer to live with their OAB symptoms rather than incur side effects or complex dosing schemes. Pharmacological advances ultimately led to development of a long-acting formulation of oxybutynin in the form of oxybutynin extended release (ER with the hope that this drug would maintain efficacy while decreasing bothersome side effects and improve compliance with the convenience of once daily dosing regimen. This paper will review the major clinical studies involving oxybutynin ER as well as its role in different patient populations and potential concerns with its use.Keywords: overactive bladder, urinary urge incontinence, antimuscarinic, oxybutynin 

  10. Principles of human joint replacement design and clinical application

    CERN Document Server

    Buechel, Frederick F

    2015-01-01

    This book is written for the users and designers of joint replacements. In its second extended edition it conveys to the reader the knowledge accumulated by the authors during their forty year effort on the development of replacement devices for the lower limb for the purpose of aiding the reader in their design and evaluation of joint replacement devices. The early chapters describe the engineering, scientific and medical principles needed for replacement joint evaluation. One must understand the nature and performance of the materials involved and their characteristics in vivo, i.e. the response of the body to implant materials. It is also essential to understand the response of the implants to applied loading and motion, particularly in the hostile physiological environment. A chapter describes the design methodology now required for joint replacement in the USA and EU countries. The remaining chapters provide a history of joint replacement, an evaluation of earlier and current devices and sample case hist...

  11. Principles of Human Joint Replacement Design and Clinical Application

    CERN Document Server

    Buechel, Frederick F

    2012-01-01

    Drs. Buechel, an orthopaedic surgeon, and Pappas, a professor of Mechanical Engineering, are the designers of several successful joint replacement systems. The most well-known of these is the pioneering LCS knee replacement. They have written this book for the users and designers of joint replacements. It is an attempt to convey to the reader the knowledge accumulated by the authors during their thirty five year effort on the development of replacement devices for the lower limb for the purpose of aiding the reader in their design and evaluation of joint replacement devices. The early chapters describe the engineering, scientific and medical principles needed for replacement joint evaluation. One must understand the nature and performance of the materials involved and their characteristics in vivo, i.e. the response of the body to implant materials. It is also essential to understand the response of the implants to applied loading and motion, particularly in the hostile physiological environment. A chapter de...

  12. CREATION OF THE NOMOGRAM THAT PREDICTS PATHOLOGICAL LOCAL EXTENT OF THE BLADDER CANCER BASED ON CLINICAL VARIABLES

    OpenAIRE

    L. V. Mirylenka; O. G. Sukonko; A. V. Pravorov; A. I. Rolevich; A. S. Mavrichev

    2014-01-01

    Objective: to develop nomogram based on clinical variables, that predicts pathological local extent of the bladder cancer рТ3-рТ4 (рТ3+).Material and methods: We used data of 511 patients with bladder cancer, that have undergone radical cystectomy between 1999 and 2008 at N.N. Alexandrov National Cancer Centre. For prediction of pT3+ on preoperative data were used mono- and multivariate logistic regression analysis. Coefficients from logistic regression equalization were used to construct nom...

  13. Credentialing of radiotherapy centres for a clinical trial of adaptive radiotherapy for bladder cancer (TROG 10.01)

    International Nuclear Information System (INIS)

    Background: Daily variations in bladder filling make conformal treatment of bladder cancer challenging. On-line adaptive radiotherapy with a choice of plans has been demonstrated to reduce small bowel irradiation in single institution trials. In order to support a multicentre feasibility clinical trial on adaptive radiotherapy for bladder cancer (TROG 10.01) a credentialing programme was developed for centres wishing to participate. Methods: The credentialing programme entails three components: a facility questionnaire; a planning exercise which tests the ability of centres to create three adaptive plans based on a planning and five cone beam CTs; and a site visit during which image quality, imaging dose and image guidance procedures are assessed. Image quality and decision making were tested using customised inserts for a Perspex phantom (Modus QUASAR) that mimic different bladder sizes. Dose was assessed in the same phantom using thermoluminescence dosimetry (TLD). Results: All 12 centres participating in the full credentialing programme were able to generate appropriate target volumes in the planning exercise and identify the correct target volume and position the bladder phantom in the phantom within 3 mm accuracy. None of the imaging doses exceeded the limit of 5 cGy with a CT on rails system having the lowest overall dose. Conclusion: A phantom mimicking the decision making process for adaptive radiotherapy was found to be well suited during site visits for credentialing of centres participating in a clinical trial of adaptive radiotherapy for bladder cancer. Combined with a planning exercise the site visit allowed testing the ability of centres to create adaptive treatment plans and make appropriate decisions based on the volumetric images acquired at treatment.

  14. Evaluation of delivered dose for a clinical daily adaptive plan selection strategy for bladder cancer radiotherapy

    International Nuclear Information System (INIS)

    Purpose: To account for variable bladder size during bladder cancer radiotherapy, a daily plan selection strategy was implemented. The aim of this study was to calculate the actually delivered dose using an adaptive strategy, compared to a non-adaptive approach. Material and methods: Ten patients were treated to the bladder and lymph nodes with an adaptive full bladder strategy. Interpolated delineations of bladder and tumor on a full and empty bladder CT scan resulted in five PTVs for which VMAT plans were created. Daily cone beam CT (CBCT) scans were used for plan selection. Bowel, rectum and target volumes were delineated on these CBCTs, and delivered dose for these was calculated using both the adaptive plan, and a non-adaptive plan. Results: Target coverage for lymph nodes improved using an adaptive strategy. The full bladder strategy spared the healthy part of the bladder from a high dose. Average bowel cavity V30Gy and V40Gy significantly reduced with 60 and 69 ml, respectively (p < 0.01). Other parameters for bowel and rectum remained unchanged. Conclusions: Daily plan selection compared to a non-adaptive strategy yielded similar bladder coverage and improved coverage for lymph nodes, with a significant reduction in bowel cavity V30Gy and V40Gy only, while other sparing was limited

  15. Clinical results of a concomitant boost radiotherapy technique for muscle-invasive bladder cancer

    International Nuclear Information System (INIS)

    Purpose: to update the results of external radiotherapy with a focal concomitant boost technique on local control and bladder function in patients with muscle-invasive bladder cancer. Patients and methods: the authors retrospectively evaluated 92 elderly or disabled patients with localized T2-4 N0-1 M0 transitional cell carcinoma of the bladder and a median age of 79 years, not suitable for radical surgery and treated between 1994 and 2005. Treatment consisted of a dose of 40 Gy/2 Gy to the small pelvis with a daily concomitant boost of 0.75 Gy to the tumor. Total dose was 55 Gy in 4 weeks. Results: complete remission rate after evaluation by means of cystoscopy at 3 months was 78%. 3-year local control rate amounted to 56%, and 3-year overall survival to 36%. The posttreatment bladder capacity was comparable with the pretreatment capacity and was ≥ 200 ml in 81% of the cases. Mean bladder capacity did not deteriorate at longer follow-up. Conclusion: the local control rate after external beam radiotherapy in elderly patients with a focal concomitant boost for localized muscle-invasive bladder cancer was 56% at 3 years. Functional bladder outcome was good. (orig.)

  16. Clinical results of a concomitant boost radiotherapy technique for muscle-invasive bladder cancer

    Energy Technology Data Exchange (ETDEWEB)

    Piet, A.H.M.; Hulshof, M.C.C.M.; Pieters, B.R.; Koning, C.C.E. [Dept. of Radiation Oncology, Academic Medical Center, Univ. of Amsterdam (Netherlands); Pos, F.J. [Dept. of Radiation Oncology, The Netherlands Cancer Inst., Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Reijke, T.M. de [Dept. of Urology, Academic Medical Center, Univ. of Amsterdam (Netherlands)

    2008-06-15

    Purpose: to update the results of external radiotherapy with a focal concomitant boost technique on local control and bladder function in patients with muscle-invasive bladder cancer. Patients and methods: the authors retrospectively evaluated 92 elderly or disabled patients with localized T2-4 N0-1 M0 transitional cell carcinoma of the bladder and a median age of 79 years, not suitable for radical surgery and treated between 1994 and 2005. Treatment consisted of a dose of 40 Gy/2 Gy to the small pelvis with a daily concomitant boost of 0.75 Gy to the tumor. Total dose was 55 Gy in 4 weeks. Results: complete remission rate after evaluation by means of cystoscopy at 3 months was 78%. 3-year local control rate amounted to 56%, and 3-year overall survival to 36%. The posttreatment bladder capacity was comparable with the pretreatment capacity and was {>=} 200 ml in 81% of the cases. Mean bladder capacity did not deteriorate at longer follow-up. Conclusion: the local control rate after external beam radiotherapy in elderly patients with a focal concomitant boost for localized muscle-invasive bladder cancer was 56% at 3 years. Functional bladder outcome was good. (orig.)

  17. AB061. Clinical analysis of small cell carcinoma of the bladder: 9 cases report and literature review

    OpenAIRE

    Chen, Zhi; Liu, Qingquan; Chen, Ruibao; Liu, Zhuo; Li, Mingchao; Ling, Qing; Wu, Licheng; Yang, Jun; Liu, Xiaming; Wang, Tao; Wang, Shaogang; Yang, Weimin

    2016-01-01

    Objective To present our experience with nine patients with small cell carcinoma of the bladder (SCCB) who were treated with different modalities and review the literature for patients with SCCB who have been reported in 56 literatures. SCCB is a rare, highly aggressive tumor that presents in an advanced stage and has a propensity for early metastasis. Hematuria is the main clinical manifestations. Surgery, chemotherapy, and radiotherapy, either alone or as part of combined therapy have been ...

  18. CREATION OF THE NOMOGRAM THAT PREDICTS PATHOLOGICAL LOCAL EXTENT OF THE BLADDER CANCER BASED ON CLINICAL VARIABLES

    Directory of Open Access Journals (Sweden)

    L. V. Mirylenka

    2012-01-01

    Full Text Available Objective: to develop nomogram based on clinical variables, that predicts pathological local extent of the bladder cancer рТ3-рТ4 (рТ3+.Material and methods: We used data of 511 patients with bladder cancer, that have undergone radical cystectomy between 1999 and 2008 at N.N. Alexandrov National Cancer Centre. For prediction of pT3+ on preoperative data were used mono- and multivariate logistic regression analysis. Coefficients from logistic regression equalization were used to construct nomogram. Nomogram accuracy was evaluated with concordance index (с-index and by building the calibration plot. Internal validation by bootstrap method with 200 variants of dataset was performed.Results: We developed nomogram, that include: clinical stage сТ, tumor grade, tumor macroscopic appearance, presence of upper tract dilatation, prostatic urethra and/or prostatic lobe(s involvement, 3 or more bladder walls involvement, ESR and creatinine level. Bootstrapcorrected prognostic accuracy of nomogram was 81,4%, that 12,6% better than clinical stage accuracy.Conclusion: developed nomogram can significantly improve pathologic tumor stage prediction accuracy that may be used to select patients for neoadjuvant chemotherapy.

  19. Experimental and clinical treatment of bladder cancer with 125I-iododeoxyuridine

    International Nuclear Information System (INIS)

    Radionuclide can cause auger effect through disintegration low-energy electron (125I-iododeoxyuridine (125I-UdR) is an efficient carrier inducting 125I to cell nucleolus, it is incorporated into DNA specificity only in S-phase cells. A series of studies show that 125I can absorb more likely to tumor cells, instead of the normal cell division, thus effectively splitting radiotherapy of malignant lesions. As bladder is a natural lumen, it has a unique easy perfusion and observational. 125I-UdR can kill effiently and selectively the cells of bladder turnout, reducing markedly the ratio of its recurrence of surgical treatment of patients with bladder cancer, so as to improve the survival rate. It can be used as a surgical adjuvant treatment method, is expected to be a safe, efficient and less adverse reaction the new therapies for bladder cancer treatment. (authors)

  20. Gall bladder distention in newborns.

    OpenAIRE

    Corbett, R P; Egner, J R

    1988-01-01

    Three cases of gall bladder distention in asphyxiated newborns are described. Clinical and ultrasound examination showed this to be a benign, transient phenomenon. A causal relation between tissue hypoxia and gall bladder distention is proposed.

  1. Posterior tibial nerve stimulation for treating neurologic bladder in women: a randomized clinical trial.

    OpenAIRE

    Tahereh Eftekhar; Nastaran Teimoory; Elahe Miri; Abolghasem Nikfallah; Mahsa Naeimi; Mahsa Ghajarzadeh

    2014-01-01

    Overactive bladder (OAB) is a disabling disorder. Treatment of cases with OAB includes behavioral, pharmacological, surgical interventions and peripheral electrical stimulation. The goal of this study was to determine effects of posterior tibial nerve stimulation on sexual function and pelvic disorders in women with Overactive bladder (OAB). Fifty women were randomly assigned to PTNS (posterior tibial nerve stimulation) plus tolterodine or tolterodine alone treatment. Tolterodine group receiv...

  2. Adult urinary bladder tumors with rabdomyosarcomatous differentiation: Clinical, pathological and immunohistochemical studies

    OpenAIRE

    Zhang Paul J; Bing Zhanyong

    2011-01-01

    Abstract Adult rhabdomyosarcoma (RMS) in the urinary bladder is rare, and is the subject of case reports and small series. It consists of sheets of small round blue cells with high nuclear cytoplasmic ratio, brisk mitosis and apoptosis. In this study, we reported one case of pure rhabdomyosarcoma and two cases of urothelial carcinomas with extensive rhabdomyosarcomatous differentiation. In addition, their immunohistochemical profile was compared to that of small cell carcinoma of the bladder....

  3. Human urinary exosomes in bladder cancer patients : properties, concentrations and possible clinical application

    OpenAIRE

    Riches, Andrew Clive; Powis, Simon John; Mullen, Peter; Harrison, David James; Hacker, Christian; Lucocq, John Milton; Bowness, James Simeon; Chapman, Alex; Cameron, Ruth; McLornan, Liz; Chinn, David John; Leung, Steve

    2015-01-01

    OBJECTIVE: High grade bladder cancer is extremely aggressive. Early detection is thus an important challenge. De- velopment of non-invasive diagnostic tools particularly using urine samples could be of importance in the diagnosis and surveillance of these patients. Exosomes are small vesicles present in the urine and have the potential to be used as biomarkers of cancer. Thus studies of the properties and concentrations of these particles in bladder cancer patients are of importance.MATERIALS...

  4. Immunotherapeutic strategies for bladder cancer.

    Science.gov (United States)

    Chevalier, Mathieu F; Nardelli-Haefliger, Denise; Domingos-Pereira, Sonia; Jichlinski, Patrice; Derré, Laurent

    2014-01-01

    Bladder cancer is a common urologic malignancy with rising incidence in the elderly population. In most cases, bladder cancer is non-muscle-invasive at diagnosis and shows dramatically high recurrence rates, although current treatments often reduce the risk of disease progression. Immunotherapy using intravesical instillation of Bacillus Calmette-Guérin (BCG) remains the most effective therapy for patients with high risk tumors. However, BCG-therapy has important limitations including substantial adverse events and frequent treatment failure. Thus, it appears crucial to either improve or replace current therapy using new immunotherapeutic strategies. Here, we discuss the clinical trials that assessed therapeutic vaccination of bladder cancer patients using tumor associated antigens and we also argue for novel approaches arising from murine models. Vaccination routes to induce appropriate T-cell homing in the tumor site as well as the use of local immunostimulation to enhance recruitment of vaccine-induced T cells are discussed to highlight what we believe is a promising therapeutic vaccination strategy for patients with non-muscle-invasive bladder cancer. PMID:24384699

  5. Replacing worn overdenture abutments of an unknown implant system by using laser welding: a clinical report.

    Science.gov (United States)

    Mohunta, Vrinda V; Stevenson, James A; Lee, Damian J

    2014-09-01

    This clinical report describes a procedure for replacing worn ball abutments with low-profile resilient abutments by using laser welding when the implant system for a mandibular implant-supported overdenture could not be identified. PMID:24836281

  6. Bladder Management

    Science.gov (United States)

    ... Catheterization • Urinary Tract Infections: Indwelling (Foley) Catheter Bladder Management [ Download this pamphlet: "Bladder Management" - (PDF, 499KB) ] The ... and medication or surgery may be helpful. Bladder Management Foley or Suprapubic Catheter A tube is inserted ...

  7. Allograft Pancreatic Duct Dilatation Following Bladder Drained Simultaneous Pancreas-Kidney Transplantation: Clinical Significance

    Directory of Open Access Journals (Sweden)

    Ciancio G

    2000-05-01

    Full Text Available OBJECTIVE: Radiologic imaging of the allograft pancreatic duct dilatation is an uncommon multifactorial finding that is not well described. The purpose of this investigation is to determine the clinical correlation of this finding. DESIGN: Retrospective study. SETTING: University Hospital, USA. SUBJECTS: One hundred forty five simultaneous pancreas-kidney transplants have been performed for treatment of type I diabetes mellitus and end-stage renal disease between February 1993 and December 1999 at the University of Miami. MAIN OUTCOME MEASURES: In 5 recipients, the pancreatic duct was noted to be dilated by ultrasound 1-18 months post-transplant. RESULTS: In all 5 recipients a Foley catheter was placed as the first line of treatment. This reduced the size of the pancreatic duct in one patient, who presented with normal serum amylase and lipase and hyperglycemia. A pancreas biopsy done with Foley catheter in place showed fibrosis with no evidence of rejection. Four patients with dilated pancreatic duct presented with increased serum amylase and lipase; however improvement of the pancreatic duct dilatation was seen only after anti-rejection therapy. One of the patients developed recurrence of pancreatic duct dilatation and a video-urodynamic study subsequently demonstrated voiding with abdominal straining and no detrusor activity. He ultimately underwent enteric conversion with resolution of pancreatic duct dilatation. CONCLUSIONS: This infrequent complication of dilated transplant pancreatic duct could be multifactorial. It could suggest the diagnosis of reflux pancreatitis, which should resolve with bladder decompression. In fact, 1 patient presented with reflux pancreatitis caused by external sphincter detrusor pseudodyssynergia. However, this ultrasound finding may also be associated with pancreas rejection (4/5 patients.

  8. Identifying distinct classes of bladder carcinoma using microarrays

    DEFF Research Database (Denmark)

    Andersen, Lars Dyrskjøt; Andersen, Thomas Thykjær; Kruhøffer, Mogens; Jensen, Jens Ledet; Marcussen, Niels; Dutoit, Stephen Jacques Hamilton; Wolf, Hans; Ørntoft, Torben Falck

    2003-01-01

    immunohistological or molecular markers have been identified to define clinically relevant subsets of bladder cancer. Here we report the identification of clinically relevant subclasses of bladder carcinoma using expression microarray analysis of 40 well characterized bladder tumors. Hierarchical cluster analysis...

  9. Adult urinary bladder tumors with rabdomyosarcomatous differentiation: Clinical, pathological and immunohistochemical studies

    Directory of Open Access Journals (Sweden)

    Zhang Paul J

    2011-07-01

    Full Text Available Abstract Adult rhabdomyosarcoma (RMS in the urinary bladder is rare, and is the subject of case reports and small series. It consists of sheets of small round blue cells with high nuclear cytoplasmic ratio, brisk mitosis and apoptosis. In this study, we reported one case of pure rhabdomyosarcoma and two cases of urothelial carcinomas with extensive rhabdomyosarcomatous differentiation. In addition, their immunohistochemical profile was compared to that of small cell carcinoma of the bladder. Our study showed that sufficient sampling was critical for the diagnosis of urothelial carcinoma with extensive rhabdomyosarcomatous differentiation. As adult RMS in the bladder and urothelial carcinoma with rhabdomyosarcomatous differentiation shared morphological features with small cell carcinoma of the bladder, appropriate immunohistochemical stains were necessary in the differential diagnosis. We showed both rhabdomyosarcoma and rhabdomyosarcomatous areas of the urothelial carcinoma were positive for myogenin, negative for cytokeratin and chromogranin stains. In contrast, small cell carcinoma was positive for cytokeratin, and 7 out of 9 cases were also positive for chromogranin. Both rhabdomyosarcoma and small cell carcinoma could be positive for synaptophysin, a potential pitfall to avoid. In addition, all of the tumors with rhabdomyosarcomatous differentiation were negative for FKHR rearrangement.

  10. Molecular markers for urothelial bladder cancer prognosis: Toward implementation in clinical practice

    NARCIS (Netherlands)

    Rhijn, B.W. van; Catto, J.W.; Goebell, P.J.; Knuchel, R.; Shariat, S.F.; Poel, H.G. van der; Sanchez-Carbayo, M.; Thalmann, G.N.; Schmitz-Drager, B.J.; Kiemeney, L.A.L.M.

    2014-01-01

    OBJECTIVES: To summarize the current status of clinicopathological and molecular markers for the prediction of recurrence or progression or both in non-muscle-invasive and survival in muscle-invasive urothelial bladder cancer, to address the reproducibility of pathology and molecular markers, and to

  11. Should the visceral peritoneum at the bladder flap closed at caesarean sections a post partum sonographic and clinical assessment?

    OpenAIRE

    Malvasi, A; Tinelli, A; M. Guido; Zizza, Antonella; Farine, D.; Stark, M.

    2010-01-01

    Objective. To compare cesarean section (CS) using open or closed visceral peritoneum of the bladder flap (BF) in relation to fluid collection in vesico-uterine space (VUS) by ultrasound (US) and clinical outcome. Material and methods. A prospective cohort of repeat CS in 474 in advanced first and second stage of labor was studied. All women underwent a Misgav Ladach CS, in local combined anesthesia. These were divided into two groups by surgical management of the BF at the time of CS: Group I...

  12. Proton Radiotherapy for Pediatric Bladder/Prostate Rhabdomyosarcoma: Clinical Outcomes and Dosimetry Compared to Intensity-Modulated Radiation Therapy

    International Nuclear Information System (INIS)

    Purpose: In this study, we report the clinical outcomes of 7 children with bladder/prostate rhabdomyosarcoma (RMS) treated with proton radiation and compare proton treatment plans with matched intensity-modulated radiation therapy (IMRT) plans, with an emphasis on dose savings to reproductive and skeletal structures. Methods and Materials: Follow-up consisted of scheduled clinic appointments at our institution or direct communication with the treating physicians for referred patients. Each proton radiotherapy plan used for treatment was directly compared to an IMRT plan generated for the study. Clinical target volumes and normal tissue volumes were held constant to facilitate dosimetric comparisons. Each plan was optimized for target coverage and normal tissue sparing. Results: Seven male patients were treated with proton radiotherapy for bladder/prostate RMS at the Massachusetts General Hospital between 2002 and 2008. Median age at treatment was 30 months (11–70 months). Median follow-up was 27 months (10–90 months). Four patients underwent a gross total resection prior to radiation, and all patients received concurrent chemotherapy. Radiation doses ranged from 36 cobalt Gray equivalent (CGE) to 50.4 CGE. Five of 7 patients were without evidence of disease and with intact bladders at study completion. Target volume dosimetry was equivalent between the two modalities for all 7 patients. Proton radiotherapy led to a significant decrease in mean organ dose to the bladder (25.1 CGE vs. 33.2 Gy; p = 0.03), testes (0.0 CGE vs. 0.6 Gy; p = 0.016), femoral heads (1.6 CGE vs. 10.6 Gy; p = 0.016), growth plates (21.7 CGE vs. 32.4 Gy; p = 0.016), and pelvic bones (8.8 CGE vs. 13.5 Gy; p = 0.016) compared to IMRT. Conclusions: This study provides evidence of significant dose savings to normal structures with proton radiotherapy compared to IMRT and is well tolerated in this patient population. The long-term impact of these reduced doses can be tested in future studies

  13. CLINICAL SIGNIFICANCE OF TELOMERASE ACTIVITY AND PERIPHERAL VENOUS BLOOD CK-20 EXPRESSION IN BLADDER TRANSITIONAL CELL CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    钟惟德; 曾广翘; 蔡岳斌; 胡建波; 魏鸿蔼

    2003-01-01

    Objective: The relationship between peripheral blood CK-20 Mrna expression and tissue telomerase activity in bladder transitional cell carcinoma (TCCB) was investigated to evaluate the feasibility of their combined detection in early-stage diagnosis and prognosis estimation of TCCB. Methods: the blood CK-20 was detected by semi-nested RT-PCR and telomerase activity in tumor tissue was examined with silver-stained TRAP reaction. Results: the blood CK-20 expression and tissue telomerase activity in TCCB were 41% and 93% respectively. No statistical significance was detected among pathological grading and clinical staging (P>0.05). Positive correlation was shown between CK-20 expression and telomerase activity with the pathologic grade or clinical stage. Conclusion: combined use of blood CK-20 and tissue telomerase activity detections might be of great importance for clinical diagnosis, treatment and prognosis evaluation.

  14. Do financial incentives trump clinical guidance? Hip Replacement in England and Scotland.

    Science.gov (United States)

    Papanicolas, Irene; McGuire, Alistair

    2015-12-01

    Following devolution in 1999 England and Scotland's National Health Services diverged, resulting in major differences in hospital payment. England introduced a case payment mechanism from 2003/4, while Scotland continued to pay through global budgets. We investigate the impact this change had on activity for Hip Replacement. We examine the financial reimbursement attached to uncemented Hip Replacement in England, which has been more generous than for its cemented counterpart, although clinical guidance from the National Institute for Clinical Excellence recommends the later. In Scotland this financial differential does not exist. We use a difference-in-difference estimator, using Scotland as a control, to test whether the change in reimbursement across the two countries had an influence on treatment. Our results indicate that financial incentives are directly linked to the faster uptake of the more expensive, uncemented Hip Replacement in England, which ran against the clinical guidance. PMID:26359587

  15. Clinical evaluation of intra-operative radiotherapy combined with subtotal cystectomy for invasive bladder carcinoma

    International Nuclear Information System (INIS)

    From 1981 to 1994, intra-operative radiotherapy after subtotal cystectomy was performed on 22 patients with invasive bladder carcinoma on whom radical cystectomy could not be recommended because of old age or condition. All the patients received 25 to 30 Gy of radiotherapy focused on trigonum and internal urethral orifice after subtotal cystectomy with uretero-cutaneostomy. Of 22 patients, 15 patients died. Five patients died of bladder cancer, one died of gastic cancer, one died of rectal cancer and the others died of pneumonia, heart failure, sepsis and senility. The five-year survival rate was 41% and the cause-specific five-year survival rate was 75%. Local recurrence was seen only in one patient, who received second intra-operative radiotherapy and recovered well in complete remission. We believe that intra-operative radiotherapy after subtotal cystectomy is useful for patients with invasive bladder carcinoma on whom radical cystectomy could not be recommended because of old age or condition. (author)

  16. Mitochondrial Replacement Therapy: Halachic Considerations for Enrolling in an Experimental Clinical Trial.

    Science.gov (United States)

    Tendler, Rabbi Moshe D; Loike, John D

    2015-01-01

    The transition of new biotechnologies into clinical trials is a critical step in approving a new drug or therapy in health care. Ethically recruiting appropriate volunteers for these clinical trials can be a challenging task for both the pharmaceutical companies and the US Food and Drug Administration. In this paper we analyze the Jewish halachic perspectives of volunteering for clinical trials by focusing on an innovative technology in reproductive medicine, mitochondrial replacement therapy. The halachic perspective encourages individuals to volunteer for such clinical trials under the ethical principles of beneficence and social responsibility, when animal studies have shown that health risks are minimal. PMID:26241230

  17. Mitochondrial Replacement Therapy: Halachic Considerations for Enrolling in an Experimental Clinical Trial

    Directory of Open Access Journals (Sweden)

    Rabbi Moshe D. Tendler

    2015-07-01

    Full Text Available The transition of new biotechnologies into clinical trials is a critical step in approving a new drug or therapy in health care. Ethically recruiting appropriate volunteers for these clinical trials can be a challenging task for both the pharmaceutical companies and the US Food and Drug Administration. In this paper we analyze the Jewish halachic perspectives of volunteering for clinical trials by focusing on an innovative technology in reproductive medicine, mitochondrial replacement therapy. The halachic perspective encourages individuals to volunteer for such clinical trials under the ethical principles of beneficence and social responsibility, when animal studies have shown that health risks are minimal.

  18. Experimental results and clinical impact of using autologous rectus fascia sheath for vascular replacement

    NARCIS (Netherlands)

    Kobori, Laszlo; Nemeth, Tibor; Nagy, Peter; Dallos, Gabor; Sotonyi, Peter; Fehervari, Imre; Nemes, Balazs; Gorog, Denes; Patonai, Attila; Monostory, Katalin; Doros, Attila; Sarvary, Enikoe; Fazakas, Janos; Gerlei, Zsuzsanna; Benkoe, Tamas; Piros, Laszlo; Jaray, Jeno; De Jong, Koert P.

    2008-01-01

    Vascular complications are major causes of graft failure in liver transplantation. The use of different vascular grafts is common but the results are controversial. The aim of this study was to create an 'ideal' arterial interponate for vascular replacements in the clinical field. An autologous, tub

  19. Targeted next-generation sequencing can replace Sanger sequencing in clinical diagnostics

    NARCIS (Netherlands)

    Sikkema-Raddatz, B.; Johansson, L.F.; de Boer, E.N.; Almomani, R.; Boven, L.G.; van den Berg, M.P.; van Spaendonck-Zwarts, K.Y.; van Tintelen, J.P.; Sijmons, R.H.; Jongbloed, J.D.H.; Sinke, R.J.

    2013-01-01

    Mutation detection through exome sequencing allows simultaneous analysis of all coding sequences of genes. However, it cannot yet replace Sanger sequencing (SS) in diagnostics because of incomplete representation and coverage of exons leading to missing clinically relevant mutations. Targeted next-g

  20. Key signaling pathways in the muscle-invasive bladder carcinoma: Clinical markers for disease modeling and optimized treatment.

    Science.gov (United States)

    Kiselyov, Alex; Bunimovich-Mendrazitsky, Svetlana; Startsev, Vladimir

    2016-06-01

    In this review, we evaluate key molecular pathways and markers of muscle-invasive bladder cancer (MIBC). Overexpression and activation of EGFR, p63, and EMT genes are suggestive of basal MIBC subtype generally responsive to chemotherapy. Alterations in PPARγ, ERBB2/3, and FGFR3 gene products and their signaling along with deregulated p53, cytokeratins KRT5/6/14 in combination with the cellular proliferation (Ki-67), and cell cycle markers (p16) indicate the need for more radical treatment protocols. Similarly, the "bell-shape" dynamics of Shh expression levels may suggest aggressive MIBC. A panel of diverse biological markers may be suitable for simulation studies of MIBC and development of an optimized treatment protocol. We conducted a critical evaluation of PubMed/Medline and SciFinder databases related to MIBC covering the period 2009-2015. The free-text search was extended by adding the following keywords and phrases: bladder cancer, metastatic, muscle-invasive, basal, luminal, epithelial-to-mesenchymal transition, cancer stem cell, mutations, immune response, signaling, biological markers, molecular markers, mathematical models, simulation, epigenetics, transmembrane, transcription factor, kinase, predictor, prognosis. The resulting selection of ca 500 abstracts was further analyzed in order to select the latest publications relevant to MIBC molecular markers of immediate clinical significance. PMID:26547270

  1. Bladder Retraining

    Science.gov (United States)

    ... a better voiding pattern around the clock. Do Kegel Exercises Help People with IC? Some bladder retraining programs recommend practicing Kegel exercises as part of bladder retraining. Kegel exercises ...

  2. Urinary Bladder

    Science.gov (United States)

    ... to the symphysis pubis, and below the parietal peritoneum . The size and shape of the urinary bladder ... outer layer of the bladder wall is parietal peritoneum. In all other regions, the outer layer is ...

  3. Bladder Health

    Science.gov (United States)

    ... life (the person’s level of health, comfort, and happiness). In fact, people with bladder problems may have a lower quality of life than people with diabetes, heart disease, or high blood pressure. Bladder problems ...

  4. Origins of Bladder Cancer.

    Science.gov (United States)

    Czerniak, Bogdan; Dinney, Colin; McConkey, David

    2016-05-23

    Bladder cancer, one of the most frequently occurring human cancers, develops via two tracks referred to as papillary and nonpapillary that correspond to clinically different forms of the disease. Most bladder cancers are chemically induced, with tobacco smoking being the leading risk factor. Recent advances in bladder cancer research have enhanced our understanding of the origin of this disease from urothelial progenitor cells via field effects along papillary/luminal and nonpapillary/basal pathways. Evident from the outset of the disease, the diversity of the luminal and basal pathways, together with cell lineage tracing studies, postulates the origin of molecularly distinct subtypes from different uroprogenitor cells. The molecular mechanisms initiating field effects involve a new class of genes referred to as forerunner (FR) genes that generally map around major tumor suppressors such as RB1. These genes are silenced, predominantly by hypermethylation and less frequently by mutations, and drive the expansion of intraurothelial preneoplastic cells. Different FR genes are involved in various molecular subtypes of bladder cancer and they sensitize the uroprogenitor cells to the development of luminal and basal bladder cancers in animal models. In human bladder cancer, luminal and basal forms have dissimilar clinical behavior and response to conventional and targeted chemotherapeutic manipulations. These new research developments hold the promise of expanding our armamentarium of diagnostic and treatment options for patients with bladder cancer and improving our ability to select patients most likely to respond to a specific therapy. PMID:26907529

  5. Clinical Evaluation of Reasons for Replacement of Amalgam Restorations in Patients Referring to a Dental School in Iran

    OpenAIRE

    Pouralibaba, Firoz; Joulaei, Mohammad; Kashefimehr, Atabak; Pakdel, Farzaneh; Jamali, Zahra; Esmaeili, Ali

    2010-01-01

    Background and aims The present study evaluated the most common reasons for replacing amalgam restorations in a university clinic. Materials and methods A total of 217 restorations which needed to be replaced were clinically and radiographically evaluated in a period of 4 months. The frequencies of reasons for replacing amalgam restorations were calculated: The assessed items included recurrent caries, tooth structure fracture (functional or non-functional cusps), amalgam bulk fracture, amalg...

  6. Single Tooth Replacement Using InCeram Resin Bonded Fixed Partial Denture: A Clinical Report.

    Directory of Open Access Journals (Sweden)

    Elnaz Moslehifard

    2014-02-01

    Full Text Available This clinical report describes a treatment option for replacement of a missing mandibular anterior tooth using InCeram resin bonded fixed partial denture (RBFPD. The conventional approach for replacing mandibular incisors dictates the placement of either a conventional porcelain-fused-to-metal (PFM bridge, Maryland bridge, or fiber-reinforced composite veneer bridge and several appearance-related disadvantages have been reported in the use of a prosthesis that incorporates a metal substructure. The InCeram bridge is a minimally invasive restoration and eliminates undesirable incisal graying frequently observed in metal RBFPDs. This method was successfully clinically applied to overcome shortcomings of other approaches that may require a minimal invasive technique to preserve lasting sound tooth structure.

  7. Clinical experience of MRI in two dogs with muscle-invasive transitional cell carcinoma of the urinary bladder.

    Science.gov (United States)

    Lee, Kija; Choi, Sooyoung; Choi, Hojung; Lee, Youngwon

    2016-09-01

    This study described high-field magnetic resonance imaging (MRI) and computed tomography (CT) characteristics of muscle-invasive bladder transitional cell carcinoma (TCC) in two dogs. Ultrasonography revealed a urinary bladder mass with ambiguous result about invasion to the muscular layer. Contrast-enhanced CT showed that the bladder wall in which the mass was attached was more intensely enhanced than the normal bladder walls, supporting invasion to the muscular layer. The mass revealed an intermediate signal intensity with interruption of the hypointense muscular layer on T2-weighted MRI and showed greater enhancement compared with the normal bladder wall on postcontrast T1-weighted images. T2-weighted MRI, postcontrast T1-weighted MRI and contrast-enhanced dual-phasic CT were useful for evaluating muscle-invasive bladder TCC in dogs. PMID:27149892

  8. Replacement of missing teeth with fiber-reinforced composite FPDs: clinical protocol

    OpenAIRE

    Bouillaguet, Serge; Schütt, Andrea; Marin, Isabelle; Etechami, Leila; Di Salvo, Giancarlo; Krejci, Ivo

    2003-01-01

    The concept of minimally invasive preparation protocols has resulted in reduced loss of critical tooth structures and maintenance of optimal strength, form, and aesthetics. While various treatment options have been described for single-tooth replacement, fiber-reinforced composite (FRC) fixed partial dentures (FPDs) provide a viable treatment alternative with proven mechanical properties, aesthetics, and function. This article presents several clinical scenarios in which minimally invasive ad...

  9. The role of PD-L1 in the radiation response and clinical outcome for bladder cancer

    OpenAIRE

    Chun-Te Wu; Wen-Cheng Chen; Ying-Hsu Chang; Wei-Yu Lin; Miao-Fen Chen

    2016-01-01

    Identification of potential factors that can stratify a tumor’s response to specific therapies will aid in the selection of cancer therapy. The aim was to highlight the role of programmed cell death 1 ligand 1 (PD-L1) in bladder cancer. In this study, 92 of muscle-invasive bladder cancers and 28 of non- muscle invasive bladder cancers were selected for immunohistochemical staining analysis. Furthermore, human and murine bladder cancer cell lines were used to examine the correlation between PD...

  10. Neurogenic Bladder

    Directory of Open Access Journals (Sweden)

    Peter T. Dorsher

    2012-01-01

    Full Text Available Congenital anomalies such as meningomyelocele and diseases/damage of the central, peripheral, or autonomic nervous systems may produce neurogenic bladder dysfunction, which untreated can result in progressive renal damage, adverse physical effects including decubiti and urinary tract infections, and psychological and social sequelae related to urinary incontinence. A comprehensive bladder-retraining program that incorporates appropriate education, training, medication, and surgical interventions can mitigate the adverse consequences of neurogenic bladder dysfunction and improve both quantity and quality of life. The goals of bladder retraining for neurogenic bladder dysfunction are prevention of urinary incontinence, urinary tract infections, detrusor overdistension, and progressive upper urinary tract damage due to chronic, excessive detrusor pressures. Understanding the physiology and pathophysiology of micturition is essential to select appropriate pharmacologic and surgical interventions to achieve these goals. Future perspectives on potential pharmacological, surgical, and regenerative medicine options for treating neurogenic bladder dysfunction are also presented.

  11. Effects of clinical pathways in the joint replacement: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Faggiano F

    2009-07-01

    Full Text Available Abstract Background A meta-analysis was performed to evaluate the use of clinical pathways for hip and knee joint replacements when compared with standard medical care. The impact of clinical pathways was evaluated assessing the major outcomes of in-hospital hip and knee joint replacement processes: postoperative complications, number of patients discharged at home, length of in-hospital stay and direct costs. Methods Medline, Cinahl, Embase and the Cochrane Central Register of Controlled Trials were searched. The search was performed from 1975 to 2007. Each study was assessed independently by two reviewers. The assessment of methodological quality of the included studies was based on the Jadad methodological approach and on the New Castle Ottawa Scale. Data analysis abided by the guidelines set out by The Cochrane Collaboration regarding statistical methods. Meta-analyses were performed using RevMan software, version 4.2. Results Twenty-two studies met the study inclusion criteria and were included in the meta-analysis for a total sample of 6,316 patients. The aggregate overall results showed significantly fewer patients suffering postoperative complications in the clinical pathways group when compared with the standard care group. A shorter length of stay in the clinical pathway group was also observed and lower costs during hospital stay were associated with the use of the clinical pathways. No significant differences were found in the rates of discharge to home. Conclusion The results of this meta-analysis show that clinical pathways can significantly improve the quality of care even if it is not possible to conclude that the implementation of clinical pathways is a cost-effective process, because none of the included studies analysed the cost of the development and implementation of the pathways. Based on the results we assume that pathways have impact on the organisation of care if the care process is structured in a standardised way

  12. Use of a latex biomembrane for bladder augmentation in a rabbit model: biocompatibility, clinical and histological outcomes

    Directory of Open Access Journals (Sweden)

    Andre L. A. Domingos

    2009-04-01

    Full Text Available PURPOSE: To investigate histological features and biocompatibility of a latex biomembrane for bladder augmentation using a rabbit model. MATERIAL AND METHODS: After a partial cystectomy, a patch of a non-vulcanized latex biomembrane (2x4 cm was sewn to the bladder with 5/0 monofilament polydioxanone sulfate in a watertight manner. Groups of 5 animals were sacrificed at 15, 45 and 90 days after surgery and the bladder was removed. The 5-µm preparations obtained from grafted area and normal bladder were stained with hematoxylin-eosin. Immunohistochemical staining was performed with a primary antibody against alpha-actin to assess muscle regeneration. RESULTS: No death, urinary leakage or graft extrusion occurred in any group. All bladders showed a spherical shape. Macroscopically, after 90 days, the latex biomembrane was not identifiable and the patch was indistinguishable from normal bladder. A bladder stone was found in one animal (6.6%. On the 90th day, histology revealed continuity of transitional epithelium of host bladder tissue on the patch area. At this time, the muscle layers were well organized in a similar fashion to native bladder muscle layers. The inflammatory process was higher on grafted areas when compared to controls: 15 days - p < 0.0001, 45 days - p < 0.001, and 90 days - p < 0.01. The anti alpha-actin immunoexpression peaked at 45 days, when the graft was observed covered by muscle cells. CONCLUSION: The latex biomembrane is biocompatible and can be used in models for bladder augmentation in rabbits. It promotes epithelium and muscle regeneration without urinary leakage.

  13. Neurogenic Bladder and Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Krupin V.N.

    2011-12-01

    Full Text Available There have been presented general information of neurogenic bladder and the data on pathophysiology of lower urinary tract dysfunction in patients with multiple sclerosis. The characteristics of clinical presentations of neurogenic bladder in multiple sclerosis have been stated. There have been considered diagnosis and treatment problems of urinary disorders in patients with multiple sclerosis.

  14. The ethical challenges of the clinical introduction of mitochondrial replacement techniques.

    Science.gov (United States)

    Appleby, John B

    2015-11-01

    Mitochondrial DNA (mtDNA) diseases are a group of neuromuscular diseases that often cause suffering and premature death. New mitochondrial replacement techniques (MRTs) may offer women with mtDNA diseases the opportunity to have healthy offspring to whom they are genetically related. MRTs will likely be ready to license for clinical use in the near future and a discussion of the ethics of the clinical introduction of MRTs is needed. This paper begins by evaluating three concerns about the safety of MRTs for clinical use on humans: (1) Is it ethical to use MRTs if safe alternatives exist? (2) Would persons with three genetic contributors be at risk of suffering? and (3) Can society trust that MRTs will be made available for humans only once adequate safety testing has taken place, and that MRTs will only be licensed for clinical use in a way that minimises risks? It is then argued that the ethics debate about MRTs should be reoriented towards recommending ways to reduce the possible risks of MRT use on humans. Two recommendations are made: (1) licensed clinical access to MRTs should only be granted to prospective parents if they intend to tell their children about their MRT conception by adulthood; and (2) sex selection should be used in conjunction with the clinical use of MRTs, in order to reduce transgenerational health risks. PMID:26239841

  15. Clinical implications in the shift of syndecan-1 expression from the cell membrane to the cytoplasm in bladder cancer

    International Nuclear Information System (INIS)

    To determine the diagnostic and prognostic capability of urinary and tumoral syndecan-1 (SDC-1) levels in patients with cancer of the urinary bladder. SDC-1 levels were quantitated by enzyme-linked immunosorbent assay (ELISA) in 308 subjects (102 cancer subjects and 206 non-cancer subjects) to assess its diagnostic capabilities in voided urine. The performance of SDC-1 was evaluated using the area under the curve of a receiver operating characteristic curve. In addition, immunohistochemical (IHC) staining assessed SDC-1 protein expression in 193 bladder specimens (185 cancer subjects and 8 non-cancer subjects). Outcomes were correlated to SDC-1 levels. Mean urinary levels of SDC-1 did not differ between the cancer subjects and the non-cancer subjects, however, the mean urinary levels of SDC-1 were reduced in high-grade compared to low-grade disease (p < 0.0001), and in muscle invasive bladder cancer (MIBC) compared to non-muscle invasive bladder cancer (NMIBC) (p = 0.005). Correspondingly, preliminary data note a shift from a membranous cellular localization of SDC-1 in normal tissue, low-grade tumors and NMIBC, to a distinctly cytoplasmic localization in high-grade tumors and MIBC was observed in tissue specimens. Alone urinary SDC-1 may not be a diagnostic biomarker for bladder cancer, but its urinary levels and cellular localization were associated with the differentiation status of patients with bladder tumors. Further studies are warranted to define the potential role for SDC-1 in bladder cancer progression

  16. Exogenous glycosaminoglycans coat damaged bladder surfaces in experimentally damaged mouse bladder

    Directory of Open Access Journals (Sweden)

    Hurst Robert E

    2005-03-01

    Full Text Available Abstract Background Interstital cystitis is often treated with exogenous glycosaminoglycans such as heparin, chondroitin sulphate (Uracyst, hyaluronate (Cystistat or the semi-synthetic pentosan polysulphate (Elmiron. The mechanism of action is presumed to be due to a coating of the bladder surface to replace the normally present chondroitin sulphate and heparan sulphate lost as a result of the disease. This study used fluorescent labelled chondroitin sulphate to track the distribution of glycosaminoglycans administered intravesically to mouse bladder that had been damaged on the surface. Methods The surfaces of mouse bladders were damaged by 3 mechanisms – trypsin, 10 mM HCl, and protamine sulphate. Texas Red-labeled chondroitin sulphate was instilled into the bladders of animals with damaged bladders and controls instilled only with saline. Bladders were harvested, frozen, and sectioned for examination by fluorescence. Results The normal mouse bladder bound a very thin layer of the labelled chondroitin sulphate on the luminal surface. Trypsin- and HCl-damaged bladders bound the labelled chondroitin sulphate extensively on the surface with little penetration into the bladder muscle. Protamine produced less overt damage, and much less labelling was seen, presumably due to loss of the label as it complexed with the protamine intercalated into the bladder surface. Conclusion Glycosaminoglycan administered intravesically does bind to damaged bladder. Given that the changes seen following bladder damage resemble those seen naturally in interstitial cystitis, the mechanisms proposed for the action of these agents is consistent with a coating of damaged bladder.

  17. The clinical significance of gall-bladder non-visualization in cholescintigraphy of patients with choledochal cysts

    Energy Technology Data Exchange (ETDEWEB)

    Kao Panfu [Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taipei (Taiwan, Province of China); Huang Miauju [Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taipei (Taiwan, Province of China); Tzen Kaiyuan [Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taipei (Taiwan, Province of China); You Dongling [Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taipei (Taiwan, Province of China); Liaw Yunfan [Liver Unit, Chang Gung Memorial Hospital, Taipei (Taiwan, Province of China)

    1996-11-01

    Intravenous radionuclide cholescintigraphy (IVRC) provides a very specific picture for choledochal cysts. However, the clinical significance of the non-visualization of the gall-bladder (GB) activity in these cases is unclear. In this study, we reviewed 27 patients with choledochal cysts who underwent IVRC within 7 days prior to operation and correlated the GB findings on IVRC with the histopathological results. In 18 of the 27 patients (66.7%), there was non-visualization of the GB at 4 h post injection. Among these, two had histopathological features of acute cholecystitis (AC), 11 had chronic cholecystitis (CC), and five had normal GBs. In the other nine patients with visualization of the GB, there were five cases of CC and four normal GBs. If we apply the finding of non-visualization of the GB at 4 h post injection as the criterion for the diagnosis of AC, the diagnostic accuracy was only 40.7% (11/27). We concluded that: (1) GB disease (AC and CC) was common (66.7%: 7.4% and 59.3% respectively) in choledochal cyst patients. (2) Non-visualization of the GB on IVRC did not necessarily indicate AC in choledochal cyst cases, and the diagnostic accuracy was low. (3) GB disease is not the only cause of GB non-visualization on IVRC. A huge choledochal cyst causing a mass or reservoir effect may be a cause of GB compression and result in non-visualization of the GB. (orig.). With 3 figs., 3 tabs.

  18. Micro-separation in vitro produces clinically relevant wear of ceramic-ceramic total hip replacements

    Energy Technology Data Exchange (ETDEWEB)

    Nevelos, J.; Fisher, J. [Leeds Univ. (United Kingdom). School of Mechanical Engineering; Ingham, E. [Leeds Univ. (United Kingdom). Div. of Microbiology; Doyle, C. [Stryker Howmedica Osteonics, Newbury (United Kingdom); Streicher, R. [Stryker Howmedica Osteonics, Kilchberg (Switzerland); Nevelos, A. [Bradford Royal Infirmary, Bradford (United Kingdom)

    2001-07-01

    Typical clinical wear rates for well-positioned first generation ceramic-ceramic total hip arthroplasties (THAs) were of the order of 1-5 mm{sup 3}/year. This wear took the form of a 'stripe' of worn area on the heads with an Ra of approximately 0.1 {mu}m. As-manufactured unworn areas have an average Ra of 0.005 {mu}m Ra. This wear pattern has not been recorded following standard simulator testing with typical wear rates of less than 0.1 mm{sup 3} per million cycles. Therefore new material combinations for ceramic-ceramic total hip arthroplasty cannot be validated using standard hip simulator testing methods. However, recent fluoroscopy studies have shown that the head and cup of total hip replacements can separate during normal gait. This separation would lead to rim contact upon heel strike as shown in Figure 1. (orig.)

  19. Bladder exstrophy repair

    Science.gov (United States)

    Bladder birth defect repair; Everted bladder repair; Exposed bladder repair; Repair of bladder exstrophy ... in boys and is often linked to other birth defects. Surgery is necessary to: Allow the child to ...

  20. Replacing stressful challenges with positive coping strategies: a resilience program for clinical placement learning.

    Science.gov (United States)

    Delany, C; Miller, K J; El-Ansary, D; Remedios, L; Hosseini, A; McLeod, S

    2015-12-01

    Clinical education is foundational to health professional training. However, it is also a time of increased stress for students. A student's perception of stressors and their capacity to effectively manage them is a legitimate concern for educators, because anxiety and decreased coping strategies can interfere with effective learning, clinical performance and capacity to care for patients. Resilience is emerging as a valuable construct to underpin positive coping strategies for learning and professional practice. We report the development and evaluation of a psycho-education resilience program designed to build practical skills-based resilience capacities in health science (physiotherapy) students. Six final year undergraduate physiotherapy students attended four action research sessions led by a clinical health psychologist. Resilience strategies drawn from cognitive behavioural therapy, and positive and performance psychology were introduced. Students identified personal learning stressors and their beliefs and responses. They chose specific resilience-based strategies to address them, and then reported their impact on learning performance and experiences. Thematic analysis of the audio-recorded and transcribed action research sessions, and students' de identified notes was conducted. Students' initial descriptions of stressors as 'problems' outside their control resulting in poor thinking and communication, low confidence and frustration, changed to a focus on how they managed and recognized learning challenges as normal or at least expected elements of the clinical learning environment. The research suggests that replacing stressful challenges with positive coping strategies offers a potentially powerful tool to build self-efficacy and cognitive control as well as greater self-awareness as a learner and future health practitioner. PMID:25835325

  1. Clinical Practice Pattern of Immediate Intravesical Chemotherapy following Transurethral Resection of a Bladder Tumor in Korea: National Health Insurance Database Study.

    Science.gov (United States)

    Seo, Gi Hyeon; Kim, Jae Heon; Ku, Ja Hyeon

    2016-01-01

    We evaluated the frequency and practice pattern of immediate postoperative intravesical chemotherapy (PIC) after transurethral resection of a bladder tumor (TURBT) in suspected non-muscle-invasive bladder cancer (NMIBC). Information from the Health Insurance Review and Assessment Service database from January 1, 2008 to December 31, 2013 was used. Patients with bladder cancer who received TURBT were considered as the cases (37,941 patients and 59,568 cases). The time of PIC after TURBT, types of PIC regimens, and the potential effect of PIC on the delay for additional treatment were analyzed. The study cohort included 23,726 subjects and 30,473 cases with a mean age of 66.8 ± 12.0 years, including 19,362 (81.6%) male patients. The rate of immediate PIC was 11.0% of cases (3,359 cases). There was significant difference in the frequency rate of additional treatment among patients with immediate PIC and patients without immediate PIC within 1 year from the first TURBT (15.2% vs 16.6%, p = 0.035). However, no difference was revealed for whole observational period (33.7% vs 34.5%, p = 0.373). The frequency rate of immediate PIC after TURBT for suspected NMIBC was low in real clinical practice. More efforts are needed to improve the usage rate of PIC after TURBT for suspected NMIBC. PMID:26976048

  2. Experimental bladder defect in rabbit repaired with homologous bladder extracellular matrix graft

    Institute of Scientific and Technical Information of China (English)

    YANG Si-xing; SHEN Fu-jin; HU Yun-fei; JIN Hua-min; WANG Ling-long

    2005-01-01

    @@ Approximately 400 million people worldwide suffer from bladder disease such as congenital abnormalities, cancer, trauma, infection, iatrogenic injuries or other conditions which may lead to painful bladder damage or loss, so eventual bladder augmentation or substitution should be required. Gastrointestinal segments are commonly used as tissues for bladder replacement or repair, but have been associated with multiple complications such as infection, metabolic disturbances, increased mucus production, and malignancy.1 Because of the problems encountered with the use of gastrointestinal segments, several bladder substitutes have been attempted with both organic materials (skin, dura mater, peritoneum or fascia) and synthetics (such as poly vinyl, sponge, silicone). These attempts have usually failed due to mechanical, structural or biocompatibility problems. Permanent synthetic materials succumb to mechanical failure and urinary stone formation. Degradable materials lead to fibroblast deposition, scarring, and a reduced reservoir volume.2,3 It is evident that bladder tissue cannot be replaced easily due to its elastic properties and urothelial permeability function.

  3. Titanium ball joint total ossicular replacement prosthesis--experimental evaluation and midterm clinical results.

    Science.gov (United States)

    Gostian, A O; Pazen, D; Luers, J C; Huttenbrink, K B; Beutner, D

    2013-07-01

    During reconstruction of the ossicular chain, there is a need to address the forces and loads caused by the ambient atmospheric pressure variations and the resulting tympanic membrane movements. It is understood that when a rigid middle ear prosthesis is inserted the malleoincudal joint, a keyfactor in controlling pressure variations in the middle ear space is bypassed. In this paper we describe a modified total titanium ossicular replacement prosthesis with an innovative micro ball joint in the headplate which is designed to compensate for tympanic membrane movements caused by atmospheric pressure variations. The characteristics of this modified prosthesis were examined in temporal bone experiments and compared to the standard titanium total ossicular reconstruction prosthesis. Sound-induced stapes footplate movements were investigated by means of a Laser vibrometer and revealed no significant differences between the two prostheses in vitro. Intraoperatively, the insertion of the modified prosthesis required more delicate handling. The angle between the shaft and the headplate was variable and ranged from 60 to 90° as estimated by the surgeon. Twelve consecutive patients were eligible for clinical evaluation. The pure tone average (PTA) air-bone gap after a mean follow up period of 32 months was 18.8 dB. Furthermore, no extrusion, dislocation or other adverse events were observed. We conclude that the modified total ossicular replacement prosthesis with integrated micro ball joint yields similar volume velocities of the stapes footplate in the laboratory experiments compared to the standard rigid prosthesis. The audiological and morphological results are encouraging and show that the mobile prosthesis headplate adjusting to the level of the tympanic membrane is a further step in the development of a physiological middle ear implant. This article is part of a special issue entitled "MEMRO 2012". PMID:23142147

  4. Routine clinical estimation of rectal, rectosigmoidal, and bladder doses from intracavitary brachytherapy in the treatment of carcinoma of the cervix

    International Nuclear Information System (INIS)

    An evaluation of rectal, rectosigmoidal, and bladder doses from intracavitary brachytherapy in carcinoma of the cervix has been initiated on a routine basis in an effort to obtain the optimum radiotherapeutic dose. Contrast radiography on a radiotherapy simulator is used to image the rectum and bladder, and dose rates are determined at predesignated reference points with the aid of computer calculated dose distributions. Forty-three patients have been reviewed in order to ascertain the correlation between radiation injury and dose at reference points in the rectum and bladder. In a related study involving 77 patients, the doses at points A and B and the prescription in mghr were analyzed in relation to radiation injury. There was no apparent association between the incidence of radiation injury in either the mghr prescription or the doses at points A or B. Computer calculations were supplemented with in vivo and in vitro thermoluminescent dosimeter (TLD) measurements. We conclude that routine contrast radiography of the rectum and the bladder with dose calculations at selected reference points provides important information for optimizing radiotherapy in carcinoma of the cervix without a significant increase in treatment planning effort or patient discomfort

  5. Underactive Bladder in Older Adults.

    Science.gov (United States)

    Chuang, Yao-Chi; Plata, Mauricio; Lamb, Laura E; Chancellor, Michael B

    2015-11-01

    Overactive bladder is one of the most common bladder problems, but an estimated 20 million Americans have underactive bladder (UAB), which makes going to the bathroom difficult, increases the risk of urinary tract infections, and even leads to institutionalization. This article provides an overview of UAB in older adults, and discusses the prevalence, predisposing factors, cause, clinical investigations, and treatments. At present, there is no effective therapy for UAB. A great deal of work still needs to be done on understanding the pathogenesis and the development of effective therapies. PMID:26476113

  6. 菌状导尿管在截瘫患者膀胱造瘘的护理体会%Paraplegia in a patient with bladder stoma replacement of indwelling catheter nursing experience

    Institute of Scientific and Technical Information of China (English)

    张瑾; 孙英; 刘冰

    2013-01-01

    目的:探讨菌状导尿管在截瘫患者膀胱造瘘口应用的护理体会。方法:系统回顾13位截瘫患者167人次造瘘口使用菌状导尿管的操作护理。结论:本组操作成功率95﹪,院内感染发生率94%,说明正确的操作方法及护理措施,能减轻截瘫患者的痛苦,减少院内感染的发生。提高了工作效率,适应临床值得推广。%purpose:Discussion of paraplegia patients with bladder stoma replacement of indwelling catheter nursing.Method:A systematic review of 13 patients with paraplegia and 167 person-time stoma catheter nursing.Conclusion: The success rate of the operation is 95% and incidence rate of nosocomial infection in 94%. This means the correct method of operation and nursing measures can reduce paraplegia patients' pain and the occurrence of nosocomial infection. This way can Improve work efficiency and worthy to worth to populate and apply

  7. Clinical study on postoperative steroid hormon replacement for preclinical Cushing's syndrome

    International Nuclear Information System (INIS)

    Diagnostic criteria for preclinical Cushing's syndrome (PCS) were reported in 1996. However, requirement of postoperative steroid hormone replacement is still controversial issue. In this study, we observed recent surgical cases retrospectively and evaluate the use of postoperative steroid hormone replacement. Eighteen patients with PCS underwent surgery from 1997 to 2007 in Jikei University Hospital. Thirteen of them received postoperative steroid hormone replacement. We investigated preoperative hormone activity by 131I-adosterol scintigraphy and suppression of adrenocorticotropic hormone (ACTH) and evaluated the requirement of postoperative steroid hormone replacement. Preoperative serum cortisol was normal range in all patients. Serum ACTH was suppressed in 10 of them (56%). In 131I-adosterol scintigraphy, accumulation in ipsilateral side was observed in all patients. Accumulation in contralateral side was observed in 13 patients whose serum ACTH had tendency to be suppressed. Mean period of steroid hormone replacement was 19.8 weeks. Patients with lower preoperative ACTH tended to require longer period until withdrawal of steroid hormone replacement. In addition, patients received steroid hormone replacement with higher starting dose significantly required longer period. Three of them had complications during tapering of steroid hormone. Postoperative adrenal insufficiency is important issue as postoperative management of PCS patients whose function of contralateral adrenal or pituitary gland is suppressed. 131I-adosterol scintigraphy and preoperative serum ACTH were important factors to evaluate the requirement of postoperative steroid hormone replacement. Especially, patients with low preoperative serum ACTH tended to require long duration of postoperative steroid hormone replacement. On the other hand, patients with accumulation of contralateral side in 131I-adosterol scintigraphy and without suppression of serum ACTH may not require steroid hormone

  8. Clinical longevity of extensive direct composite restorations in amalgam replacement : Up to 3.5 years follow-up

    NARCIS (Netherlands)

    Scholtanus, Johannes D.; Ozcan, Mutlu

    2014-01-01

    Objectives: This prospective clinical trial evaluated the longevity of direct resin composite (DRC) restorations made on stained dentin that is exposed upon removal of existing amalgam restorations in extensive cavities with severely reduced macro-mechanical retention for amalgam replacement. Method

  9. Introduction of online adaptive radiotherapy for bladder cancer through a multicentre clinical trial (Trans-Tasman Radiation Oncology Group 10.01): lessons learned

    International Nuclear Information System (INIS)

    Online adaptive radiotherapy for bladder cancer is a novel radiotherapy technique that was found feasible in a pilot study at a single academic institution. In September 2010 this technique was opened as a multicenter study through the Trans-Tasman Radiation Oncology Group (TROG 10.01 bladder online adaptive radiotherapy treatment). Twelve centers across Australia and New-Zealand registered interest into the trial. A multidisciplinary team of radiation oncologists, radiation therapists and medical physicists represented the trial credentialing and technical support team. To provide timely activation and proper implementation of the adaptive technique the following key areas were addressed at each site: Staff education/training; Practical image guided radiotherapy assessment; provision of help desk and feedback. The trial credentialing process involved face-to-face training and technical problem solving via full day site visits. A dedicated 'help-desk' team was developed to provide support for the clinical trial. 26% of the workload occurred at the credentialing period while the remaining 74% came post-center activation. The workload was made up of the following key areas; protocol clarification (36%), technical problems (46%) while staff training was less than 10%. Clinical trial credentialing is important to minimizing trial deviations. It should not only focus on site activation quality assurance but also provide ongoing education and technical support. (author)

  10. Introduction of online adaptive radiotherapy for bladder cancer through a multicentre clinical trial (Trans-Tasman Radiation Oncology Group 10.01: Lessons learned

    Directory of Open Access Journals (Sweden)

    Daniel Pham

    2013-01-01

    Full Text Available Online adaptive radiotherapy for bladder cancer is a novel radiotherapy technique that was found feasible in a pilot study at a single academic institution. In September 2010 this technique was opened as a multicenter study through the Trans-Tasman Radiation Oncology Group (TROG 10.01 bladder online adaptive radiotherapy treatment. Twelve centers across Australia and New-Zealand registered interest into the trial. A multidisciplinary team of radiation oncologists, radiation therapists and medical physicists represented the trial credentialing and technical support team. To provide timely activation and proper implementation of the adaptive technique the following key areas were addressed at each site: Staff education/training; Practical image guided radiotherapy assessment; provision of help desk and feedback. The trial credentialing process involved face-to-face training and technical problem solving via full day site visits. A dedicated "help-desk" team was developed to provide support for the clinical trial. 26% of the workload occurred at the credentialing period while the remaining 74% came post-center activation. The workload was made up of the following key areas; protocol clarification (36%, technical problems (46% while staff training was less than 10%. Clinical trial credentialing is important to minimizing trial deviations. It should not only focus on site activation quality assurance but also provide ongoing education and technical support.

  11. Stem cell applications for pathologies of the urinary bladder

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    New stem cell based therapies are undergoing intenseresearch and are widely investigated in clinical fieldsincluding the urinary system. The urinary bladderperforms critical complex functions that rely on its highlycoordinated anatomical composition and multiplex ofregulatory mechanisms. Bladder pathologies resulting insevere dysfunction are common clinical encounter andoften cause significant impairment of patient's quality oflife. Current surgical and medical interventions to correcturinary dysfunction or to replace an absent or defectivebladder are sub-optimal and are associated with notablecomplications. As a result, stem cell based therapiesfor the urinary bladder are hoped to offer new venuesthat could make up for limitations of existing therapies.In this article, we review research efforts that describethe use of different types of stem cells in bladderreconstruction, urinary incontinence and retentiondisorders. In particular, stress urinary incontinence hasbeen a popular target for stem cell based therapiesin reported clinical trials. Furthermore, we discuss therelevance of the cancer stem cell hypothesis to thedevelopment of bladder cancer. A key subject thatshould not be overlooked is the safety and quality ofstem cell based therapies introduced to human subjectseither in a research or a clinical context.

  12. Oral nutrition or water loading before hip replacement surgery; a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Ljunggren Stefan

    2012-07-01

    Full Text Available Abstract Background Surgery induces insulin resistance that might be alleviated by a nutritional drink given preoperatively. The authors hypothesized that some of the beneficial effects of the drink could be attributed to the volume component (approximately 1 L rather than to the nutrients. Methods Sixty patients scheduled for elective total hip replacement under spinal anesthesia were recruited to a clinical trial, and randomly allocated to preoperative fasting, to oral ingestion of tap water, or to oral ingestion of a carbohydrate drink. An intravenous glucose tolerance test calculated glucose clearance and insulin sensitivity on the day before surgery, in the postoperative ward, and on the day after surgery. Other parameters were stress (cortisol in plasma and urine, muscle catabolism (urinary 3-methylhistidine, and wellbeing. Results Fifty-seven patients completed the study. In the postoperative ward, the glucose clearance and the insulin response had decreased from the previous day by 23% and 36%, respectively. Insulin sensitivity did not decrease until the next morning (−48% and was due to an increased insulin response (+51%. Cortisol excretion was highest on the day of surgery, while 3-methylhistidine increased 1 day later. Follow-up on the third postoperative day showed an average of 1.5 complications per patient. Wellbeing was better 2 weeks after than before the surgery. None of the measured parameters differed significantly between the study groups. Conclusions Preoperative ingestion of tap water or a nutritional drink had no statistically significant effect on glucose clearance, insulin sensitivity, postoperative complications, or wellbeing in patients undergoing elective hip surgery. Trial registration Registration number: NCT 01211184 (http://www.clinicaltrials.gov

  13. Breakfast replacement with a low-glycaemic response liquid formula in patients with type 2 diabetes: a randomised clinical trial.

    Science.gov (United States)

    Stenvers, Dirk J; Schouten, Lydia J; Jurgens, Jordy; Endert, Erik; Kalsbeek, Andries; Fliers, Eric; Bisschop, Peter H

    2014-08-28

    Low-glycaemic index diets reduce glycated Hb (HbA1c) in patients with type 2 diabetes, but require intensive dietary support. Using a liquid meal replacement with a low glycaemic response (GR) may be an alternative dietary approach. In the present study, we investigated whether breakfast replacement with a low-GR liquid meal would reduce postprandial glycaemia and/or improve long-term glycaemia. In the present randomised, controlled, cross-over design, twenty patients with type 2 diabetes consumed either a breakfast replacement consisting of an isoenergetic amount of Glucerna SR or a free-choice breakfast for 3 months. Postprandial AUC levels were measured using continuous glucose measurement at home. After the 3-month dietary period, meal profiles and oral glucose tolerance were assessed in the clinical setting. The low-GR liquid meal replacement reduced the AUC of postprandial glucose excursions at home compared with a free-choice control breakfast (estimated marginal mean 141 (95 % CI 114, 174) v. estimated marginal mean 259 (95 % CI 211, 318) mmol × min/l; P= 0·0002). The low-GR liquid meal replacement also reduced glucose AUC levels in the clinical setting compared with an isoenergetic control breakfast (low GR: median 97 (interquartile range (IQR) 60-188) mmol × min/l; control: median 253 (IQR 162-386) mmol × min/l; Pmeal replacement did not affect fasting plasma glucose, HbA1c or lipid levels, and even slightly reduced oral glucose tolerance. In conclusion, the low-GR liquid meal replacement is a potential dietary approach to reduce postprandial glycaemia in patients with type 2 diabetes. However, clinical trials into the effects of replacing multiple meals on long-term glycaemia in poorly controlled patients are required before a low-GR liquid meal replacement can be adopted as a dietary approach to the treatment of type 2 diabetes. PMID:25091284

  14. Clinical significance of serum and urinary HER2/neu protein levels in primary non-muscle invasive bladder cancer

    Directory of Open Access Journals (Sweden)

    Ozgur Arikan

    2015-12-01

    Full Text Available Objective: We aimed to compare serum and urinary HER2/neu levels between healthy control group and patients with non-muscle invasive bladder cancer. Additionally, we evaluated relationship of HER2/neu levels with tumor stage, grade, recurrence and progression. Materials and Methods: Fourty-four patients with primary non-muscle invasive bladder tumors (Group 2 and 40 healthy control group (Group 1 were included the study. Blood and urinary samples were collected from all patients and HER2/neu levels were measured by ELISA method. Blood and urinary HER2/neu levels and additionally, ratio of urinary HER2/neu levels to urinary creatinine levels were recorded. Demographic data and tumor characteristics were recorded. Results: Mean serum HER2/neu levels were similar between two groups and statistically significant difference wasn't observed. Urinary HER2/neu levels were significantly higher in group 2 than group 1. Ratio of urinary HER2/neu to urinary creatinine was significantly higher in group 2 than group 1, (p=0,021. Serum and urinary HER2/ neu levels were not associated with tumor stage, grade, recurrence and progression while ratio of urinary HER2/neu to urinary creatinin levels were significantly higher in high-grade tumors. HER2/neu, the sensitivity of the test was found to be 20.5%, and the specificity was 97.5%, also for the urinary HER2/neu/urinary creatinine ratio, the sensitivity and specificity of the test were found to be 31.8% and 87.5%, respectively. Conclusions: Urinary HER2/neu and ratio of urinary creatinine urine were significantly higher in patients with bladder cancer compared to healthy subjects. Large series and controlled studies are needed for use as a tumor marker.

  15. Seal, replacement or monitoring amalgam restorations with occlusal marginal defects? Results of a 10-year clinical trial.

    Science.gov (United States)

    Moncada, G; Fernández, E; Mena, K; Martin, J; Vildósola, P; De Oliveira Junior, O B; Estay, J; Mjör, I A; Gordan, V V

    2015-11-01

    The aim of this prospective and blind clinical trial was to assess the effectiveness of sealing localized marginal defects of amalgam restoration that were initially scheduled to be replaced. A cohort of twenty six patients with 60 amalgam restorations (n=44Class I and n=16Class II), that presented marginal defects deviating from ideal (Bravo) according to USPHS criteria, were assigned to either sealing or replacement groups: A: sealing n=20, Replacement n=20, and no treatment (n=20). Two blind examiners evaluated the restorations at baseline (K=0.74) and after ten years (K=0.84) according with USPHS criteria, in four parameters: marginal adaptation (MA), secondary caries (SC), marginal staining (MS) and teeth sensitivity (TS). Multiple comparison of restorations degradation/upgrade was analyzed by Friedman test and the comparisons within groups were performed by Wilcoxon test. After 10 years, 44 restorations were assessed (73.3%), Group A: n=14 and Group B: n=16; and Group C: n=14 sealing and replacement amalgam restorations presented similar level of quality in MA (p=0.76), SC (p=0.25) and TS (p=0.52), while in MS (p=0.007) presented better performance in replacement group after 10-years. Most of the occlusal amalgam restorations with marginal gaps showed similar long term outcomes than the restorations were sealed, replaced, or not treated over a 10-year period. Most of the restorations of the three groups were clinically acceptable, under the studied parameters. All restorations had the tendency to present downgrade/deterioration over time. PMID:26231302

  16. Joint Replacement Surgery

    Science.gov (United States)

    ... a Clinical Trial Journal Articles Arthritis July 2014 Joint Replacement Surgery: Health Information Basics for You and Your Family What Is Joint Replacement Surgery? Joint replacement surgery is removing a ...

  17. SOX4 expression in bladder carcinoma

    DEFF Research Database (Denmark)

    Aaboe, Mads; Birkenkamp-Demtroder, Karin; Wiuf, Carsten;

    2006-01-01

    The human transcription factor SOX4 was 5-fold up-regulated in bladder tumors compared with normal tissue based on whole-genome expression profiling of 166 clinical bladder tumor samples and 27 normal urothelium samples. Using a SOX4-specific antibody, we found that the cancer cells expressed the...

  18. Randomized trial of nicotine replacement therapy (NRT), bupropion and NRT plus bupropion for smoking cessation: Effectiveness in clinical practice

    OpenAIRE

    Stapleton, J.; Z Abdi; Strang, J.; Sutherland, G; West, R; Vangeli, E.; Hajek, P; McRobbie, H; Humphrey, K.; Wheeler, J.; O'Gara, C; Ali, R

    2013-01-01

    Background and aims: Bupropion was introduced for smoking cessation following a pivotal trial showing that it gave improved efficacy over the nicotine patch and also suggesting combination treatment was beneficial. We tested in clinical practice for an effectiveness difference between bupropion and nicotine replacement therapy (NRT), whether the combination improves effectiveness and whether either treatment might be more beneficial for certain subgroups of smokers. Design: Open-label randomi...

  19. Replacement of missing lateral incisors with lithium disilicate glass-ceramic veneer-fixed dental prostheses: a clinical report

    OpenAIRE

    Bissasu, Sami M; Al-houri, Nabil A

    2014-01-01

    Key Clinical Message This report describes the use of lithium disilicate glass-ceramic veneer-fixed dental prostheses in replacing congenitally missing maxillary lateral incisors. This kind of prosthesis has an advantage over a lingual-retainer resin-bonded fixed dental prosthesis in its capability of changing the color and shape of the abutment teeth. The prostheses provided an acceptable esthetics and comfort for the patient.

  20. Temporal changes in clinic and ambulatory blood pressure during cyclic post-menopausal hormone replacement therapy

    DEFF Research Database (Denmark)

    Sørensen, M B; Rasmussen, Verner; Jensen, Gorm Boje; Ottesen, B

    2000-01-01

    OBJECTIVE: Post-menopausal hormone replacement (HRT) might protect against cardiovascular disease, possibly by arterial vasodilation and reduced blood pressure. Progestogens are needed to avoid endometrial disease but vascular effects are controversial. The objective was to assess temporal changes...... in blood pressure (BP) by two measurement techniques during a cyclic hormone replacement regimen. DESIGN AND METHODS: Sixteen healthy and normotensive post-menopausal women (age 55 +/- 3 years) were studied in a placebo-controlled, randomized crossover study, and were randomized to 17beta...

  1. Association between the clinical classification of hypothyroidism and reduced TSH in LT4 supplemental replacement treatment for pregnancy in China.

    Science.gov (United States)

    Zhang, Lyu; Zhang, Zhaoyun; Ye, Hongying; Zhu, Xiaoming; Li, Yiming

    2016-05-01

    The study was aimed to evaluate the effects of levothyroxine (LT4) supplemental replacement treatment for pregnancy and analyze the associations between the clinical classification of hypothyroidism and reduced thyroid-stimulating hormone (TSH) in LT4 therapy. Totally, 195 pregnant women with hypothyroidism receiving routine prenatal care were enrolled. They were categorized into three groups: overt hypothyroidism (OH), subclinical hypothyroidism (SCH) with negative thyroperoxidase antibody (TPOAb), and SCH with positive TPOAb. The association between the clinical classification and reduced TSH in LT4 supplemental replacement treatment was assessed. The results indicated that reduced TSH was significantly different among the groups according to the clinical classifications (p = 0.043). The result was also significantly different between patients with OH and patients with SCH and negative TPOAb (p = 0.036). Similar result was reported for the comparison between patients with OH and patients with SCH and positive TPOAb (p = 0.016). Multiple variable analyses showed that LT4 supplementation, gestational age and the variable of clinical classifications were associated with reduced TSH independently. Our data suggested that the therapeutic effect of substitutive treatment with LT4 was significantly associated with different clinical classifications of hypothyroidism in pregnancy and the treatment should begin as soon as possible after diagnosis. PMID:26651855

  2. Neoadjuvant Chemotherapy in Neuroendocrine Bladder Cancer: A Case Report

    OpenAIRE

    Prelaj, Arsela; Rebuzzi, Sara Elena; Magliocca, Fabio Massimo; Speranza, Iolanda; Corongiu, Emanuele; Borgoni, Giuseppe; Perugia, Giacomo; Liberti, Marcello; Bianco, Vincenzo

    2016-01-01

    Patient: Male, 71 Final Diagnosis: Neuroendocrine cancer bladder Symptoms: Dysuria • haematuria Medication: — Clinical Procedure: Transurethral resection of the bladder tumor Specialty: Oncology Objective: Rare disease Background: Small cell carcinoma of the urinary bladder is a rare and aggressive form of bladder cancer that mainly presents at an advanced stage. As a result of its rarity, it has been described in many case reports and reviews but few retrospective and prospective trials, sho...

  3. Iatrogenic neonatal bladder perforation

    Directory of Open Access Journals (Sweden)

    Lilia Trigui

    2011-01-01

    Full Text Available Neonatal bladder rupture is rare as a complication of bladder obstruction due to abnormal anatomy or iatrogenic causes. The present study describes the case of a 3-day-old infant with ascites due to bladder perforation secondary probably to manual decompression of the bladder. The infant underwent successful surgical repair of the perforation.

  4. Local infiltration analgesia in joint replacement: the evidence and recommendations for clinical practice

    DEFF Research Database (Denmark)

    Kehlet, H; Andersen, L Ø

    2011-01-01

    Relief of acute pain after hip and knee replacement represents a major therapeutic challenge as post-operative pain hinders early mobilisation and rehabilitation with subsequent consequences on mobility, duration of hospitalisation and overall recovery. In recent years, there has been increased...... interest in high-volume local wound infiltration/infusion techniques in these operations with a combined administration of local anaesthetics, NSAIDs and epinephrine. This review provides an update of the current knowledge of the efficacy of the high-volume wound infiltration technique based on randomised...... either intraoperatively or with a post-operative wound infusion catheter technique, provided that multimodal, oral non-opioid analgesia is given. In knee replacement, the data support the intraoperative use of the local infiltration technique but not the post-operative use of wound catheter...

  5. HDL-replacement therapy: mechanism of action, types of agents and potential clinical indications

    OpenAIRE

    Remaley, Alan T.; Amar, Marcelo; Sviridov, Dmitri

    2008-01-01

    HDL-replacement therapy is a promising new treatment strategy involving the acute administration of HDL to rapidly stabilize patients at imminent risk for developing a myocardial infarction, such as those with acute coronary syndrome. This review will first focus on the anti-atherogenic mechanisms for HDL, such as the stimulation of the reverse cholesterol transport pathway, and then discuss the other potential beneficial biological effects of HDL on atherosclerosis. The various types of HDL-...

  6. Nutritional status and clinical outcome of children on continuous renal replacement therapy: a prospective observational study

    OpenAIRE

    Castillo Ana; Santiago Maria J; López-Herce Jesús; Montoro Sandra; López Jorge; Bustinza Amaya; Moral Ramón; Bellón Jose M

    2012-01-01

    Abstract Background No studies on continuous renal replacement therapy (CRRT) have analyzed nutritional status in children. The objective of this study was to assess the association between mortality and nutritional status of children receiving CRRT. Methods Prospective observational study to analyze the nutritional status of children receiving CRRT and its association with mortality. The variables recorded were age, weight, sex, diagnosis, albumin, creatinine, urea, uric acid, severity of il...

  7. Clinical review: Use of renal replacement therapies in special groups of ICU patients

    OpenAIRE

    Hoste, Eric; Dhondt, Annemieke

    2012-01-01

    Acute kidney injury (AKI) in ICU patients is typically associated with other severe conditions that require special attention when renal replacement therapy (RRT) is performed. RRT includes a wide range of techniques, each with specific characteristics and implications for use in ICU patients. In the present review we discuss a wide range of conditions that can occur in ICU patients who have AKI, and the implications this has for RRT. Patients at increased risk for bleeding should be treated ...

  8. Temporal changes in clinic and ambulatory blood pressure during cyclic post-menopausal hormone replacement therapy

    DEFF Research Database (Denmark)

    Sørensen, M B; Rasmussen, Verner; Jensen, Gorm Boje;

    2000-01-01

    OBJECTIVE: Post-menopausal hormone replacement (HRT) might protect against cardiovascular disease, possibly by arterial vasodilation and reduced blood pressure. Progestogens are needed to avoid endometrial disease but vascular effects are controversial. The objective was to assess temporal change...... but the reduction varies with the HRT regimen, which might explain the diversity in previous BP findings during HRT. Norethisterone acetate might possess additive blood pressure-lowering effects in postmenopausal women....

  9. Clinical utility of three-dimensional contrast-enhanced ultrasound in the differentiation between noninvasive and invasive neoplasms of urinary bladder

    International Nuclear Information System (INIS)

    for inter-reader agreements were 0.717, 0.794 and 0.914. Conclusion: Three-dimensional contrast-enhanced ultrasound imaging, with contrast-enhanced spatial visualization is clinical useful for differentiating invasive and noninvasive neoplasms of urinary bladder objectively.

  10. Immunotherapy for bladder cancer.

    Science.gov (United States)

    Fuge, Oliver; Vasdev, Nikhil; Allchorne, Paula; Green, James Sa

    2015-01-01

    It is nearly 40 years since Bacillus Calmette-Guérin (BCG) was first used as an immunotherapy to treat superficial bladder cancer. Despite its limitations, to date it has not been surpassed by any other treatment. As a better understanding of its mechanism of action and the clinical response to it have evolved, some of the questions around optimal dosing and treatment protocols have been answered. However, its potential for toxicity and failure to produce the desired clinical effect in a significant cohort of patients presents an ongoing challenge to clinicians and researchers alike. This review summarizes the evidence behind the established mechanism of action of BCG in bladder cancer, highlighting the extensive array of immune molecules that have been implicated in its action. The clinical aspects of BCG are discussed, including its role in reducing recurrence and progression, the optimal treatment regime, toxicity and, in light of new evidence, whether or not there is a superior BCG strain. The problems of toxicity and non-responders to BCG have led to development of new techniques aimed at addressing these pitfalls. The progress made in the laboratory has led to the identification of novel targets for the development of new immunotherapies. This includes the potential augmentation of BCG with various immune factors through to techniques avoiding the use of BCG altogether; for example, using interferon-activated mononuclear cells, BCG cell wall, or BCG cell wall skeleton. The potential role of gene, virus, or photodynamic therapy as an alternative to BCG is also reviewed. Recent interest in the immune check point system has led to the development of monoclonal antibodies against proteins involved in this pathway. Early findings suggest benefit in metastatic disease, although the role in superficial bladder cancer remains unclear. PMID:26000263

  11. Imaging of urinary bladder tumors

    International Nuclear Information System (INIS)

    Full text: Primary bladder neoplasms account for 2%-6% of all tumors, with urinary bladder cancer ranked as the fourth most common cancer in males. Transitional cell carcinoma (TCC) is the most common subtype of urothelial tumour accounting for approximately 90% of all urothelial cancers. It is typically observed in men aged 50-70 years with history of smoking or occupational exposure to carcinogens. Most urothelial neoplasms are low-grade papillary tumors, with high incidence of recurrence, requires rigorous follow-up but have a relatively good prognosis. Other bladder neoplasm include squamous cell carcinoma accounts for 2%-15% mainly according to geographic location; adenocarcinoma - less than 2% /both occurring in the context of chronic bladder infection and irritation/; mesenchymal tumors in 5%, with the most common examples being rhabdomyosarcoma in children and leiomyosarcoma in adults. More rare mesenchymal tumors include paraganglioma, lymphoma, leiomyoma and solitary fibrous tumor which have no specific typical imaging findings to be differentiated. Multidetector computed tomography urography is an efficient tool for diagnosis and follow-up in patients with transitional cell carcinoma and it can be considered the primary radiologic method for detection, staging and assessment of the entire urothelium regarding the multicentric nature of TCC. MRI is rapidly expanding modality of choice especially in locally staging the tumor and in controversies. Accurate TNM staging is primordial in choosing treatment and prognosis for patients with bladder carcinoma. Correct interpretation and classification of the tumour is helpful for the urologists to determine further management in these cases. The learning objectives of the presentation are: to illustrate the spectrum of CT and MRI findings and to assess their clinical value in patients with transitional cell carcinoma and some other bladder neoplasm; to discuss the TNM staging based on the imaging findings; to be

  12. Oral Rehydration Therapy and Feeding Replaces Total Parenteral Nutrition: A Clinical Vignette.

    Science.gov (United States)

    Wright, Scott Mitchell; Noon, Muhammad Jawad; Greenough, William Bates

    2016-02-01

    A 27-year-old patient with spina bifida and a high output loss of water and electrolytes from her ileostomy was successfully liberated from dependency on total parenteral nutrition and intravenous fluid and electrolyte replacement by the use of a rice-based oral rehydration therapy (ORT). This allowed her to return home to the care of her mother. We suggest that ORT can be effective in the context of modern high-technology settings, as well as in resource-poor situations. PMID:25982236

  13. Diabetes mellitus and cellular replacement therapy: Expected clinical potential and perspectives

    Institute of Scientific and Technical Information of China (English)

    Alexander; E; Berezin

    2014-01-01

    Diabetes mellitus(DM) is the most prevailing disease with progressive incidence worldwide. Despite contemporary treatment type one DM and type two DM are frequently associated with long-term major microvascular and macrovascular complications. Currently restoration of failing β-cell function, regulation of metabolic processes with stem cell transplantation is discussed as complements to contemporary DM therapy regimens. The present review is considered paradigm of the regenerative care and the possibly effects of cell therapy in DM. Reprogramming stem cells, bone marrowderived mononuclear cells; lineage-specified progenitor cells are considered for regenerative strategy in DM. Finally, perspective component of stem cell replacement in DM is discussed.

  14. Hypersensitive bladder: a solution to confused terminology and ignorance concerning interstitial cystitis.

    Science.gov (United States)

    Homma, Yukio

    2014-04-01

    Taxonomy or nomenclature concerning interstitial cystitis and its related symptom syndromes is in a state of confusion. After analyzing the reasons for confusion in regard to three components (disease name, symptoms, Hunner's lesion), I would like to propose a new term, "hypersensitive bladder", taking after overactive bladder, as a solution. Hypersensitive bladder symptoms are defined as "increased bladder sensation, usually associated with urinary frequency and nocturia, with or without bladder pain." The proposal of hypersensitive bladder is based on: (i) it does not appear a symptom syndrome, but a disease by ending with an organ name, "bladder"; (ii) it does not contain confusable symptom terms (pain and urgency), but indicates irritative symptoms including pain and urgency; and (iii) it suggests pathophysiological hyperactivity of sensory nerves. Interstitial cystitis is defined by three requirements: (i) hypersensitive bladder symptoms; (ii) bladder pathology; and (iii) no other diseases, where bladder pathology should be clearly stated either as Hunner's lesion or glomerulations after hydrodistention. Hypersensitive bladder can be used for the condition with hypersensitive bladder symptoms, but no obvious disease explaining hypersensitive bladder symptoms identified. Interstitial cystitis is a representative disease causing hypersensitive bladder symptoms, most typically with pain, but might be painless and indistinguishable from overactive bladder. Introducing hypersensitive bladder as a counter concept of overactive bladder into bladder dysfunction taxonomy will facilitate clinical practice and research progress, and attract considerable attention from the medical world. PMID:24807494

  15. Bladder Dysfunction and Urinary Incontinence

    OpenAIRE

    F. faizi

    2009-01-01

      "nIn the name of God. Dear colleagues, ladies and gentlemen, it is a great honor to be here. Bladder dysfunction is serious enough to seek serious help. If you may know I am working in a private clinic which it is impossible to follow the patients so this lecture is based on unusual and rare cases who came to me. Bladder dysfunction (BD) is common among 30% of young and old people who are suffering from it, however it is more common in old ages. According to a research, women ...

  16. A clinical comparative study of anatomic parameters before and after total hip replacement on congenital dysplasia.

    Science.gov (United States)

    Huang, Ziqiang; Zhou, Yonggang; Chai, Wei; Ji, Weiping; Cui, Guopeng; Ma, Miaoqun; Zhu, Yin

    2016-07-01

    [Purpose] To study preoperative and postoperative hip circumference data of various types of congenital dysplasia of the hip treated with total hip replacement, including the femoral offset, femoral neck length, height, and hip abductor arm parameters. [Subjects and Methods] This study included seventy-eight cases of congenital dysplasia of the hip (I-III type). Furthermore, four parameters were measured, including the preoperative and postoperative femoral offset. Statistical data analysis was performed using the SPSS 13.0 software. [Results] The femoral offset was 33.3 ± 8.4 mm (preoperative) and 39.1 ± 7.1 mm (postoperative). The femoral head height was 59.5 ± 8.7 mm (preoperative) and 68.8 ± 11.0 mm (postoperative). The femoral neck length was 50.8 ± 10.8 mm (preoperative) and 61.5 ± 10.4 mm (postoperative). The hip abductor arm was 54.3 ± 9.6 mm (preoperative) 64.7 ± 10.1 mm (postoperative). The preoperative and postoperative parameters showed statistical differences. Furthermore, no significant differences were evidenced when comparing the postoperative hip parameters with the normal data parameters. [Conclusion] Total hip replacement on congenital dysplasia of the hip could lead to the rebuilt of an almost normal physiological anatomy for each hip case (type I-III). PMID:27512242

  17. 膀胱冲洗频率与导尿管更换时间对导尿管内腔生物膜的影响%Influence of frequency of bladder irrigation and catheter replacement cycle on biofilm forming in inner side of catheter

    Institute of Scientific and Technical Information of China (English)

    袁展望; 李武平; 史皆然; 付菊芳; 刘冰; 孙惠英; 白艳玲; 杨凡

    2014-01-01

    OBJECTIVE To explore the impact of the bladder irrigation and catheter replacement cycle on the biofilm forming in the inner side of catheter so as to provide guidance for clinical treatment .METHODS The urine and catheter specimens were collected from 157 critically ill patients who were treated in ICU from Mar 2013 to Dec 2013 ,then the culture of pathogens and the bacterial colony counts counting were carried out and observed by using electroscope;the participants were divided into the irrigation group with 76 cases and the non-irrigation group with 81 cases according to the status of bladder irrigation and catheter replacement ;the data were statistically analyzed with the use of SPSS19 .0 software ,and the count data were analyzed by means of chi-square test .RESULTS The urine was cultured positive in 26 cases in the irrigation group with the positive rate of 34 .21%and was cultured positive in 27 cases in the non-irrigation group with the positive rate of 33 .33% .The urine was cultured positive in 23 cases in the participants who were with the catheter replacement cycle of one week with the positive rate of 31 .08% and was cultured positive in 30 cases in the participants who were with the catheter replacement cycle of two weeks with the positive rate of 36 .14% ,there was no statistically significant difference . A total of 82 strains of pathogens have been cultured from the inner sides of the catheters ;the Escherichia coli was the predominant species of gram-negative bacteria ,accounting for 26 .83% ;the Enterococcus f aecalis was dominant among the gram-positive cocci ,accounting for 24 .39% ;the mature biofilm formed inside the catheter lumen when the bacterial quantitative was no less than 10 000/μl .CONCLUSIONS The bladder irrigation can neither inhibit the bacterial colonization in the inner sides of catheter nor prevent the formation of biofilm ;the critically ill patients do not need to change the catheters within two weeks but need to change when

  18. Immunotherapy for bladder cancer

    Directory of Open Access Journals (Sweden)

    Fuge O

    2015-05-01

    Full Text Available Oliver Fuge,1 Nikhil Vasdev,1 Paula Allchorne,2 James SA Green2 1Department of Urology, Lister Hospital, Stevenage, UK; 2Department of Urology, Bartshealth NHS Trust, Whipps Cross Rd, London, UK Abstract: It is nearly 40 years since Bacillus Calmette–Guérin (BCG was first used as an immunotherapy to treat superficial bladder cancer. Despite its limitations, to date it has not been surpassed by any other treatment. As a better understanding of its mechanism of action and the clinical response to it have evolved, some of the questions around optimal dosing and treatment protocols have been answered. However, its potential for toxicity and failure to produce the desired clinical effect in a significant cohort of patients presents an ongoing challenge to clinicians and researchers alike. This review summarizes the evidence behind the established mechanism of action of BCG in bladder cancer, highlighting the extensive array of immune molecules that have been implicated in its action. The clinical aspects of BCG are discussed, including its role in reducing recurrence and progression, the optimal treatment regime, toxicity and, in light of new evidence, whether or not there is a superior BCG strain. The problems of toxicity and non-responders to BCG have led to development of new techniques aimed at addressing these pitfalls. The progress made in the laboratory has led to the identification of novel targets for the development of new immunotherapies. This includes the potential augmentation of BCG with various immune factors through to techniques avoiding the use of BCG altogether; for example, using interferon-activated mononuclear cells, BCG cell wall, or BCG cell wall skeleton. The potential role of gene, virus, or photodynamic therapy as an alternative to BCG is also reviewed. Recent interest in the immune check point system has led to the development of monoclonal antibodies against proteins involved in this pathway. Early findings suggest

  19. Bladder preservation using chemoradiation therapy for locally invasive bladder cancer

    International Nuclear Information System (INIS)

    We investigated the long-term results and molecular markers of outcome with selective organ preservation in invasive bladder cancer using chemoradiation therapy. We examined locally invasive bladder cancer in 32 patients (30 men, 2 women; mean age at treatment 68.1 years) who underwent bladder-sparing protocols in the Department of Urology at Sumitomo Hospital between 2000 and 2005. The clinical stage was T2, T3, and T4 in 13, 16, and 3 patients, respectively. Our protocol includes aggressive transurethral resection of the bladder tumor (TURBT) and 46 Gy radiotherapy (2 Gy/fraction, 5 fractions/week) to the pelvis with concurrent cisplatin chemotherapy (20 mg/body/day, 5 days/week, the first and fourth week, intravenously). The initial evaluation included magnetic resonance imaging (MRI), urine cytology, and cystoscopy with a biopsy. During follow-up, if the patients developed superficial recurrence, they was treated with TURBT and intravesical Bacillus Calmette-Guerin (BCG), while patients with invasive recurrence were advised to undergo a salvage cystectomy. We examined the association between the expression of the Bcl-2 family in pretreatment TUR specimens and patient outcome. The mean follow-up was 54.6 months. The first assessment after the induction chemoradiotherapy showed that bladder preservation was achieved in 27 patients (84.4%). The actuarial local control rate with an intact bladder was 56.3% (18 patients) at 3 years. The 1-, 3-, and 5-year cancer-specific survival rate was 90.6, 84.0, and 66.9%, respectively. The 5-year cancer-specific survival rate was 75.0, 67.2, and 33.3% in T2, T3, and T4, respectively. Bcl-x positivity was significantly associated with a poor cancer-specific survival rate (log-rank test, p=0.038). Chemoradiation therapy for invasive bladder cancer can achieve survival rates similar to those in patients treated with radical cystectomy, with successful bladder preservation. Our results suggest that the expression of Bcl-x is a

  20. Advanced small cell carcinoma of the bladder: clinical characteristics, treatment patterns and outcomes in 960 patients and comparison with urothelial carcinoma.

    Science.gov (United States)

    Geynisman, Daniel M; Handorf, Elizabeth; Wong, Yu-Ning; Doyle, Jamie; Plimack, Elizabeth R; Horwitz, Eric M; Canter, Daniel J; Uzzo, Robert G; Kutikov, Alexander; Smaldone, Marc C

    2016-02-01

    To describe the clinical characteristics, treatment patterns and outcomes in advanced small cell bladder cancer (aSCBC) patients and compare to those with urothelial carcinoma (UC). Individuals in the National Cancer Data Base with a diagnosis of either nodal (TxN+M0) or distant metastatic (TxNxM1) disease were identified from 1998 to 2010. We assessed the relationships between stage, treatment modalities and survival in the aSCBC cohort and compared these to UC patients. In the 960 patient aSCBC cohort (62% M1), 50% received palliative therapy alone, 68% in M1 versus 21% in M0 groups (P carcinoma patients (n = 27,796, 45% M1) lived longer compared to aSCBC patients in the N+M0 group (17.3 months vs. 13.0 months, P = 0.0007). There were not clinically significant differences in OS between UC and aSCBC patients in the M1 group. Advanced SCBC is a rare disease with a poor survival and palliative therapy is common, especially in M1 patients. In comparison to UC, the outcomes for aSCBC patients are worse in those with lymph node only involvement but similar in those with distant disease. PMID:26679712

  1. Ossiculoplasty in Missing Malleus and Stapes Patients : Experimental and Preliminary Clinical Results With a New Malleus Replacement Prosthesis With the Otology-Neurotology Database

    NARCIS (Netherlands)

    Vincent, Robert; Bittermann, Arnold J. N.; Wenzel, Gentiana; Oates, John; Sperling, Neil; Lenarz, Thomas; Grolman, Wilko

    2013-01-01

    Objective: To present the preliminary results of new malleus replacement prosthesis combined with a total ossicular prosthesis in middle ear reconstruction in patients missing the malleus and stapes. Study Design: Prospective experimental and nonrandomized clinical study. Setting: Tertiary referral

  2. Neurogenic bladder in spinal cord injury patients

    Directory of Open Access Journals (Sweden)

    Al Taweel W

    2015-06-01

    Full Text Available Waleed Al Taweel, Raouf SeyamDepartment of Urology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi ArabiaAbstract: Neurogenic bladder dysfunction due to spinal cord injury poses a significant threat to the well-being of patients. Incontinence, renal impairment, urinary tract infection, stones, and poor quality of life are some complications of this condition. The majority of patients will require management to ensure low pressure reservoir function of the bladder, complete emptying, and dryness. Management typically begins with anticholinergic medications and clean intermittent catheterization. Patients who fail this treatment because of inefficacy or intolerability are candidates for a spectrum of more invasive procedures. Endoscopic managements to relieve the bladder outlet resistance include sphincterotomy, botulinum toxin injection, and stent insertion. In contrast, patients with incompetent sphincters are candidates for transobturator tape insertion, sling surgery, or artificial sphincter implantation. Coordinated bladder emptying is possible with neuromodulation in selected patients. Bladder augmentation, usually with an intestinal segment, and urinary diversion are the last resort. Tissue engineering is promising in experimental settings; however, its role in clinical bladder management is still evolving. In this review, we summarize the current literature pertaining to the pathology and management of neurogenic bladder dysfunction in patients with spinal cord injury.Keywords: neurogenic bladder, spinal cord injury, urodynamics, intestine, intermittent catheterization

  3. Why Clinical Experience and Mentoring Are Replacing Student Teaching on the Best Campuses. A White Paper

    Science.gov (United States)

    Fraser, James W.; Watson, Audra M.

    2014-01-01

    Woodrow Wilson Senior Fellow James W. Fraser and Audra Watson, the Foundation's Director of Mentoring and Induction Strategy, take a look at emerging trends in clinical preparation for new teachers. This new white paper is based on experience with the Woodrow Wilson Teaching Fellowships, and includes observations from some of the colleges and…

  4. Replacing Stressful Challenges with Positive Coping Strategies: A Resilience Program for Clinical Placement Learning

    Science.gov (United States)

    Delany, C.; Miller, K. J.; El-Ansary, D.; Remedios, L.; Hosseini, A.; McLeod, S.

    2015-01-01

    Clinical education is foundational to health professional training. However, it is also a time of increased stress for students. A student's perception of stressors and their capacity to effectively manage them is a legitimate concern for educators, because anxiety and decreased coping strategies can interfere with effective learning, clinical…

  5. Bladder Cancer Advocacy Network

    Science.gov (United States)

    ... future bladder cancer research through the Patient Survey Network. Read More... Don’t Miss the 2016 BCAN ... Click here for more details Bladder Cancer Advocacy Network 4915 St. Elmo Avenue, Suite 202 Bethesda, Maryland ...

  6. Efeitos da Corticosteroidoterapia na Uretra e na Bexiga de Ratas Castradas antes e durante Reposição Estrogênica Effects of Corticosteroids in the Urethra and Bladder of Castrated Female Rats before and during Estrogen Replacement Teraphy

    Directory of Open Access Journals (Sweden)

    João Batista dos Santos Junior

    2000-12-01

    Full Text Available Objetivo: avaliar os efeitos do uso de corticóides sobre os vasos e o epitélio da bexiga e da uretra de ratas. Método: utilizaram-se 54 ratas, divididas em 5 grupos: Grupo I - dez ratas castradas; Grupo II - onze ratas castradas que receberam succinato sódico de prednisolona, na dose de 15 mg/kg de peso, por via intraperitoneal durante 26 dias; Grupo III - doze ratas castradas que receberam o mesmo corticosteróide, na mesma dose associado ao 17 beta-estradiol na dose de 10 mg/kg, subcutâneo, nos últimos 5 dias antes de serem sacrificadas; Grupo IV - onze ratas castradas que receberam placebo por 26 dias; Grupo V - dez ratas não-castradas que receberam o mesmo corticosteróide, na dose e duração do grupo II. Resultados: observou-se na bexiga do grupo castrado que recebeu corticosteróide uma média de 1,8 vasos, número semelhante ao que recebeu corticosteróide e estrogênio, contra 0,8 vasos no grupo com placebo. Já na uretra, identificaram-se 0,7 vaso no grupo com corticosteróide, contra 0,9 vaso do grupo com corticosteróide associado ao estrogênio e 0,4 vaso no grupo placebo. Quanto à mucosa, observou-se que a espessura do epitélio vesical passou de 14,1 mm do grupo placebo para 20,6 mm no que recebeu corticosteróide e para 22,6 mm com corticosteróide e estrogênio. Da mesma maneira, a espessura do epitélio uretral passou de 12,4 mm no grupo controle para 15,1 mm no grupo com corticosteróide e para 16,7 mm com corticosteróide e estrogênio. Conclusões: a prednisolona, na dose e na duração utilizadas, aumentaram o número de vasos e a espessura do epitélio da bexiga e da uretra.Purpose: the effects of corticosteroids on the female urinary tract are not well understood, specially in climacteric women with or without estrogen replacement therapy. We studied the effects of corticosteroids on the blood vessels and epithelium of the bladder and urethra of female rats. Method: fifty-four female rats were used, divided into

  7. Clinical and economic outcomes after surgical aortic valve replacement in Medicare patients

    OpenAIRE

    Clark MA; Duhay FG; Thompson AK; Keyes MJ; Svensson LG; Bonow RO; Stockwell BT; Cohen DJ

    2012-01-01

    Mary Ann Clark,1 Francis G Duhay,2 Ann K Thompson,2 Michelle J Keyes,3 Lars G Svensson,4 Robert O Bonow,5 Benjamin T Stockwell,3 David J Cohen61The Neocure Group LLC, Washington, DC, 2Edwards Lifesciences Corporation, Irvine, CA, 3The Burgess Group LLC, Alexandria, VA, 4Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, Cleveland, OH, 5Center for Cardiovascular Innovation, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL...

  8. Nutritional status and clinical outcome of children on continuous renal replacement therapy: a prospective observational study

    Directory of Open Access Journals (Sweden)

    Castillo Ana

    2012-09-01

    Full Text Available Abstract Background No studies on continuous renal replacement therapy (CRRT have analyzed nutritional status in children. The objective of this study was to assess the association between mortality and nutritional status of children receiving CRRT. Methods Prospective observational study to analyze the nutritional status of children receiving CRRT and its association with mortality. The variables recorded were age, weight, sex, diagnosis, albumin, creatinine, urea, uric acid, severity of illness scores, CRRT-related complications, duration of admission to the pediatric intensive care unit, and mortality. Results The sample comprised 174 critically ill children on CRRT. The median weight of the patients was 10 kg, 35% were under percentile (P 3, and 56% had a weight/P50 ratio of less than 0.85. Only two patients were above P95. The mean age for patients under P3 was significantly lower than that of the other patients (p = 0.03. The incidence of weight under P3 was greater in younger children (p = 0.007 and in cardiac patients and in those who had previous chronic renal insufficiency (p = 0.047. The mortality analysis did not include patients with pre-existing renal disease. Mortality was 38.9%. Mortality for patients with weight P3 (51% vs 33%; p = 0.037. In the univariate and multivariate logistic regression analyses, the only factor associated with mortality was protein-energy wasting (malnutrition (OR, 2.11; 95% CI, 1.067-4.173; p = 0.032. Conclusions The frequency of protein-energy wasting in children who require CRRT is high, and the frequency of obesity is low. Protein-energy wasting is more frequent in children with previous end-stage renal disease and heart disease. Underweight children present a higher mortality rate than patients with normal body weight.

  9. Clinical predictors of elective total joint replacement in persons with end-stage knee osteoarthritis

    Directory of Open Access Journals (Sweden)

    Axe Michael J

    2010-05-01

    Full Text Available Abstract Background Arthritis is a leading cause of disability in the United States. Total knee arthroplasty (TKA has become the gold standard to manage the pain and disability associated with knee osteoarthritis (OA. Although more than 400 000 primary TKA surgeries are performed each year in the United States, not all individuals with knee OA elect to undergo the procedure. No clear consensus exists on criteria to determine who should undergo TKA. The purpose of this study was to determine which clinical factors will predict the decision to undergo TKA in individuals with end-stage knee OA. Knowledge of these factors will aid in clinical decision making for the timing of TKA. Methods Functional data from one hundred twenty persons with end-stage knee OA were obtained through a database. All of the individuals complained of knee pain during daily activities and had radiographic evidence of OA. Functional and clinical tests, collectively referred to as the Delaware Osteoarthritis Profile, were completed by a physical therapist. This profile consisted of measuring height, weight, quadriceps strength and active knee range of motion, while functional mobility was assessed using the Timed Up and Go (TUG test and the Stair Climbing Task (SCT. Self-perceived functional ability was measured using the activities of daily living subscale of the Knee Outcome Survey (KOS-ADLS. A logistic regression model was used to identify variables predictive of TKA use. Results Forty subjects (33% underwent TKA within two years of evaluation. These subjects were significantly older and had significantly slower TUG and SCT times (p 2 = 0.403. Conclusions Younger patients with full knee ROM who have a higher self-perception of function are less likely to undergo TKA. Physicians and clinicians should be aware that potentially modifiable factors, such as knee ROM can be addressed to potentially postpone the need for TKA.

  10. Bladder Dysfunction and Urinary Incontinence

    Directory of Open Access Journals (Sweden)

    F. faizi

    2009-01-01

    Full Text Available   "nIn the name of God. Dear colleagues, ladies and gentlemen, it is a great honor to be here. Bladder dysfunction is serious enough to seek serious help. If you may know I am working in a private clinic which it is impossible to follow the patients so this lecture is based on unusual and rare cases who came to me. Bladder dysfunction (BD is common among 30% of young and old people who are suffering from it, however it is more common in old ages. According to a research, women are more involved as in men which prostate has a role is more common. The usual cases were: "n1. A young girl, aged 20, who had to wake up five times during the night to micturate. "n2. Also a lady said when I roll in bed I wet myself. "n3. A young lady who always had to use a pad. "n4. A man said I can’t use underground. "n5. I cannot go out since I have to micturate every hour. "n6. One said I have to wake up every hour at night. "n7. Young people say we have to micturate 3-4 times at night. "n8. A young man said as soon as I feel to micturate I empty my bladder before I’ve reached the WC and I wet myself to the ankle, how could I have a job? "n9. Some women wet themselves when they cough. "nIn order to know and diagnosis, the physiology of bladder function must be known. "nThe bladder is divided into two parts: "nThe Dom, which is innervated by Beta-Adrenergic. It relaxes the bladder in order to comply the urine. "nFrom the orifice of the urether and posterior ridge of the trigon to the bladder neck or internal sphincter. The prostatic urethra plays a major role in conti- nence. It has two parts,   "n1: From the bladder neck to V.M. this is enclaved by extension of detrusor muscles like a sleeve. These muscles contract during ejaculation to prevent retrograde ejaculation. "nDistal urethra from V.M. to the external sphincter which is covered by voluntary muscles. "nThe internal pressure of the urethra is higher than the bladder. If the pressure of the bladder rises

  11. Total cervical disk replacement with a prestige LP® prosthesis: clinical and functional outcomes

    Directory of Open Access Journals (Sweden)

    Rafael Osório Rocha

    2014-01-01

    Full Text Available Objective: To determine the clinical and functional results of short- and medium-term cervical arthroplasty with the Prestige LP® prosthesis for the treatment of compressive myelopathy, radiculopathy and axial pain with radiculopathty. Methods: This retrospective study, conducted from 2009 to 2012, included 18 patients. Only 16 were found for the second stage of research, conducted in 2011 and 2012. Pre- and postoperative assessments were carried out using the CSOQ (Cervical Spine Outcomes Questionnaire. Odom criteria were used only in the postoperative evaluation. Both were translated and adapted to the local culture. Results: There was no postoperative radiculopathy or other complications requiring prolonged hospitalization. In most patients, there was a significant improvement in axial pain and radiculopathy, and there was only one indication of conversion to fusion. Conclusions: In selected cases of cervical degenerative disc disease, herniated cervical disc and compressive myeolopathy, cervical arthroplasty proved to be an effective and safe treatment in the short and medium terms.

  12. Hemodynamic function of the standard St. Jude bileaflet disc valve has no clinical impact 10 years after aortic valve replacement

    DEFF Research Database (Denmark)

    Lund, Ole; Dorup, Inge; Emmertsen, Kristian;

    2005-01-01

    OBJECTIVES: Size mismatch and impaired left ventricular function have been shown to determine the hemodynamic function of the standard St. Jude bileaflet disc valve early after aortic valve replacement (AVR). We aimed to analyse St. Jude valve hemodynamic function and its clinical impact in the...... regurgitation were excluded from further analysis: they had significantly lower St. Jude valve gradient and left ventricular ejection fraction (LVEF) and larger mass index (LVMi) than 37 without. RESULTS: In the 37 patients without left sided valve regurgitation peak and mean gradients were inversely related to...... St. Jude valve geometric orifice area (GOA) indexed for either body surface area or left ventricular end-diastolic dimension (LVEDD). The gradients correlated directly with LVEDD but not with LVEF or LVMi. Eleven patients with hypertension had higher peak gradients (31+/-13 versus 22+/-8 mmHg, p<0...

  13. Chemoprevention of bladder cancer.

    Science.gov (United States)

    Kamat, Ashish M; Lamm, Donald L

    2002-02-01

    possibility with long-term administration, the dose should be decreased to 16,000 IU after 3 years. High doses of beta-carotene should be avoided based on a large clinical trial reporting a 25% increase in the number of cases of prostate cancer and a statistically significant increase in the incidence of lung cancer. Vitamin B6 has been studied in several clinical trials in bladder cancer. The US-based Veterans Administration cooperative study found benefit for vitamin B6 when given as a single agent. Data for vitamins C and E are insufficient to recommend either agent as stand-alone treatment. Nonetheless, each of these vitamins is known to have beneficial effects, including improved function of the immune system. It is possible that only a small percentage of patients with bladder cancer respond to vitamins B6, C, or E, yet each is safe, nontoxic, and inexpensive. In an effort to pool the efficacy of individual agents and to increase the power of study, the authors evaluated the combination of vitamins A, B6, C, and E in a double-blind trial. The observed 50% 5-year reduction in tumor recurrence was highly significant and greater than would be expected for any of the individual ingredients and suggests that combinations of nutritional agents may be most appropriate. A large-volume study along similar lines is being conducted. Among the numerous other compounds and dietary substances purported to have chemopreventive effect, soybeans, garlic, and green tea stand out as having the greatest promise and can freely be recommended to patients. For synthetically synthesized agents such as celecoxib, piroxicam, or DFMO, recommendations must be deferred until the results of clinical trials are conclusively in favor of their use. Many of the dietary factors found to be protective against bladder cancer are being investigated in other cancers and are beneficial to general health. Although naturally occurring nutrients are ideal, especially because the delicate balance of various

  14. Thulium laser treatment for bladder cancer

    OpenAIRE

    Wei Wang; Haitao Liu; Shujie Xia

    2016-01-01

    Recent innovations in thulium laser techniques have allowed application in the treatment of bladder cancer. Laser en bloc resection of bladder cancer is a transurethral procedure that may offer an alternative to the conventional transurethral resection procedure. We conducted a review of basic thulium laser physics and laser en bloc resection procedures and summarized the current clinical literature with a focus on complications and outcomes. Literature evidence suggests that thulium laser te...

  15. Clinical application of single-tooth replacement with ankylos implant system

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical effects of Ankylos implant system to restore the loss of single-tooth. Methods: 90 cases with loss of single-tooth were selected and treated with routinely two-stage surgery. When the patients presented with deficient alveolar ridge, guided bone regeneration (GBR), osteotome sinus floor elevation, lateral antrostomy surgery with simultaneous placement of implant were applied. They were restored with platinum ceramic crown. All the implants were followed up, and the records were kept about stability of the implant and abutment, the status of surrounding soft tissue, sealability of implant abutment junction and the marginal bone lossing through X-ray checking,and satisfaction of the patients to mastication and aspect of the restorations. The follow-up time was 1-2.5 years. Results: Among the cases,one case had peri-implant inflammation, and one case had porcelain dropped. No loosening occurred in the other implants and abuments. Implant abutment junction was sealed well. The marginal bone loss 1 year after final restoration was less than 1 mm. Soft tissue surrounding implants was healthy. The satisfaction rate was 98.9% (89/90). According to standard of implant success, 88 cases were successful, the 2.5-year cumulative success rate was 97.8%, 2 cases failed, and the failure rate was 2.2 %. Conclusion: A satisfactory treatment effects could be gotten by using Ankylos implant system to restore the loss of single-tooth. (authors)

  16. 经尿道膀胱肿瘤电切术与绿激光治疗非肌层侵润性膀胱癌的临床效果及预后分析%The Clinical Effect and Prognostic Analysis of Transurethral Resection of Bladder Tumor and Green Laser in the Treatment of Non Muscle Invasive Bladder Cancer

    Institute of Scientific and Technical Information of China (English)

    柳坤

    2015-01-01

    目的:探究与分析经尿道膀胱肿瘤电切术和绿激光治疗非肌层浸润性膀胱癌的临床效果及预后。方法选自我院2014年8月~2015年5月收治的非浸润性膀胱癌患者86例,按随机数法分为电切组和激光组,分别给予经尿道电切术和绿激光治疗,观察两组患者手术中的情况以及手术后的情况,将结果进行对比分析。结果激光组患者在术中及术后的不良反应低于电切组,P<0.05,差异具有统计学意义。结论经尿道膀胱肿瘤电切术和绿激光治疗法均能有效治疗非肌层浸润性膀胱癌,绿激光治疗更为安全高效。%Objective To explore and analyze the clinical efficacy and prognosis for patients with non-muscle invasive bladder cancer treated with transurethral bladder tumor resection and green laser. Methods 86 cases of non invasive bladder cancer patients were selected from August 2014 to May 2015 that treated at our hospital. All the patients were divided into two groups, the resection group and the laser group, separately treated with transurethral resection and green laser. The intraoperative and postoperative condition of patients would be analyzed and compared between groups. Results In the laser group, the adverse events of intraoperative and postoperative patients was significantly lower than that of the resection group, P<0.05, compared with statistical significance. Conclusion Transurethral resection of bladder tumor and green laser therapy can effectively treat non-muscle invasive bladder cancer. The green laser treatment is worthy of further research and extension in the clinic with the advantage of more safe and effective..

  17. Gall bladder carcinoma presenting with spinal metastasis: A rare phenomenon

    Directory of Open Access Journals (Sweden)

    Mohit K Joshi

    2013-01-01

    Full Text Available Skeletal metastasis as a primary presentation of gall bladder carcinoma is rare. A 50-year-old lady presented with neck pain and weakness in her right upper limb of 3 months duration. Clinical and imaging work-up suggested locally advanced gall bladder carcinoma with metastasis to cervical vertebra and sternum. Only one case till date has been reported where the patient presented with neurological symptoms due to pathological fracture secondary to metastasis from an occult gall bladder carcinoma. Although rare, an occult gall bladder cancer may present with neurological symptoms due to pathological fracture of spine secondary to metastasis. We present a brief review of literature of patients who presented with skeletal metastases in clinically silent gall bladder malignancy. Palliative care issues in advanced gall bladder carcinoma have also been discussed.

  18. Tissue engineering and cell based therapies, from the bench to the clinic: The potential to replace, repair and regenerate

    Directory of Open Access Journals (Sweden)

    Fodor William L

    2003-11-01

    Full Text Available Abstract The field of Regenerative Biology as it applies to Regenerative Medicine is an increasingly expanding area of research with hopes of providing therapeutic treatments for diseases and/or injuries that conventional medicines and even new biologic drug therapies cannot effectively treat. Extensive research in the area of Regenerative Medicine is focused on the development of cells, tissues and organs for the purpose of restoring function through transplantation. The general belief is that replacement, repair and restoration of function is best accomplished by cells, tissues or organs that can perform the appropriate physiologic/metabolic duties better than any mechanical device, recombinant protein therapeutic or chemical compound. Several strategies are currently being investigated and include, cell therapies derived from autologous primary cell isolates, cell therapies derived from established cell lines, cell therapies derived from a variety of stem cells, including bone marrow/mesenchymal stem cells, cord blood stem cells, embryonic stem cells, as well as cells tissues and organs from genetically modified animals. This mini-review is not meant to be exhaustive, but aims to highlight clinical applications for the four areas of research listed above and will address a few key advances and a few of the hurdles yet to be overcome as the technology and science improve the likelihood that Regenerative Medicine will become clinically routine.

  19. Nested quantitative PCR approach for urinary cell-free EZH2 mRNA and its potential clinical application in bladder cancer.

    Science.gov (United States)

    Zhang, Xin; Zhang, Yanli; Liu, Xinfeng; Liu, Tong; Li, Peilong; Du, Lutao; Yang, Yongmei; Wang, Lili; Wang, Chuanxin

    2016-10-15

    EZH2 is overexpressed in bladder cancer (BC) and plays important roles in tumor development and progression. Recent studies show cell free (cf) RNAs released from cancer cells can reflect tissues changes and are stable and detectable in urine. Although conventional quantitative real-time PCR (qPCR) is highly sensitive, low abundances of urinary cf-RNAs usually result in false-negatives. Thus, this study develops a nested qPCR (nqPCR) approach to quantify cf-EZH2 mRNA in urine and further assess its clinical significance for BC. Forty urine samples were first selected to evaluate feasibility of nqPCR. Then, levels of urinary cf-EZH2 mRNA were detected using developed method in an independent cohort of subjects with 91 healthy, 81 cystitis, 169 nonmuscle invasive BC (NMIBC) and 103 muscle-invasive BC (MIBC). In cf-EZH2 mRNA detection, nqPCR method was significantly associated with qPCR, but it could detect more urine samples and increase detection limit three orders of magnitude. Based on nqPCR method, cf-EZH2 mRNA levels have been found to be increased in urine of NMIBC and MIBC patients (p  0.05). Moreover, it also could distinguish MIBC from NMIBC, with AUC of 0.787. For MIBC patients, high expression of cf-EZH2 mRNA associated with advanced stage and was an independent predictor of reduced disease free survival or overall survival. In conclusion, detection of cf-EZH2 mRNA in urine by nqPCR is a sensitive and noninvasive approach and may be used for diagnosis and prognosis prediction of MIBC. PMID:27300769

  20. CORRECTION OF BLADDER EXSTROPHY IN ADOLESCENT: 2 CASE REPORT

    OpenAIRE

    A. Burgio; G. Di Maggio; Ferrara, F.; G. Giannotti; Pavone, M.; A.L Bulotta; Messina, M.

    2012-01-01

    Introduction: bladder exstrophy is characterized by an incomplete development of anterior portion of bladder, urethra, abdominal wall and a median separation of pubic symphysis. We describe 2 clinical cases in adolescent treated with different surgical approach. Materials and Methods: two patients, one male and one female, respectively, 10 and 14 years old. Both cases had relapse: the bladder plate was performed in female when she was 2 years and in male when he was 6 years old. The male show...

  1. URACHAL CARCINOMA IN BLADDER

    Institute of Scientific and Technical Information of China (English)

    薛丽燕; 吕宁; 何祖根; 林冬梅; 刘秀云

    2004-01-01

    Objective: To investigate the clinicopathologic features and diagnostic criteria of urachal carcinoma in the bladder.Methods: Seven cases of urachal carcinoma in the bladder were analyzed retrospectively. Results: All the tumors were found locating in the dome of bladder. Of them, 4 were mucinous adenocarcinoma, one was well differentiated papillary enteric adenocarcinoma, one was well differentiated squamous carcinoma, and one was neuroendocrine carcinoma. Cystomorphous urachal remnants were found in 4 cases. The main complaint was hematuria and all patients underwent partial excision of bladder and urachus. Conclusion: Mucinous adenocarcinoma is the main histo-pathological type, and cystomorphous urachal remnants are often accompanied with urachal carcinoma in the bladder. The key diagnostic criteria of urachal carcinoma in bladder are site and histopathology. And to examine the specimens carefully to find the urachal remnants is important.

  2. Treatment Option Overview (Bladder Cancer)

    Science.gov (United States)

    ... Cancer Treatment Bladder Cancer Screening Research Bladder Cancer Treatment (PDQ®)–Patient Version General Information About Bladder Cancer ... Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) depends on ...

  3. Ultrasonographic evaluation of urinary bladder neoplasias

    Directory of Open Access Journals (Sweden)

    Nipa Patidar

    2015-12-01

    Full Text Available Background: Ultrasound has been shown to be a sensitive method for evaluating patients with chronic obstruction, bladder outlet obstruction, urinary tract infection, renal failure, renal and bladder neoplasm and renal transplants. It is now recommended as the method of choice for preliminary assessment and follow-up of several of these disorders. The objective of the study was to evaluate the specificity and sensitivity of ultrasonographic features of neoplastic lesions of urinary bladder. Methods: Clinical impression about the suspected abnormality was obtained from the case papers or from referring by clinical colleagues. Data was recorded under headings like clinical history, clinical examinations, investigations like urine analysis, serum creatinine and blood urea, X-ray of chest and Kidney Urinary Bladder, pelvic and abdominal Ultrasonography, and if require CT scan and guided biopsy. Results: out of total 35 cases 29 were Transitional Cell Carcinoma, 4 were Squamous Cell Carcinoma, One leiomyoma and one was secondary from bronchogenic carcinoma. Most of tumours were irregular in shape in both TCC and SCC patients. Most of tumour showed heterogeneous echo-texture in ultrasonography. While all SCC showed heterogeneous with calcification echo-texture. Most of the cases had residual urine volume was less than 100 cc. Conclusions: The primary advantage of ultrasound over the conventional study was found to be its ability to detect focal or diffuse bladder wall abnormalities in patients who presented with commonest complaint of painless hematuria. [Int J Res Med Sci 2015; 3(12.000: 3775-3778

  4. Somatic modulation of spinal reflex bladder activity mediated by nociceptive bladder afferent nerve fibers in cats.

    Science.gov (United States)

    Xiao, Zhiying; Rogers, Marc J; Shen, Bing; Wang, Jicheng; Schwen, Zeyad; Roppolo, James R; de Groat, William C; Tai, Changfeng

    2014-09-15

    The goal of the present study was to determine if supraspinal pathways are necessary for inhibition of bladder reflex activity induced by activation of somatic afferents in the pudendal or tibial nerve. Cats anesthetized with α-chloralose were studied after acute spinal cord transection at the thoracic T9/T10 level. Dilute (0.25%) acetic acid was used to irritate the bladder, activate nociceptive afferent C-fibers, and trigger spinal reflex bladder contractions (amplitude: 19.3 ± 2.9 cmH2O). Hexamethonium (a ganglionic blocker, intravenously) significantly (P < 0.01) reduced the amplitude of the reflex bladder contractions to 8.5 ± 1.9 cmH2O. Injection of lidocaine (2%, 1-2 ml) into the sacral spinal cord or transection of the sacral spinal roots and spinal cord further reduced the contraction amplitude to 4.2 ± 1.3 cmH2O. Pudendal nerve stimulation (PNS) at frequencies of 0.5-5 Hz and 40 Hz but not at 10-20 Hz inhibited reflex bladder contractions, whereas tibial nerve stimulation (TNS) failed to inhibit bladder contractions at all tested frequencies (0.5-40 Hz). These results indicate that PNS inhibition of nociceptive afferent C-fiber-mediated spinal reflex bladder contractions can occur at the spinal level in the absence of supraspinal pathways, but TNS inhibition requires supraspinal pathways. In addition, this study shows, for the first time, that after acute spinal cord transection reflex bladder contractions can be triggered by activating nociceptive bladder afferent C-fibers using acetic acid irritation. Understanding the sites of action for PNS or TNS inhibition is important for the clinical application of pudendal or tibial neuromodulation to treat bladder dysfunctions. PMID:25056352

  5. Hacia una clínica de las suplencias en la psicosis. // Towards a clinic of replacements in psychosis.

    Directory of Open Access Journals (Sweden)

    Jesús Manuel Ramírez Escobar.

    2008-12-01

    Full Text Available The current work deals with the formation of a social link during psychosis and the difficulties it involves. In order to do this, the central axis of work will be the concept developed by Lacan with respect to the psychosis until reaching the notion of replacement, a concept different to that of stabilization, as we will see at the beginning of Lacan’s structuralist work in the fifties. Subsequently, we will study the pertinence of the topology developed by this author during the seventies in what could be named a clinic of the Brunnian link, which clears new ways to a differential clinic, so it is possible to wonder about the role of the psychoanalyst in the direction of the cure on the formation of a social link at the end of the analysis. // El presente trabajo versa acerca de la conformación de un lazo social en la psicosis y de las dificultades que ello comporta. Para realizar lo anterior, el eje de trabajo será la elaboración desplegada por Lacan al respecto de las psicosis hasta llegar a la noción de suplencia, un concepto diferente al de estabilización, como veremos en el inicio del trabajo estructuralista de Lacan en los años cincuenta. Posteriormente, se toca la pertinencia de la topología desplegada por Lacan en los años setenta en lo que podríamos llamar una clínica del nudo borromeo, la cual abre nuevas vías para una clínica diferencial, para así llegar a preguntarnos sobre el lugar del analista en la dirección de la cura respecto de la constitución de un lazo social al final del análisis.

  6. One case treated bladder cancer with Immunity-herbal acupuncture

    Directory of Open Access Journals (Sweden)

    Dong-Suk Kim

    2002-02-01

    Full Text Available In oriental medicine bladder cancer had been called '溺血(Hematuria', 血淋(Blood Stranguria', 濕熱河注(Downward Flow of Damp-heat' and so on. The symptoms are Hematuria, Oliguria, Lower abdomen pain, febrile sensation and Anemia etc. These are similar to the symptoms of bladder cancer by modem medicine. I have experienced a bladder cancer patient who was diagnosed as stage Ⅲ. She has been treated bladder cancer with Immunity herbal acupuncture and Her clinical and objective symptoms have been better. Therefore I report this results.

  7. Spectrum of Lesions in Cystoscopic Bladder Biopsies -A Histopathological Study

    Directory of Open Access Journals (Sweden)

    Mahesh Kumar U

    2012-04-01

    Full Text Available Background: Diseases of the bladder, particularly inflammation (cystitis, constitute an important source of clinical signs and symptoms. Tumors of the bladder are an important source of both morbidity and mortality. Objectives: 1 To study the histopathological features of various lesions in bladder biopsies. 2 To study the frequency of different pathological lesions, particularly Transitional Cell Carcinoma (TCC in urinary bladder biopsies. Results: Sixty cases of urinary bladder biopsies were received. Out of 60 patients, 43 were males and 17 were females. The spectrum of pathological lesions included inflammations, metaplastic lesions and tumours. Transitional cell carcinoma was the most common tumour seen in this study. A case of paraganglioma and malakoplakia were also seen. Conclusions: Our study has revealed that the bladder tumours are the commonest lesions in cystoscopic biopsies and TCC was the predominant tumour type

  8. Association of PAX5 Expression with Clinical Outcome in Patients with TaT1 Transitional Cell Carcinoma of the Bladder

    Czech Academy of Sciences Publication Activity Database

    Babjuk, M.; Soukup, V.; Mareš, J.; Dušková, J.; Pecen, Ladislav; Pešl, M.; Pavlík, I.; Dvořáček, J.

    2006-01-01

    Roč. 67, č. 4 (2006), s. 756-761. ISSN 0090-4295 R&D Projects: GA MZd NR8095; GA MZd NR8934 Institutional research plan: CEZ:AV0Z10300504 Keywords : bladder carcinoma * PAX5 expression Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 2.130, year: 2006

  9. Bladder wall thickness and ultrasound estimated bladder weight in healthy adults with portative ultrasound device

    OpenAIRE

    Selcen Kanyilmaz; Funda Atamaz Calis; Yasemin Cinar; Yesim Akkoc

    2013-01-01

    Background: The aim of this study was to investigate bladder wall thickness (BWT) and ultrasound estimated bladder weight (UEBW) values in healthy population with a portative ultrasound device and their relationship with demographic parameters. Materials and Methods: The study was carried out in Neurorehabilitation Clinic of Ege University Hospital. Ninety-five subjects (48 women and 47 men) aged between 18 and 56 were included in the study. BWT and UEBW were determined non-invasively with a ...

  10. Intraoperative radiation therapy in patients with bladder cancer. A review of techniques allowing improved tumor doses and providing high cure rates without loss of bladder function

    International Nuclear Information System (INIS)

    Conventional external beam irradiation, using modern megavoltage techniques and doses that do not harm bladder function, will permanently eradicate local bladder cancer in 30% to 50% of patients, compared with 70% to 90% with cystectomy. In appropriately chosen patients, open surgery can safely provide excellent exposure for the selective delivery of more radiant energy directly to the tumor and less to the uninvolved portion of the bladder. Intraoperative radiation therapy, by either a removable radium or iridium implant or a large single dose of electrons, has been reported to be safe and can permanently cure the bladder of cancer and also preserve bladder function in more than 75% of patients with solitary tumors that invade into but not beyond the bladder muscle. With the increasing interest in and availability of intraoperative radiation therapy in the US, this curative and bladder-sparing treatment for operable patients with bladder cancer invading the trigone is appropriate for careful clinical trial. 13 references

  11. Radiosensitizing efficacy of iso-metronidazole after intravesical application in bladder cancer. A clinical phase II study. Die strahlensensibilisierende Wirkung von iso-Metronidazol nach intravesikaler Applikation beim Harnblasenkarzinom. Eine klinische Phase-II-Studie

    Energy Technology Data Exchange (ETDEWEB)

    Kob, D.; Lilienthal, A.; Bauhardt, H. (Jena Univ. (Germany). Klinik und Poliklinik fuer Radiologie); Merkle, K.; Schroeder, E.; Schroeder, E.; Hentschel, M. (Zentralinstitut fuer Krebsforschung, Berlin-Buch (Germany). Abt. Klinische Strahlenbiologie)

    1991-09-01

    The radiosensitizing efficacy of iso-Metronidazole, a 4-Nitroimidazole derivative, was evaluated in a prospective clinical phase II study. The results of combined radiotherapy of 25 patients with bladder cancer were compared with those of a control group of 25 patients treated with radiotherapy only. Tumor regression six months after radiotherapy was used as an endpoint. The surgical procedure was performed as double TUR. Evaluating the local tumor control after additional application of iso-Metronidazole a gain factor of 1.2 is obtained. (orig.).

  12. Stages of Bladder Cancer

    Science.gov (United States)

    ... red in color). Frequent urination. Pain during urination. Lower back pain. Tests that examine the urine and bladder are used to help detect (find) and diagnose bladder cancer. The following tests and ... left. Treatment given after surgery, to lower the risk that the cancer will come back, ...

  13. Bladder pain syndrome

    DEFF Research Database (Denmark)

    Hanno, Philip; Nordling, Jørgen; Fall, Magnus

    2011-01-01

    Bladder pain syndrome is a deceptively intricate symptom complex that is diagnosed on the basis of chronic pelvic pain, pressure, or discomfort perceived to be related to the urinary bladder, accompanied by at least one other urinary symptom. It is a diagnosis of exclusion in a patient who has...

  14. Bladder pain syndrome

    DEFF Research Database (Denmark)

    Hanno, Philip; Nordling, Jørgen; Fall, Magnus

    2011-01-01

    Bladder pain syndrome is a deceptively intricate symptom complex that is diagnosed on the basis of chronic pelvic pain, pressure, or discomfort perceived to be related to the urinary bladder, accompanied by at least one other urinary symptom. It is a diagnosis of exclusion in a patient who has ex...

  15. 间歇导尿更换卧位对脊髓伤致神经源性膀胱患者泌尿系感染的影响%Intermittent catheterization to replace lie on spinal cord injury patients with neurogenic bladder Urinary tract infection

    Institute of Scientific and Technical Information of China (English)

    黄学英; 王丽华; 柳尧花

    2013-01-01

    目的:探讨无菌间歇导尿(Sterile Intermittent Catheterization,SIC)更换卧位对脊髓损伤(spinal cord injury ,SCI)致神经源性膀胱功能障碍( neurogenic bladder ,NB),泌尿系感染( urinary tract infection ,UTI)并发症的影响。方法:SCI符合美国脊髓损伤学会(American Spinal Injury Association , ASIA)2011年标准;NB符合亚洲神经源性膀胱诊断治疗指南(2011版)的诊断标准。患者115例患者分为对照组56例,观察组59例,2组患者制定饮水计划并书写排尿日记,接受常用的膀胱功能训练,SIC,观察组导尿后采取更换卧位,分别叩击耻骨上、骶尾部和右侧/或左侧臀部,2次夹闭尿管、3次开放彻底引流尿液。观察指标:血常规、尿常规、细菌培养、肾功能、B超等辅助检查,每次导尿时观察尿液的物理状态。结果:2组患者UTI的发生随间歇导尿呈减少趋势,但对照组经过3周的间歇导尿UTI发生并无减少。观察组与照组比较3周后有显著性差异(P∠0.01)。结论:SIC更换卧位引流尿液,能有效降低SCI致NB患者UTI的发生。%Objective:To discuss sterile Intermittent Catheterization replace the lying position of spinal cord injury , cause neurogenic bladder dysfunction urinary tract infection complications.Methods:SCL conforms to the American Spinal Injury Association 2011 standard;NB in Asian neurogenic bladder guide (2011) diagnostic criteria for the diagnosis and treatment.56 cases patients, 115 patients were divided into control group, 59 cases of observation group, 2 groups of patients developed a plan of drinking water and voiding diary writing , commonly used bladder function training, SIC, Observation group after urethral catheterization to replace recumbent position , respectively the taps on the pubic bone, the tail and/or on the right side on the left side of the hips,, turn off 2 times, 3 times open drainage of urine

  16. Clinical and Radiographic Mid-Term Outcomes After Total Shoulder Replacement: A Retrospective Study Protocol Including 400 Anatomical and Reverse Prosthetic Implants

    Science.gov (United States)

    Merolla, Giovanni; Tartarone, Antonio; Porcellini, Giuseppe

    2016-01-01

    Objectives: To obtain outcomes data on anatomical and reverse total shoulder arthroplasty by analysis of clinical scores and standard radiographs. Subject selection and enrollment: 400 consecutive series of patients replaced with anatomical and reverse total shoulder arthroplasty (minimum 3 years follow-up). Study Design: retrospective monocenter. Preoperative assessment: Demographics, clinical scores (Constant-Murley) as available, shoulder X-ray (AP, outlet and axillary views) . Last follow-up: Postoperative radiographhs and clinical scores. Adverse events and complications to be reported as occurred since implantation. Statistical analysis: Data collected will be summarized and analyzed for statistical significance. PMID:27326389

  17. Clear cell urothelial carcinoma of the urinary bladder: a case report and review of the literature

    OpenAIRE

    Knez, Virginia M; Barrow, Willis; Lucia, M. Scott; Wilson, Shandra; La Rosa, Francisco G.

    2014-01-01

    Introduction The occurrence of clear cell tumors in the bladder is not uncommon. Clear cell dysplasia is well-described and characterized by focal replacement of transitional mucosa by cells with abundant clear cytoplasm, nuclear enlargement, and a granular chromatin pattern. Clear cells can also be seen in clear cell adenocarcinoma, which is rare, comprising 0.5% to 2.0% of the reported bladder carcinomas. Other clear cell tumors found in the bladder to be considered in the differential diag...

  18. Replacement of Anterior Composite Resin Restorations Using Conservative Ceramics for Occlusal and Periodontal Rehabilitation: An 18-Month Clinical Follow-Up.

    Science.gov (United States)

    da Cunha, Leonardo Fernandes; Prochnow, Rayane Alexandra; Costacurta, Adriana Osten; Gonzaga, Carla Castiglia; Correr, Gisele Maria

    2016-01-01

    This case report describes a patient with discolored and fractured composite resin restorations on the anterior teeth in whom substitution was indicated. After wax-up and mock-up, the composite was removed and replaced with minimally invasive ceramic laminates. An established and predictable protocol was performed using resin cement. Minimally invasive ceramic restorations are increasingly being used to replace composite restorations. This treatment improves the occlusal and periodontal aspects during the planning and restorative phases, such as anterior guides, and laterality can be restored easily with ceramic laminates. In addition, the surface smoothness and contour of ceramic restorations do not affect the health of the surrounding periodontal tissues. Here we present the outcome after 18 months of clinical follow-up in a patient in whom composite resin restorations in the anterior teeth were replaced with minimally invasive ceramic laminates. PMID:27555970

  19. Replacement of Anterior Composite Resin Restorations Using Conservative Ceramics for Occlusal and Periodontal Rehabilitation: An 18-Month Clinical Follow-Up

    Science.gov (United States)

    Prochnow, Rayane Alexandra; Costacurta, Adriana Osten; Correr, Gisele Maria

    2016-01-01

    This case report describes a patient with discolored and fractured composite resin restorations on the anterior teeth in whom substitution was indicated. After wax-up and mock-up, the composite was removed and replaced with minimally invasive ceramic laminates. An established and predictable protocol was performed using resin cement. Minimally invasive ceramic restorations are increasingly being used to replace composite restorations. This treatment improves the occlusal and periodontal aspects during the planning and restorative phases, such as anterior guides, and laterality can be restored easily with ceramic laminates. In addition, the surface smoothness and contour of ceramic restorations do not affect the health of the surrounding periodontal tissues. Here we present the outcome after 18 months of clinical follow-up in a patient in whom composite resin restorations in the anterior teeth were replaced with minimally invasive ceramic laminates. PMID:27555970

  20. Pokemon蛋白在膀胱尿路上皮癌中的表达及其意义%Expression of Pokemon protein and its clinical significance in bladder transitional cell carcinoma

    Institute of Scientific and Technical Information of China (English)

    侯列军; 虞亦鸣; 孙灵军; 虞建达

    2014-01-01

    Objective To explore the expression of Pokemon protein in bladder transitional cell carcinoma and its cor-relation with clinical features. Methods From March 2010 to August 2013, at Department of Urinary Surgery in Affili-ated Hospital of Ningbo University, 27 resection samples of patiens with bladder transitional cell carcinoma, including carcinoma tissue, paracancerous tissue and normal tissue were selected. Western blot was applied to detect the expres-sion of Pokemon protein in tissue and clinical-pathological features was analyzed. Results The result of Westen blot showed that the expression of Pokemon protein in bladder transitional cell carcinoma tissue was significantly higher than those of paracancerous tissue and normal tissue, the differences were statistically significant (P< 0.05). The ex-pression of Pokemon was related to different tumor degree, and no related to patient's gender, age, smoking history and TNM stages. Conclusion Pokemon protein is expressed in bladder transitional cell carcinoma and it may play a key role in the genesis of transitional cell carcinoma of bladder. It may be the therapeutic target of transitional cell carcino-ma of bladder in the future.%目的:检测膀胱尿路上皮癌组织中Pokemon蛋白的表达,分析其与临床病理特征间的关系。方法收集2010年3月~2013年8月宁波大学附属医院泌尿外科27例膀胱尿路上皮癌术中切除的癌、癌旁及临近正常组织,应用免疫印迹法(Western blot)检测标本中Pokemon蛋白的表达,并对其与膀胱癌的临床病理特征进行分析。结果 Western blot检测到Pokemon蛋白在膀胱尿路上皮癌组织中表达较高、在癌旁及正常组织中表达较低,差异有统计学意义(P<0.05)。膀胱癌组织中Pokemon蛋白表达与肿瘤病理分级有关,而与患者的性别、年龄、吸烟史及TNM临床分期无明显相关。结论 Pokemon蛋白表达和膀胱尿路上皮癌的发病及恶性程度有关,可能成

  1. The use of ultrasound-estimated bladder weight in diagnosing bladder outlet obstruction and detrusor overactivity in men with lower urinary tract symptoms

    OpenAIRE

    Housami, Fadi; Drake, Marcus; Abrams, Paul

    2009-01-01

    Objectives: Measurement of bladder weight using ultrasound estimates of bladder wall thickness and bladder volume is an emerging clinical measurement technique that may have a role in the diagnosis of lower urinary tract dysfunction. We have reviewed available literature on this technique to assess current clinical status. Methods: A systematic literature search was carried out within PubMed and MedLine to identify relevant publications. These were then screened for relevance. Preliminary res...

  2. The various types of neurogenic bladder dysfunction: an update of current therapeutic concepts.

    Science.gov (United States)

    Madersbacher, H

    1990-05-01

    Increased experience with treatment strategies developed during the last 10 years in the field of neurourology justifies an update of current therapeutic concepts. Based on a rather simple, but clinically useful, classification of detrusor-sphincter dysfunction the therapeutic concepts now available for four prototypes of detrusor-sphincter dysfunction are discussed. (1) For the combination of a hyperreflexive detrusor with a hyperreflexive (spastic) sphincter, characteristic for the reflex- and the uninhibited neuropathic bladder, detrusor-sphincter dyssynergia (DSD) is still the greatest problem, and transurethral sphincterotomy is the method of choice if this situation cannot otherwise be managed. One concept is to convert detrusor hyperreflexia into hyporeflexia by adequate pharmacotherapy, which is nowadays available, and to assist or to accomplish bladder emptying by clean intermittent (self-) catheterisation (CIC) with the advantage of dry intervals in between. Japanese colleagues recommend bladder overdistension during the spinal shock phase to achieve detrusor hyporeflexia, but this procedure is rather decisive at an early stage of the disability, leaving the detrusor no chance for further rehabilitation. Another possibility is rhizotomy of the sacral posterior roots to eliminate detrusor hyperreflexia, and the simultaneous implantation of a sacral anterior root stimulator (Brindley) to achieve electrically induced micturition. From our personal experience with 12 patients this concept is ideal for female patients with unbalanced reflex bladder and otherwise uncontrollable reflex incontinence. (2) The combination of a weak detrusor with a spastic sphincter is a clear indication for CIC, as the bladder is emptied regularly, and due to the spastic sphincter, the patient stays continent as long as controlled fluid intake prohibits overflow incontinence. The implantation of an anterior sacral root stimulator is an alternative approach provided that at least

  3. The SNAP trial: a randomised placebo-controlled trial of nicotine replacement therapy in pregnancy – clinical effectiveness and safety until 2 years after delivery, with economic evaluation

    OpenAIRE

    Cooper, Sue; Lewis, Sarah; Thornton, Jim; Marlow, Neil; Watts, Kim; Britton, John; Grainge, Matthew J.; Taggar, Jaspal; Essex, Holly; Parrott, Steve; Dickinson, Anne; Whitemore, Rachel; Coleman, Tim

    2014-01-01

    BACKGROUND: Smoking during pregnancy causes many adverse pregnancy and birth outcomes. Nicotine replacement therapy (NRT) is effective for cessation outside pregnancy but efficacy and safety in pregnancy are unknown. We hypothesised that NRT would increase smoking cessation in pregnancy without adversely affecting infants. OBJECTIVES: To compare (1) at delivery, the clinical effectiveness and cost-effectiveness for achieving biochemically validated smoking cessation of NRT patches wi...

  4. Evidence of Uncultivated Bacteria in the Adult Female Bladder

    OpenAIRE

    Wolfe, Alan J.; Toh, Evelyn; Shibata, Noriko; Rong, Ruichen; Kenton, Kimberly; FitzGerald, MaryPat; Mueller, Elizabeth R.; Schreckenberger, Paul; Dong, Qunfeng; Nelson, David E; Brubaker, Linda

    2012-01-01

    Clinical urine specimens are usually considered to be sterile when they do not yield uropathogens using standard clinical cultivation procedures. Our aim was to test if the adult female bladder might contain bacteria that are not identified by these routine procedures. An additional aim was to identify and recommend the appropriate urine collection method for the study of bacterial communities in the female bladder. Consenting participants who were free of known urinary tract infection provid...

  5. Bladder Wall Thickness Mapping for Magnetic Resonance Cystography

    OpenAIRE

    Zhao, Yang; Liang, Zhengrong; Zhu, Hongbin; Han, Hao; Duan, Chaijie; Yan, Zengmin; Lu, Hongbing; Gu, Xianfeng

    2013-01-01

    Clinical studies have shown the evidence that the bladder wall thickness is an effective biomarker for bladder abnormalities. The clinical optical cystoscopy, the current gold standard, cannot show the wall thickness. The use of ultrasound by experts may generate some local thickness information, but the information is limited in field-of-view and is user dependent. Recent advances in magnetic resonance (MR) imaging technologies lead MR-based virtual cystoscopy or MR cystography toward a pote...

  6. Small cell carcinoma of the urinary bladder

    International Nuclear Information System (INIS)

    Small cell carcinoma of the urinary bladder (SCCUB) is an extremely rare tumor that exhibits aggressive behavior and accounts for approximately less than 1% of all primary bladder tumors. Small cell carcinoma generally occurs in the lung, accounting for 25% of all pulmonary malignancies. SCCUB exhibits a similar microscopic and immunohistochemical appearance to that of small cell carcinoma of the lung. There is no consensus about the standard therapy, owing to its rarity. Surgical resection seems to be the mainstay of treatment for patients with limited stage, together with neoadjuvant or adjuvant platinum-based chemotherapy. Radiation therapy has same small effect for palliative purposes, as well as being an alternative to radical cystectomy. Patients with advanced stage, although given platinum-based chemotherapy, have a poor prognosis. We herein review epidemiology, clinical presentation, diagnosis, pathological features, and current management of small cell carcinoma of the urinary bladder. (author)

  7. Overactive bladder - 18 years - Part I.

    Science.gov (United States)

    Truzzi, Jose Carlos; Gomes, Cristiano Mendes; Bezerra, Carlos A; Plata, Ivan Mauricio; Campos, Jose; Garrido, Gustavo Luis; Almeida, Fernando G; Averbeck, Marcio Augusto; Fornari, Alexandre; Salazar, Anibal; Dell'Oro, Arturo; Cintra, Caio; Sacomani, Carlos Alberto Ricetto; Tapia, Juan Pablo; Brambila, Eduardo; Longo, Emilio Miguel; Rocha, Flavio Trigo; Coutinho, Francisco; Favre, Gabriel; Garcia, Jose Antonio; Castano, Juan; Reyes, Miguel; Leyton, Rodrigo Eugenio; Ferreira, Ruiter Silva; Duran, Sergio; Lopez, Vanda; Reges, Ricardo

    2016-01-01

    Overactive bladder syndrome is one of the lower urinary tract dysfunctions with the highest number of scientific publications over the past two decades. This shows the growing interest in better understanding this syndrome, which gathers symptoms of urinary urgency and increased daytime and nighttime voiding frequency, with or without urinary incontinence and results in a negative impact on the quality of life of approximately one out of six individuals - including both genders and almost all age groups. The possibility of establishing the diagnosis just from clinical data made patients' access to specialized care easier. Physiotherapy resources have been incorporated into the urological daily practice. A number of more selective antimuscarinic drugs with consequent lower adverse event rates were released. Recently, a new class of oral drugs, beta-adrenergic agonists has become part of the armamentarium for Overactive Bladder. Botulinum toxin injections in the bladder and sacral neuromodulation are routine modalities of treatment for refractory cases. During the 1st Latin-American Consultation on Overactive Bladder, a comprehensive review of the literature related to the evolution of the concept, epidemiology, diagnosis, and management was conducted. This text corresponds to the first part of the review Overactive Bladder 18-years. PMID:27176184

  8. Transurethral en bloc resection of bladder tumors

    Directory of Open Access Journals (Sweden)

    A. G. Martov

    2015-01-01

    Full Text Available Background. The high incidence of recurrent non-muscle-invasive bladder carcinoma (BC necessitates searches for new surgical methods. Objective: to comparatively evaluate the efficiency and safety of en block resection of bladder tumors versus transurethral resection (TUR. Subjects and methods. In January 2010 to June 2013, a total of 292 patients with primary and recurrent bladder tumor stages, cTa-T2, underwent transurethral endoscopic treatment (as TUR at the Unit of Minimally Invasive Urology, Moscow City Clinical Hospital Fifty-Seven. A major portion of these patients were included in the study of the efficiency and safety of en bloc TUR of bladder tumors. The criteria for study inclusion were primary or recurrent non-muscle-invasive bladder tumor measuring 1 to 3 cm, stage pTa-T1, signed informed consent to participate in the study and patients» readiness to undergo control examinations in inpatient setting for one year. The exclusion criteria were a confirmed or detected muscleinvasive tumor, multiple bladder involvement (> 3 tumors, as well as detected tumors spreading to the ureter, bladder neck, and prostatic urethra. The primary study endpoint was considered to be a recurrence of a tumor after TUR of the bladder (TURB. The secondary endpoint was the frequency of concealed bladder perforation, blood transfusions, recystoscopies for bladder tamponade, early recystoscopies to specify a BC stage, and the frequency of immediate intravesical injection of a chemical. For final analysis, the investigators selected 106 patients in a group where tumors were removed en bloc (a study group and 133 patients in a group where tumors were retrieved using traditional TURB (a control group. In the study group, the tumor was removed en bloc by a monopolar J-shaped electrode (sand wedge electrode in 45 patients, by a hook-like electrode in 14, by a hybrid procedure (hydropreparation and monopolar electrosurgery by a water-jet hybrid knife in 10, and by

  9. Transurethral en bloc resection of bladder tumors

    Directory of Open Access Journals (Sweden)

    A. G. Martov

    2015-03-01

    Full Text Available Background. The high incidence of recurrent non-muscle-invasive bladder carcinoma (BC necessitates searches for new surgical methods. Objective: to comparatively evaluate the efficiency and safety of en block resection of bladder tumors versus transurethral resection (TUR. Subjects and methods. In January 2010 to June 2013, a total of 292 patients with primary and recurrent bladder tumor stages, cTa-T2, underwent transurethral endoscopic treatment (as TUR at the Unit of Minimally Invasive Urology, Moscow City Clinical Hospital Fifty-Seven. A major portion of these patients were included in the study of the efficiency and safety of en bloc TUR of bladder tumors. The criteria for study inclusion were primary or recurrent non-muscle-invasive bladder tumor measuring 1 to 3 cm, stage pTa-T1, signed informed consent to participate in the study and patients» readiness to undergo control examinations in inpatient setting for one year. The exclusion criteria were a confirmed or detected muscleinvasive tumor, multiple bladder involvement (> 3 tumors, as well as detected tumors spreading to the ureter, bladder neck, and prostatic urethra. The primary study endpoint was considered to be a recurrence of a tumor after TUR of the bladder (TURB. The secondary endpoint was the frequency of concealed bladder perforation, blood transfusions, recystoscopies for bladder tamponade, early recystoscopies to specify a BC stage, and the frequency of immediate intravesical injection of a chemical. For final analysis, the investigators selected 106 patients in a group where tumors were removed en bloc (a study group and 133 patients in a group where tumors were retrieved using traditional TURB (a control group. In the study group, the tumor was removed en bloc by a monopolar J-shaped electrode (sand wedge electrode in 45 patients, by a hook-like electrode in 14, by a hybrid procedure (hydropreparation and monopolar electrosurgery by a water-jet hybrid knife in 10, and by

  10. Clinical Experience with Radiotherapy Alone and Radio chemotherapy with Platin Based Regimens in Organ-Sparing Treatment of Invasive Bladder Cancer

    International Nuclear Information System (INIS)

    To evaluate experience with combined modality treatment and selective bladder preservation and to identify factors that may predict treatment response, risk of relapse, and survival. Patients and Methods: Between January 1998 and January 2007, 186 patients with muscle invasive transitional- cell carcinoma (TCC) of the urinary bladder were treated with radiotherapy (RT; n=72), or radio chemotherapy (RCT; n=114) with platin based regimens after transurethral resection (TUR) of the tumor. About 3 to 4 weeks after RT/RCT, response was evaluated by re staging-TUR. In case of complete response (CR), patients were observed at regular intervals. In case of persistent or recurrent invasive tumor, salvage-cystectomy was recommended. Median follow-up was 58.8 months (range, 3.1 to 100.4 months). Results: Complete response was achieved in 72.6% of patients. Local control after CR without any relapse was maintained in 70.9% of patients at 5 years. Distant metastases were diagnosed in 50 patients with an actuarial rate of 28.23% at 5 years. Five-year overall survival (OAS) was 64.82% for the whole group of patients, and it was 67.14% for cases who preserved their bladder. Early tumor stage, age <60 years, low tumor grade, absence of pelvic lymph nodes, and a complete TUR were the most important significant factors predicting CR and survival. RCT was more significantly effective than RT alone in development of CR. Salvage cystectomy was associated with a 4.55% disease-free survival rate and 30.78% overall survival rate at 5 years. Conclusion: Transurethral resection with radio chemotherapy are reasonable option for patients seeking an alternative to radical cystectomy. Ideal candidates are those with early-stage, age <60 years, low tumor grade, and absence of pelvic lymph nodes; in whom a complete TUR is accomplished.

  11. 胆囊胆固醇性息肉临床超声诊断价值%The gal bladder cholesterol polyps clinical ultrasound diagnostic value

    Institute of Scientific and Technical Information of China (English)

    曹喜凤; 杨忠云; 苑广杰

    2014-01-01

    The gal bladder cholesterol polyps is due to the local disturbance of cholesterol metabolism,increase cholesterol levels in bile and deposition in the gal bladder mucosa lamina propria macrophages,gradual y formed the mucosal surface of yel ow nodules.Ultrasonic ultrasonographic performance general size is normal;The gal bladG der wal thickness can be;Polyps form a more granular or papil ary,much length range,the or narrow base,don't change with position and moving;The echo of the polyp shows strong echo or medium echo,but behind the silent shadow;Smal er,some is only strong echo point;Contrast-enhanced ultrasound can improve the detection rate of blood flow to the gal bladder cholesterol sex polyp.%胆囊胆固醇性息肉是由于胆固醇代谢的局部紊乱,使胆汁中胆固醇含量增高而沉积于胆囊黏膜固有层巨噬细胞内,逐渐形成了黏膜表面突出的黄色小结节。超声声像图表现一般大小正常;胆囊壁可轻度增厚;息肉形态多呈颗粒状或乳头状,多有长短不等的蒂,或基底较窄,不随体位改变而移动;息肉的回声呈强回声或中等回声,但后方无声影;体积较小,有的仅为强回声点;超声造影可提高胆囊胆固醇性息肉的血流显示率。

  12. Hip Replacement

    Science.gov (United States)

    Hip replacement is surgery for people with severe hip damage. The most common cause of damage is ... therapy, pain medicines, and exercise haven't helped, hip replacement surgery might be an option for you. ...

  13. Electrochemical sensing of nuclear matrix protein 22 in urine with molecularly imprinted poly(ethylene-co-vinyl alcohol) coated zinc oxide nanorod arrays for clinical studies of bladder cancer diagnosis.

    Science.gov (United States)

    Lee, Mei-Hwa; Thomas, James L; Chang, Yu-Chia; Tsai, Yuh-Shyan; Liu, Bin-Da; Lin, Hung-Yin

    2016-05-15

    In 1996 and 2000, the US Food and Drug Administration (FDA) approved the use of Nuclear matrix protein 22 (NMP22) as a monitoring tool for predicting the recurrence/clearing of bladder cancer, and for screening undiagnosed individuals who have symptoms of, or are at risk for, that disease. The fabrication of electrodes for sensing NMP22 and their integration with a portable potentiostat in a homecare system may have great value. This work describes a sensing element comprised of molecularly imprinted polymers (MIPs) for the specific recognition of NMP22 target molecules. Zinc oxide (ZnO) nanorods (214±45nm in diameter and 1.08±0.11μm long) were hydrothermally grown on the sensing electrodes to increase the surface area to be coated with MIPs. A portable potentiostat was assembled and a data acquisition (DAQ) card and the Labview program were utilized to monitor electrochemical reaction to sense NMP22 in urine samples. Finally, in phase 0 clinical trials, measurements were made of samples from a few patients with bladder cancer using the NMP22 MIP-coated ZnO nanorods electrodes that were integrated into a portable potentiostat, revealing NMP 22 concentrations in the range 128±19 to 588±53ng/mL. PMID:26774095

  14. CT diagnosis of intraperitoneal bladder rupture with blunt abdominal trauma

    International Nuclear Information System (INIS)

    Objective: To evaluate CT examination in the diagnosis of intraperitoneal bladder rupture (IPBR) caused by blunt abdominal trauma. Methods: All CT and clinical data of 9 patients with IPBR were reviewed retrospectively. Results: IPBR was detected on CT scans in all 9 patients. CT findings of IPBR included low -attenuation free intraperitoneal fluid collections in the lateral paravesical fossae, the pericolic space, the culde-sac of the pelvis, Morison's pouch, the peri-hepatic space, the perisplenic space and interspace of bowel loops in 9 cases with a lower CT density compared with pure blood. The disruption of the bladder wall was located by CT scan in 5 cases: high-attenuation bladder wall with focal defect in 3 cases and a tear drop-like deformity of the bladder in 2 cases. Other CT findings supporting the diagnosis of IPBR included an underfilled bladder in 8 cases, bladder contusion in 4 cases, and blood clots within the bladder in 6 cases. Conclusion: The presence of intraperitoneal fluid with a CT density less than that of pure blood strongly suggests extravasated urine in the trauma. Intraperitoneal and extraperitoneal rupture can be distinguished based on location of extravasated urine seen on CT scans. The precise localization of the ruptured bladder wall may be demonstrated by CT scan, which is valuable for surgical treatment

  15. Bladder endothelin-1 receptor binding of bosentan and ambrisentan.

    Science.gov (United States)

    Osano, Ayaka; Yokoyama, Yoshinari; Hayashi, Hideki; Itoh, Kunihiko; Okura, Takashi; Deguchi, Yoshiharu; Ito, Yoshihiko; Yamada, Shizuo

    2014-01-01

    The present study aimed to characterize bladder endothelin-1 (ET-1) receptor binding of clinically used ET-1 receptor antagonists by using [(125)I]ET-1. The inhibition of specific [(125)I]ET-1 binding was measured in the presence of ET-1 and its receptor antagonists. Specific binding of [(125)I]ET-1 in rat bladder was saturable and of high affinity, which characterized selective labeling of bladder ET-1 receptors. ET-1, bosentan, ambrisentan, and CI-1020 inhibited specific [(125)I]ET-1 binding in a concentration-dependent manner at nanomolar ranges of IC50. Nonlinear least squares regression analysis revealed the presence of high- and low-affinity ET-1 receptor sites for ambrisentan and CI-1020. Bosentan and ambrisentan significantly increased the dissociation constant for bladder [(125)I]ET-1 binding without affecting maximal number of binding sites (Bmax). Thus, bosentan and ambrisentan seem to bind to bladder ET-1 receptor in a competitive and reversible manner. Oral administration of bosentan caused a dose-dependent decrease in Bmax for bladder [(125)I]ET-1 binding, suggesting significant binding of bladder ET-1 receptors in vivo. A significant amount of pharmacologically relevant ET-1 receptors may exist in the bladder. These receptors may be implicated in the pathogenesis of lower urinary tract symptoms and may also be promising targets for the development of therapeutic agents. PMID:24389822

  16. Different effects of bladder distention on point A-based and 3D-conformal intracavitary brachytherapy planning for cervical cancer

    OpenAIRE

    Ju, Sang Gyu; Huh, Seung Jae; Shin, Jung Suk; Park, Won; Nam, Heerim; Bae, Sunhyun; Oh, Dongryul; Hong, Chae-Seon; Kim, Jin Sung; Han, Youngyih; Choi, Doo Ho

    2012-01-01

    This study sought to evaluate the differential effects of bladder distention on point A-based (AICBT) and three-dimensional conformal intracavitary brachytherapy (3D-ICBT) planning for cervical cancer. Two sets of CT scans were obtained for ten patients to evaluate the effect of bladder distention. After the first CT scan, with an empty bladder, a second set of CT scans was obtained with the bladder filled. The clinical target volume (CTV), bladder, rectum, and small bowel were delineated on ...

  17. Resin-Bonded Fiber-Reinforced Composite for Direct Replacement of Missing Anterior Teeth: A Clinical Report

    Directory of Open Access Journals (Sweden)

    Sufyan Garoushi

    2011-01-01

    Full Text Available Missing anterior teeth is of serious concern in the social life of a patient in most of societies. While conventional fixed partial dentures and implant-supported restorations may often be the treatment of choice, fiber-reinforced composite (FRC resins offer a conservative, fast, and cost-effective alternative for single and multiple teeth replacement. This paper presents two cases where FRC technology was successfully used to restore anterior edentulous areas in terms of esthetic values and functionality.

  18. Is there a clinical interaction between low molecular weight heparin and non-steroidal analgesics after total hip replacement?

    OpenAIRE

    Weale, A. E.; Warwick, D. J.; Durant, N; Prothero, D.

    1995-01-01

    The benefits of parenteral non-steroidal analgesic drugs and low molecular weight heparin anticoagulants have been shown before, but there is concern that the use of these agents in combination may potentiate haemorrhagic side-effects because of simultaneous inhibition of the clotting cascade and platelet mechanisms of haemostasis. In a prospective controlled trial, 60 patients undergoing total hip replacement were randomised into two groups. Those in one group received intramuscular ketorola...

  19. Exogenous glycosaminoglycans coat damaged bladder surfaces in experimentally damaged mouse bladder

    OpenAIRE

    Hurst Robert E; Coffman Jean; Kyker Kimberly D

    2005-01-01

    Abstract Background Interstital cystitis is often treated with exogenous glycosaminoglycans such as heparin, chondroitin sulphate (Uracyst), hyaluronate (Cystistat) or the semi-synthetic pentosan polysulphate (Elmiron). The mechanism of action is presumed to be due to a coating of the bladder surface to replace the normally present chondroitin sulphate and heparan sulphate lost as a result of the disease. This study used fluorescent labelled chondroitin sulphate to track the distribution of g...

  20. Nerve Disease and Bladder Control

    Science.gov (United States)

    ... Research Training & Career Development Grant programs for students, postdocs, and faculty Research at NIDDK Labs, faculty, and ... KB) Alternate Language URL Nerve Disease and Bladder Control Page Content On this page: What bladder control ...

  1. Multidisciplinary Approach in the Treatment of Patients with Small Cell Bladder Carcinoma

    OpenAIRE

    Macedo, L. Traldi; Ribeiro, J.; Curigliano, G; Fumagalli, L.; Locatelli, M.; Campello Carvalheira, J. Barreto; Quintela, A.; Bertelli, S.; O. De Cobelli

    2011-01-01

    Abstract Small cell carcinoma of the urinary bladder (SCCUB) is considered to be a tumor with a neuroendocrine phenotype characterised by aggressive behaviour and poor prognosis. Small cell carcinoma of the urinary bladder comprises 0,35 to 1% of all bladder cancers and is frequently observed in combination with other histological subtypes of carcinoma. Clinical presentation is characterized by advanced stage at diagnosis and rapidly progressive disease. In daily clinical practice ...

  2. Promotion in urinary bladder carcinogenesis.

    OpenAIRE

    Cohen, S M

    1983-01-01

    Aromatic amines, including 2-naphthylamine, 4-aminobiphenyl and benzidine, are known urinary bladder carcinogens in man and other species, but in rodents, aromatic amines and amides have usually induced liver tumors, occasionally also with tumors of the bladder and other tissues. Variations in organ specificity are related to differences in metabolism; for the production of bladder tumors, the rates of acetylation and deacetylation appear to be critical. Bladder specific carcinogens in rodent...

  3. Invasive bladder cancer: treatment strategies using transurethral surgery, chemotherapy and radiation therapy with selection for bladder conservation

    International Nuclear Information System (INIS)

    Purpose: Combined modality therapy has become the standard oncologic approach to achieve organ preservation in many malignancies. Methods and Materials: Although radical cystectomy has been considered as standard treatment for invasive bladder carcinoma in the United States, good results have been recently reported from several centers using multimodality treatment, particularly in patients with clinical T2 and T3a disease who do not have a ureter obstructed by tumor. Results: The components of the combined treatment are usually transurethral resection of the bladder tumor (TURBT) followed by concurrent chemotherapy and radiation therapy. Following an induction course of therapy a histologic response is evaluated by cystoscopy and rebiopsy. Clinical 'complete responders' (tumor site rebiopsy negative and urine cytology with no tumor cells present) continue with a consolidation course of concurrent chemotherapy and radiation. Those patients not achieving a clinical complete response are recommended to have an immediate cystectomy. Individually the local monotherapies of radiation, TURBT, or multidrug chemotherapy each achieve a local control rate of the primary tumor of from 20 to 40%. When these are combined, clinical complete response rates of from 65 to 80% can be achieved. Seventy-five to 85% of the clinical complete responders will remain with bladders free of recurrence of an invasive tumor. Conclusions: Bladder conservation trials using combined modality treatment approaches with selection for organ conservation by response of the tumor to initial treatment report overall 5-year survival rates of approximately 50%, and a 40-45% 5-year survival rate with the bladder intact. These modern multimodality bladder conservation approaches offer survival rates similar to radical cystectomy for patients of similar clinical stage and age. Bladder-conserving therapy should be offered to patients with invasive bladder carcinoma as a realistic alternative to radical

  4. THE DIAGNOSIS AND PREDICTION OF NON-MUSCLE INVASIVE BLADDER CANCER RECURRENCE, BY APPLYING CLINICAL METHODS AND FISH ANALYSIS (A REVIEW OF LITERATURE

    Directory of Open Access Journals (Sweden)

    A. V. Troyanov

    2014-08-01

    Full Text Available The review deals with the-state-of-the-art of diagnosis and prediction of non-muscle invasive bladder cancer (BC. It gives data on the chromosomal abnormalities identified in urothelial cancer cells according to the results of trials. The development of a procedure for FISH diagnosis of BC is noted to be warranted. An algorithm for interpreting the result of the FISH analysis is given. The use of data on chromosomal abnormalities as additional predictors of the course of non-muscle invasive BC is described. The application of the FISH technique in assessing the results of adjuvant treatment in patients with non-muscle invasive BC is also depicted. In summary, the main problems in the existing algorithms for its diagnosis and prediction, by employing the FISH technique, are indicated.

  5. THE DIAGNOSIS AND PREDICTION OF NON-MUSCLE INVASIVE BLADDER CANCER RECURRENCE, BY APPLYING CLINICAL METHODS AND FISH ANALYSIS (A REVIEW OF LITERATURE

    Directory of Open Access Journals (Sweden)

    A. V. Troyanov

    2012-01-01

    Full Text Available The review deals with the-state-of-the-art of diagnosis and prediction of non-muscle invasive bladder cancer (BC. It gives data on the chromosomal abnormalities identified in urothelial cancer cells according to the results of trials. The development of a procedure for FISH diagnosis of BC is noted to be warranted. An algorithm for interpreting the result of the FISH analysis is given. The use of data on chromosomal abnormalities as additional predictors of the course of non-muscle invasive BC is described. The application of the FISH technique in assessing the results of adjuvant treatment in patients with non-muscle invasive BC is also depicted. In summary, the main problems in the existing algorithms for its diagnosis and prediction, by employing the FISH technique, are indicated.

  6. [Emphysematous cystitis with total necrotization of the bladder

    DEFF Research Database (Denmark)

    Rindom, A.B.; Gudnason, H.M.; Thind, Peter

    2008-01-01

    treatment to prostatocystectomy. We report the case of a 74-year old male diabetic presenting who was found to have emphysematous cystitis with total necrotization of the bladder. To our knowledge this is the only reported case with a totally necrotized bladder in emphysematous cystitis Udgivelsesdato: 2008/11/17......Emphysematous cystitis is a rare disease of the bladder caused by gas-forming bacteria. Diabetics are the most commonly infected and the clinical picture ranges from dysuria to sepsis and peritonitis. The diagnosis is primarily radiological. Treatment ranges from catheterization and antibiotic...

  7. Left-sided gall bladder: Report of two cases

    Directory of Open Access Journals (Sweden)

    Chrungoo R

    2007-01-01

    Full Text Available Left-sided gall bladder without situs inversus viscerum is a rare albeit recognized clinical entity. We report our experience of two cases of left-sided gall bladder in two women aged 36 and 48 who underwent laparoscopic cholecystectomy for chronic calculous cholecystitis. Left-sided gall bladder may provide an unusual surprise to the surgeons during laparoscopy as routine pre-operative studies may not always detect the anomaly. Awareness of the unpredictable confluence of the cystic duct into the common bile duct (CBD and selective use of intraoperative cholangiography aid in the safe laparoscopic management of this unusual entity.

  8. Placenta paraaortic with bladder invasion: A plea for multidisciplinary approach

    International Nuclear Information System (INIS)

    Placenta previa percreta with the urinary bladder invasion is a rare but potentially lethal condition. It has an increasing clinical significance due to its association with previous cesarean sections and uterine curettage. Herein, we report on a patient with placenta percreta and bladder invasion, who presented with hematuria and in whom delivery was delayed to almost full term highlighting the potential catastrophic results and the need for a multidisciplinary approach with the need to involve surgeons who are familiar with vascular and urologic surgery. We also present an elegant MRI of placenta percreta invading the urinary bladder, which shows that MRI is potentially an excellent diagnostic diagnostic modality in this difficult condition. (author)

  9. Therapeutic potential of rivaroxaban in the prevention of venous thromboembolism following hip and knee replacement surgery: a review of clinical trial data

    Directory of Open Access Journals (Sweden)

    Kwong LM

    2011-07-01

    Full Text Available Louis M KwongDepartment of Orthopaedic Surgery, Harbor-UCLA Medical Center, Torrance, CA, USAAbstract: Rivaroxaban (Bayer AG, Leverkusen, Germany is a highly selective direct inhibitor of factor Xa. It has completed Phase III clinical trials evaluating its efficacy and safety against enoxaparin in the prophylaxis against venous thromboembolism (VTE in orthopedic patients following primary total hip and total knee arthroplasty. Rivaroxaban has been extensively studied worldwide in 12,729 patients in the Regulation of Coagulation in Major Orthopedic Surgery Reducing the Risk of DVT and PE (RECORD program. Pivotal clinical trials have demonstrated the superior efficacy in reducing total VTE in comparison with both the North American and European regimens of enoxaparin. Safety of the drug was found to be excellent, with no demonstrable cardiovascular or hepatic effects and no statistically significant increase in major bleeding. A pooled analysis of data collected on the patients from the four RECORD trials revealed rivaroxaban to be the first antithrombotic agent to demonstrate superiority over another antithrombotic (enoxaparin in reducing symptomatic VTE and all-cause mortality. While there was a significant difference in the composite safety endpoint of major and clinically relevant nonmajor bleeding in the pooled analysis with the use of rivaroxaban compared with enoxaparin, there was no significant difference in major bleeding or in any other bleeding.Keywords: rivaroxaban, venous thromboembolism, hip replacement, knee replacement

  10. Histopathological characterization of a syngeneic orthotopic murine bladder cancer model

    Directory of Open Access Journals (Sweden)

    Daher C. Chade

    2008-03-01

    Full Text Available PURPOSE: We developed and characterized by histopathology and immunohistochemistry a syngeneic murine bladder tumor model derived from the MB49 tumor cell line. MATERIALS AND METHODS: Bladder tumor implantation was achieved by intravesical instillation of 5 x 10(5 MB49 tumor cells in C57BL/6 mice. A chemical lesion of the bladder was performed in order to promote intravesical tumor implantation. The bladder wall lesion was accomplished by transurethral instillation of silver nitrate (AgNO3. After 15 days, the animals were sacrificed, examined macroscopically for intravesical tumor and bladder weight. Histology and immunohistochemistry were performed using cytokeratin 7 (CK7, carcinoembrionic antigen (Dako-CEA, p53 and c-erbB2 oncoprotein (Her2/neu. RESULTS: Twenty-nine out of 30 animals (96.7% developed intravesical tumors in a 15-day period. Macroscopically, the mean bladder weight was 0.196g (0.069-0.538g, 10 to 15 times the normal bladder weight. The immunohistochemical analysis showed significant membrane expression of CEA and CK7: a similar finding for human urothelial cancer. We also characterized absence of expression of p53 and anti-Her2/neu in the murine model. CONCLUSIONS: High tumor take rates were achieved by using the chemical induction of the bladder tumor. Although electric cauterization is widely described in the literature for syngeneic orthotopic animal models, the technique described in this study represents an alternative for intravesical bladder tumor implantation. Moreover, the histopathology and immunohistochemical analysis of the murine bladder tumor model derived from the MB49 cell line showed a resemblance to human infiltrating urothelial carcinoma, allowing clinical inference from experimental immunotherapy testing.

  11. Five-year clinical results of cervical total disc replacement compared with anterior discectomy and fusion for treatment of 2-level symptomatic degenerative disc disease: a prospective, randomized, controlled, multicenter investigational device exemption clinical trial.

    Science.gov (United States)

    Radcliff, Kris; Coric, Domagoj; Albert, Todd

    2016-08-01

    OBJECTIVE The purpose of this study was to report the outcome of a study of 2-level cervical total disc replacement (Mobi-C) versus anterior cervical discectomy and fusion (ACDF). Although the long-term outcome of single-level disc replacement has been extensively described, there have not been previous reports of the 5-year outcome of 2-level cervical disc replacement. METHODS This study reports the 5-year results of a prospective, randomized US FDA investigational device exemption (IDE) study conducted at 24 centers in patients with 2-level, contiguous, cervical spondylosis. Clinical outcomes at up to 60 months were evaluated, including validated outcome measures, incidence of reoperation, and adverse events. The complete study data and methodology were critically reviewed by 3 independent surgeon authors without affiliation with the IDE study or financial or institutional bias toward the study sponsor. RESULTS A total of 225 patients received the Mobi-C cervical total disc replacement device and 105 patients received ACDF. The Mobi-C and ACDF follow-up rates were 90.7% and 86.7%, respectively (p = 0.39), at 60 months. There was significant improvement in all outcome scores relative to baseline at all time points. The Mobi-C patients had significantly more improvement than ACDF patients in terms of Neck Disability Index score, SF-12 Physical Component Summary, and overall satisfaction with treatment at 60 months. The reoperation rate was significantly lower with Mobi-C (4%) versus ACDF (16%). There were no significant differences in the adverse event rate between groups. CONCLUSIONS Both cervical total disc replacement and ACDF significantly improved general and disease-specific measures compared with baseline. However, there was significantly greater improvement in general and disease-specific outcome measures and a lower rate of reoperation in the 2-level disc replacement patients versus ACDF control patients. Clinical trial registration no. NCT00389597

  12. Bladder involvement in systemic lupus erythematosus

    Directory of Open Access Journals (Sweden)

    Eric Roger Wroclawski

    2009-12-01

    Full Text Available Objective: To study bladder involvement in systemic lupus erythematosus patients through clinical and laboratorial evaluation, ultrasonography, radiological and endoscopic examination. Methods: Thirty-nine patients, either outpatients or inpatients at the Department of Rheumatology of Hospital das Clínicas da Faculdade de Medicina from Universidade de São Paulo were evaluated as to clinical and laboratorial data. All patients were submitted to ultrasonographic evaluation of the upper urinary tract, radiological and endoscopic examinations of the middle and lower urinary tracts. Rresults: Mean age of patients varied between 13 and 62 years (median = 29 years. Thirty-six were females and three were males. The disease varied from 6 months to 22 years (median three years and one month. Clinical and laboratory activity of the disease was present in 30 patients. Twenty-two patients had the diagnosis of lupus established for three years or more. Twenty-five patients were asymptomatic and all had received corticosteroids for treatment at least once. Twenty-three received antimalarial drugs; ten received cytostatics, and seven patients received non-steroid anti-inflammatory drugs. Upper urinary tract ultrasonography was normal in all cases but one with staghorn calculus associated with neurogenic bladder secondary to neurological involvement by the disease. Vesicoureteral reflux was observed in two cases. Other two patients had significant post-voiding residual urine, both with neurogenic bladder secondary to nervous system involvement by lupus. The average bladder maximum capacity in an awaken patient was 342 mL, and was decreased in 18.9% of cases. This subgroup of patients presented a greater frequency of urinary symptoms and greater use of cytostatic drugs (Z > Z5%. A pathognomonic cystoscopic pattern of bladder involvement in systemic lupus erythematosus could not be established. Cystoscopic aspects similar to those seen in the initial or minor

  13. Unusual presentation of cutaneous metastasis from bladder urothelial carcinoma

    Institute of Scientific and Technical Information of China (English)

    Chin-Pao Chang; I-Yen Lee; Hung-Jen Shih

    2013-01-01

    Cutaneous metastases from urothelial carcinoma of the bladder are a rare disease.In previous reports,the most common metastatic cutaneous lesions were non-tender nodules on the abdominal skin.We report a patient with bladder urothelial carcinoma with cutaneous metastases initially presenting as right leg and suprapubic lymphedema.Bladder tumor was the incidental finding by magnetic resonance venography.Urothelial carcinoma (clinical stage Ⅳ) was diagnosed,and chemotherapy was performed.Extensive painful erythematous plaques with an erysipelas-like appearance located on the suprapubic area,chest and abdomen were noted,and cutaneous metastases were confirmed by histopathology.Subsequently,extensive scrotal and prepuce ulcerative changes developed.This paper reports a rare case of extensive cutaneous metastasis of bladder urothelial carcinoma who presented an interesting clinical course.

  14. Bladder wall thickness and ultrasound estimated bladder weight in healthy adults with portative ultrasound device

    Directory of Open Access Journals (Sweden)

    Selcen Kanyilmaz

    2013-01-01

    Full Text Available Background: The aim of this study was to investigate bladder wall thickness (BWT and ultrasound estimated bladder weight (UEBW values in healthy population with a portative ultrasound device and their relationship with demographic parameters. Materials and Methods: The study was carried out in Neurorehabilitation Clinic of Ege University Hospital. Ninety-five subjects (48 women and 47 men aged between 18 and 56 were included in the study. BWT and UEBW were determined non-invasively with a portative ultrasound device; Bladder Scan BVM 6500 (Verathon Inc., WA, USA at a frequency of 3.7 MHz at functional bladder capacity. These values were compared by gender, and their relation was assessed with age, body mass index (BMI and parity. Results: Mean BWT was 2.0 ± 0.4 mm and UEBW was 44.6 ± 8.3 g at a mean volume of 338.0 ± 82.1 ml. Although higher results were obtained in men at higher bladder volumes, the results did not differ significantly by gender. Correlation analyses revealed statistically significant correlation between UEBW and age (r = 0.32. BWT was negatively correlated with volume (r = -0.50 and bladder surface area (r = -0.57. Also, statistically significant correlations were observed between UEBW and volume (r = 0.36, bladder surface area (r = 0.48 and BWT (r = 0.25. Conclusion: Determined values of BWT and UEBW in healthy population are estimated with portative ultrasound devices, which are future promising, for their convenient, easy, non-invasive, time-efficient hand-held use for screening.

  15. Virtual 3D bladder reconstruction for augmented medical records from white light cystoscopy (Conference Presentation)

    Science.gov (United States)

    Lurie, Kristen L.; Zlatev, Dimitar V.; Angst, Roland; Liao, Joseph C.; Ellerbee, Audrey K.

    2016-02-01

    Bladder cancer has a high recurrence rate that necessitates lifelong surveillance to detect mucosal lesions. Examination with white light cystoscopy (WLC), the standard of care, is inherently subjective and data storage limited to clinical notes, diagrams, and still images. A visual history of the bladder wall can enhance clinical and surgical management. To address this clinical need, we developed a tool to transform in vivo WLC videos into virtual 3-dimensional (3D) bladder models using advanced computer vision techniques. WLC videos from rigid cystoscopies (1280 x 720 pixels) were recorded at 30 Hz followed by immediate camera calibration to control for image distortions. Video data were fed into an automated structure-from-motion algorithm that generated a 3D point cloud followed by a 3D mesh to approximate the bladder surface. The highest quality cystoscopic images were projected onto the approximated bladder surface to generate a virtual 3D bladder reconstruction. In intraoperative WLC videos from 36 patients undergoing transurethral resection of suspected bladder tumors, optimal reconstruction was achieved from frames depicting well-focused vasculature, when the bladder was maintained at constant volume with minimal debris, and when regions of the bladder wall were imaged multiple times. A significant innovation of this work is the ability to perform the reconstruction using video from a clinical procedure collected with standard equipment, thereby facilitating rapid clinical translation, application to other forms of endoscopy and new opportunities for longitudinal studies of cancer recurrence.

  16. Urethral obstruction from dislodged bladder Diverticulum stones: a case report

    OpenAIRE

    Okeke Linus I; Takure Augustine O; Adebayo Sikiru A; Oluyemi Olukayode Y; Oyelekan Abimbola AA

    2012-01-01

    Abstract Background Secondary urethral stone although rare, commonly arises from the kidneys, bladder or are seen in patients with urethral stricture. These stones are either found in the posterior or anterior urethra and do result in acute urinary retention. We report urethral obstruction from dislodged bladder diverticulum stones. This to our knowledge is the first report from Nigeria and in English literature. Case presentation A 69 year old, male, Nigerian with clinical and radiological f...

  17. Proepithelin is an autocrine growth factor for bladder cancer

    OpenAIRE

    Lovat, Francesca; Bitto, Alessandro; Xu, Shi-Qiong; Fassan, Matteo; Goldoni, Silvia; Metalli, David; Wubah, Vera; McCue, Peter; Serrero, Ginette; Gomella, Leonard G.; Baffa, Raffaele; Iozzo, Renato V.; Morrione, Andrea

    2009-01-01

    The growth factor proepithelin functions as an important regulator of proliferation and motility. Proepithelin is overexpressed in a great variety of cancer cell lines and clinical specimens of breast, ovarian and renal cancer, as well as glioblastomas. Using recombinant proepithelin on 5637 transitional cell carcinoma-derived cells, we have shown previously that proepithelin plays a critical role in bladder cancer by promoting motility of bladder cancer cells. In this study, we used the ONCO...

  18. Directed Replacement

    CERN Document Server

    Karttunen, L

    1996-01-01

    This paper introduces to the finite-state calculus a family of directed replace operators. In contrast to the simple replace expression, UPPER -> LOWER, defined in Karttunen (ACL-95), the new directed version, UPPER @-> LOWER, yields an unambiguous transducer if the lower language consists of a single string. It transduces the input string from left to right, making only the longest possible replacement at each point. A new type of replacement expression, UPPER @-> PREFIX ... SUFFIX, yields a transducer that inserts text around strings that are instances of UPPER. The symbol ... denotes the matching part of the input which itself remains unchanged. PREFIX and SUFFIX are regular expressions describing the insertions. Expressions of the type UPPER @-> PREFIX ... SUFFIX may be used to compose a deterministic parser for a ``local grammar'' in the sense of Gross (1989). Other useful applications of directed replacement include tokenization and filtering of text streams.

  19. Is there a clinical interaction between low molecular weight heparin and non-steroidal analgesics after total hip replacement?

    Science.gov (United States)

    Weale, A E; Warwick, D J; Durant, N; Prothero, D

    1995-01-01

    The benefits of parenteral non-steroidal analgesic drugs and low molecular weight heparin anticoagulants have been shown before, but there is concern that the use of these agents in combination may potentiate haemorrhagic side-effects because of simultaneous inhibition of the clotting cascade and platelet mechanisms of haemostasis. In a prospective controlled trial, 60 patients undergoing total hip replacement were randomised into two groups. Those in one group received intramuscular ketorolac and those in the other group opioid analgesia. All patients received enoxaparin subcutaneously, once daily. There were 34 patients in the NSAID group and 26 in the opiate group. There were no significant differences between the two groups for intraoperative blood loss, postoperative drainage, transfusion requirements, bruising, wound oozing and leg swelling. From this study it would appear that there is a low risk of significant haemostatic potentiation associated with concurrent use of low molecular weight heparin and a modest dose of ketorolac tromethamine. PMID:7717643

  20. Individualized Nonadaptive and Online-Adaptive Intensity-Modulated Radiotherapy Treatment Strategies for Cervical Cancer Patients Based on Pretreatment Acquired Variable Bladder Filling Computed Tomography Scans

    Energy Technology Data Exchange (ETDEWEB)

    Bondar, M.L., E-mail: m.bondar@erasmusmc.nl [Department of Radiation Oncology, Erasmus-MC Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Hoogeman, M.S.; Mens, J.W.; Quint, S. [Department of Radiation Oncology, Erasmus-MC Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Ahmad, R. [Department of Radiation Oncology, Erasmus-MC Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Programme of Diagnostic Imaging and Radiotherapy, University Kebangsaan Malaysia (Malaysia); Dhawtal, G.; Heijmen, B.J. [Department of Radiation Oncology, Erasmus-MC Daniel den Hoed Cancer Center, Rotterdam (Netherlands)

    2012-08-01

    Purpose: To design and evaluate individualized nonadaptive and online-adaptive strategies based on a pretreatment established motion model for the highly deformable target volume in cervical cancer patients. Methods and Materials: For 14 patients, nine to ten variable bladder filling computed tomography (CT) scans were acquired at pretreatment and after 40 Gy. Individualized model-based internal target volumes (mbITVs) accounting for the cervix and uterus motion due to bladder volume changes were generated by using a motion-model constructed from two pretreatment CT scans (full and empty bladder). Two individualized strategies were designed: a nonadaptive strategy, using an mbITV accounting for the full-range of bladder volume changes throughout the treatment; and an online-adaptive strategy, using mbITVs of bladder volume subranges to construct a library of plans. The latter adapts the treatment online by selecting the plan-of-the-day from the library based on the measured bladder volume. The individualized strategies were evaluated by the seven to eight CT scans not used for mbITVs construction, and compared with a population-based approach. Geometric uniform margins around planning cervix-uterus and mbITVs were determined to ensure adequate coverage. For each strategy, the percentage of the cervix-uterus, bladder, and rectum volumes inside the planning target volume (PTV), and the clinical target volume (CTV)-to-PTV volume (volume difference between PTV and CTV) were calculated. Results: The margin for the population-based approach was 38 mm and for the individualized strategies was 7 to 10 mm. Compared with the population-based approach, the individualized nonadaptive strategy decreased the CTV-to-PTV volume by 48% {+-} 6% and the percentage of bladder and rectum inside the PTV by 5% to 45% and 26% to 74% (p < 0.001), respectively. Replacing the individualized nonadaptive strategy by an online-adaptive, two-plan library further decreased the percentage of

  1. Individualized Nonadaptive and Online-Adaptive Intensity-Modulated Radiotherapy Treatment Strategies for Cervical Cancer Patients Based on Pretreatment Acquired Variable Bladder Filling Computed Tomography Scans

    International Nuclear Information System (INIS)

    Purpose: To design and evaluate individualized nonadaptive and online-adaptive strategies based on a pretreatment established motion model for the highly deformable target volume in cervical cancer patients. Methods and Materials: For 14 patients, nine to ten variable bladder filling computed tomography (CT) scans were acquired at pretreatment and after 40 Gy. Individualized model-based internal target volumes (mbITVs) accounting for the cervix and uterus motion due to bladder volume changes were generated by using a motion-model constructed from two pretreatment CT scans (full and empty bladder). Two individualized strategies were designed: a nonadaptive strategy, using an mbITV accounting for the full-range of bladder volume changes throughout the treatment; and an online-adaptive strategy, using mbITVs of bladder volume subranges to construct a library of plans. The latter adapts the treatment online by selecting the plan-of-the-day from the library based on the measured bladder volume. The individualized strategies were evaluated by the seven to eight CT scans not used for mbITVs construction, and compared with a population-based approach. Geometric uniform margins around planning cervix–uterus and mbITVs were determined to ensure adequate coverage. For each strategy, the percentage of the cervix–uterus, bladder, and rectum volumes inside the planning target volume (PTV), and the clinical target volume (CTV)-to-PTV volume (volume difference between PTV and CTV) were calculated. Results: The margin for the population-based approach was 38 mm and for the individualized strategies was 7 to 10 mm. Compared with the population-based approach, the individualized nonadaptive strategy decreased the CTV-to-PTV volume by 48% ± 6% and the percentage of bladder and rectum inside the PTV by 5% to 45% and 26% to 74% (p < 0.001), respectively. Replacing the individualized nonadaptive strategy by an online-adaptive, two-plan library further decreased the percentage of

  2. Radical cystectomy for the treatment of T1 bladder cancer: the Canadian Bladder Cancer Network experience

    Science.gov (United States)

    Chalasani, Venu; Kassouf, Wassim; Chin, Joseph L.; Fradet, Yves; Aprikian, Armen G.; Fairey, Adrian S.; Estey, Eric; Lacombe, Louis; Rendon, Ricardo; Bell, David; Cagiannos, Ilias; Drachenberg, Darrell; Lattouf, Jean-Baptiste; Izawa, Jonathan I.

    2011-01-01

    Background: Radical cystectomy may provide optimal survival outcomes in the management of clinical T1 bladder cancer. We present our data from a large, multi-institutional, contemporary Canadian series of patients who underwent radical cystectomy for clinical T1 bladder cancer in a single-payer health care system. Methods: We collected a pooled database of 2287 patients who underwent radical cystectomy between 1993 and 2008 in 8 different centres across Canada; 306 of these patients had clinical T1 bladder cancer. Survival data were analyzed using Kaplan-Meier method and Cox regression analysis. Results: The median age of patients was 67 years with a mean follow-up time of 35 months. The 5-year overall, disease-specific and disease-free survival was 71%, 77% and 59%, respectively. The 10-year overall and disease-specific survival were 60% and 67%, respectively. Pathologic stage distribution was p0: 32 (11%), pT1: 78 (26%), pT2: 55 (19%), pT3: 60 (20%), pT4: 27 (9%), pTa: 16 (5%), pTis: 28 (10%), pN0: 215 (74%) and pN1-3: 78 (26%). Only 12% of patients were given adjuvant chemotherapy. On multivariate analysis, only margin status and pN stage were independently associated with overall, disease-specific and disease-free survival. Interpretation: These results indicate that clinical T1 bladder cancer may be significantly understaged. Identifying factors associated with understaged and/or disease destined to progress (despite any prior intravesical or repeat transurethral therapies prior to radical cystectomy) will be critical to improve survival outcomes without over-treating clinical T1 disease that can be successfully managed with bladder preservation strategies. PMID:21470529

  3. Spontaneous puerperal extraperitoneal bladder wall rupture in young woman with diagnostic dilemma

    Science.gov (United States)

    Sabat, Debabrat Kumar; Panigrahi, Pradeep Kumar; Sahoo, Ranjan Kumar; Acharya, Mousumi; Sahu, Mahesh Ch

    2015-01-01

    A young female presented with an acute abdominal pain and oliguria for 1 week following normal vaginal delivery. No history of hematuria was present. Patient was having lochia rubra. Sealed uterine rupture was suspected clinically. Initial ultrasound of the patient showed distended urinary bladder containing Foley catheter ballon with clamping of Foley catheter and particulate ascites. Abdominal paracentesis revealed hemorrhagic fluid. Contrast-enhanced computed tomography of abdomen revealed ascites, distended urinary bladder and no extraluminal contrast extravasation in delayed scan. As patient condition deteriorated, repeat ultrasound guided abdominal paracentesis was done which revealed transudative peritoneal collection with distended bladder. Cystoscopy revealed urinary bladder ruptures with exudate sealing the rupture site. Exploratory laparotomy was done and a diagnosis of extraperitoneal bladder rupture was confirmed. The rent was repaired in layers. She was put on continuous bladder drainage for 3 weeks followed by bladder training. It presented in a unique way as there was hemorrhagic peritoneal tap, no macroscopic hematuria and urinary bladder was distended in spite of urinary bladder wall rupture which delayed the diagnosis and treatment. Complete emptying of urinary bladder before second stage of labor and during postpartum period with perineal repair is mandatory to prevent urinary bladder rupture. PMID:26985426

  4. Analysis on Pathogenesis of 50 Cases of Bladder Proliferative Lesions

    Institute of Scientific and Technical Information of China (English)

    陈志强; 蓝儒竹; 叶章群; 杨为民

    2003-01-01

    In order to study the pathogenesis, clinical and pathological characteristics of prolifera-tive lesions of the bladder, 50 cases of proliferative lesions of the bladder from 150 patients withcomplaints of frequency, urgency, hematuria and dysuria were subjected to cystoscopic biopsy ofthe suspicious foci in the bladder. In combination with the symptoms, urine routine and urodynam-ics, the relationship of proliferative lesions of the bladder to the inflammation and obstruction of thelower urinary tract was analyzed. Of the 50 cases of proliferative bladder lesions, 44 cases (88%)had lower urinary tract infection and 29 (58%) lower urinary tract obstruction. The patients withlower urinary tract obstruction were all complicated with infection. Three cases were associatedwith transitional cell carcinoma. Malignant cells were detected in 1 case by urinary cytologic exami-nation. Proliferative lesions of the bladder, especially those without other obvious mucosa changesunder cystoscopy, are common histological variants of urothelium in the patients with chronic in-flammation and obstruction of the lower urinary tract. Chronic inflammation and obstruction of thelower urinary tract might be the causes for proliferative lesions of the bladder. It is suggested thatdifferent treatments should be applied according to the scope and histological type of the prolifera-tive lesions.

  5. CLINICAL STUDY ON PATELLAR REPLACEMENT IN TOTAL KNEE ARTHROPLASTY%人工全膝关节置换术中髌骨置换的临床研究

    Institute of Scientific and Technical Information of China (English)

    鲍亮; 高智慧; 施小强; 房晓敏; 金群华

    2013-01-01

    replacement group). There was no significant difference in gender, age, disease duration, osteoarthritis grading, the clinical and functional scores of American Knee Society Score (KSS), the patellar tilt angle, tibiofemoral angle, and patellar ligament ratio between 2 groups (P > 0.05), they were comparable. After 6 weeks, 3, 6, and 12 months of operation, clinical and imaging evaluation methods were used to assessment the effectiveness. Results Primary healing of incision was obtained in all patients of 2 groups. Deep venous thrombosis occurred in 6 cases of replacement group and in 8 cases of non pattelar replacement group. All patients were followed up 12 months. The postoperative incidence of anterior knee pain in replacement group was significantly lower than that in non pattelar replacement group (P 0.05). The joint function score of the replacement group was significantly higher than that of the non pattelar replacement group at the other time point (P 0.05). X-ray film showed no patellar fracture and dislocation, or loosening and breakage of internal fixation. At 12 months after operation, the tibiofemoral angle, the patellar ligament ratio, and the patellar tilt angle showed no significant difference between 2 groups [P > 0.05). Conclusion Patella replacement can improve knee function score and the patella score, and reduce the incidence of postoperative anterior knee pain.

  6. Clinical features of GH deficiency and effects of 3 years of GH replacement in adults with controlled Cushing's disease

    DEFF Research Database (Denmark)

    Höybye, Charlotte; Ragnarsson, Oskar; Jönsson, Peter J;

    2010-01-01

    Patients in remission from Cushing's disease (CD) have many clinical features that are difficult to distinguish from those of concomitant GH deficiency (GHD). In this study, we evaluated the features of GHD in a large cohort of controlled CD patients, and assessed the effect of GH treatment....

  7. Adverse Event Recording and Reporting in Clinical Trials Comparing Lumbar Disk Replacement with Lumbar Fusion: A Systematic Review.

    Science.gov (United States)

    Hiratzka, Jayme; Rastegar, Farbod; Contag, Alec G; Norvell, Daniel C; Anderson, Paul A; Hart, Robert A

    2015-12-01

    Study Design Systematic review. Objectives (1) To compare the quality of adverse event (AE) methodology and reporting among randomized trials comparing lumbar fusion with lumbar total disk replacement (TDR) using established AE reporting systems; (2) to compare the AEs and reoperations of lumbar spinal fusion with those from lumbar TDR; (3) to make recommendations on how to report AEs in randomized controlled trials (RCTs) so that surgeons and patients have more-detailed and comprehensive information when making treatment decisions. Methods A systematic search of PubMed, the Cochrane collaboration database, and the National Guideline Clearinghouse through May 2015 was conducted. Randomized controlled trials with at least 2 years of follow-up comparing lumbar artificial disk replacement with lumbar fusion were included. Patients were required to have axial or mechanical low back pain of ≥3 months' duration due to degenerative joint disease defined as degenerative disk disease, facet joint disease, or spondylosis. Outcomes included the quality of AE acquisition methodology and results reporting, and AEs were defined as those secondary to the procedure and reoperations. Individual and pooled relative risks and their 95% confidence intervals comparing lumbar TDR with fusion were calculated. Results RCTs demonstrated a generally poor description of methods for assessing AEs. There was a consistent lack of clear definition or grading for these events. Furthermore, there was a high degree of variation in reporting of surgery-related AEs. Most studies lacked adequate reporting of the timing of AEs, and there were no clear distinctions between acute or chronic AEs. Meta-analysis of the pooled data demonstrated a twofold increased risk of AEs in patients having lumbar fusion compared with patients having lumbar TDR at 2-year follow-up, and this relative risk was maintained at 5 years. Furthermore, the pooled data demonstrated a 1.7 times greater relative risk of

  8. Primary posterior perineal herniation of urinary bladder

    Directory of Open Access Journals (Sweden)

    Kurumboor Prakash

    2013-01-01

    Full Text Available Primary perineal hernia is a rare clinical condition wherein herniation of viscera occurs through pelvic diaphragm. They are usually mistaken for sciatic hernia, rectal prolapse or other diseases in the perineum. Correct identification of the type of hernia by imaging is crucial for planning treatment. We present a case of primary posterior herniation of urinary bladder and rectal wall through levator ani repaired laparoscopically using a mesh repair.

  9. 钬激光联合吡柔比星灌注治疗浅表性膀胱癌%Clinical study of holmium laser resection as well as instant intravesical Pirarubicin instillation for superficial bladder carcinoma

    Institute of Scientific and Technical Information of China (English)

    杨光天; 赵海岩; 温峰

    2012-01-01

    B ( P < 0.05 ).There were 4 cases of recurrence in group A,recurrence rate was 15.4% (4/26).While there were 11 cases of recurrence in group B,recurrence rate was 44.0% (11/25 ).Significant difference in cancer recurrence rate was found between two groups ( P < 0.05 ).Conclusion Compared with transurethral resection therapy transurethral holmium laser resection as well as instant intravesical Pirarubicin instillation for superficial bladder carcinoma was more effective and quicker recovery,which has a good applied future in the clinical practice.

  10. [Morquio disease (Mucopolysaccharidosis type IV-A): clinical aspects, diagnosis and new treatment with enzyme replacement therapy].

    Science.gov (United States)

    Politei, Juan; Schenone, Andrea B; Guelbert, Norberto; Fainboim, Alejandro; Szlago, Marina

    2015-08-01

    Mucopolysaccharidosis type IV-A (Morquio A disease) is an autosomal recessive lysosomal storage disease caused by mutations in the gene encoding the N-acetylgalactosamine-6-sulfate sulfatase, that results in impaired catabolism of two glycosaminoglycans, chondroitin-6-sulfate and keratan sulfate. Clinical presentations reflect a spectrum of progression from a severe phenotype to an attenuated expression. Accumulation of substrate manifests predominantly as short stature and skeletal dysplasia, including atlantoaxial instability and cervical cord compression. Other abnormalities in the visual, auditory, cardiovascular and respiratory systems can also affect individuals with Morquio disease. Elosulfase alfa showed in clinical trials in children and adults a significant and sustained improvement in endurance and urinary levels of keratan sulfate. Data from the ongoing observational, multinational Morquio A Registry Study will provide valuable information on the long-term efficacy and safety of elosulfase alfa in patients, as well as on the natural history of this very rare disease. PMID:26172013

  11. Preclinical dosimetry of magnetic fluid hyperthermia for bladder cancer

    Science.gov (United States)

    Oliveira, Tiago R.; Stauffer, Paul R.; Lee, Chen-Ting; Landon, Chelsea; Etienne, Wiguins; Maccarini, Paolo F.; Inman, Brant; Dewhirst, Mark W.

    2013-02-01

    Background Despite positive efficacy, thermotherapy is not widely used in clinical oncology. Difficulties associated with field penetration and controlling power deposition patterns in heterogeneous tissue have limited its use for heating deep in the body. Heat generation using iron-oxide super-paramagnetic nanoparticles excited with magnetic fields has been demonstrated to overcome some of these limitations. The objective of this preclinical study is to investigate the feasibility of treating bladder cancer with magnetic fluid hyperthermia (MFH) by analyzing the thermal dosimetry of nanoparticle heating in a rat bladder model. Methods The bladders of 25 female rats were injected with 0.4 ml of Actium Biosystems magnetite-based nanoparticles (Actium Biosystems, Boulder CO) via catheters inserted in the urethra. To assess the distribution of nanoparticles in the rat after injection we used the 7 T small animal MRI system (Bruker ClinScan, Bruker BioSpin MRI GmbH, Ettlingen, Germany). Heat treatments were performed with a small animal magnetic field applicator (Actium Biosystems, Boulder CO) with a goal of raising bladder temperature to 42°C in rat with seven fiberoptic temperature probes (OpSens Technologies, Quebec Canada) to characterize our ability to localize heat within the bladder target. Results The MRI study confirms the effectiveness of the catheterization procedure to homogenously distribute nanoparticles throughout the bladder. Thermal dosimetry data demonstrate our ability to controllably raise temperature of rat bladder >1°C/min to a steady-state of 42°C. Conclusion Our data demonstrate that a MFH system provides well-localized heating of rat bladder with effective control of temperature in the bladder and minimal heating of surrounding tissues.

  12. Implant Optimisation for Primary Hip Replacement in Patients over 60 Years with Osteoarthritis: A Cohort Study of Clinical Outcomes and Implant Costs Using Data from England and Wales.

    Directory of Open Access Journals (Sweden)

    Simon S Jameson

    Full Text Available Hip replacement is one of the most commonly performed surgical procedures worldwide; hundreds of implant configurations provide options for femoral head size, joint surface material and fixation method with dramatically varying costs. Robust comparative evidence to inform the choice of implant is needed. This retrospective cohort study uses linked national databases from England and Wales to determine the optimal type of replacement for patients over 60 years undergoing hip replacement for osteoarthritis.Implants included were the commonest brand from each of the four types of replacement (cemented, cementless, hybrid and resurfacing; the reference prosthesis was the cemented hip procedure. Patient reported outcome scores (PROMs, costs and risk of repeat (revision surgery were examined. Multivariable analyses included analysis of covariance to assess improvement in PROMs (Oxford hip score, OHS, and EQ5D index (9159 linked episodes and competing risks modelling of implant survival (79,775 procedures. Cost of implants and ancillary equipment were obtained from National Health Service procurement data.EQ5D score improvements (at 6 months were similar for all hip replacement types. In females, revision risk was significantly higher in cementless hip prostheses (hazard ratio, HR = 2.22, p<0.001, when compared to the reference hip. Although improvement in OHS was statistically higher (22.1 versus 20.5, p<0.001 for cementless implants, this small difference is unlikely to be clinically important. In males, revision risk was significantly higher in cementless (HR = 1.95, p = 0.003 and resurfacing implants, HR = 3.46, p<0.001, with no differences in OHS. Material costs were lowest with the reference implant (cemented, range £1103 to £1524 and highest with cementless implants (£1928 to £4285. Limitations include the design of the study, which is intrinsically vulnerable to omitted variables, a paucity of long-term implant survival data (reflecting the

  13. Small cell carcinoma of the urinary bladder: A case report and review of the literature

    OpenAIRE

    Ismaili Nabil; Ghanem Samia; Mellas Nawfel; Afqir Said; Taleb Meriem; Amrani Meryem; Gamra Lamia; Errihani Hassan

    2009-01-01

    Small cell carcinoma of the bladder (SCCB) is extremely rare. In this paper, we present a case of metastatic SCCB managed by chemotherapy and we would provide a brief review of the epidemiology, clinical features, diagnosis, pathologic features, staging, treatment, and prognosis of SCCB. A 52-year-old man was admitted with signs and symptoms suggestive of a bladder cancer. Computed tomography of the pelvis and abdomen showed a large tumor at the right bladder wall, measuring 10 cm in diameter...

  14. Cytological Diagnosis of Small Cell Carcinoma of Urinary Bladder in a Patient with CLL

    OpenAIRE

    Gülçin Güler Şimşek; Servet Güreşçi; Ural Oğuz; Ali Ünsal

    2014-01-01

    Small cell carcinoma of the urinary bladder (SCCUB) is an extremely rare bladder malignancy characterized by an aggressive clinical behavior. So, it is important to diagnose this high grade disease by urinary cytology. We report a case of SCCUB in an old man with chronic lymphocytic leukemia (CLL) in remission, while bladder tumor was diagnosed by cytology. With this article, we aimed to review and to update the literature concerning this tumor.

  15. Cytological Diagnosis of Small Cell Carcinoma of Urinary Bladder in a Patient with CLL

    Directory of Open Access Journals (Sweden)

    Gülçin Güler Şimşek

    2014-03-01

    Full Text Available Small cell carcinoma of the urinary bladder (SCCUB is an extremely rare bladder malignancy characterized by an aggressive clinical behavior. So, it is important to diagnose this high grade disease by urinary cytology. We report a case of SCCUB in an old man with chronic lymphocytic leukemia (CLL in remission, while bladder tumor was diagnosed by cytology. With this article, we aimed to review and to update the literature concerning this tumor.

  16. Impedance ratio method for urine conductivity-invariant estimation of bladder volume

    OpenAIRE

    Thomas Schlebusch; Jakob Orschulik; Jaakko Malmivuo; Steffen Leonhardt; Dorothea Leonhäuser; Joachim Grosse; Michael Kowollik; Ruth Kirschner-Hermanns; Marian Walter

    2014-01-01

    Non-invasive estimation of bladder volume could help patients with impaired bladder volume sensation to determine the right moment for catheterisation. Continuous, non-invasive impedance measurement is a promising technology in this scenario, although influences of body posture and unknown urine conductivity limit wide clinical use today. We studied impedance changes related to bladder volume by simulation, in-vitro and in-vivo measurements with pigs. In this work, we present a method to redu...

  17. An unusual case of cancer of the urachal remnant following repair of bladder exstrophy.

    LENUS (Irish Health Repository)

    Fanning, D M

    2012-02-01

    INTRODUCTION: We report the first case of cancer of the urachal remnant following repair of bladder exstrophy, in a renal transplant recipient. METHOD: A retrospective review of this clinical case and the associated literature were performed. CONCLUSION: This unusual case highlights two very rare entities. Bladder exstrophy has an incidence of 1 in 50,000 newborns, whereas urachal cancer accounts for less than 1% of all bladder tumours.

  18. An unusual case of cancer of the urachal remnant following repair of bladder exstrophy.

    LENUS (Irish Health Repository)

    Fanning, D M

    2009-03-18

    INTRODUCTION: We report the first case of cancer of the urachal remnant following repair of bladder exstrophy, in a renal transplant recipient. METHOD: A retrospective review of this clinical case and the associated literature were performed. CONCLUSION: This unusual case highlights two very rare entities. Bladder exstrophy has an incidence of 1 in 50,000 newborns, whereas urachal cancer accounts for less than 1% of all bladder tumours.

  19. Female Bladder Outlet Obstruction.

    Science.gov (United States)

    Hoffman, Daniel S; Nitti, Victor W

    2016-04-01

    The non-specific symptoms the patients express upon the presentation of female bladder outlet obstruction make it a challenge to diagnose. There are subtle differences between the obstructed patient and those whose bladders are underactive and/or fail to mount a detrusor contraction. These disparities can be extracted through a thorough history and examination. At times, the clinician may utilize nomograms, non-invasive uroflow, and urodynamics with the addition of fluoroscopy to establish the diagnosis of obstruction. Management of the obstruction depends on the nature of the condition, whether functional or anatomical. The increase in the number of sling procedures performed to treat stress urinary incontinence has resulted in a rise in the number of iatrogenic obstructions. The temporal relationship between surgery and obstruction is the key to identifying the problem. PMID:26902625

  20. Bladder sensory desensitization decreases urinary urgency

    Directory of Open Access Journals (Sweden)

    Avelino António

    2007-06-01

    Full Text Available Abstract Background Bladder desensitization has been investigated as an alternative treatment for refractory detrusor overactivity. Most open and controlled clinical trials conducted with intravesical RTX showed that desensitization delays the appearance of involuntary detrusor contractions during bladder filling and decreases the number of episodes of urgency incontinence. Urgency is being recognised as the fundamental symptom of overactive bladder (OAB, a symptomatic complex which recent epidemiological studies have shown to affect more than 10% of the Western population. As anti-muscarinic drugs, the first line treatment for OAB, are far from being able to fully control urgency, the opportunity to test other therapeutic approaches is created. The present work was, therefore, designed as an exploratory investigation to evaluate the effect of bladder desensitization on urinary urgency. Methods Twenty-three OAB patients with refractory urgency entered, after given informed consent, a 30 days run-in period in which medications influencing the bladder function were interrupted. At the end of this period patients filled a seven-day voiding chart where they scored, using a 0–4 scale, the bladder sensations felt before each voiding. Then, patients were instilled with 100 ml of 10% ethanol in saline (vehicle solution and 30 days later a second seven-day voiding chart was collected. Finally, patients were instilled with 100 ml of 50 nM RTX in 10% ethanol in saline. At 1 and 3 months additional voiding charts were collected. At the end of the vehicle and 3 months period patients were asked to give their subjective impression about the outcome of the treatment and about the willingness to repeat the previous instillation. Results At the end of the run-in period the mean number of episodes of urgency per week was 71 ± 12 (mean ± SEM. After vehicle instillation, the mean number of episodes of urgency was 56 ± 11, but only 4 patients (17% considered

  1. Botulinum Toxin A for Bladder Pain Syndrome/Interstitial Cystitis

    Science.gov (United States)

    Chiu, Bin; Tai, Huai-Ching; Chung, Shiu-Dong; Birder, Lori A.

    2016-01-01

    Botulinum neurotoxin A (BoNT-A), derived from Clostridium botulinum, has been used clinically for several diseases or syndrome including chronic migraine, spasticity, focal dystonia and other neuropathic pain. Chronic pelvic or bladder pain is the one of the core symptoms of bladder pain syndrome/interstitial cystitis (BPS/IC). However, in the field of urology, chronic bladder or pelvic pain is often difficult to eradicate by oral medications or bladder instillation therapy. We are looking for new treatment modality to improve bladder pain or associated urinary symptoms such as frequency and urgency for patients with BPS/IC. Recent studies investigating the mechanism of the antinociceptive effects of BoNT A suggest that it can inhibit the release of peripheral neurotransmitters and inflammatory mediators from sensory nerves. In this review, we will examine the evidence supporting the use of BoNTs in bladder pain from basic science models and review the clinical studies on therapeutic applications of BoNT for BPS/IC. PMID:27376330

  2. Bladder neck contracture

    OpenAIRE

    Simhan, Jay; Ramirez, Daniel; Hudak, Steven J.; Morey, Allen F.

    2014-01-01

    Bladder neck contracture (BNC) is a well-described complication of the surgical treatment of benign and malignant prostate conditions. Nevertheless, etiologies of BNC development are highly dependent on the primary treatment modality undertaken with BNC also occurring after pelvic radiation. The treatment options for BNC can range from simple, office-based dilation procedures to more invasive, complex abdomino-perineal reconstructive surgery. Although numerous strategies have been described, ...

  3. Gall bladder ascariasis

    OpenAIRE

    Ranendra Hajong

    2013-01-01

    Hepatobiliary ascariasis is commonly reported from highly endemic regions like India, Bangladesh, Latin America, parts of Middle East and Africa. In humans, the usual habitat of Ascaris lumbricoides is the small intestine. When the worm load is high, going as high as more than 1000 worms, then the worms tend to migrate away from the usual site. Patients with hepatobiliary ascariasis may present with biliary colic due to obstruction caused by the worms in the gall bladder, common bile duct or ...

  4. Nomograms Predicting Response to Therapy and Outcomes After Bladder-Preserving Trimodality Therapy for Muscle-Invasive Bladder Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Coen, John J., E-mail: jcoen@harthosp.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Paly, Jonathan J.; Niemierko, Andrzej [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Kaufman, Donald S. [Department of Medical Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Heney, Niall M. [Department of Urology, Massachusetts General Hospital, Boston, Massachusetts (United States); Spiegel, Daphne Y.; Efstathiou, Jason A.; Zietman, Anthony L.; Shipley, William U. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2013-06-01

    Purpose: Selective bladder preservation by use of trimodality therapy is an established management strategy for muscle-invasive bladder cancer. Individual disease features have been associated with response to therapy, likelihood of bladder preservation, and disease-free survival. We developed prognostic nomograms to predict the complete response rate, disease-specific survival, and likelihood of remaining free of recurrent bladder cancer or cystectomy. Methods and Materials: From 1986 to 2009, 325 patients were managed with selective bladder preservation at Massachusetts General Hospital (MGH) and had complete data adequate for nomogram development. Treatment consisted of a transurethral resection of bladder tumor followed by split-course chemoradiation. Patients with a complete response at midtreatment cystoscopic assessment completed radiation, whereas those with a lesser response underwent a prompt cystectomy. Prognostic nomograms were constructed predicting complete response (CR), disease-specific survival (DSS), and bladder-intact disease-free survival (BI-DFS). BI-DFS was defined as the absence of local invasive or regional recurrence, distant metastasis, bladder cancer-related death, or radical cystectomy. Results: The final nomograms included information on clinical T stage, presence of hydronephrosis, whether a visibly complete transurethral resection of bladder tumor was performed, age, sex, and tumor grade. The predictive accuracy of these nomograms was assessed. For complete response, the area under the receiving operating characteristic curve was 0.69. The Harrell concordance index was 0.61 for both DSS and BI-DFS. Conclusions: Our nomograms allow individualized estimates of complete response, DSS, and BI-DFS. They may assist patients and clinicians making important treatment decisions.

  5. Observational clinical study of 22 adult-onset Pompe disease patients undergoing enzyme replacement therapy over 5years.

    Science.gov (United States)

    Stepien, Karolina M; Hendriksz, Christian J; Roberts, Mark; Sharma, Reena

    2016-04-01

    Pompe disease is an autosomal recessive disease resulting from deficiency of the acid alpha-glucosidase (GAA). The late-onset Pompe Disease (LOPD) patients develop muscular and respiratory complications later in life. We describe a retrospective observational cohort study including 22 patients with LOPD. The cohort was assessed at baseline before Enzyme Replacement Therapy (ERT) with alglucosidase alpha (20mg/kg biweekly) was commenced and subsequently relevant information was collected at 2, 4 and 5years later. The median age of the patients at study entry was 44years (16-64years), with median disease duration of 11.5years (4-31years). At baseline, 10 patients (45%) could walk without support, 12 (55%) could walk with unilateral or bilateral support including 3/12 were wheelchair bound. Mean predicted FVC % was 55.7 (95% CI 45-66) of predicted normal at baseline and showed no significant change after 5years (54.6 (95% CI 43-66)), (all p=0.9815). Mean FVC % supine was 41.8 (95% CI 33.8-49) of predicted normal at baseline and remained significantly unchanged at 5years (48.4 (95% CI 37-59.6)), (all p=0.8680). The overnight non-invasive ventilator dependence increased by 18.2% as compared with baseline and requirement of mobility aids increased during this period by 5.2% as compared with the baseline. Mean walking distance at 6min walk test was 411.5 (95% CI 338-485) at baseline, 266.5 (95% CI 187-346) m at 2years, 238.6 (95% CI 162-315) m at 4years and 286.8 (95% CI 203-370) m at 5years (p=0.1981; ANOVA was completed only for 14 patients). A gradual decline in FVC% predicted was noted only in four cases and a decline in FVC% supine in two other. Only one patient showed a decline in both pulmonary function tests. In all remaining cases (17/22) respiratory function remains stable. In conclusion overall pulmonary function tests and mobility remained stable for 5years in majority of patients on ERT. However, in some patients they continued to decline in spite of ERT

  6. Contemporary Management of Bladder Cancer

    Science.gov (United States)

    Bell, David; Fradet, Yves

    1991-01-01

    Bladder cancer is currently the fifth most common cancer in Western society, and its incidence appears to be increasing. Important advances have recently occurred in both diagnostic and therapeutic approaches to bladder neoplasms. Presentation is not unique, and physician awareness is important to identify patients who are at risk for bladder neoplasia and consequently require further investigation. A diagnostic approach and contemporary management are discussed. ImagesFigure 1Figure 4 PMID:21229043

  7. Bladder Dysfunction and Vesicoureteral Reflux

    OpenAIRE

    Ulla Sillén

    2008-01-01

    In this overview the influence of functional bladder disturbances and of its treatment on the resolution of vesicoureteral reflux (VUR) in children is discussed. Historically both bladder dysfunction entities, the overactive bladder (OAB) and the dysfunctional voiding (DV), have been described in conjunction with VUR. Treatment of the dysfunction was also considered to influence spontaneous resolution in a positive way. During the last decades, however, papers have been published which could ...

  8. Permeability and ultrastructure of human bladder epithelium

    DEFF Research Database (Denmark)

    Eldrup, J; Thorup, Jørgen Mogens; Nielsen, S L;

    1983-01-01

    Leakage of tight junctions as observed with electron microscopy and demonstration of solute transport across bladder epithelium was investigated in 13 patients with different bladder diseases: urinary retention and infection, bladder tumours and interstitial cystitis. The latter group showed cons...

  9. Treatment Options by Stage (Bladder Cancer)

    Science.gov (United States)

    ... Cancer Treatment Bladder Cancer Screening Research Bladder Cancer Treatment (PDQ®)–Patient Version General Information About Bladder Cancer ... Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) depends on ...

  10. Diet in bladder cancer ethiopathogenesis

    Directory of Open Access Journals (Sweden)

    Đokić M.

    2005-01-01

    Full Text Available The aim of this paper is to show influence of different foods on bladder cancer appearance, as well as possible consequent ways of prevention. Consumption of food rich in animal fat and cholesterol, fried foods, especially several times used cookin oil for frying, processed meat with additives (nitrates, nitrites, azo-colourrs can influence bladder cancer occurrence. Regularly, continuous consumption of fermented milk products, which contains come types of milky - acids bacterias, is considered as protective factor in developing bladder cancer. Reports that fruit and vegetable are protective food items are pretty consistent. Data about mineral intake and bladder cancer are obscure.

  11. Advanced 3-D analysis, client-server systems, and cloud computing-Integration of cardiovascular imaging data into clinical workflows of transcatheter aortic valve replacement.

    Science.gov (United States)

    Schoenhagen, Paul; Zimmermann, Mathis; Falkner, Juergen

    2013-06-01

    Degenerative aortic stenosis is highly prevalent in the aging populations of industrialized countries and is associated with poor prognosis. Surgical valve replacement has been the only established treatment with documented improvement of long-term outcome. However, many of the older patients with aortic stenosis (AS) are high-risk or ineligible for surgery. For these patients, transcatheter aortic valve replacement (TAVR) has emerged as a treatment alternative. The TAVR procedure is characterized by a lack of visualization of the operative field. Therefore, pre- and intra-procedural imaging is critical for patient selection, pre-procedural planning, and intra-operative decision-making. Incremental to conventional angiography and 2-D echocardiography, multidetector computed tomography (CT) has assumed an important role before TAVR. The analysis of 3-D CT data requires extensive post-processing during direct interaction with the dataset, using advance analysis software. Organization and storage of the data according to complex clinical workflows and sharing of image information have become a critical part of these novel treatment approaches. Optimally, the data are integrated into a comprehensive image data file accessible to multiple groups of practitioners across the hospital. This creates new challenges for data management requiring a complex IT infrastructure, spanning across multiple locations, but is increasingly achieved with client-server solutions and private cloud technology. This article describes the challenges and opportunities created by the increased amount of patient-specific imaging data in the context of TAVR. PMID:24282750

  12. CLINICO-PATHOLOGICAL STUDY OF CARCINOMA GALL BLADDER

    Directory of Open Access Journals (Sweden)

    Ravindra

    2015-12-01

    Full Text Available INTRODUCTION Gall bladder cancer is 5th most common cancer of GIT. It is associated with cholelithiasis in significant number of patients. Cholelithiasis is cause or effect of gall bladder cancer is still uncertain. There are many risk factors which are common to both gall stones and cancer. Preoperative diagnosis of gall bladder cancer is increased with better and new investigation facilities. AIM The study was aimed to assess clinicopathological behaviour, sociodemography, diagnostic modalities and treatment of cancer gall bladder. MATERIAL AND METHODS It was a type of prospective study which included 75 patients with clinical features suggestive of biliary disease. Various diagnostic modalities and treatment options were assessed along with sociodemography and clinical picture. RESULT Common clinical features were pain abdomen, obstructive jaundice and lump. Nearly one third of the patients were having anaemia and abnormal liver function tests. Majority had gall bladder fossa mass with liver extension and gall stones. The most common histopathological variety of carcinoma Gallbladder was Adenocarcinoma. CONCLUSION Carcinoma Gallbladder was found to affect predominantly the older female patients after the age of 40 years. Cholelithiasis was found in 69.3% patients of carcinoma Gallbladder. The most common clinical presentation was pain abdomen (90.7%. The most common histopathological variety of carcinoma Gallbladder was Adenocarcinoma. Majority of patients were treated with palliative measures.

  13. Combined therapy of urinary bladder radiation injury

    Energy Technology Data Exchange (ETDEWEB)

    Zaderin, V.P.; Polyanichko, M.F. (Rostovskij-na-Donu Nauchno-Issledovatel' skij Onkologicheskij Inst. (USSR))

    1982-01-01

    A scheme of therapy of radiation cystitis is suggested. It was developed on the basis of evaluation of literature and clinical data of 205 patients with radiation injury of the urinary bladder. The method is based on general and local therapy of damaged tissues by antiinflammatory drugs, anesthetics and stimulators of reparative regeneration. Severe ulcerative and incrustation cystites, refractory to conservative therapy, were treated by surgery, using antiseptics and reparation stimulators before, during and after operation. As a result, there were hardly any complications after reconstruction of the bladder with intestinal and peritoneal tissues. 104 patients (96.1%) were cured completely and ability to work was restored in 70 patients (76.9%).

  14. Calcitonin-producing well-differentiated neuroendocrine carcinoma (carcinoid tumor) of the urinary bladder: case report

    International Nuclear Information System (INIS)

    The occurrence of calcitonin-secreting primary carcinoid tumor of the urinary bladder is extremely rare. The case of a 68-year-old male with carcinoid tumor arising in the urinary bladder is presented. Transurethral resection of a polypoid small tumor 0.4 cm in diameter was performed. Immunohistochemical study using neuroendocrine markers allowed a straightforward diagnosis of a low-grade neuroendocrine carcinoma (carcinoid tumor) of the urinary bladder. Immunohistochemistry demonstrated calcitonin immunoreactivity in the most of the tumor cells. This tumor shows specific clinical, macroscopical and histological features and must be considered in the differential diagnosis of bladder neoplasms

  15. Diagnosis and treatment in primary bladder small cell carcinoma: Literature review

    Directory of Open Access Journals (Sweden)

    Orcun Celik

    2016-03-01

    Full Text Available Small cell bladder carcinoma is a rare and frequently fatal disease. It can be distinguished from classical urothelial carcinoma microscopically and immunohistochemically. Small cell bladder carcinoma has histologically similar properties with other small cell carcinomas in other organs. It has a worse prognosis when compared to urothelial bladder cancer. Multimodal treatments are recommended although there is no widely accepted consensus regarding to the treatment algorithm because of its rarity. In this review, clinical properties and diagnosis of small cell bladder carcinoma, its histopathological and immunohistochemical properties and treatment modalities are examined.

  16. Diagnosis and treatment in primary bladder small cell carcinoma: Literature review.

    Science.gov (United States)

    Celik, Orcun; Ekin, Gokhan; Ipekci, Tumay; Budak, Salih; Ilbey, Yusuf Ozlem

    2016-03-01

    Small cell bladder carcinoma is a rare and frequently fatal disease. It can be distinguished from classical urothelial carcinoma microscopically and immunohistochemically. Small cell bladder carcinoma has histologically similar properties with other small cell carcinomas in other organs. It has a worse prognosis when compared to urothelial bladder cancer. Multimodal treatments are recommended although there is no widely accepted consensus regarding to the treatment algorithm because of its rarity. In this review, clinical properties and diagnosis of small cell bladder carcinoma, its histopathological and immunohistochemical properties and treatment modalities are examined. PMID:27072176

  17. A Large Bladder Tumor Covered With a Thick “Shell” of Necrotic Material

    OpenAIRE

    Wang, Lei; Zhou, Zhe; Gong, Miao-zi; Pan, Dong-liang; ZHANG, XIANG-HUA; Li, Ning-chen; Na, Yan-qun

    2016-01-01

    Abstract Bladder tumor arising in a spina bifida patient is rare and may be clinically latent. We report the case of a 61-year-old female patient with spina bifida, neurogenic bladder, and a history of recurrent urinary tract infections. A B-ultrasound and non-contrast computed tomography scan did not reveal any bladder mass, but an unexplained “well-filled” bladder was observed, which was confusing as the catheter was present and open. However, a subsequent cystoscopic evaluation revealed a ...

  18. Renal failure with a large bladder calculus related to a foreign body: a case report

    OpenAIRE

    Minter, Janelle; Chiovaro, Joseph

    2014-01-01

    Key Clinical Message We encountered a patient with renal failure in the setting of long-standing difficulty urinating, which he previously treated with intermittent self-catheterizations. Imaging showed a large urinary calculus in the bladder. This case illustrates the importance of taking a detailed history and the dramatic long-term effects of bladder calculi.

  19. Impact of Overactive Bladder Syndrome on Female Sexual Function

    Directory of Open Access Journals (Sweden)

    Serdar Toksöz

    2015-12-01

    Full Text Available The etiology of female sexual dysfunction includes psychological, physiological and iatrogenic causes. Physiological and iatrogenic causes are abdominal surgery, menopause, smoking, spinal cord injuries and some antipsychotic, antihypertensive, and antidepressant drugs. When assessing sexual function, sexual function questionnaires, such as the Female Sexual Function Index, and the Sexual Function Questionnaire are used. The prevalence of female sexual dysfunction is 43% and it has been reported to increase depending on menopause and age. Estrogen, estrogen + testosterone and tibolone, PDE5, apomorphine, bupropion and flibanserin are used in the treatment of female sexual dysfunction. Overactive bladder is a disease affecting the quality of life and is characterized by urgency, frequency, nocturia and urge incontinence with especially filling phase of the bladder resulting from loss of detrusor muscle inhibition. The prevalence of overactive bladder in women in the United States has been reported to be 16.9%. Lower urinary tract symptoms and overactive bladder syndrome are not known how to cause female sexual dysfunction. Menopause and partner status were the most important predictors for female sexual dysfunction. It has been reported that overactive bladder syndrome and urinary incontinence provide prediction of development of female sexual dysfunction. Shame, fear of incontinence, and urinary incontinence as well as urge sensation during sexual intercourse in individuals with overactive bladder syndrome have been reported to be the main factors causing female sexual dysfunction. Pathophysiological relationship between the two disorders has not been elucidated and further clinical and experimental studies are needed in this regard.

  20. Postmortem MRI of bladder agenesis

    Energy Technology Data Exchange (ETDEWEB)

    Barber, Brendan R. [St George' s Hospital, Radiology Department, London (United Kingdom); Weber, Martin A. [Great Ormond Street Hospital for Children, Department of Histopathology, London (United Kingdom); Bockenhauer, Detlef [Great Ormond Street Hospital for Children, Department of Nephrology, London (United Kingdom); Hiorns, Melanie P.; McHugh, Kieran [Great Ormond Street Hospital for Children, Radiology Department, London (United Kingdom)

    2011-01-15

    We report a 35-week preterm neonate with bladder agenesis and bilateral dysplastic kidneys. A suprapubic catheter was inadvertently inserted into one of the larger inferior cysts of the left dysplastic kidney. A postmortem MRI scan was performed with the findings being confirmed on autopsy. We are unaware of another postmortem MRI study demonstrating bladder agenesis. (orig.)

  1. Management of invasive bladder cancer

    International Nuclear Information System (INIS)

    Muscle invasive disease accounts for a quarter of all cases of bladder cancer. A bewildering variety of treatment options are available for patients with this disease, with combinations of surgery and/or radiotherapy, with or without chemotherapy. This review discusses these treatment options and their relative merits for patients with muscle invasive bladder cancer. 22 refs., 3 figs., 7 tabs

  2. Tissue engineering of urinary bladder – current state of art and future perspectives

    OpenAIRE

    Adamowicz, Jan; Kowalczyk, Tomasz; Drewa, Tomasz

    2013-01-01

    Introduction Tissue engineering and biomaterials science currently offer the technology needed to replace the urinary tract wall. This review addresses current achievements and barriers for the regeneration of the urinary blad- der based on tissue engineering methods. Materials and methods Medline was search for urinary bladder tissue engineering regenerative medicine and stem cells. Results Numerous studies to develop a substitute for the native urinary bladder wall us- ing the tissue engine...

  3. Shoulder replacement - discharge

    Science.gov (United States)

    Total shoulder arthroplasty - discharge; Endoprosthetic shoulder replacement - discharge; Partial shoulder replacement - discharge; Partial shoulder arthroplasty - discharge; Replacement - shoulder - discharge; ...

  4. Calcifications of the bladder in schistosomiasis

    International Nuclear Information System (INIS)

    In schistosomiasis calcification of the urinary bladder are characteristic signs that allow a corresponding diagnosis in endemic regions. Problems concerning differential diagnosis occur only in very rare cases. The calcifications of the bladder can be easily detected by native diagnostics. A late complication in an affected bladder is often a bladder carcinoma. (orig.)

  5. Bladder wall thickness mapping for magnetic resonance cystography

    International Nuclear Information System (INIS)

    Clinical studies have shown evidence that the bladder wall thickness is an effective biomarker for bladder abnormalities. Clinical optical cystoscopy, the current gold standard, cannot show the wall thickness. The use of ultrasound by experts may generate some local thickness information, but the information is limited in field-of-view and is user dependent. Recent advances in magnetic resonance (MR) imaging technologies lead MR-based virtual cystoscopy or MR cystography toward a potential alternative to map the wall thickness for the entire bladder. From a high-resolution structural MR volumetric image of the abdomen, a reasonable segmentation of the inner and outer borders of the bladder wall can be achievable. Starting from here, this paper reviews the limitation of a previous distance field-based approach of measuring the thickness between the two borders and then provides a solution to overcome the limitation by an electric field-based strategy. In addition, this paper further investigates a surface-fitting strategy to minimize the discretization errors on the voxel-like borders and facilitate the thickness mapping on the three-dimensional patient-specific bladder model. The presented thickness calculation and mapping were tested on both phantom and human subject datasets. The results are preliminary but very promising with a noticeable improvement over the previous distance field-based approach. (paper)

  6. Bladder wall thickness mapping for magnetic resonance cystography

    Science.gov (United States)

    Zhao, Yang; Liang, Zhengrong; Zhu, Hongbin; Han, Hao; Duan, Chaijie; Yan, Zengmin; Lu, Hongbing; Gu, Xianfeng

    2013-08-01

    Clinical studies have shown evidence that the bladder wall thickness is an effective biomarker for bladder abnormalities. Clinical optical cystoscopy, the current gold standard, cannot show the wall thickness. The use of ultrasound by experts may generate some local thickness information, but the information is limited in field-of-view and is user dependent. Recent advances in magnetic resonance (MR) imaging technologies lead MR-based virtual cystoscopy or MR cystography toward a potential alternative to map the wall thickness for the entire bladder. From a high-resolution structural MR volumetric image of the abdomen, a reasonable segmentation of the inner and outer borders of the bladder wall can be achievable. Starting from here, this paper reviews the limitation of a previous distance field-based approach of measuring the thickness between the two borders and then provides a solution to overcome the limitation by an electric field-based strategy. In addition, this paper further investigates a surface-fitting strategy to minimize the discretization errors on the voxel-like borders and facilitate the thickness mapping on the three-dimensional patient-specific bladder model. The presented thickness calculation and mapping were tested on both phantom and human subject datasets. The results are preliminary but very promising with a noticeable improvement over the previous distance field-based approach.

  7. Familial aggregation of bladder cancer

    Directory of Open Access Journals (Sweden)

    Ilić Milena

    2011-01-01

    Full Text Available Background. Except for smoking and certain occupational exposures, the etiology of bladder cancer is largely unknown. Several case reports have described familial aggregation of transitional cell carcinoma of the bladder. Although the majority of patients with bladder cancer do not have family history of transitional cell carcinoma of the urinary tract, the study of familial transitional cell carcinoma may lead to the knowledge on the pathogenesis of this disease. The purpose of this study was to describe three cases of urinary bladder cancer in a single three-member family, i.e. in two generations (mother and son and a family member related by marriage (the patient’s wife. Case report. Three cases of urinary bladder cancer occurred in a three-member family within the interval of 5 years. The following common characteristics were detected in our patients: old age (over 60, working as farmers for more than 50 years, negative personal medical history on relevant health disorders, place of birth - village, place of residence - village, the same water supply, similar nutrition, positive family history on urinary bladder cancer or other malignant tumors, the first sign of illness was macroscopic hematuria in all the patients and the same pathohistological type of cancer - carcinoma papillare transitiocellulare. Conclusion. The stated common characteristics in our cases indicate, above all, the impact of exposure to external surrounding factors on the occurrence of urinary bladder cancer.

  8. Expression of Bmi-1 is a prognostic marker in bladder cancer

    Directory of Open Access Journals (Sweden)

    Xu Li-Hua

    2009-02-01

    Full Text Available Abstract Background The molecular mechanisms of the development and progression of bladder cancer are poorly understood. The objective of this study was to analyze the expression of Bmi-1 protein and its clinical significance in human bladder cancer. Methods We examined the expression of Bmi-1 mRNA and Bmi-1 protein by RT-PCR and Western blot, respectively in 14 paired bladder cancers and the adjacent normal tissues. The expression of Bmi-1 protein in 137 specimens of bladder cancer and 30 specimens of adjacent normal bladder tissue was determined by immunohistochemistry. Statistical analyses were applied to test the relationship between expression of Bmi-1, and clinicopathologic features and prognosis. Results Expression of Bmi-1 mRNA and protein was higher in bladder cancers than in the adjacent normal tissues in 14 paired samples (P P P P P > 0.5. In superficial bladder cancers, the expression of Bmi-1 protein in recurrent cases was higher than in recurrence-free cases (62.5% versus 13.7%, P P P > 0.05. Five-year survival in the group with higher Bmi-1 expression was 50.8%, while it was 78.5% in the group with lower Bmi-1 expression (P P Conclusion Expression of Bmi-1 was greater in bladder cancers than in the adjacent normal tissues. The examination of Bmi-1 protein expression is potentially valuable in prognostic evaluation of bladder cancer.

  9. Closure and augmentation of bladder exstrophy using rectus abdominis musculo-peritoneal flap

    Directory of Open Access Journals (Sweden)

    P Agarwal

    2011-01-01

    Full Text Available Background: The aim of this study was to investigate the efficacy of the rectus abdominis myo-peritoneal flap (RAMP technique for the closure and augmentation of small, non-elastic, non-compliant bladder exstrophies. Materials and Methods: The RAMP technique was used in three boys with bladder exstrophy who presented late with small, non-elastic, non-compliant bladder. The clinical outcome, imaging, cystoscopy, biochemical and microbiological studies were assessed during a follow-up of 36 months. Results: Bladder closure and augmentation was achieved in all patients without any complications. There were no urinary tract infections, metabolic problems or electrolyte disturbances and the kidney function remained normal in all patients. Radiography confirmed intact function and anatomy of the urinary tract and cystoscopy showed complete coverage of the inner peritoneal layer of RAMP with uroepithelium. No stone formation or mucous production was detected. Conclusions: The RAMP technique is a good alternative for closing bladder exstrophies and achieves an increase in bladder capacity and compliance. The technique is indicated in the closure of large bladder defects, bladder exstrophies with small, inelastic, non-compliant bladder remnants and failed primary closures.

  10. A clinical analysis and prognostic study of 187 cases with T1G3 bladder cancer%T1G3膀胱癌187例临床分析及预后研究

    Institute of Scientific and Technical Information of China (English)

    李晓东; 孙光; 刘晓强; 刘硕

    2011-01-01

    目的 分析T1G3膀胱癌的临床特点及复发、进展、死亡的风险因素,提高对T1G3膀胱癌的认识和治疗效果. 方法 收集1998年1月至2006年10月天津市泌尿外科研究所诊断为T1G3膀胱癌且资料完整的患者187例.男162例,女25例.年龄35~92岁,平均66岁.进行临床流行病学调查并随访预后情况.寿命表法估计1、2、3、5年复发率、进展率及死亡率.将年龄、性别、出现症状至就诊时间、有无肾积水、手术方式、术后是否即刻灌药、膀胱灌注药物种类、肿瘤直径、肿瘤数量、肿瘤形态、有无原位癌、复发次数、初次复发时间≤6个月作为变量,分别进行肿瘤复发、疾病进展、死亡的Kaplan-meier单因素及Cox多因素生存分析. 结果 本组患者随访12~111个月,平均46个月.肿瘤复发100例(53.5%),进展61例(32.6%),死亡37例(19.8%).1、2、3、5年肿瘤复发率分别为35.0%、60.0%、63.0%、65.0%,疾病进展率分别为12.0%、27.0%、34.0%、38.0%,死亡率分别为0、11.0%、17.0%、26.0%.肿瘤直径、肿瘤数量、即刻灌注、初次复发时间≤6个月是T1G3膀胱癌复发的危险因素;肿瘤形态、原位癌、初次复发时间≤6个月、复发次数是T1G3膀胱癌进展的危险因素.肿瘤进展是患者死亡的危险因素. 结论 肿瘤直径≥3 cm、多发、初次复发时间≤6个月的T1G3膀胱癌患者更容易复发,应加强随访,即刻膀胱灌注可以降低T1G3膀胱肿瘤复发的风险.对肿瘤形态呈结节状、合并原位癌、初次复发时间≤6个月、多次复发等进展高危风险因素的T1G3膀胱肿瘤患者,应早期行膀胱切除.%Objective The clinical features of T1G3 bladder cancer and the risk factors of the recurrence,progression and death were studied. Methods One hundred and eighty-seven cases with T1G3 bladder cancer were diagnosed from 1998 to 2006 in the Institute of Urology of Tianjin.There were 162

  11. Use of Aleuria alantia Lectin Affinity Chromatography to Enrich Candidate Biomarkers from the Urine of Patients with Bladder Cancer

    Directory of Open Access Journals (Sweden)

    Sarah R. Ambrose

    2015-09-01

    Full Text Available Developing a urine test to detect bladder tumours with high sensitivity and specificity is a key goal in bladder cancer research. We hypothesised that bladder cancer-specific glycoproteins might fulfill this role. Lectin-ELISAs were used to study the binding of 25 lectins to 10 bladder cell lines and serum and urine from bladder cancer patients and non-cancer controls. Selected lectins were then used to enrich glycoproteins from the urine of bladder cancer patients and control subjects for analysis by shotgun proteomics. None of the lectins showed a strong preference for bladder cancer cell lines over normal urothlelial cell lines or for urinary glycans from bladder cancer patients over those from non-cancer controls. However, several lectins showed a strong preference for bladder cell line glycans over serum glycans and are potentially useful for enriching glycoproteins originating from the urothelium in urine. Aleuria alantia lectin affinity chromatography and shotgun proteomics identified mucin-1 and golgi apparatus protein 1 as proteins warranting further investigation as urinary biomarkers for low-grade bladder cancer. Glycosylation changes in bladder cancer are not reliably detected by measuring lectin binding to unfractionated proteomes, but it is possible that more specific reagents and/or a focus on individual proteins may produce clinically useful biomarkers.

  12. Experimental rat bladder urothelial cell carcinoma models

    OpenAIRE

    Arentsen, Harm C.; Hendricksen, Kees; Oosterwijk, Egbert; Witjes, J Alfred

    2009-01-01

    Bladder cancer is a major public health problem. Currently available therapeutic options seem to be unable to prevent bladder cancer recurrence and progression. To enable preclinical testing of new intravesical therapeutic agents, a suitable bladder tumor model that resembles human disease is highly desirable. The aim of this topic paper was to discuss the problems associated with current in vivo animal bladder tumor models, focusing on the orthotopic syngeneic rat bladder tumor model. In the...

  13. Small cell carcinoma of the urinary bladder

    OpenAIRE

    Terada, Tadashi

    2012-01-01

    Primary small cell carcinoma of the urinary bladder is very rare; only several studies have been reported in the English literature. A 62-year-old woman was admitted to our hospital because of hematuria and dysuria. Bladder endoscopy revealed a large polypoid tumor at the bladder base. Transurethral bladder tumorectomy (TUR-BT) was performed. Many TUR-BT specimens were obtained. Histologically, the bladder tumor was pure small cell carcinoma. Immunohistochemically, the tumor cells were positi...

  14. Chemoimmunotherapy of murine bladder cancer.

    Science.gov (United States)

    Stogdill, B J; Lamm, D L; Livingston, R B

    1981-11-01

    The lethality of invasive transitional cell carcinoma (TCC) has prompted a search for effective, minimally toxic, adjuvant therapy. Such agents were evaluated in a murine bladder cancer (MBT2) model which parallels the clinical disease. One hundred C3H/He mice were inoculated i.d. with 2.5 x 10(4) viable MBT2 tumor cells and randomized to receive either normal saline (control), cis-Platinum (CPT), cyclophosphamide (CY), methotrexate (MTX), BCG, (CY + MTX), or (CY + MTX + BCG). Chemotherapy was given intraperitoneally weekly starting on day 7 after inoculation. Immunotherapy was given intralesionally on days 1 and 10 only. All mice were treated for 5 weeks followed by 5 weeks of observation. At 5 weeks, tumors of mice receiving cyclophosphamide alone or either of the combinations of therapy were smaller (P less than 0.01) than tumors of controls or other single agents alone. Each regimen increased survival, but only the combination regimen increase survival significantly (P less than 0.01). In the doses and schedule used in this model. Combination chemotherapy and chemoimmunotherapy significantly delay tumor growth and increase duration of survival (P less than 0.01) when compared with controls or single agent groups. PMID:7298287

  15. Gall bladder ascariasis

    Directory of Open Access Journals (Sweden)

    Ranendra Hajong

    2013-01-01

    Full Text Available Hepatobiliary ascariasis is commonly reported from highly endemic regions like India, Bangladesh, Latin America, parts of Middle East and Africa. In humans, the usual habitat of Ascaris lumbricoides is the small intestine. When the worm load is high, going as high as more than 1000 worms, then the worms tend to migrate away from the usual site. Patients with hepatobiliary ascariasis may present with biliary colic due to obstruction caused by the worms in the gall bladder, common bile duct or as a result of obstructive symptoms caused by calcified worms or lithiasis, which is commonly found in patients with hepatobiliary ascariasis. Acute pancreatitis may also be caused by ascariasis. Management usually is conservative if it is still alive or can be extracted by endoscopic retrograde cholangio-pancreatography or surgery.

  16. Teardrop bladder: additional considerations

    International Nuclear Information System (INIS)

    Nine cases of teardrop bladder (TDB) seen at excretory urography are presented. In some of these patients, the iliopsoas muscles were at the upper limit of normal in size, and additional evaluation of the perivesical structures with computed tomography (CT) was necessary. CT demonstrated only hypertrophied muscles with or without perivesical fat. The psoas muscles and pelvic width were measured in 8 patients and compared with the measurements of a control group of males without TDB. Patients with TDB had large iliopsoas muscles and narrow pelves compared with the control group. The psoas muscle width/pelvic width ratio was significantly greater (p < 0.0005) in patients with TDB than in the control group, with values of 1.04 + 0.05 and 0.82 + 0.09, respectively. It is concluded that TDB is not an uncommon normal variant in black males. Both iliopsoas muscle hypertrophy and a narrow pelvis are factors that predispose a patient to TDB

  17. Clinical and radiologic comparison of dynamic cervical implant arthroplasty and cervical total disc replacement for single-level cervical degenerative disc disease.

    Science.gov (United States)

    Shichang, Liu; Yueming, Song; Limin, Liu; Lei, Wang; Zhongjie, Zhou; Chunguang, Zhou; Xi, Yang

    2016-05-01

    Anterior cervical discectomy and fusion, to date the most successful spine procedure for the surgical treatment of cervical radiculopathy, has limitations that have led to the development of non-fusion cervical procedures, such as cervical total disc replacement (TDR) and dynamic cervical implant (DCI) arthroplasty. We compared the clinical and radiological results of DCI and cervical TDR for the treatment of single-level cervical degenerative disc disease in Chinese patients. A retrospective review of 179 patients with cervical spondylotic myelopathy who underwent DCI or TDR between April 2010 and October 2012 was conducted, and 152 consecutive patients (67 patients single-level DCI and 85 single-level TDR) who completed at least 2years of follow-up were included. Clinical and radiological assessments were performed preoperatively and at 1week and 3, 6, 12, and 24months postoperatively. The most common operative level was C5/C6 (49.3%). The differences in blood loss, duration of surgery, and duration of hospitalization were not statistically significant. The Japanese Orthopaedic Association scale, Visual Analog Scale, Neck Disability Index, and Short Form-36 scores improved significantly after surgery in both the DCI and TDR groups (P<0.05), but the differences were not statistically significant at the final follow-up. The rate of occurrence of heterotopic ossification was 22.4% and 28.2% in the DCI and TDR groups, respectively. As an effective non-fusion technique, DCI is a more economical procedure. Further prospective, randomized studies with long-term follow-up periods are needed to determine the long-term effects. PMID:26928156

  18. Bladder outlet reconstruction: fate of the silicone sheath.

    Science.gov (United States)

    Kropp, B P; Rink, R C; Adams, M C; Keating, M A; Mitchell, M E

    1993-08-01

    The placement of a 1.5 cm. wide silicone sheath around a newly constructed urethra/bladder neck to ensure maintenance of repair length and to facilitate future placement of a sphincter cuff was reported by our institution in 1985. We present our long-term followup and new recommendations for use of the silicone sheath. A total of 15 silicone sheaths was placed between March 1981 and July 1984. Of the sheaths 14 were placed at the time of urinary reconstruction around the Young-Dees-Leadbetter bladder neck repair and 1 was placed after erosion of an artificial urinary sphincter cuff. Of the 15 sheaths 10 have eroded into the urethra and 4 sheaths remain in situ. Another sheath was replaced 2 years after its original insertion with an artificial urinary sphincter cuff. Mean time to erosion was 48.2 months, with a range of 2 to 108 months. Long-term followup of 10 patients revealed that 4 ultimately required ligation of the bladder neck and construction of continent stoma after erosion, 1 is dry after placement of a bulbar artificial urinary sphincter, 2 remain dry after removal of the eroded sheath alone, 2 required bladder neck revision to achieve continence after erosion and the most recent patient remains diverted with a suprapubic tube. All 4 patients with sheaths still remaining are dry without evidence of erosion (mean duration 116 months). These long-term results using a silicone wrap around a newly constructed bladder neck reveal an unacceptably high rate of erosion. Therefore, we no longer recommend or support the use of the silicone sheath in the manner we have described for bladder neck reconstruction. PMID:8326628

  19. Ct2 Bladder Cancer.

    Science.gov (United States)

    Soloway, Mark S

    2016-09-01

    The patient is an 80-year-old man who presented with gross hematuria. His past medical history indicates he was a cigarette smoker with 50 pack/years. He was successfully treated for carcinoma of the lung 7 years ago. He received chemotherapy, radiation, and surgery. He has mild COPD but has a good performance status. His laboratory studies do not indicate any abnormalities in terms of renal function. He does not have any significant cardiac disease. He has a medium build. He had prostate cancer and underwent a successful radical prostatectomy 10 years ago. His PSA is undetectable. He has some urinary incontinence and wears two pads/day. He underwent the appropriate investigations for gross hematuria. A CT scan of the abdomen and pelvis was normal with the exception of a 4-cm posterior mass in the bladder. There was no hydronephrosis and no enlarged lymph nodes. He underwent a transurethral resection of a solitary bladder tumor performed by another urologist. The tumor was described as large and sessile. It was located on the posterior wall and was approximately 4 cm. The bimanual examination did not reveal a mass. The pathology report stated that the tumor was a high-grade urothelial carcinoma with invasion into the muscularis propria. There was no lymphovascular invasion. I performed a reTURBT, and at that procedure, I did not identify any obvious tumor but the prior resection site was evident. I resected the prior tumor site quite extensively both in depth and width. The pathology revealed only focal carcinoma in situ. There was ample muscle in the specimen and there was some fat as well. As stated, they were free of any cancer. The patient is receptive to any treatment approach. PMID:27457483

  20. Diagnosing and Treating Inflammatory Myofibroblastic Tumor of the Bladder

    Directory of Open Access Journals (Sweden)

    Ridwan Alam

    2016-01-01

    Full Text Available Inflammatory myofibroblastic tumor (IMT is an uncommon condition that is rarely encountered in the urinary tract. In this report, we present a case of IMT of the bladder in a woman with multiple previous pelvic surgeries. We further review the relevant literature to highlight this rare but important clinical presentation.

  1. Risk of bladder cancer in patients with diabetes

    DEFF Research Database (Denmark)

    Goossens, Maria E; Zeegers, Maurice P; Bazelier, Marloes T;

    2015-01-01

    OBJECTIVE: The objective of this study was to examine the association between diabetes, and both urinary bladder cancer (UBC) risk and mortality. METHODS: We conducted a retrospective cohort study using data from the UK Clinical Practice Research Datalink (CPRD) linked to the Office of National...

  2. Heterotopic pancreas in gall bladder associated with chronic cholecystolithiasis

    OpenAIRE

    Elhence, Poonam; Bansal, Rani; Agrawal, Nivesh

    2012-01-01

    Heterotopic pancreatic tissue in the gallbladder is a very uncommon lesion, which is an incidental finding in most cases. We report here, a case of an 18-year-old, post puerperal female, suffering from right upper quadrant abdominal pain with a clinical diagnosis of chronic cholecystitis, in whom heterotopic pancreatic tissue was found in the gall bladder.

  3. Gene profiling suggests a common evolution of bladder cancer subtypes

    OpenAIRE

    Hansel, Donna E.; Zhang, ZhongFa; Petillo, David; Teh, Bin T.

    2013-01-01

    Abstract Background Bladder cancer exists as several distinct subtypes, including urothelial carcinoma (UCa), squamous cell carcinoma (SCCa), adenocarcinoma and small cell carcinoma. These entities, despite showing distinct morphology and clinical behavior, arise from the urothelial lining and are often accompanied by similar precursor/in situ findings. The relationship between these subtypes has not been explored in detail. ...

  4. Genetics Home Reference: bladder cancer

    Science.gov (United States)

    ... ND, Rubenstein JN, Eggener SE, Kozlowski JM. The p53 tumor suppressor gene and nuclear protein: basic science review and relevance in the management of bladder cancer. J Urol. 2003 Apr;169(4):1219-28. ...

  5. Bladder neck obstruction in women

    International Nuclear Information System (INIS)

    Primary bladder nech obstruction in women is quite rare and its symptoms - dysuria, frequency and urgency - are equivocal. Routine radiological investigations alone do not allow a diagnosis to be made, due to the lack of simultaneous measurements of detrusorial pressure and uroflow. A precise diagnosis is thus to be obtained by synchronous video-urodynamic studies which allow the depiction of nonfunneling or tight bladder neck during the entire phase of detrusor contraction, of bladder trabeculations and diverticula, vesico-ureteral reflux, long micturition time and incomplete voiding. When these radiological signs are associated with a rise in detrusorial voiding pressure over 60 cm of water and with peak urine flow lower than 15 ml/s, the diagnosis of bladder neck obstruction is unquestionable and the appropriate farmacologic/endoscopic treatment can be administered

  6. Nerve Disease and Bladder Control

    Science.gov (United States)

    ... Coordinating Committees NIDDK Advisory Council, Board of Scientific Advisors, and committees that coordinate research activities Research Areas ... bladder diary-a record of your fluid intake, trips to the bathroom, and episodes of urine leakage. ...

  7. Drugs Approved for Bladder Cancer

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for bladder cancer. The list includes generic names, brand names, and common drug combinations, which are shown in capital letters.

  8. Urinary Bladder Cancer in Yemen

    OpenAIRE

    Abdullah Saleh Al-Samawi; Saleh Mansoor Aulaqi

    2013-01-01

    Objectives: The aims of this study are to highlight the clinicopathological features of urinary bladder cancer in Yemen, and to describe the histological grading of urothelial neoplasms according to the World Health Organization and International Society of Urologic pathology (WHO/ISUP 1998) classification.Methods: This is a descriptive record-based study of 316 cases of bladder cancer diagnosed by two pathologists at the Department of pathology, Sana'a University from 1st January 2005 to 30t...

  9. Diet in bladder cancer ethiopathogenesis

    OpenAIRE

    Đokić M.; Janković Slavenka M.; Ilić M.; Radosavljević V.

    2005-01-01

    The aim of this paper is to show influence of different foods on bladder cancer appearance, as well as possible consequent ways of prevention. Consumption of food rich in animal fat and cholesterol, fried foods, especially several times used cookin oil for frying, processed meat with additives (nitrates, nitrites, azo-colourrs) can influence bladder cancer occurrence. Regularly, continuous consumption of fermented milk products, which contains come types of milky - acids bacterias, is conside...

  10. Bladder Schwannoma - A Case Presentation

    OpenAIRE

    Mosier, Andrew D.; Leitman, David A.; Keylock, Joren; Nguyen, David; Grant, David

    2012-01-01

    Bladder schwannomas are exceedingly rare, benign or malignant, nerve sheath tumors that are most often discovered in patients with a known diagnosis of Neurofibromatosis type 1 (NF1). A few sporadic case reports of bladder schwannoma have been published in urologic, obstetric/gynecologic, and pathologic journals. However, this is the first case report in the radiologic literature where computed tomography imaging and radiology-specific descriptions are discussed. Furthermore, the patient pres...

  11. Encrusted and incarcerated urinary bladder catheter: what are the options?

    Directory of Open Access Journals (Sweden)

    Christopher C.K. Ho

    2010-11-01

    Full Text Available Urinary bladder catheter encrustations are known complications of long-term urinary catheterisation, which is commonly seen in clinical practice. These encrustations can impede deflation of the balloon and therefore cause problems in the removal of the catheter. The options in managing an encrusted and incarcerated urinary bladder catheter include extracorporeal shock wave lithotripsy and lithoclast. We describe here another technique of dealing with a stuck and encrustated catheter, via direct crushing of the encrustations with a rigid cystoscope inserted through a suprapubic cystostomy tract.

  12. Impedance ratio method for urine conductivity-invariant estimation of bladder volume

    Directory of Open Access Journals (Sweden)

    Thomas Schlebusch

    2014-09-01

    Full Text Available Non-invasive estimation of bladder volume could help patients with impaired bladder volume sensation to determine the right moment for catheterisation. Continuous, non-invasive impedance measurement is a promising technology in this scenario, although influences of body posture and unknown urine conductivity limit wide clinical use today. We studied impedance changes related to bladder volume by simulation, in-vitro and in-vivo measurements with pigs. In this work, we present a method to reduce the influence of urine conductivity to cystovolumetry and bring bioimpedance cystovolumetry closer to a clinical application.

  13. Candida tropicalis infection in a term neonate with gall bladder masses and infective endocarditis

    Institute of Scientific and Technical Information of China (English)

    Mamta Jajoo; Vishal Kumar; Vishnu K Goyal; Amit Garg

    2012-01-01

    ABSTRACT Candidaendocarditis is extremely rare in term neonates, and gall bladder involvement due to candidemia has never been reported amongst neonates and infants. A term, appropriate for gestational age neonate developedCandidatropicalis blood stream infection in second week of life. He was started on conventional amphotericin B. However, he failed to show any clinical improvement, and candidemia keep on persisting. Repeat sanctuary sites screening revealed multiple echogenic masses in heart (vegetations) and gall bladder. On changing the treatment to liposomal amphotericin B and fluconazole, he recovered clinically, echogenic masses in gall bladder disappeared, and intracardiac vegetations decreased in size.

  14. Bladder Preservation by Combined Modality Therapy for Invasive Bladder Cancer: A Five-Year Follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Jae Ho; Lim, Ji Hoon; Seong, Jin Sil; Pyo, Hong Ryull; Koom, Woong Soup; Suh, Chang Ok; Hong, Sung Jun [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2001-12-15

    Purpose : To determine the long-term results of bladder-preserving approach by transurethral resection of the bladder (TURB), systemic chemotherapy, and radiation therapy for muscle-invasive bladder cancer Methods and materials : From 1991 Jan, through 1994 Dec., 25 patients with muscle invading clinical stage T2 to T4NxM0 bladder cancer were treated width induction by maximal TURB and (arm 1, n=4) three cycles of chemotherapy [MVAC(methotrexate, vincristine, adriamycin, ciplatin)] followed by 64.8 Gy of radiation with concomitant cisplatin, or two cycles of chemotherapy [MCV (methotrexate, ciplatin, vincristine)] after irradiation with concomitant cisplatin (arm 2, n=14), or concurrent chemoradiation only (arm 3, n=7). Tumor response was scored as a clinical complete response (CR) when the cystoscopic tumor-site biopsy and urine cytology results were negative. Those with less than a CR underwent cystectomy. The median follow-up of al patients was 70 months. Results : Most treatment toxicities were mild to moderate. Grade 3 acute hematologic toxicity and chronic cystitis were observed in only 1 and 2 patients, respectively. Overall 5 year survival was 67.3%. Complete remission rate was 80% (20/25). Sixth-three percent of all survivors retained their bladders. In multivariate analysis, prognostic factors that significantly affect survival were T-stage (p=0.013) and Complete remission (p=0.002). Conclusion : Combined modality therapy with TURB, chemotherapy, and radiation has a 67.3% overall 5 year survival rate. This result is similar to cystectomy-based studies for patients of similar clinical stages. Sixty-three percent of long term survivors preserved their bladders.

  15. Bladder Preservation by Combined Modality Therapy for Invasive Bladder Cancer: A Five-Year Follow-up

    International Nuclear Information System (INIS)

    Purpose : To determine the long-term results of bladder-preserving approach by transurethral resection of the bladder (TURB), systemic chemotherapy, and radiation therapy for muscle-invasive bladder cancer Methods and materials : From 1991 Jan, through 1994 Dec., 25 patients with muscle invading clinical stage T2 to T4NxM0 bladder cancer were treated width induction by maximal TURB and (arm 1, n=4) three cycles of chemotherapy [MVAC(methotrexate, vincristine, adriamycin, ciplatin)] followed by 64.8 Gy of radiation with concomitant cisplatin, or two cycles of chemotherapy [MCV (methotrexate, ciplatin, vincristine)] after irradiation with concomitant cisplatin (arm 2, n=14), or concurrent chemoradiation only (arm 3, n=7). Tumor response was scored as a clinical complete response (CR) when the cystoscopic tumor-site biopsy and urine cytology results were negative. Those with less than a CR underwent cystectomy. The median follow-up of al patients was 70 months. Results : Most treatment toxicities were mild to moderate. Grade 3 acute hematologic toxicity and chronic cystitis were observed in only 1 and 2 patients, respectively. Overall 5 year survival was 67.3%. Complete remission rate was 80% (20/25). Sixth-three percent of all survivors retained their bladders. In multivariate analysis, prognostic factors that significantly affect survival were T-stage (p=0.013) and Complete remission (p=0.002). Conclusion : Combined modality therapy with TURB, chemotherapy, and radiation has a 67.3% overall 5 year survival rate. This result is similar to cystectomy-based studies for patients of similar clinical stages. Sixty-three percent of long term survivors preserved their bladders

  16. Nursing intervention by telephone interviews of patients aged over 65 years after total hip replacement improves health status: a randomised clinical trial Nursing intervention by telephone interviews of patients aged over 65 years after total hip replacement improves health status: a randomised

    DEFF Research Database (Denmark)

    Hørdam, Britta

    2010-01-01

    Nursing intervention by telephone interviews of patients aged over 65 years after total hip replacement improves health status: a randomised clinical trial Objective: We hypothesised that all areas of health status after total hip replacement could be improved in patients aged over 65 years and...... postoperatively was carried out. Sample: 180 patients aged 65 years and over were randomised 4 weeks preoperatively to either control or intervention groups. Measurements: both groups received conventional surgical treatment, but the intervention group was interviewed by telephone 2 and 10 weeks after surgery...

  17. Effect of Bladder Distension on Dose Distribution of Intracavitary Brachytherapy for Cervical Cancer: Three-Dimensional Computed Tomography Plan Evaluation

    International Nuclear Information System (INIS)

    Purpose: To quantify the effect of bladder volume on the dose distribution during intracavitary brachytherapy for cervical cancer. Methods and Patients: The study was performed on 10 women with cervical cancer who underwent brachytherapy treatment. After insertion of the brachytherapy applicator, the patients were transferred to the computed tomography unit. Two sets of computed tomography slices were taken, including the pelvis, one with an empty bladder and one after the bladder was filled with saline. The target and critical organs were delineated by the radiation oncologist and checked by the expert radiologist. The radiotherapy plan was run on the Plato planning system, version 14.1, to determine the dose distributions, dose-volume histograms, and maximal dose points. The doses and organ volumes were compared with the Wilcoxon signed ranks test on a personal computer using the Statistical Package for Social Sciences, version 11.0, statistical program. Results: No significant difference regarding the dose distribution and target volumes between an empty or full bladder was observed. Bladder fullness significantly affected the dose to the small intestine, rectum, and bladder. The median of maximal doses to the small intestine was significantly greater with an empty bladder (493 vs. 284 cGy). Although dosimetry revealed lower doses for larger volumes of bladder, the median maximal dose to the bladder was significantly greater with a full bladder (993 vs. 925 cGy). The rectal doses were also affected by bladder distension. The median maximal dose was significantly lower in the distended bladder (481vs. 628 cGy). Conclusions: Bladder fullness changed the dose distributions to the bladder, rectum, and small intestine. The clinical importance of these changes is not known and an increase in the use of three-dimensional brachytherapy planning will highlight the answer to this question

  18. Immune checkpoint blockade therapy for bladder cancer treatment.

    Science.gov (United States)

    Kim, Jayoung

    2016-06-01

    Bladder cancer remains the most immunogenic and expensive malignant tumor in the United States today. As the 4th leading cause of death from cancer in United States, Immunotherapy blocking immune checkpoints have been recently been applied to many aggressive cancers and changed interventions of urological cancers including advanced bladder cancer. The applied inhibition of PD-1-PD-L1 interactions can restore antitumor T-cell activity and enhance the cellular immune attack on antigens. The overall goals of this short review article are to introduce current cancer immunotherapy and immune checkpoint inhibitors, and to provide new insight into the underlying mechanisms that block immune checkpoints in tumor microenvironment. Furthermore, this review will address the preclinical and clinical trials to determine whether bladder cancer patients could benefit from this new cancer therapy in near future. PMID:27326412

  19. Differential expression of microRNAs in mouse embryonic bladder

    International Nuclear Information System (INIS)

    MicroRNAs (miRNAs) are involved in several biological processes including development, differentiation and proliferation. Analysis of miRNA expression patterns in the process of embryogenesis may have substantial value in determining the mechanism of embryonic bladder development as well as for eventual therapeutic intervention. The miRNA expression profiles are distinct among the cellular types and embryonic stages as demonstrated by microarray technology and validated by quantitative real-time RT-PCR approach. Remarkably, the miRNA expression patterns suggested that unique miRNAs from epithelial and submucosal areas are responsible for mesenchymal cellular differentiation, especially regarding bladder smooth muscle cells. Our data show that miRNA expression patterns are unique in particular cell types of mouse bladder at specific developmental stages, reflecting the apparent lineage and differentiation status within the embryonic bladder. The identification of unique miRNAs expression before and after smooth muscle differentiation in site-specific area of the bladder indicates their roles in embryogenesis and may aid in future clinical intervention.

  20. Hip replacement

    International Nuclear Information System (INIS)

    Patients with problems following implantation of cemented total hip prostheses must be clinically examined. This examination is followed by a series of diagnostic imaging procedures. These include X-ray diagnosis, 3-phase 99mTc-MDP bone scans, scientigraphy for inflammation, and arthrography, performed singly or as sequential studies. X-ray findings and scientigraphic patterns arousing or confirming a suspicion of aseptic (mechanical) or septic (infectious) loosening of the prosthesis are evaluated and discussed. (orig.)

  1. CORRECTION OF BLADDER EXSTROPHY IN ADOLESCENT: 2 CASE REPORT

    Directory of Open Access Journals (Sweden)

    A. Burgio

    2012-01-01

    Full Text Available Introduction: bladder exstrophy is characterized by an incomplete development of anterior portion of bladder, urethra, abdominal wall and a median separation of pubic symphysis. We describe 2 clinical cases in adolescent treated with different surgical approach. Materials and Methods: two patients, one male and one female, respectively, 10 and 14 years old. Both cases had relapse: the bladder plate was performed in female when she was 2 years and in male when he was 6 years old. The male showed bladder exstrophy with epispadias; the female showed bifido clitoris, absence of minora labia with a small vaginal orifice. In both patients ano-rectal manometric and barium enema had normal parameters. The x-Ray basin showed diastasis of pubic bones, respectively, 7.5 cm in male and 10 cm in female. The male had closure of bladder and abdominal wall with transformation of epispadias to peno-scrotal hypospadias. The female had rectal reservoir (about 250cc, with amputation of the rectum with Hartmann’s method and recanalization with Duhamel’s method, anastomosis uretero rectal and vaginoplasty. Results: clinical and laboratory follow-up to date is 6 months. The female holds the urine about 2-3 hours during the day; in the night losses are not reported; the male shows dehiscence of abdominal and vesical wall with suprapubic fistula and loss of urine. The urethral peno-scrotal meatus appears patent. Conclusions: our experience, although limited in the number of cases and in the time of observation, is in agreement with the literature: we can say that the correction of bladder exstrophy in adolescents might be a urinary diversion with creation of rectal reservoir, useful for age of the patients and postoperative management. It is always necessary an adequate follow-up to check any complications.

  2. Photosensitivity of murine skin greatly depends on the genetic background: clinically relevant dose as a new measure to replace minimal erythema dose in mouse studies.

    Science.gov (United States)

    Gyöngyösi, Nóra; Lőrincz, Kende; Keszeg, András; Haluszka, Dóra; Bánvölgyi, András; Tátrai, Erika; Kárpáti, Sarolta; Wikonkál, Norbert M

    2016-07-01

    Artificial UV irradiation of murine skin is a frequently used method for testing photosensitivity, study carcinogenesis and photoprotective effects of different compounds. However, doses of UV radiation and mouse strains used in experiments vary greatly. The genetic background of mice may influence the photosensitivity as melanin content, pigmentation and hair cycle parameters are dissimilar. Doses of UV are often expressed in relation to the minimal erythema dose (MED) that was not necessarily determined for the given strain. We set out to standardize the method of measuring photosensitivity in three commonly used mouse strains, C57BL/6N, Balb/c and SKH-1. We found that MED may not be determined for some strains as erythema development in mice with diverse genotypes differs greatly. We measured the oedema response in vivo and ex vivo by using OCT. Given the strain-specific variability of erythema, we introduced Clinically Relevant Dose (CRD) as a new term to replace MED in experiments, to describe the lowest dose that triggers a perceptible skin reaction in mice. Not only the CRD but the proportion of erythema and oedema were different in strains examined. C57BL/6N mice display skin reactions at the lowest UVB dose, while SKH-1 hairless mice show changes, mostly oedema, after higher doses of UVB. The cellular composition and skin thickness were examined by histopathology. IL-1beta and IL-6 levels in skin correlated with the increasing doses of UVB. Despite the variations in the degree of erythema and oedema, no major differences in cytokine expressions were seen among various strains of mice. PMID:26910301

  3. A Large Bladder Tumor Covered With a Thick “Shell” of Necrotic Material

    Science.gov (United States)

    Wang, Lei; Zhou, Zhe; Gong, Miao-zi; Pan, Dong-liang; Zhang, Xiang-hua; Li, Ning-chen; Na, Yan-qun

    2016-01-01

    Abstract Bladder tumor arising in a spina bifida patient is rare and may be clinically latent. We report the case of a 61-year-old female patient with spina bifida, neurogenic bladder, and a history of recurrent urinary tract infections. A B-ultrasound and non-contrast computed tomography scan did not reveal any bladder mass, but an unexplained “well-filled” bladder was observed, which was confusing as the catheter was present and open. However, a subsequent cystoscopic evaluation revealed a large bladder mass measuring 9.5 × 9.0 × 6.5 cm3, which almost filled the entire bladder. The mass had coarse and flocculent surface and seemed to be free from each observed wall of the urinary bladder. It was diagnosed as an infectious necrotic mass based on its appearance. During transurethral resection of the mass, a bladder tumor was suspected as small blood vessels and bleeding appeared within the inner layer of the mass. Pathological examination revealed necrotic material, inflammatory cells, and urothelial carcinoma cells. Then, a radical cystectomy was performed, and the pathological results indicated stage pT3bN0M0 transitional cell carcinoma. In the gross specimen, the base of the tumor measured 3 × 3 cm2 on the top of the back wall of the bladder. Bladder tumors may have atypical presentations in patients with spina bifida. Regular screening is helpful for earlier detection and improving outcomes of bladder tumors in such patients. PMID:27100442

  4. Small cell carcinoma of the urinary bladder: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Ismaili Nabil

    2009-01-01

    Full Text Available Small cell carcinoma of the bladder (SCCB is extremely rare. In this paper, we present a case of metastatic SCCB managed by chemotherapy and we would provide a brief review of the epidemiology, clinical features, diagnosis, pathologic features, staging, treatment, and prognosis of SCCB. A 52-year-old man was admitted with signs and symptoms suggestive of a bladder cancer. Computed tomography of the pelvis and abdomen showed a large tumor at the right bladder wall, measuring 10 cm in diameter, and a multinodular liver disease. Diagnosis of small cell carcinoma was established from the histological study of the transurethral resection of the bladder tumor. The patient received 12 cycles of platinum-based chemotherapy with a good partial response of bladder tumor and liver metastasis. The patient is still alive, 18 months after diagnosis.

  5. Glucocorticosteroid-sensitive inflammatory eosinophilic pseudotumor of the bladder in an adolescent: a case report

    Directory of Open Access Journals (Sweden)

    Qu Chuangyu

    2009-11-01

    Full Text Available Abstract Introduction Inflammatory eosinophilic pseudotumor of the bladder is a rare inflammatory bladder disease. The etiology and pathophysiology of this condition are still unclear. Few case reports have described inflammatory eosinophilic pseudotumor of the bladder in adults or children. Although benign, this disease is occasionally clinically aggressive and locally invasive, thus open surgical removal or complete transurethral resection is recommended. Case presentation We present the case of a biopsy-proven inflammatory eosinophilic pseudotumor of the bladder in a previously healthy 16-year-old male adolescent with 2-month history of frequent micturition and dysuria with no significant apparent causative factors. The tumor regressed after a 6-week course of glucocorticosteroids. Conclusion To the best of our knowledge, our case is a rare case of inflammatory eosinophilic pseudotumor of the bladder treated with complete conservative management. Due to its glucocorticosteroid-sensitive nature, we postulate that this disease belongs to a subgroup of eosinophilic disorders.

  6. COMBINED TREATMENT OF LOCALLY-ADVANCED BLADDER CANCER

    Directory of Open Access Journals (Sweden)

    I. V. Chernyshev

    2015-01-01

    Full Text Available Bladder cancer (BC is an important clinical and scientific challenge. In 2013, in Russia, the absolute number of patients with first-ever diagnosis of bladder cancer was 12 992 people. There is an increasing proportion of detection of bladder cancer stage I–II disease patterns: 2003–50.8% in 2013–69.6%, while the number of newly diagnosed patients in III and IV clinical stages remains at 30%. The proportion of individuals who completed the treatment of the number of newly diagnosed patients with bladder cancer in 2013, was as follows: only surgical method — 65.4%, 33.5% combined. Purpose. Improvement of the results of treatment of patients with locally advanced bladder cancer. Materials and methods. The main treatment for muscle-invasive bladder cancer is radical cystectomy. In the combined treatment of bladder cancer chemotherapy is the component that systemic exposure to the tumor, the way of regional and distant metastases. The study included 132 patients with locally advanced bladder cancer who were treated for 2005–2013, divided into four groups: NACT + CE — 27 people (20.5%, CE + ACT — 21 (15.9%, NACT + CE + ACT — 21 (15.9% only CE — 63 (47.7%. An important component of treatment has been the use of platinum (cisplatin or carboplatin in Schemes M–VAC and GP. An objective response is possible in 44.7%, and the stabilization process in 40.4% of patients.Results. The clinical effect is evaluated in all patients. In the group of NACT 21% of patients survived for more than 4 years, but did not survive the 5‑year mark. In the group of CE + ACT the indicator achieved only 3‑year survival rate, which amounted to 43%. In the group of CE — none of the patients did not live up to 3 years, with 2‑year survival rate was 30%. In the group of ACT + NCT + CE 3 patients (15% were alive at the time, passed the threshold of the 5‑year survival rate, there is no progression of cancer.Conclusion. Combined treatment mode NACT

  7. A randomized clinical trial of a peri-operative behavioral intervention to improve physical activity adherence and functional outcomes following total knee replacement

    Directory of Open Access Journals (Sweden)

    Zheng Hua

    2011-10-01

    Full Text Available Abstract Background Total knee replacement (TKR is a common and effective surgical procedure to relieve advanced knee arthritis that persists despite comprehensive medical treatment. Although TKR has excellent technical outcomes, significant variation in patient-reported functional improvement post-TKR exists. Evidence suggests that consistent post-TKR exercise and physical activity is associated with functional gain, and that this relationship is influenced by emotional health. The increasing use of TKR in the aging US population makes it critical to find strategies that maximize functional outcomes. Methods/Design This randomized clinical trial (RCT will test the efficacy of a theory-based telephone-delivered Patient Self-Management Support intervention that seeks to enhance adherence to independent exercise and activity among post- TKR patients. The intervention consists of 12 sessions, which begin prior to surgery and continue for approximately 9 weeks post-TKR. The intervention condition will be compared to a usual care control condition using a randomized design and a probabilistic sample of men and women. Assessments are conducted at baseline, eight weeks, and six- and twelve- months. The project is being conducted at a large healthcare system in Massachusetts. The study was designed to provide greater than 80% power for detecting a difference of 4 points in physical function (SF36/Physical Component Score between conditions (standard deviation of 10 at six months with secondary outcomes collected at one year, assuming a loss to follow up rate of no more than 15%. Discussion As TKR use expands, it is important to develop methods to identify patients at risk for sub-optimal functional outcome and to effectively intervene with the goal of optimizing functional outcomes. If shown efficacious, this peri-TKR intervention has the potential to change the paradigm for successful post-TKR care. We hypothesize that Patient Self-Management Support

  8. Expression of multidrug resistance proteins P-glycoprotein, multidrug resistance protein 1, breast cancer resistance protein and lung resistance related protein in locally advanced bladder cancer treated with neoadjuvant chemotherapy: biological and clinical implications.

    NARCIS (Netherlands)

    Diestra, JE; Condom, E; Muro, XG Del; Scheffer, G.L.; Perez, J; Zurita, AJ; Munoz-Segui, J; Vigues, F; Scheper, R.J.; Capella, G; Germa-Lluch, JR; Izquierdo, M.A.

    2003-01-01

    PURPOSE: Resistance to chemotherapy is a major obstacle to overcome in the conservative treatment of patients with locally advanced bladder cancer (LABC). We investigated the predictive value of the response to neoadjuvant chemotherapy (NACT) and prognosis of the expression of multidrug resistance (

  9. Bursting stimulation of proximal urethral afferents improves bladder pressures and voiding

    Science.gov (United States)

    Bruns, Tim M.; Bhadra, Narendra; Gustafson, Kenneth J.

    2009-12-01

    Reflex bladder excitation has been evoked via pudendal nerve, pudendal nerve branch and intraurethral stimulation; however, afferent-evoked bladder emptying has been less efficient than direct activation of the bladder via sacral root stimulation. A stimulation method that improves activation of the urethra-bladder excitatory reflex with minimal sphincter recruitment may lead to improved bladder emptying. Fine wire electrodes were placed in the wall of the urethra in five cats. Placement of electrodes near the proximal urethra evoked bladder contractions with minimal sphincter activation. On these electrodes, lower frequency burst-patterned stimuli evoked greater bladder voiding efficiencies (71.2 ± 27.8%) than other stimulus patterns on the same electrodes (50.4 ± 41.5%, p > 0.05) or any stimulus pattern on electrodes that elicited urethral closure (16.5 ± 12.7%, p < 0.05). Fine wire electrodes specifically targeted afferent fibers in the urethra, indicating the feasibility of clinical evaluations using the same method. This work may improve the translation of next generation neuroprostheses for bladder control.

  10. Renal Replacement Therapy.

    Science.gov (United States)

    Ricci, Zaccaria; Romagnoli, Stefano; Ronco, Claudio

    2016-01-01

    During the last few years, due to medical and surgical evolution, patients with increasingly severe diseases causing multiorgan dysfunction are frequently admitted to intensive care units. Therapeutic options, when organ failure occurs, are frequently nonspecific and mostly directed towards supporting vital function. In these scenarios, the kidneys are almost always involved and, therefore, renal replacement therapies have become a common routine practice in critically ill patients with acute kidney injury. Recent technological improvement has led to the production of safe, versatile and efficient dialysis machines. In addition, emerging evidence may allow better individualization of treatment with tailored prescription depending on the patients' clinical picture (e.g. sepsis, fluid overload, pediatric). The aim of the present review is to give a general overview of current practice in renal replacement therapies for critically ill patients. The main clinical aspects, including dose prescription, modality of dialysis delivery, anticoagulation strategies and timing will be addressed. In addition, some technical issues on physical principles governing blood purification, filters characteristics, and vascular access, will be covered. Finally, a section on current standard nomenclature of renal replacement therapy is devoted to clarify the "Tower of Babel" of critical care nephrology. PMID:26918174

  11. Effects of estrogen and tibolone on bladder histology and estrogen receptors in rats

    Institute of Scientific and Technical Information of China (English)

    YANG Xin; LI Ya-zhen; MAO Zhuo; GU Pei; SHANG Ming

    2009-01-01

    Background Estrogen deficiency causes atrophic changes within the urogenital tract, and is associated with urinary symptoms. The purpose of this study was to investigate the effects of estrogen and tibolone on bladder histology, and the changes of estrogen receptor α and β (ERα and β) protein expression in the detrusor muscle.Methods Forty female rats were separated into four groups of ten each. They received a sham operation (Sham), ovariectomy (Ovx), ovariectomy plus estrogen replacement (Ovx+E), or ovariectomy plus tibolone treatment (Ovx+T). After 12 weeks each rat was anesthetized and the bladders were removed. The bladders' ultra structure, collagen fiber (CF) to smooth muscle(SM) ratio and ER subtypes were studied. Statistical analyses were performed using the one-way analysis of variance test.Results Ovx resulted in significant degeneration in bladder ultra structure; however, estrogen and tibolone reversed those changes. Ovx increased the CF/SM ratio, estrogen and tibolone resulted in an increase. Two estrogen receptors (ERs) were expressed in the bladder detrusor, with ERβ the main subtype. Ovx resulted in up-regulation of ERα and down-regulation of ERβ. With estrogen and tibolone treatment, ERβ showed a significant increase but ERα showed no significant difference compared with Ovx.Conclusions Estrogen deficiency deteriorates bladder ultra structure and histology. Supplementary estrogen can improve bladder function which may be due to inhibition of collagen hyperplasia and increased SM density. ERβ has an important role in mediating estrogen function in the bladder. Tibolone has a mild estrogenic action and has an effect on bladder function and structure to some degree.

  12. Clinicopathologic characterization of intradiverticular carcinoma of urinary bladder - a study of 22 cases from a single cancer center

    OpenAIRE

    Zhong, Hua; George, Saby; Kauffman, Eric; Guru, Khurshid; Azabdaftari, Gissou; XU, BO

    2014-01-01

    Background To examine histopathologic features and clinical outcomes of intradiverticular bladder carcinomas. Methods Twenty-two consecutive patients with intradiverticular bladder carcinoma treated with either endoscopic transurethral resection or partial or radical cystectomy at a single institution between years of 1995 to 2011. Clinicopathologic characteristics and oncologic outcomes of patients were retrospectively analyzed, including tissue histology re-review by genitourinary pathologi...

  13. Bladder cancer immunotherapy.

    Science.gov (United States)

    Lamm, D L; Thor, D E; Stogdill, V D; Radwin, H M

    1982-11-01

    A randomized controlled prospective evaluation of intravesical and percutaneous bacillus Calmette-Guerin immunotherapy was done in 57 patients with transitional cell carcinoma of the bladder. In addition, 9 patients at high risk for tumor recurrence were treated with bacillus Calmette-Guerin produced a self-limited cystitis and 1 complication (hydronephrosis) of immunotherapy was observed. Of the 57 randomized patients 54 were followed for 3 to 30 months. Tumor recurrence was documented in 13 of 26 controls (50 per cent) and only 6 of 28 patients (21 per cent) treated with bacillus Calmette-Guerin (p equals 0.027, chi-square). The interval free of disease was prolonged significantly with bacillus Calmette-Guerin treatment (p equals 0.014, generalized Wilcoxon test). Importantly, a simple purified protein derivative skin test distinguished those patients who responded to bacillus Calmette-Guerin immunotherapy from those who did not. Only 1 of 17 treated patients (6 per cent) whose purified protein derivative test converted from negative to positive had tumor recurrence compared to 5 recurrences (38 per cent) among the 13 patients whose test remained negative or had been positive before treatment (p equals 0.022, chi-square). Bacillus Calmette-Guerin was given to 10 patients with stage B transitional cell carcinoma who were not candidates for cystectomy and 7 are free of disease. Of 5 patients with carcinoma in situ 3 remain free of tumor after bacillus Calmette-Guerin treatment and 5 of 6 who had multiple recurrences after intravesical chemotherapy responded favorably to bacillus Calmette-Guerin immunotherapy. PMID:6757467

  14. Small Cell Carcinoma of the Bladder

    OpenAIRE

    Çiçek, Tufan; Coşkunoğlu, Esra Zeynep; Duran, Berkan; Çiftci, Egemen

    2015-01-01

    Small Cell Carcinoma of the bladder accounts for less than 1% of all bladder tumors. Small Cell Carcinoma of the bladder has an aggressive behaviour and is usually metastatic at diagnosis. Due to its infrequent occurence, the literature on this entity is limited; which unsurprisingly leads to an uncertanity in defining an ideal therapeutic approach. This report, overviews the literature while describing a 70- year- old female patient who is diagnosed with small cell carcinoma of the bladder a...

  15. Small Cell Carcinoma of the Bladder

    OpenAIRE

    Tufan Cicek; Esra Zeynep Coskunoglu; Berkan Duran; Egemen Ciftci

    2015-01-01

    Small Cell Carcinoma of the bladder accounts for less than 1% of all bladder tumors. Small Cell Carcinoma of the bladder has an aggressive behaviour and is usually metastatic at diagnosis. Due to its infrequent occurence, the literature on this entity is limited; which unsurprisingly leads to an uncertanity in defining an ideal therapeutic approach. This report, overviews the literature while describing a 70- year- old female patient who is diagnosed with small cell carcinoma of the bladder ...

  16. Urethral obstruction from dislodged bladder Diverticulum stones: a case report

    Directory of Open Access Journals (Sweden)

    Okeke Linus I

    2012-11-01

    Full Text Available Abstract Background Secondary urethral stone although rare, commonly arises from the kidneys, bladder or are seen in patients with urethral stricture. These stones are either found in the posterior or anterior urethra and do result in acute urinary retention. We report urethral obstruction from dislodged bladder diverticulum stones. This to our knowledge is the first report from Nigeria and in English literature. Case presentation A 69 year old, male, Nigerian with clinical and radiological features of acute urinary retention, benign prostate enlargement and bladder diverticulum. He had a transurethral resection of the prostate (TURP and was lost to follow up. He re-presented with retained urethral catheter of 4months duration. The catheter was removed but attempt at re-passing the catheter failed and a suprapubic cystostomy was performed. Clinical examination and plain radiograph of the penis confirmed anterior and posterior urethral stones. He had meatotomy and antegrade manual stone extraction with no urethra injury. Conclusions Urethral obstruction can result from inadequate treatment of patient with benign prostate enlargement and bladder diverticulum stones. Surgeons in resource limited environment should be conversant with transurethral resection of the prostate and cystolithotripsy or open prostatectomy and diverticulectomy.

  17. Metal ion concentrations in body fluids after implantation of hip replacements with metal-on-metal bearing--systematic review of clinical and epidemiological studies.

    Directory of Open Access Journals (Sweden)

    Albrecht Hartmann

    Full Text Available INTRODUCTION: The use of metal-on-metal (MoM total hip arthroplasty (THA increased in the last decades. A release of metal products (i.e. particles, ions, metallo-organic compounds in these implants may cause local and/or systemic adverse reactions. Metal ion concentrations in body fluids are surrogate measures of metal exposure. OBJECTIVE: To systematically summarize and critically appraise published studies concerning metal ion concentrations after MoM THA. METHODS: Systematic review of clinical trials (RCTs and epidemiological studies with assessment of metal ion levels (cobalt, chromium, titanium, nickel, molybdenum in body fluids after implantation of metalliferous hip replacements. Systematic search in PubMed and Embase in January 2012 supplemented by hand search. Standardized abstraction of pre- and postoperative metal ion concentrations stratified by type of bearing (primary explanatory factor, patient characteristics as well as study quality characteristics (secondary explanatory factors. RESULTS: Overall, 104 studies (11 RCTs, 93 epidemiological studies totaling 9.957 patients with measurement of metal ions in body fluids were identified and analyzed. Consistently, median metal ion concentrations were persistently elevated after implantation of MoM-bearings in all investigated mediums (whole blood, serum, plasma, erythrocytes, urine irrespective of patient characteristics and study characteristics. In several studies very high serum cobalt concentrations above 50 µg/L were measured (detection limit typically 0.3 µg/L. Highest metal ion concentrations were observed after treatment with stemmed large-head MoM-implants and hip resurfacing arthroplasty. DISCUSSION: Due to the risk of local and systemic accumulation of metallic products after treatment with MoM-bearing, risk and benefits should be carefully balanced preoperatively. The authors support a proposed "time out" for stemmed large-head MoM-THA and recommend a restricted

  18. Thermal dosimetry for bladder hyperthermia treatment. An overview.

    Science.gov (United States)

    Schooneveldt, Gerben; Bakker, Akke; Balidemaj, Edmond; Chopra, Rajiv; Crezee, Johannes; Geijsen, Elisabeth D; Hartmann, Josefin; Hulshof, Maarten C C M; Kok, H Petra; Paulides, Margarethus M; Sousa-Escandon, Alejandro; Stauffer, Paul R; Maccarini, Paolo F

    2016-06-01

    The urinary bladder is a fluid-filled organ. This makes, on the one hand, the internal surface of the bladder wall relatively easy to heat and ensures in most cases a relatively homogeneous temperature distribution; on the other hand the variable volume, organ motion, and moving fluid cause artefacts for most non-invasive thermometry methods, and require additional efforts in planning accurate thermal treatment of bladder cancer. We give an overview of the thermometry methods currently used and investigated for hyperthermia treatments of bladder cancer, and discuss their advantages and disadvantages within the context of the specific disease (muscle-invasive or non-muscle-invasive bladder cancer) and the heating technique used. The role of treatment simulation to determine the thermal dose delivered is also discussed. Generally speaking, invasive measurement methods are more accurate than non-invasive methods, but provide more limited spatial information; therefore, a combination of both is desirable, preferably supplemented by simulations. Current efforts at research and clinical centres continue to improve non-invasive thermometry methods and the reliability of treatment planning and control software. Due to the challenges in measuring temperature across the non-stationary bladder wall and surrounding tissues, more research is needed to increase our knowledge about the penetration depth and typical heating pattern of the various hyperthermia devices, in order to further improve treatments. The ability to better determine the delivered thermal dose will enable clinicians to investigate the optimal treatment parameters, and consequentially, to give better controlled, thus even more reliable and effective, thermal treatments. PMID:27132465

  19. Bladder dysfunction in advanced Parkinson's disease

    DEFF Research Database (Denmark)

    Winge, Kristian; Nielsen, Kurt K

    2012-01-01

    Parkinson's disease (PD) patients often have lower urinary tract symptoms. Seventy-four percent of patients with early-to-moderate disease report more than one bladder disturbance symptom. Severe bladder symptoms are reported in 27-39% of PD patients. The aim of this study was to evaluate the sev...... the severity of bladder dysfunction in patients with advanced PD....

  20. Operative Management of Crossover Femoral-femoral Graft Erosion into Bladder: A Case Report.

    Science.gov (United States)

    Motiani, Karan; Mahdy, Ayman

    2016-09-01

    Erosion of vascular grafts is not uncommon as seen in the recent literature. There have been many case reports documenting the work up and management of erosion of these grafts into bowel. We report a case of a crossover femoral-femoral graft that eroded into the anterior bladder wall and was incidentally found as an adherent bladder stone during cystoscopy. We demonstrate the importance of having a high level of clinical suspicion for eroding vascular grafts when preoperative imaging shows close proximity of graft to bladder. PMID:27462547

  1. Bladder Endometriosis Mimicking TCC - A Case Report.

    Science.gov (United States)

    Gupta, Asish; Bhatnagar, Atul; Seth, B N; Dang, Arbinder; Gupta, Vineeta

    2016-02-01

    Endometriosis is the ectopic presence of endometrial tissue outside the uterus. Though on its own endometriosis is not a rare lesion, the involvement of the urinary tract is rare but with the bladder being the most commonly affected organ. Endometriosis is usually seen in females between the ages of 30-40 years and may occur due to fluctuating levels of oestrogen and progesterone. Clinically the patient maybe asymptomatic or show symptoms of dysmenorrhea, irregular or heavy periods, pain in the pelvic area, lower abdomen or in the back. It has been suggested that ultrasonography should be done either before or during menstruation as the lesion becomes more evident and a biopsy taken during this period is a strong aid in reaching a final diagnosis. We report here an unusual case of bladder endometriosis where the patient came with severe pelvic pain and an endoluminal mass seen on the ultrasonographic report. Based on these findings a differential of transitional cell carcinoma was given which was ruled out based on the cystoscopic findings. PMID:27042525

  2. Detrusor function with lesions of the cauda equina, with special emphasis on the bladder neck.

    Science.gov (United States)

    Light, J K; Beric, A; Petronic, I

    1993-03-01

    A total of 13 patients with proved lesions of the cauda equina underwent neurological evaluation. All patients had video urodynamic testing, while 9 underwent a varying combination of pelvic floor electromyography, lumbosacral evoked potentials to tibial nerve stimulation and the sympathetic skin response from the perineum. All patients had detrusor areflexia with varying degrees of bladder neck incompetence. Reports of clinical and experimental studies are discussed in relation to the pathophysiology of bladder neck function following lesions of the pudendal and preganglionic pelvic nerve to explain why there have been conflicting reports in the literature regarding bladder neck function with lesions of the cauda equina. The adaptive changes observed in the experimental animal, consisting of random regeneration of the cholinergic neuroeffective junctions, adrenergic hyperinnervation and an increased sensitivity of the prejunctional inhibitory muscarinic receptors on the adrenergic nerve, may explain the degree of variability of bladder neck incompetence observed clinically. PMID:8437259

  3. Contribution to the morphology and diagnostics of acquired displacements of the urinary bladder

    International Nuclear Information System (INIS)

    Acquired displacements of the urinary bladder refer to intrapelvic pathological anatomy. These alterations of the bladder are predominantly detected via an initial radiologic study with intravenous urography or suprapubic pelvic ultrasonography. According to their clinical incidence displacements of the bladder can occur in: 1. Pelvic space-occupying lesions, 2. Displacements in musculofascial defects of supporting structures as well as in extirpation cavities of the small pelvis, 3. Extrapelvic space-occupying lesions. Herniation, prolapse and descensus of the bladder can be accurately diagnosed by correct examination via intravenous urography. The diagnostics of pelvic and extrapelvic pathogenetic causes require the complex application of all methods of diagnostic imaging, the value of which is determined by clinical diagnosis and by the choice of an appropriate therapy. (orig.)

  4. A Clinical Study of Domestic Tolterodine Tartrate Tablets for Urinary Bladder Hyperactivity%国产酒石酸托特罗定片治疗膀胱过度活动症的临床研究

    Institute of Scientific and Technical Information of China (English)

    张唯力; 胡自力; 胡蓉; 钟铃; 李青; 张玲; 杨光永; 徐明祺

    2001-01-01

    目的:研究国产酒石酸托特罗定片治疗膀胱过度活动症的疗效和安全性。方法:选择膀胱过度活动症56例,随机分为托特罗定组和奥昔布宁组各28例,疗程6周。结果:托特罗定片和奥昔布宁片治疗膀胱过度活动症疗效相当,前者的不良反应发生率低于后者。结论:托特罗定片是治疗膀胱过度活动症更为理想的药物。%OBJECTIVE:To study the therapeutic effect and safety of domestic tolterodine tartrate in treating patients with urinary bladder overactivity.METHODS:56 cases of bladder overactivity were divided into two groups randomly:tolterodine and control(oxybutynin)group.The course of treatment was 6 weeks.RESULTS:The effect of tolterodine in treatment group was comparable to that of oxybutynin in control group,however,the adverse reactions in oxybutynin group were more common than those in tolterodine group.CONCLUSION:Tolterodine is a suitable drug to treat bladder overactivity.

  5. Bowel and Bladder-Control Anxiety: A Preliminary Description of a Viscerally-Centred Phobic Syndrome

    OpenAIRE

    Kamboj, S. K.; Langhoff, C.; Pajak, R.; A. Zhu; A. Chevalier; Watson, S.

    2013-01-01

    Background: People with anxiety disorders occasionally report fears about losing control of basic bodily functions in public. These anxieties often occur in the absence of physical disorder and have previously been recognized as “obsessive” anxieties reflecting a preoccupation with loss of bowel/bladder control. Motivated by our observations of the non-trivial occurrence of such anxieties in our clinical practice we sought to fill a gap in the current understanding of “bowel/bladder-control a...

  6. The Health Economics of Bladder Cancer: A Comprehensive Review of the Published Literature

    OpenAIRE

    Botteman, Marc F; Pashos, Chris L; Alberto Redaelli; Benjamin Laskin; Robert Hauser

    2003-01-01

    The aim of this paper was to conduct a critical systematic review of the available literature on the clinical and economic burden of bladder cancer in developed countries, with a focus on the cost effectiveness of interventions aimed at reducing that burden. Forty-four economic studies were included in the review. Because of long- term survival and the need for lifelong routine monitoring and treatment, the cost per patient of bladder cancer from diagnosis to death is the highest of all cance...

  7. Primary non-Hodgkin's lymphoma of the bladder: case report and literature review

    Science.gov (United States)

    Mahfoud, Tarik; Tanz, Rachid; Mesmoudi, Mohamed; Khmamouche, Mohamed Réda; El Khannoussi, Basma; Ichou, Mohamed; Errihani, Hassan

    2013-01-01

    Primary non-Hodgkin's lymphoma (NHL) of the bladder is a very rare entity. The clinical, radiological and endoscopic signs are not specifics. The diagnosis is exclusively histological. Chemotherapy, radiotherapy and surgery are the different therapeutic options used either alone or in combination. We report a 57 years old patient treated with chemotherapy (6 cycles of R-CHOP) for primary NHL of the bladder with a complete response while discussing the different specificities of this disease. PMID:24319526

  8. Ultrasound Thickness of Bladder Wall in Continent and Incontinent Women and Its Correlation with Cystometry

    OpenAIRE

    Edney Norio Otsuki; Edward Araujo Júnior; Emerson Oliveira; Marair Gracio Ferreira Sartori; Manoel João Batista Castelo Girão; Zsuzsanna Ilona Katalin Jármy-Di Bella

    2014-01-01

    Objective. To compare bladder wall thickness in two kinds of urinary incontinent women—stress urinary incontinence (SUI) and overactive bladder (OAB) with urodynamic detrusor overactivity (DO), and to compare them with continent patients by ultrasound, also, correlate with cystometric results in incontinent women. Methods. 91 women were divided into the following groups: continent (n = 31), SUI (n = 30), and DO (n = 30) groups after clinical evaluation and urodynamic test (only in incontinent...

  9. Bladder Wall Telangiectasia in a Patient with Ataxia-Telangiectasia and How to Manage?

    OpenAIRE

    Fatma Deniz Aygün; Serdar Nepesov; Haluk Çokuğraş; Yıldız Camcıoğlu

    2015-01-01

    Ataxia-telangiectasia (A-T) is a rare neurodegenerative, inherited disease causing severe morbidity. Oculocutaneous telangiectasias are almost constant findings among the affected cases as telangiectasia is considered the main clinical finding for diagnosis. Vascular abnormalities in organs have been reported infrequently but bladder wall telangiectasias are extremely rare. We aimed to report recurrent hemorrhage from bladder wall telangiectasia in a 9-year-old boy with A-T who had received i...

  10. [Specific types of bladder cancer].

    Science.gov (United States)

    Bertz, S; Hartmann, A; Knüchel-Clarke, R; Gaisa, N T

    2016-02-01

    Bladder cancer shows rare variants and special subtypes with diverse prognostic importance and therefore may necessitate different therapeutic approaches. For pathologists it is important to histologically diagnose and specify such variants. Nested variants of urothelial carcinoma with inconspicuous, well-formed tumor cell nests present with an aggressive course. The plasmacytoid variant, which morphologically resembles plasma cells is associated with a shorter survival time and a high frequency of peritoneal metastasis. Micropapillary urothelial carcinoma with small papillary tumor cell islands within artificial tissue retraction spaces and frequent lymphovascular invasion also has a poor prognosis. Other important rare differential variants listed in the World Health Organization (WHO) classification are microcystic, lymphoepithelioma-like, sarcomatoid, giant cell and undifferentiated urothelial carcinomas. Additionally, there are three special types of bladder cancer: squamous cell carcinoma, adenocarcinoma and small cell neuroendocrine carcinoma of the bladder. These tumors are characterized by pure squamous cell or glandular differentiation and are sometimes less responsive to adjuvant (chemo)therapy. Small cell carcinoma of the bladder mimics the neuroendocrine features of its pulmonary counterpart, shows an aggressive course but is sensitive to (neo-)adjuvant chemotherapy. The morphology and histology of the most important variants and special types are discussed in this review. PMID:26782034

  11. Microsatellite instability in bladder cancer

    DEFF Research Database (Denmark)

    Gonzalez-Zulueta, M; Ruppert, J M; Tokino, K; Tsai, Y C; Spruck, C H; Miyao, N; Nichols, P W; Hermann, G G; Horn, T; Steven, K

    1993-01-01

    Somatic instability at microsatellite repeats was detected in 6 of 200 transitional cell carcinomas of the bladder. Instabilities were apparent as changes in (GT)n repeat lengths on human chromosome 9 for four tumors and as alterations in a (CAG)n repeat in the androgen receptor gene on the X chr...

  12. Alternating chemo-radiotherapy in bladder cancer: A conservative approach

    Energy Technology Data Exchange (ETDEWEB)

    Orsatti, M.; Franzone, P.; Giudici, S. [Istituto Nazionale per la Ricerca sul Cancro, Genova (Switzerland)] [and others

    1995-08-30

    The aim of this Phase II study was to determine a bladder-sparing treatment in patients with invasive bladder cancer, allowing a better quality of life. Objectives were to test toxicity and disease-free and overall survival of patients given an alternated chemo-radiotherapy definitive treatment. Seventy-six patients with bladder cancer Stage T1G3 through T4 N0 M0 were entered in the same chemotherapy regimen (Cisplatin 20 mg/mq and 5-Fluorouracil 200 mg/mq daily for 5 days) alternated with different radiotherapy scheduling, the first 18 patients received two cycles of 20 Gy/10 fractions/12 days each; the second group of 58 patients received two cycles of 25 Gy/10 fractions/12 days each (the last 21 patients received Methotrexate 40 mg/mq instead of 5-Fluorouracil). A clinical complete response was observed in 57 patients (81%), partial response in 7 patients (10%), and a nonresponse in 6 patients (9%). At a median follow-up of 45 months, 33 patients (47%) were alive and free of tumor. The 6-year overall survival and progression-free survival was 42% and 40%, respectively. Systemic side effects were mild, while a moderate or severe local toxicity was observed in 14 patients and 13 patients (about 20%), respectively. Our conservative combination treatment allowed bladder-sparing in a high rate of patients and resulted in a survival comparable to that reported after radical cystectomy. 34 refs., 4 figs., 5 tabs.

  13. A review of molecular biomarkers for bladder cancer

    Directory of Open Access Journals (Sweden)

    Miakhil I

    2013-01-01

    Full Text Available Background: Numerous molecular markers for bladder cancer have been identified and investigated with various laboratory techniques. Molecular markers are isolated from tissue, serum and urine. They fall into proteomic, genetic and epigenetic categories. Some of molecular markers show promising results in terms of facilitating early diagnosis and guiding treatment. Molecular markers or the so- called biomarkers can provide additional information alongside staging, grading and lymphovascular invasion, for better prognostication.Aim:This studyprovides an up-to-date review of the frequently studied and most important biomarkers that have shown consistent relevance in relation to bladder cancer. Methods: The key words were searched on the PubMed, Google scholar and NHS library search engines. Results: More than twenty biomarkers as per our methodology were identified but only half of them have shown consistence relevance in bladder cancer. Conclusion: It is envisaged that a combination of a few biomarkers, which are investigated frequently and have shown clinical relevance, could possibly provide useful information in predicting recurrence and provide useful prognostic information. So far none of the biomarkers for bladder cancer are adopted in the UK standard practice. Despite that the Food and Drug Administration (FDA had approved some of these biomarkers, none of the urology associations incorporated them in to their guidelines as yet. However, it won’t be long before a final consensus is reached to integrate molecular staging in to the current TNM staging system.

  14. Mesenchymal stem cells protect against the tissue fibrosis of ketamine-induced cystitis in rat bladder.

    Science.gov (United States)

    Kim, Aram; Yu, Hwan Yeul; Heo, Jinbeom; Song, Miho; Shin, Jung-Hyun; Lim, Jisun; Yoon, Soo-Jung; Kim, YongHwan; Lee, Seungun; Kim, Seong Who; Oh, Wonil; Choi, Soo Jin; Shin, Dong-Myung; Choo, Myung-Soo

    2016-01-01

    Abuse of the hallucinogenic drug ketamine promotes the development of lower urinary tract symptoms that resemble interstitial cystitis. The pathophysiology of ketamine-induced cystitis (KC) is largely unknown and effective therapies are lacking. Here, using a KC rat model, we show the therapeutic effects of human umbilical cord-blood (UCB)-derived mesenchymal stem cells (MSCs). Daily injection of ketamine to Sprague-Dawley rats for 2-weeks resulted in defective bladder function, indicated by irregular voiding frequency, increased maximum contraction pressure, and decreased intercontraction intervals and bladder capacity. KC bladders were characterized by severe mast-cell infiltration, tissue fibrosis, apoptosis, upregulation of transforming growth factor-β signaling related genes, and phosphorylation of Smad2 and Smad3 proteins. A single administration of MSCs (1 × 10(6)) into bladder tissue not only significantly ameliorated the aforementioned bladder voiding parameters, but also reversed the characteristic histological and gene-expression alterations of KC bladder. Treatment with the antifibrotic compound N-acetylcysteine also alleviated the symptoms and pathological characteristics of KC bladder, indicating that the antifibrotic capacity of MSC therapy underlies its benefits. Thus, this study for the first-time shows that MSC therapy might help to cure KC by protecting against tissue fibrosis in a KC animal model and provides a foundation for clinical trials of MSC therapy. PMID:27481042

  15. Isolated Polypoid Ganglioneuroma of Gall Bladder - A Case Report

    Directory of Open Access Journals (Sweden)

    Vandana U.G.

    2011-07-01

    Full Text Available A ganglioneuroma is a very rare neoplasm in the gastrointestinal tract and a benign neoplasm of sympathetic nervous system. They predominantly affect the colon and rectum and are rare to arise in gall bladder. Gastrointestinal ganglioneuromas occur as rare isolated (solitary polypoid lesions or more commonly as ganglioneuromatous polyposis and diffuse ganglioneuromatosis. Isolated polypoid lesions are clinically asymptomatic and incidentally detected during endoscopy or surgery. We report a case of a 42-year-female who presented clinically with features of chronic cholecystitis and was operated. There was no association of any hereditary disease. Incidentally the cholecystectomy specimen showed a small sessile polypoid lesion. Histopathological examination showed the lesion to be polypoid ganglioneuroma arising in gall bladder. The isolated polypoid ganglioneuroma is invariably benign. They do not have increased risk of von Recklinghausen’s disease or multiple endocrine neoplasia IIB and show no evidence of recurrence with excellent prognosis after total excision.

  16. Diagnosis of urinary bladder diseases in dogs by using two-dimensional and three-dimensional ultrasonography

    Directory of Open Access Journals (Sweden)

    Dinesh Dehmiwal

    2015-07-01

    Full Text Available Aim: The objective of this study was to obtain and compare two-dimensional (2D and three-dimensional (3D ultrasonographic images of the urinary bladder in different disease conditions. Materials and Methods: The present study was conducting on total 10clinical cases of the urinary bladder in dogs. The ultrasound (US machine used for this study was 3D US machine (Nemio-XG: Toshiba, Japan having a four-dimensional volumetric probe. Results: In the present study, the inflamed thickened wall was clearly visible with the distinction of different layers of the urinary bladder wall in some of the cases of cystitis using 2D ultrasonography. In 3D sonogram, the urinary bladder was visualized as a large anechoic structure with no distinction of different layers of the bladder wall. The cystoliths were clearly visible as hyperechoic structures with distal acoustic shadow in 2D sonogram and appeared as a bright echogenic area in 3D sonogram. In case of urinary bladder neoplasia in 2D ultrasonogram, the bladder lumen was found to be occluded with a large growth imaged as focal anechoic areas in the tissue of mixed echogenicity with small hyperechoic dots in this tissue parenchyma. In 3D ultrasonogram, a tissue of mixed echogenicity of pus was also observed. Conclusion: From the present study it was concluded that 2D and 3D ultrasonography is very helpful for diagnosis of different clinical conditions of the urinary bladder such as cystitis, cystoliths, and urinary bladder neoplasia. The cavity of urinary bladder was more clearly visualized in 3D ultrasonography, but the distinction of different layers of the bladder wall was visualized only in 2D ultrasonography. The distinct shadow of pus and cystoliths were visible in 2D ultrasonogram. The visualization of pus in 3D ultrasonography was done for the first time in present study.

  17. Functional role of cannabinoid receptors in urinary bladder

    OpenAIRE

    Tyagi, Pradeep; Tyagi, Vikas; Yoshimura, Naoki; Chancellor, Michael

    2010-01-01

    Cannabinoids, the active components of Cannabis sativa (maijuana), and their derivatives produce a wide spectrum of central and peripheral effects, some of which may have clinical applications. The discovery of specific cannabinoid receptors and a family of endogenous ligands of those receptors has attracted much attention to the general cannabinoid pharmacology. In recent years, studies on the functional role of cannabinoid receptors in bladder have been motivated by the therapeutic effects ...

  18. Quality of life in urinary bladder and prostate cancer patients

    OpenAIRE

    Schmidt, Stefanie

    2014-01-01

    The overall objective of this thesis was to describe the evolution of Health-Related Quality of Life in Spanish patients with urologic tumours; and to the examine clinical and treatment-related factors associated with changes in Health-Related Quality of Life during the first year of treatment. The EMPARO project is an observational, multicenter, prospective study on patients diagnosed with bladder cancer (n=326) and prostate cancer (n=472). Consecutive patients were enrolled in 7 Spanish hos...

  19. The role of botulinum toxin A in treating neurogenic bladder

    OpenAIRE

    Weckx, Filip; Tutolo, Manuela; De Ridder, Dirk; Van der Aa, Frank

    2016-01-01

    Neurogenic detrusor overactivity (NDO) can result in lower and upper urinary tract complications and eventually even in end-stage kidney failure. Since the driving force of this clinical cascade is high bladder pressure, controlling intravesical pressure in NDO patients improves both quality of life and life-expectancy in these patients. Botulinum toxin A (BTX-A) has proven its efficacy in reducing intravesical pressure and in reducing incontinence episodes. BTX-A also improves quality of lif...

  20. Urinary tract infection in the neurogenic bladder.

    Science.gov (United States)

    Vigil, Humberto R; Hickling, Duane R

    2016-02-01

    There is a high incidence of urinary tract infection (UTI) in patients with neurogenic lower urinary tract function. This results in significant morbidity and health care utilization. Multiple well-established risk factors unique to a neurogenic bladder (NB) exist while others require ongoing investigation. It is important for care providers to have a good understanding of the different structural, physiological, immunological and catheter-related risk factors so that they may be modified when possible. Diagnosis remains complicated. Appropriate specimen collection is of paramount importance and a UTI cannot be diagnosed based on urinalysis or clinical presentation alone. A culture result with a bacterial concentration of ≥10(3) CFU/mL in combination with symptoms represents an acceptable definition for UTI diagnosis in NB patients. Cystoscopy, ultrasound and urodynamics should be utilized for the evaluation of recurrent infections in NB patients. An acute, symptomatic UTI should be treated with antibiotics for 5-14 days depending on the severity of the presentation. Antibiotic selection should be based on local and patient-based resistance patterns and the spectrum should be as narrow as possible if there are no concerns regarding urosepsis. Asymptomatic bacteriuria (AB) should not be treated because of rising resistance patterns and lack of clinical efficacy. The most important preventative measures include closed catheter drainage in patients with an indwelling catheter and the use of clean intermittent catheterization (CIC) over other methods of bladder management if possible. The use of hydrophilic or impregnated catheters is not recommended. Intravesical Botox, bacterial interference and sacral neuromodulation show significant promise for the prevention of UTIs in higher risk NB patients and future, multi-center, randomized controlled trials are required. PMID:26904414

  1. Implementation of continuous renal replacement therapy with regional citrate anticoagulation on a surgical and trauma intensive care unit: impact on clinical and economic aspects—an observational study

    OpenAIRE

    Hafner, Sebastian; Stahl, Wolfgang; Fels, Theresa; Träger, Karl; Georgieff, Michael; Wepler, Martin

    2015-01-01

    Background Regional citrate anticoagulation (RCA) is being increasingly used during continuous renal replacement therapy (CRRT) in intensive care units as an alternative to systemic heparin anticoagulation. However, due to its availability in a variety of solutions and dialysis systems, RCA is still considered a complex intervention, possibly leading to confusion and pitfalls in everyday practice. We therefore tested retrospectively if the introduction of RCA as a new anticoagulation strategy...

  2. Comparing Motivational Interviewing-Based Treatment and its combination with Nicotine Replacement Therapy on smoking cessation in prisoners: a randomized controlled clinical trial

    OpenAIRE

    Jalali, Farzad; Afshari, Reza; Babaei, Ali; Abasspour, Hassan; Vahedian-Shahroodi, Mohammad

    2015-01-01

    Background The prevalence of smoking is much higher in prisoners than it is in the general population. Prisoners who smoke cause many health problems for themselves and other prisoners. Therefore, we should help them stop smoking. Objective To compare the effects of motivational interviewing-based (MI-based) treatment and its combination with nicotine replacement therapy (NRT) on smoking cessation in prisoners at Mashhad Central Prison. Methods The study was designed as a double-blind, random...

  3. An In Vivo Study of Low-Dose Intra-Articular Tranexamic Acid Application with Prolonged Clamping Drain Method in Total Knee Replacement: Clinical Efficacy and Safety

    OpenAIRE

    Paphon Sa-ngasoongsong; Pongsthorn Chanplakorn; Siwadol Wongsak; Krisorn Uthadorn; Tanapong Panpikoon; Paisan Jittorntam; Katcharin Aryurachai; Pantap Angchaisukisiri; Viroj Kawinwonggowit

    2015-01-01

    Background. Recently, combined intra-articular tranexamic acid (IA-TXA) injection with clamping drain method showed efficacy for blood loss and transfusion reduction in total knee replacement (TKR). However, until now, none of previous studies revealed the effect of this technique on pharmacokinetics, coagulation, and fibrinolysis. Materials and Methods. An experimental study was conducted, during 2011-2012, in 30 patients undergoing unilateral TKR. Patients received IA-TXA application and th...

  4. Urinary bladder rupture during voiding cystourethrography

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    Kyong Ok Lee

    2012-05-01

    Full Text Available Voiding cystourethrography (VCUG is a commonly performed diagnostic procedure for the evaluation of vesicoureteral reflux with urinary tract infection or congenital renal diseases in children. The procedure is relatively simple and cost-effective, and complications are very rare. The iatrogenic complication of VCUG range from discomfort, urinary tract infection to bacteremia, as well as bladder rupture. Bladder rupture is a rare complication of VCUG, and only a few cases were reported. Bladder rupture among healthy children during VCUG is an especially uncommon event. Bladder rupture associated with VCUG is usually more common in chronically unused bladders like chronic renal failure. Presented is a case of bladder rupture that occurred during a VCUG in a healthy 9-monthold infant, due to instilled action of dye by high pressure. This injury completely healed after 7 days of operation, and it was confirmed with a postoperative cystography. The patient’s bladder volume, underlying disease, velocity of the contrast media instilled, catheter size, and styles of instillation are important factors to prevent bladder rupture during VCUG. Management of bladder rupture should be individualized, but the majority of infants are treated with the operation. In conclusion, bladder rupture is a rare complication, however, delicate attention is needed in order to prevent more dire situations.

  5. Designing the selenium and bladder cancer trial (SELEBLAT, a phase lll randomized chemoprevention study with selenium on recurrence of bladder cancer in Belgium

    Directory of Open Access Journals (Sweden)

    Goossens Maria E

    2012-03-01

    Full Text Available Abstract Background In Belgium, bladder cancer is the fifth most common cancer in males (5.2% and the sixth most frequent cause of death from cancer in males (3.8%. Previous epidemiological studies have consistently reported that selenium concentrations were inversely associated with the risk of bladder cancer. This suggests that selenium may also be suitable for chemoprevention of recurrence. Method The SELEBLAT study opened in September 2009 and is still recruiting all patients with non-invasive transitional cell carcinoma of the bladder on TURB operation in 15 Belgian hospitals. Recruitment progress can be monitored live at http://www.seleblat.org. Patients are randomly assigned to selenium yeast (200 μg/day supplementation for 3 years or matching placebo, in addition to standard care. The objective is to determine the effect of selenium on the recurrence of bladder cancer. Randomization is stratified by treatment centre. A computerized algorithm randomly assigns the patients to a treatment arm. All study personnel and participants are blinded to treatment assignment for the duration of the study. Design The SELEnium and BLAdder cancer Trial (SELEBLAT is a phase III randomized, placebo-controlled, academic, double-blind superior trial. Discussion This is the first report on a selenium randomized trial in bladder cancer patients. Trial registration ClinicalTrials.gov identifier: NCT00729287

  6. Hemorrhagic irradiation cystitis associated with bladder transitional cell carcinoma and effects of aluminium-ammonium sulfate irrigation for massive bladder hemorrage

    International Nuclear Information System (INIS)

    Although pelvic irradiation is carried out widely on patients with uterine cancer, a few reports have dealt with the occurence of secondary bladder tumors due to pelvic irradiation. Herein, we report a case of radiation induced bladder transitional cell carcinoma. A 72-year-old woman suffered hemorrhagic irradiation cystitis for 2 years in duration following 8000 rads radiotherapy received 4 years before. Primary uterine cervical cancer was well controlled and residual tumor or recurrence of tumor was excluded by clinical examination. Cystoscopic and cytologic examination was initiated in 1981 when first episode of hematuria occurred and was repeated there-after to check for neoplasm in the bladder until June 1983, when a bladder tumor was identified. Cystoscopy revealed a small papillary tumor in trigone, and hyperemic edema and bleeding in almost the whole bladder mucosa. The pathology of the tumor was transitional cell carcinoma. Hemorrhagic cystitis was treated successfully with bladder irrigation of 3 litres of 1% aluminium-ammonium sulfate solution after 3 courses of irrigation. (author)

  7. Clinical Observation of Transurethral Resection Combined with Chemotherapy for T2 a and T2b Bladder Cancer%经尿道膀胱肿瘤电切术联合化疗治疗 T2 a及T2 b期膀胱癌的临床观察

    Institute of Scientific and Technical Information of China (English)

    罗建斌

    2015-01-01

    目的:评估经尿道膀胱肿瘤电切术联合化疗治疗T2a及T2b期膀胱癌的临床效果。方法50例膀胱细胞癌(TCC)(19例T2a,31例T2b期)随机分为2组。实验组25例行“完整的”TUR处理,随后进行2~6个周期的顺铂(70 mg/m2)和甲氨蝶呤(40 mg/m2)化疗。对照组25例行普通切除术进行治疗。比较2组患者的生活质量及复发率。结果整体中位随访47个月,膀胱镜检查评估。实验组25例患者中15例持续肌层浸润性TCC,4例原位癌皆无复发,其余6例患者术后15.6个月复发;6例复发患者中4例复发位置相同,2例复发位置不同。对照组随访期间12例患者发生表浅复发,需要内镜治疗;随访结束时6例死于转移性膀胱癌。结论尿道膀胱肿瘤电切术联合化疗能够控制T2 a及T2b期膀胱癌,能够维持60%的患者的膀胱功能,并降低患者复发率及病死率,值得临床推广。%Objective To evaluate the clinical efficacy of transurethral resection combined with chemotherapy for T2a and T2b bladder cancer.Methods 50 cases of bladder cell carcinoma ( TCC) (19 cases of T2a,31 cases of T2b stage) were randomly divided into 2 groups,each with 25 cases.The experimental group received routine"complete"TUR treatment,followed by 2~6 cycles of cisplatin ( 70 mg/m2 ) and methotrexate ( 40 mg/m2 ) chemotherapy.The control group received resection. Quality of life and relapse rates of patients were compared.Results The overall median follow-up was 47 months,endoscopy was used to assess the bladder.In the experimental group,15 cases had persistent muscle invasive TCC,4 cases of carcinoma in situ had no recurrence,and 6 cases of postoperative recurrence in 15.6 months,in which 4 cases of recurrence was in the same loca-tion,2 cases of recurrence was in different location.12 patients had superficial relapse during follow-up in the control group,and need endoscopic treatment.At the end of follow-up,6

  8. Mandatory role of proteinase-activated receptor 1 in experimental bladder inflammation

    Directory of Open Access Journals (Sweden)

    Davis Carole A

    2007-03-01

    Full Text Available Abstract Background In general, inflammation plays a role in most bladder pathologies and represents a defense reaction to injury that often times is two edged. In particular, bladder neurogenic inflammation involves the participation of mast cells and sensory nerves. Increased mast cell numbers and tryptase release represent one of the prevalent etiologic theories for interstitial cystitis and other urinary bladder inflammatory conditions. The activity of mast cell-derived tryptase as well as thrombin is significantly increased during inflammation. Those enzymes activate specific G-protein coupled proteinase-activated receptors (PARs. Four PARs have been cloned so far, and not only are all four receptors highly expressed in different cell types of the mouse urinary bladder, but their expression is altered during experimental bladder inflammation. We hypothesize that PARs may link mast cell-derived proteases to bladder inflammation and, therefore, play a fundamental role in the pathogenesis of cystitis. Results Here, we demonstrate that in addition to the mouse urinary bladder, all four PA receptors are also expressed in the J82 human urothelial cell line. Intravesical administration of PAR-activating peptides in mice leads to an inflammatory reaction characterized by edema and granulocyte infiltration. Moreover, the inflammatory response to intravesical instillation of known pro-inflammatory stimuli such as E. coli lipopolysaccharide (LPS, substance P, and antigen was strongly attenuated by PAR1-, and to a lesser extent, by PAR2-deficiency. Conclusion Our results reveal an overriding participation of PAR1 in bladder inflammation, provide a working model for the involvement of downstream signaling, and evoke testable hypotheses regarding the role of PARs in bladder inflammation. It remains to be determined whether or not mechanisms targeting PAR1 gene silencing or PAR1 blockade will ameliorate the clinical manifestations of cystitis.

  9. A contribution to improved radiotherapy for muscle-invading urinary bladder cancer

    International Nuclear Information System (INIS)

    Due to the possible side-effects of radical cystectomy for muscle-invading urinary bladder cancer (UBC), radiotherapy remains an attractive organ-sparing treatment option, either alone or combined with increasingly effective chemotherapy. Radiation dose escalation may further improve the results obtained with radiotherapy. This Ph.D. program aimed at developing improved conformal radiotherapy techniques required for dose escalation in bladder irradiation. Initially, computer-controlled movement of the collimators during beam delivery was applied to shape partially wedged beams (PWBs), designed to conform the dose distribution to bladder targets. The dosimetric verification and treatment planning implementation of PWBs were addressed. Particular attention was given to dynamic beam isodose verification with the BMS-96 diode array. The theoretical clinical impact of PWBs in bladder irradiation was evaluated in a planning study. Using PWBs the dose homogeneity inside bladder targets improved and normal tissue (small intestine and rectum) doses were reduced. Judged from normal tissue complication probability (NTCP) modeling, PWBs would allow radiation dose escalation with 2-6 Gy in up to 60% of the patients without increasing the estimated combined NTCP relative to the standard setup. This work also demonstrated the uncertainty in intestine and rectum tolerance data and the differences between the various NTCP models. Finally, the internal bladder motion and patient setup variation were quantified from weekly repeat CT scans and electronic portal images, and new bladder treatment margins were derived. Currently, a bladder dose escalation trial using the PWB principle is performed, testing if the whole bladder target dose can be increased from 64 to 68 Gy while maintaining a low level of treatment-induced complications

  10. Ultrasound Thickness of Bladder Wall in Continent and Incontinent Women and Its Correlation with Cystometry

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    Edney Norio Otsuki

    2014-01-01

    Full Text Available Objective. To compare bladder wall thickness in two kinds of urinary incontinent women—stress urinary incontinence (SUI and overactive bladder (OAB with urodynamic detrusor overactivity (DO, and to compare them with continent patients by ultrasound, also, correlate with cystometric results in incontinent women. Methods. 91 women were divided into the following groups: continent (n=31, SUI (n=30, and DO (n=30 groups after clinical evaluation and urodynamic test (only in incontinent women. Transvaginal ultrasound was performed to the bladder wall thickness (BWT measurement. The mean of BWT was calculated and data were analyzed with ANOVA and Turkey’s multiple comparison tests. Pearson’s correlation coefficient (r was used to compare two variables. Receiver operating characteristic (ROC curve was performed to study BWT as a diagnostic parameter. Results. BWT in DO group was significantly higher than that in the other groups (P<0.005. A moderate positive correlation was found between BWT and maximum bladder pressure during involuntary bladder contraction. There was no difference in BWT between SUI and continent groups. DO group had lower first desire to void and cystometric capacity. Maximum bladder pressure at detrusor contraction had a moderate positive correlation with BWT. The ROC revealed an area under the curve of 0.962 (95% CI, 0.90–1.01. Conclusions. DO patients have increased bladder wall thickness, lower first desire to void, and lower cystometric capacity. There was a moderate correlation between BWT and maximum bladder pressure during involuntary bladder contraction.

  11. Sperm associated antigen 9 plays an important role in bladder transitional cell carcinoma.

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    Deepika Kanojia

    Full Text Available BACKGROUND: Majority of bladder cancer deaths are caused due to transitional cell carcinoma (TCC which is the most prevalent and chemoresistant malignancy of urinary bladder. Therefore, we analyzed the role of Sperm associated antigen 9 (SPAG9 in bladder TCC. METHODOLOGY AND FINDINGS: We examined SPAG9 expression and humoral response in 125 bladder TCC patients. Four bladder cancer cell lines were assessed for SPAG9 expression. In addition, we investigated the effect of SPAG9 ablation on cellular proliferation, cell cycle, migration and invasion in UM-UC-3 bladder cancer cells by employing gene silencing approach. Our SPAG9 gene and protein expression analysis revealed SPAG9 expression in 81% of bladder TCC tissue specimens. High SPAG9 expression (>60% SPAG9 positive cells was found to be significantly associated with superficial non-muscle invasive stage (P = 0.042 and low grade tumors (P = 0.002 suggesting SPAG9 putative role in early spread and tumorigenesis. Humoral response against SPAG9 was observed in 95% of patients found positive for SPAG9 expression. All four bladder cancer cell lines revealed SPAG9 expression. In addition, SPAG9 gene silencing in UM-UC-3 cells resulted in induction of G0-G1 arrest characterized by up-regulation of p16 and p21 and consequent down-regulation of cyclin E, cyclin D and cyclin B, CDK4 and CDK1. Further, SPAG9 gene silencing also resulted in reduction in cellular growth, and migration and invasion ability of cancer cells in vitro. CONCLUSIONS: Collectively, our data in clinical specimens indicated that SPAG9 is potential biomarker and therapeutic target for bladder TCC.

  12. Hedyotis diffusa plus Scutellaria barbata Induce Bladder Cancer Cell Apoptosis by Inhibiting Akt Signaling Pathway through Downregulating miR-155 Expression

    OpenAIRE

    Li-Tao Pan; Yip Sheung; Wen-Peng Guo; Zhi-Bin Rong; Zhi-Ming Cai

    2016-01-01

    Traditional Chinese medicine is increasingly used to treat cancer. Our clinical experiences identify Hedyotis diffusa plus Scutellaria barbata as the most common herb-pair (couplet medicinal) used for the core treatment of bladder cancer. This study aims to investigate the antitumor effect of the herb-pair in bladder cancer cells. The results show that Hedyotis diffusa plus Scutellaria barbata inhibited bladder cancer cell growth and clone formation in a dose-dependent and time-dependent mann...

  13. Novel research approaches for interstitial cystitis/bladder pain syndrome: thinking beyond the bladder.

    Science.gov (United States)

    Mullins, Chris; Bavendam, Tamara; Kirkali, Ziya; Kusek, John W

    2015-10-01

    Despite years of basic and clinical research focused on interstitial cystitis/bladder pain syndrome (IC/BPS), including clinical trials of candidate therapies, there remains an insufficient understanding of underlying cause(s), important clinical features and a lack of effective treatments for this syndrome. Progress has been limited and is likely due to many factors, including a primary focus on the bladder and lower urinary tract as origin of symptoms without adequately considering the potential influence of other local (pelvic) or systemic factors. Traditionally, there has been a lack of sufficiently diverse expertise and application of novel, integrated methods to study this syndrome. However, some important insights have been gained. For example, epidemiological studies have revealed that IC/BPS is commonly associated with other chronic pain conditions, including fibromyalgia, irritable bowel syndrome and chronic fatigue syndrome. These observations suggest that IC/BPS may involve systemic pathophysiology, including alterations of the central nervous system in some patients. Furthermore, there may be multiple causes and contributing factors that manifest in the symptoms of IC/BPS leading to multiple patient sub-groups or phenotypes. Innovative research is necessary to allow for a more complete description of the relationship between this syndrome and other disorders with overlapping symptoms. This report provides examples of such innovative research studies and their findings which have the potential to provide fresh insights into IC/BPS and disorders associated with chronic pain through characterization of broad physiologic systems, as well as assessment of the contribution of the bladder and lower urinary tract. They may also serve as models for future investigation of symptom-based urologic and non-urologic disorders that may remain incompletely characterized by previous, more traditional research approaches. Furthermore, it is anticipated a more holistic

  14. Molecular Biomarkers in Bladder Cancer: Novel Potential Indicators of Prognosis and Treatment Outcomes

    OpenAIRE

    Masayoshi Nagata; Satoru Muto; Shigeo Horie

    2016-01-01

    Although many clinical and molecular markers for predicting outcomes in bladder cancer (BC) have been reported, their application in clinical practice remains unclear. Bladder carcinogenesis has two distinct molecular pathways that direct the development of BC. FGFR3 mutations are common in low-grade BC, while TP53 mutation or loss of RB1 is associated with muscle-invasive BC. However, no tissue-based gene markers confirmed by prospective large-scale trials in BC have been used in clinical pr...

  15. A non-invasive technique for standing surgical repair of urinary bladder rupture in a post-partum mare: a case report

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    Stephen JO

    2009-11-01

    Full Text Available Abstract An 11-year-old mare presented 36 hours after foaling with a ruptured bladder. Uroperitoneum was diagnosed on ultrasound and from the creatinine concentration of the peritoneal fluid. Bladder endoscopy demonstrated tissue necrosis and a rent in the dorsocranial aspect of the bladder. Following stabilisation, including abdominal drainage and lavage, the mare was taken to standing surgery. Under continuous sedation and epidural anaesthesia, and after surgical preparation, a Balfour retractor was placed in the vagina. Using sterile lubricant and moderate force, it was possible to insert a hand into the bladder. The tear was easily palpable on the dorsal portion of the bladder. Two fingers were inserted through the tear and used to provide traction to evert the bladder completely into the vagina where it could grasped with the surgeons other hand to prevent further trauma. A second surgeon could then visualise the entire tear and repaired this using a single layer of size zero PDS suture in a single continuous pattern. As soon as the bladder was repaired, it was replaced via the urethra. The mare did well after surgery and was discharged after 48 hours, apparently normal. This report is the first describing repair of the bladder without an abdominal incision or incision into the urethral sphincter. This greatly reduces the chance of possible complications such as urine pooling after surgery with the previously described standing technique or bladder trauma due to traction with abdominal surgery.

  16. Health-Related Quality of Life after Cystectomy and Urinary Diversion for Bladder Cancer

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    Cheryl Shih

    2011-01-01

    Full Text Available With multiple options for urinary diversion after radical cystectomy for bladder cancer that have comparable cancer control and complication rates, health-related quality of life (HRQOL has become an important consideration. This article reviews the methods for defining HRQOL, the challenges in measuring HRQOL in bladder cancer, and the literature comparing HRQOL after various methods of urinary diversion. Recent contributions include the validation of HRQOL instruments specific to bladder cancer and the publication of several prospective studies measuring HRQOL outcomes after cystectomy and urinary diversion. There is no convincing evidence from existing literature that any particular method of urinary diversion offers superior HRQOL outcomes. Rather, there is growing evidence that good HRQOL can be achieved with patient education and consideration of each patient's clinical and psychosocial situation. Future research should utilize the validated bladder cancer specific HRQOL instruments and perhaps explore the impact of preoperative counseling on postoperative HRQOL.

  17. Detection of hyaluronic acid and laminin in serum of patients with urinary bladder tumors

    International Nuclear Information System (INIS)

    Objective: To investigate the serum Hyaluronic Acid (HA) and laminin (LN) level and its clinical significance in bladder tumors. Methods: Serum samples from 34 patients with bladder tumor and 30 cases as control group were analyzed by radioimmunoassay. Results: The results showed that the HA and LN levels of serum in patients with bladder tumors were significantly higher than that in control group (P<0.01) before operation, and decreased significantly after operation. The serum levels of HA and LN in infiltrated tumors were higher than that in superficial tumors (P<0.05). The markers in patients with lymph node metastasis were higher than that without lymph node metastasis (P<0.01). Conclusion: HA and LN take part in the malignant biology behavior of bladder tumors. They may be the important markers in assisting diagnosis and disease monitoring

  18. Urinary-bladder toxicity following pelvic irradiation and simultaneous cyclophosphamide therapy

    International Nuclear Information System (INIS)

    The frequency and severity of urinary-bladder toxicity were determined retrospectively in a large series of childhood cancer patients treated with either pelvic irradiation and simultaneous cyclophosphamide or cyclophosphamide with extrapelvic irradiation. Of 50 patients who received the first combination, 17 (34 percent) developed urinary-bladder toxicity. Eight of the 17 had transient hematuria and dysuria with complete clearing clinically after cessation of treatment; nine had chronic or intermittent hematuria which persisted after treatment was stopped and often resulted in demonstrable fibrosis and telangiectasia of the bladder. By contrast, of 60 children who received cyclophosphamide with radiotherapy outside the pelvic region, only five (8 percent) developed hematuria and in all instances it was transient. This comparative study demonstrates a significantly increased frequency and severity of urinary-bladder toxicity in cancer patients receiving pelvic irradiation with simultaneous cyclophosphamide

  19. Intrauterine Contraceptive Device Migrated into the Urinary Bladder and a Review of the Literature

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    Orhan Zorba

    2013-08-01

    Full Text Available Intrauterine contraceptive devices are being used in clinical practice since 1962. Due to their efficiency and low cost, intrauterine contraceptive devices are the most popular method of reversible contraception in developing countries. The incidence of migration of an intrauterine contraceptive device, and related uterine perforation ranges from 0.003% to 0.87%. Intrauterine contraceptive device may migrate into urinary bladder, appendix, rectum, colon, peritoneum, anterior abdominal wall or ovary. Foreign bodies like sutures, stents, and needles in the urinary bladder act as niduses for calculi formation. Intrauterine contraceptive device migrated into the bladder can also become a nidus for a stone formation.Herein we report about a case whose intrauterine contraceptive devices had migrated into the bladder, and presented with lower urinary tract symptoms and suprapubic discomfort 6 years after its insertion.

  20. Potential of HSV-TK gene in gene-radiotherapy for human bladder carcinoma cells

    International Nuclear Information System (INIS)

    Objective: To explore the killing effect of retrovirus-mediated HSV-TK/GCV system combined with radiotherapy on human bladder carcinoma cells. Methods: By using retrovirus-mediated gene transfer technique, hygromycin phosphotransferase-thymidine kinase fusion gene (HyTK) was transferred into EJ bladder carcinoma cells. Antitumor effects were observed after irradiation with 60Co γ-rays as well as gancyclovir treatment. Results: EJ bladder carcinoma cells transduced with HyTK gene and treated with low concentrations of gancyclovir, which alone showed little cytotoxicity, were highly sensitive to radiation. The sensitizer enhancement ratio (SER) was 1.36. Conclusion: The combination of retrovirus-mediated HyTK/GCV gene therapy with standard radiation therapy might improve the therapeutic effectiveness for bladder carcinoma in clinical practice

  1. Intrahepatic type II gall bladder perforation by a gall stone in a CAPD patient

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    Göbel T

    2011-05-01

    Full Text Available Abstract Introduction Perforation of the gall bladder represents a rare, but life-threatening complication of cholecystitis. Clinical presentation may vary between severe peritonism in acute perforation and absence of symptoms in subacute or chronic progression of perforation. Abdominal imaging like ultrasound or CT-scan are important tools for immediate diagnose of gall bladder perforation. Case presentation We report a case of a 30-year old female patient with end-stage kidney disease treated by continuous ambulatory peritoneal dialysis (CAPD who was admitted to the emergency room with fever and mild abdominal pain. A type II gall bladder perforation by a solitary gall stone with development of a liver abscess was detected by abdominal ultrasound. Conclusion Gall bladder perforations are rare but have to be considered in patients with abdominal pain and fever. Abdominal ultrasound is a reliable tool to establish diagnosis.

  2. Analysis of intravesical recurrence after bladder-preserving therapy for muscle-invasive bladder cancer

    International Nuclear Information System (INIS)

    The aim of the present study was to analyze the pattern of recurrences after bladder-preserving therapy for muscle-invasive bladder cancer. The subjects were 77 patients with T2-3N0M0 bladder cancer whose bladder was preserved by intra-arterial chemotherapy and radiation. The patterns of the first recurrences were retrospectively analyzed. With a median follow-up of 38.5 months, 17 patients (22.1%) experienced intravesical recurrence without metastasis, 14 (82.4%) of which were cases of non-muscle-invasive bladder cancer recurrence and 3 (17.6%) of which were muscle-invasive bladder cancer recurrences. Muscle-invasive bladder cancer recurred at the same site as the initial tumor site in all three cases, whereas non-muscle-invasive bladder cancer recurred at different sites in 64% of the patients in that group. The peak hazard of the non-muscle-invasive bladder cancer recurrence was observed at around a year after treatment. Recurrent non-muscle-invasive bladder cancer was of a significantly lower histological grade with lower Ki-67-labeling indices than the initial muscle-invasive bladder cancer. Twelve (85.7%) of 14 patients with non-muscle-invasive bladder cancer recurrence achieved disease-free status. The multivariate analysis revealed that multiplicity, grade and tumor size were significantly correlated with the recurrence (P=0.0001, 0.0442 and 0.0412, respectively). Most of the recurrences after bladder-preserving therapy were cases of non-muscle-invasive bladder cancer. The recurrence pattern and characteristics of the tumors did not differ from those of primary non-muscle-invasive bladder cancer. Patients with high-risk factors would be candidates for prophylactic intravesical therapy for non-muscle-invasive bladder cancer recurrence. (author)

  3. Calcium transport in turtle bladder

    International Nuclear Information System (INIS)

    Unidirectional 45Ca fluxes were measured in the turtle bladder under open-circuit and short-circuit conditions. In the open-circuited state net calcium flux (JnetCa) was secretory (serosa to mucosa). Ouabain reversed JnetCa to an absorptive flux. Amiloride reduced both fluxes such that JnetCa was not significantly different from zero. Removal of mucosal sodium caused net calcium absorption; removal of serosal sodium caused calcium secretion. When bladders were short circuited, JnetCa decreased to approximately one-third of control value but remained secretory. When ouabain was added under short-circuit conditions, JnetCa was similar in magnitude and direction to ouabain under open-circuited conditions (i.e., absorptive). Tissue 45Ca content was ≅30-fold lower when the isotope was placed in the mucosal bath, suggesting that the apical membrane is the resistance barrier to calcium transport. The results obtained in this study are best explained by postulating a Ca2+-ATPase on the serosa of the turtle bladder epithelium and a sodium-calcium antiporter on the mucosa. In this model, the energy for calcium movement would be supplied, in large part, by the Na+-K+-ATPase. By increasing cell sodium, ouabain would decrease the activity of the mucosal sodium-calcium exchanger (or reverse it), uncovering active calcium transport across the serosa

  4. Dietary factors associated with bladder cancer

    OpenAIRE

    Piyathilake, Chandrika

    2016-01-01

    It is biologically plausible for dietary factors to influence bladder cancer risk considering that beneficial as well as harmful components of a diet are excreted through the urinary tract and in direct contact with the epithelium of the bladder. However, studies that investigated the association between dietary factors and bladder cancer (BC) risk have largely reported inconsistent results. The macronutrient intake and risk of BC could have yield inconsistent results across studies because o...

  5. Small cell carcinoma of the urinary bladder

    OpenAIRE

    Pant-Purohit, Mukta; López Beltrán, Antonio; Montironi, Rodolfo; MacLennan, Gregory T.; Cheng, Lian

    2010-01-01

    Small cell carcinoma of the urinary bladder(SCCUB) is a rare and aggressive cancer of the bladder.SCCUB is part of neuroendocrine family of tumors thataffect several organ systems including respiratory,gastrointestinal and male and female genitourinary tract.SCCUB affect males predominantly with common riskfactors include smoking, bladder calculi, bladdermanipulation, and chronic cystitis. Prognosis of SCCUBremains poor due to high metastatic potential and lack ofsymptoms in earlier stages of...

  6. What Are the Risk Factors for Bladder Cancer?

    Science.gov (United States)

    ... cancer Next Topic What causes bladder cancer? Bladder cancer risk factors A risk factor is anything that changes your ... make a person more likely to develop bladder cancer. Risk factors you can change Smoking Smoking is the most ...

  7. A Large Bladder Tumor Covered With a Thick "Shell" of Necrotic Material: Misdiagnosis of a Patient With Spina Bifida.

    Science.gov (United States)

    Wang, Lei; Zhou, Zhe; Gong, Miao-Zi; Pan, Dong-Liang; Zhang, Xiang-Hua; Li, Ning-Chen; Na, Yan-Qun

    2016-04-01

    Bladder tumor arising in a spina bifida patient is rare and may be clinically latent.We report the case of a 61-year-old female patient with spina bifida, neurogenic bladder, and a history of recurrent urinary tract infections. A B-ultrasound and non-contrast computed tomography scan did not reveal any bladder mass, but an unexplained "well-filled" bladder was observed, which was confusing as the catheter was present and open. However, a subsequent cystoscopic evaluation revealed a large bladder mass measuring 9.5 × 9.0 × 6.5 cm, which almost filled the entire bladder. The mass had coarse and flocculent surface and seemed to be free from each observed wall of the urinary bladder. It was diagnosed as an infectious necrotic mass based on its appearance.During transurethral resection of the mass, a bladder tumor was suspected as small blood vessels and bleeding appeared within the inner layer of the mass. Pathological examination revealed necrotic material, inflammatory cells, and urothelial carcinoma cells. Then, a radical cystectomy was performed, and the pathological results indicated stage pT3bN0M0 transitional cell carcinoma. In the gross specimen, the base of the tumor measured 3 × 3 cm on the top of the back wall of the bladder.Bladder tumors may have atypical presentations in patients with spina bifida. Regular screening is helpful for earlier detection and improving outcomes of bladder tumors in such patients. PMID:27100442

  8. Occasional finding of giant bladder diverticulum that simulated an ovarian cyst: A case report and literature review.

    Science.gov (United States)

    Braga, Andrea; Serati, Maurizio; Vitelli, Angela; Caccia, Giorgio

    2016-03-01

    We present a case of a preoperatively unrecognized giant bladder diverticulum in a 63-year-old postmenopausal woman. We carried out preoperative ultrasonographic evaluation and suspected an ovarian cyst. We performed two transvaginal ultrasonography scans before surgery, asking the patient to totally empty her bladder. Consequently, we decided to subject the patient to laparoscopic cyst removal. However, during surgery, the presumed ovarian cyst was not found and a bladder diverticulum was suspected. To confirm our hypothesis, we filled the bladder with saline until the reappearance of giant swelling and we recognized a bladder diverticulum. This case shows that diagnosis based on imaging alone can reveal unpleasant pitfalls. It is important to integrate clinical information, and to consider other possible investigations in order to reduce the chances of a misdiagnosis. PMID:26787074

  9. Small Cell Carcinoma of the Bladder

    Directory of Open Access Journals (Sweden)

    Tufan Cicek

    2015-09-01

    Full Text Available Small Cell Carcinoma of the bladder accounts for less than 1% of all bladder tumors. Small Cell Carcinoma of the bladder has an aggressive behaviour and is usually metastatic at diagnosis. Due to its infrequent occurence, the literature on this entity is limited; which unsurprisingly leads to an uncertanity in defining an ideal therapeutic approach. This report, overviews the literature while describing a 70- year- old female patient who is diagnosed with small cell carcinoma of the bladder arising in an unusual localization. [Cukurova Med J 2015; 40(3.000: 604-608

  10. Model for kidney-bladder excretion

    International Nuclear Information System (INIS)

    In order to calculate the effective dose, an explicit tissue weighting factor of 0.05 is given for the bladder. Consequently a model for kidney-bladder excretion is needed to calculate the additional equivalent dose to bladder wall from activity in urine. The mathematical expressions of the model were proposed in ICRP Pub. 53. However, the expressions can only be applied to the materials excreted directly through urine from body fluids. If the intakes were transferred among the tissues or organs of body successively and excreted in urine, the available expressions calculating disintegration of the intakes in urinary path and bladder contents were derived in this paper

  11. Intrafraction Bladder Motion in Radiation Therapy Estimated From Pretreatment and Posttreatment Volumetric Imaging

    International Nuclear Information System (INIS)

    Purpose: The use of image guidance protocols using soft tissue anatomy identification before treatment can reduce interfractional variation. This makes intrafraction clinical target volume (CTV) to planning target volume (PTV) changes more important, including those resulting from intrafraction bladder filling and motion. The purpose of this study was to investigate the required intrafraction margins for soft tissue image guidance from pretreatment and posttreatment volumetric imaging. Methods and Materials: Fifty patients with muscle-invasive bladder cancer (T2-T4) underwent an adaptive radiation therapy protocol using daily pretreatment cone beam computed tomography (CBCT) with weekly posttreatment CBCT. A total of 235 pairs of pretreatment and posttreatment CBCT images were retrospectively contoured by a single radiation oncologist (CBCT-CTV). The maximum bladder displacement was measured according to the patient's bony pelvis movement during treatment, intrafraction bladder filling, and bladder centroid motion. Results: The mean time between pretreatment and posttreatment CBCT was 13 minutes, 52 seconds (range, 7 min 52 sec to 30 min 56 sec). Taking into account patient motion, bladder centroid motion, and bladder filling, the required margins to cover intrafraction changes from pretreatment to posttreatment in the superior, inferior, right, left, anterior, and posterior were 1.25 cm (range, 1.19-1.50 cm), 0.67 cm (range, 0.58-1.12 cm), 0.74 cm (range, 0.59-0.94 cm), 0.73 cm (range, 0.51-1.00 cm), 1.20 cm (range, 0.85-1.32 cm), and 0.86 cm (range, 0.73-0.99), respectively. Small bladders on pretreatment imaging had relatively the largest increase in pretreatment to posttreatment volume. Conclusion: Intrafraction motion of the bladder based on pretreatment and posttreatment bladder imaging can be significant particularly in the anterior and superior directions. Patient motion, bladder centroid motion, and bladder filling all contribute to changes between

  12. Intrafraction Bladder Motion in Radiation Therapy Estimated From Pretreatment and Posttreatment Volumetric Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Foroudi, Farshad, E-mail: farshad.foroudi@petermac.org [Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Pham, Daniel [Radiation Therapy Services, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Bressel, Mathias [Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Gill, Suki [Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Kron, Tomas [Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia)

    2013-05-01

    Purpose: The use of image guidance protocols using soft tissue anatomy identification before treatment can reduce interfractional variation. This makes intrafraction clinical target volume (CTV) to planning target volume (PTV) changes more important, including those resulting from intrafraction bladder filling and motion. The purpose of this study was to investigate the required intrafraction margins for soft tissue image guidance from pretreatment and posttreatment volumetric imaging. Methods and Materials: Fifty patients with muscle-invasive bladder cancer (T2-T4) underwent an adaptive radiation therapy protocol using daily pretreatment cone beam computed tomography (CBCT) with weekly posttreatment CBCT. A total of 235 pairs of pretreatment and posttreatment CBCT images were retrospectively contoured by a single radiation oncologist (CBCT-CTV). The maximum bladder displacement was measured according to the patient's bony pelvis movement during treatment, intrafraction bladder filling, and bladder centroid motion. Results: The mean time between pretreatment and posttreatment CBCT was 13 minutes, 52 seconds (range, 7 min 52 sec to 30 min 56 sec). Taking into account patient motion, bladder centroid motion, and bladder filling, the required margins to cover intrafraction changes from pretreatment to posttreatment in the superior, inferior, right, left, anterior, and posterior were 1.25 cm (range, 1.19-1.50 cm), 0.67 cm (range, 0.58-1.12 cm), 0.74 cm (range, 0.59-0.94 cm), 0.73 cm (range, 0.51-1.00 cm), 1.20 cm (range, 0.85-1.32 cm), and 0.86 cm (range, 0.73-0.99), respectively. Small bladders on pretreatment imaging had relatively the largest increase in pretreatment to posttreatment volume. Conclusion: Intrafraction motion of the bladder based on pretreatment and posttreatment bladder imaging can be significant particularly in the anterior and superior directions. Patient motion, bladder centroid motion, and bladder filling all contribute to changes between

  13. Defining progression in nonmuscle invasive bladder cancer: it is time for a new, standard definition

    NARCIS (Netherlands)

    Lamm, D.; Persad, R.; Brausi, M.; Buckley, R.; Witjes, J.A.; Palou, J.; Bohle, A.; Kamat, A.M.; Colombel, M.; Soloway, M.

    2014-01-01

    PURPOSE: Despite being one of the most important clinical outcomes in nonmuscle invasive bladder cancer, there is currently no standard definition of disease progression. Major clinical trials and meta-analyses have used varying definitions or have failed to define this end point altogether. A stand

  14. Risk of Alcohol Consumption in Bladder Cancer: Case-Control Study from a Nationwide Inpatient Database in Japan.

    Science.gov (United States)

    Zaitsu, Masayoshi; Nakamura, Fumiaki; Toyokawa, Satoshi; Tonooka, Akiko; Takeuchi, Takumi; Homma, Yukio; Kobayashi, Yasuki

    2016-01-01

    Bladder cancer is common in Western countries, but not in Japan. Established risk factors are smoking and high-risk jobs such as printing and manufacturing. The risk of alcohol consumption in bladder cancer has been the recent focus; however, available literature on alcohol consumption and bladder cancer has been limited from Japanese population, thought to have a weak genetic tolerance to acetaldehyde. We aimed to determine whether alcohol consumption is an independent risk factor for bladder cancer among Japanese. The study was a matched case-control study from the nationwide Japanese clinical database administered by the Rosai Hospital group. We identified 739 cases of bladder cancer diagnosed between 2005 (when the database was established) and 2014 and 7,196 controls matched by sex, age, hospital, and admission period. We estimated the odds ratio of alcohol consumption for bladder cancer adjusted for the amount of smoking, high-risk occupations, and comorbidities (hypertension, hyperlipidemia, diabetes, hyperuricemia, and obesity) with conditional logistic regression. The risk of bladder cancer was significantly higher in ever drinkers than in never drinkers (odds ratio, 1.33; 95% confidence interval, 1.06 to 1.66). Furthermore, the risk threshold for alcohol consumption was more than 15 g of alcohol intake per day (one, 180-mL cup equivalent to 6 ounces of Japanese sake containing 23 grams of alcohol). Among Japanese, alcohol consumption may be an independent risk factor for bladder cancer, with a lower risk threshold. PMID:27098227

  15. Adenomyomatosis of the gall bladder: the NUH experience.

    Science.gov (United States)

    Chan-Wilde, C; Chew, R; Foong, W C; Wee, A

    1990-05-01

    Adenomyomatosis (AD) is a degenerative disorder of the gall bladder wall which can be complicated by chronic inflammation and calculi. The true incidence of this disorder in South East Asians is not known. Nine Chinese patients with AD were discovered amongst 200 consecutive right upper quadrant ultrasound examinations. Four of them had cholecystectomy and were diagnosed as cholecystitis by the pathologist. Adenomyomatosis can be suspected on ultrasonography, but should be confirmed by oral cholecystography (OCG). There is great disparity in the ultrasound, OCG, surgical and histopathological diagnosis of this condition. This may be due to the fact that only complicated cases of AD come to surgery, where the presence of chronic cholecystitis or calculi detracts from recognising or overshadows the presence of AD. It is not known whether uncomplicated AD has any clinical significance and whether it, if given sufficient time, will lead to inflammation of the gall bladder. PMID:2203297

  16. Hypertension following primary bladder closure for vesical exstrophy.

    Science.gov (United States)

    Husmann, D A; McLorie, G A; Churchill, B M

    1993-02-01

    Since the initiation of staged reconstruction for bladder exstrophy, hypertension has been a known complication of the procedure. The etiology of the elevation in blood pressure was presumably secondary to ureteral dysfunction caused by edema at the ureterovesical junction and secondary renal obstruction. This report details the clinical course of three patients who developed significant hypertension following primary bladder closure with posterior iliac osteotomies and bony immobilization by skin traction. None of the patients had urinary obstruction and all had their hypertension alleviated by removal of the traction. The presumed etiology of the elevated blood pressure within these patients is similar to that experimentally produce by inappropriately applied traction resulting in tension on the sciatic nerve and reflex induced vasoconstriction. The need to maintain appropriately applied traction and the necessity of monitoring the postoperative blood pressure is stressed. PMID:8155094

  17. Effects of fractionated colostrum replacer and vitamins A, D, and E on haptoglobin and clinical health in neonatal Holstein calves challenged with Mycobacterium avium ssp. paratuberculosis.

    Science.gov (United States)

    Krueger, L A; Reinhardt, T A; Beitz, D C; Stuart, R L; Stabel, J R

    2016-04-01

    Thirty Holstein calves were obtained from 2 dairy farms in central Iowa at birth and randomly assigned to 1 of 6 treatment groups: (1) colostrum deprived (CD), no vitamins; (2) colostrum replacer (CR), no vitamins; (3) CR, vitamin A; (4) CR, vitamin D3; (5) CR, vitamin E; and (6) CR, vitamins A, D3, E, with 5 calves per treatment in a 14-d study. Calves were fed pasteurized whole milk (CD) or fractionated colostrum replacer (CR) at birth (d 0) and injected with vitamins according to treatment group. From d 1 through d 14 of the study, all calves were fed pasteurized whole milk (PWM) supplemented with vitamins as assigned. All calves were inoculated with Mycobacterium avium ssp. paratuberculosis on d 1 and 3 of age. Calves fed CR acquired IgG1 and haptoglobin in serum within 24 h of birth, whereas CD calves did not. The CR-fed calves were 2.5 times less likely to develop scours, and CR calves supplemented with vitamins D3 and E also demonstrated a decreased incidence of scours. Serum vitamin levels of A, D, and E increased within treatment group by d 7 and 14 of the study. Interestingly, synergistic effects of supplemental vitamins A, D3, and E on serum 25-(OH)-vitamin D were observed at d 7, resulting in higher levels than in calves administered vitamin D only. Further, vitamin D3 deficiency was observed in CD and CR calves fed a basal diet of pasteurized whole milk and no supplemental vitamins. Colonization of tissues with Mycobacterium avium ssp. paratuberculosis was negligible and was not affected by colostrum feeding or vitamin supplementation. Results demonstrated passive transfer of haptoglobin to neonatal calves, and potential health benefits of supplemental vitamins D3 and E to calves fed pasteurized whole milk. PMID:26805975

  18. Space occupying lesion (paraganglioma of the urinary bladder in a young male: A case report and brief review of the literature

    Directory of Open Access Journals (Sweden)

    Rashmi Patnayak

    2015-01-01

    Full Text Available Urinary bladder paragangliomas are rare with a reported incidence of <1% of bladder tumors. In the absence of typical clinical features, histopathology helps in rendering definitive diagnosis. We describe a case of nonfunctional urinary bladder paraganglioma in a 28-year-old male who presented with the chief complaint of abdominal pain. The final diagnosis was made by histopathological and immunohistochemical analysis. It is important to distinguish paraganglioma from urothelial carcinoma as the treatment differs. This is an additional case of nonfunctional urinary bladder paraganglioma in a male patient with a brief review of the literature.

  19. The Replace Operator

    CERN Document Server

    Karttunen, L

    1995-01-01

    This paper introduces to the calculus of regular expressions a replace operator, ->, and defines a set of replacement expressions that concisely encode several alternate variations of the operation. The basic case is unconditional obligatory replacement: UPPER -> LOWER Conditional versions of replacement, such as, UPPER -> LOWER || LEFT _ RIGHT constrain the operation by left and right contexts. UPPER, LOWER, LEFT, and RIGHT may be regular expressions of any complexity. Replace expressions denote regular relations. The replace operator is defined in terms of other regular expression operators using techniques introduced by Ronald M. Kaplan and Martin Kay in "Regular Models of Phonological Rule Systems" (Computational Linguistics 20:3 331-378. 1994).

  20. Abdome agudo: ruptura espontânea de bexiga como um importante diagnóstico diferencial Acute abdomen: spontaneous bladder rupture as an important differential diagnosis

    OpenAIRE

    Carlos Augusto Gomes; André Avarese de Figueiredo; Cleber Soares Júnior; José Murillo Bastos Netto; Fabrício Rodrigues Tassi

    2009-01-01

    A case of spontaneous perforation of the bladder in a diabetic female patient is reported. It is a rare clinical condition, that should be suspected in patients with a past history of radiotherapy to the pelvis, enterocystoplasty and those suspected of having a tumor in the bladder. A general surgeon should be aware of this possibility in the differential diagnosis of an acute abdomen.

  1. Influence of implant position on clinical crown length and peri-implant soft tissue dimensions at implant-supported single crowns replacing maxillary central incisors

    DEFF Research Database (Denmark)

    Peng, Min; Fei, Wei; Hosseini, Mandana;

    2013-01-01

    The aims of the present study were to evaluate the influence of implant position on clinical crown length and marginal soft tissue dimensions at implant-supported single crowns of maxillary central incisors, and to validate the papilla index score (PIS). Twenty-five patients, who had lost one of ...

  2. A critical role for Choline Kinase alpha in the aggressiveness of bladder carcinomas

    Science.gov (United States)

    Hernando, Eva; Sarmentero-Estrada, Jacinto; Koppie, Theresa; Belda-Iniesta, Cristóbal; de Molina, Victor Ramírez; Cejas, Paloma; Ozu, Choichiro; Le, Carl; Sánchez, Jose Javier; González-Barón, Manuel; Koutcher, Jason; Cordón-Cardó, Carlos; Bochner, Bernard H.; Lacal, Juan Carlos; Ramírez de Molina, Ana

    2010-01-01

    Bladder cancer is one of the most common causes of death in industrialized countries. New tumor markers and therapeutic approaches are still needed to improve management of bladder cancer patients. Choline Kinase alpha (ChoKα) is a metabolic enzyme that has a role in cell proliferation and transformation. Inhibitors of ChoKα display antitumoral activity and are expected to be soon in clinical trials. This study is aimed to asses whether ChoKα plays a role in the aggressiveness of bladder tumors and constitute a new approach for bladder cancer treatment. We demonstrate here that ChoKα is constitutively altered in human bladder tumor cells. Furthermore, in vivo murine models including an orthotopic model to mimic as much as possible the physiological conditions, revealed that increased levels of ChoKα potentiates both tumor formation (p≤0.0001) and aggressiveness of the disease over different endpoints (p=0.011). Accordingly, increased levels of ChoKα significantly reduces survival of mice with bladder cancer (p=0.05). Finally, treatment with ChoKα specific inhibitor resulted in a significant inhibition of tumor growth (p=0.02) and in a relevant increase in survival (p=0.03). PMID:19448670

  3. Patient-recognition data-mining model for BCG-plus interferon immunotherapy bladder cancer treatment.

    Science.gov (United States)

    Shah, Shital C; Kusiak, Andrew; O'Donnell, Michael A

    2006-06-01

    Bladder cancer is the fifth most common malignant disease in the United States with an annual incidence of around 63,210 new cases and 13,180 deaths. The cost for providing care for patients with bladder cancer disease is high. Bladder cancer treatment options such as immunotherapy, chemotherapy, radiation therapy, transurethral resection, and cystectomy, are used with varying success rates. In this research, data from a nationwide bacillus Calmette-Gue rin (BCG) plus interferon-alpha (IFN-alpha) immunotherapy clinical trial was considered. Data mining algorithms were used to analyze the effectiveness of immunotherapy treatment and to understand the prominent parameters and their interactions. The extracted knowledge was used to build a patient recognition model for prediction of treatment outcomes. The data was analyzed to understand the impact of various parameters on the treatment outcome. A list of significant parameters such as cumulative tumor size, presence of residual disease, stages of prior bladder cancer, current state of bladder cancer, and the presence of current bladder cancer (T1) is provided. The decision-making approach outlined in the paper supplemented with additional knowledge bases will lead to a comprehensive analytical road map of the BCG/IFN-alpha immunotherapy treatment. It will provide individualized guidelines for each stage of the treatment as well as measure the success of the treatment. PMID:15978568

  4. Urinary Bladder Cancer in Yemen

    Directory of Open Access Journals (Sweden)

    Abdullah Saleh Al-Samawi

    2013-09-01

    Full Text Available Objectives: The aims of this study are to highlight the clinicopathological features of urinary bladder cancer in Yemen, and to describe the histological grading of urothelial neoplasms according to the World Health Organization and International Society of Urologic pathology (WHO/ISUP 1998 classification.Methods: This is a descriptive record-based study of 316 cases of bladder cancer diagnosed by two pathologists at the Department of pathology, Sana'a University from 1st January 2005 to 30th April 2009. The diagnoses were made on hematoxylin and eosin stained sections and categorized according to WHO/ISUP 1998 classification.Results: Out of 316 urinary bladder cancers, 248 (78% were urothelial neoplasms, 53 (17% were squamous cell carcinoma, 7 (2% were adenocarcinoma, and 3 (1% were rhabdomyosarcoma. The remaining cases were metastatic carcinomas (n=3, small cell carcinoma (n=1, and non-Hodgkin's lymphoma (n=1. The urothelial neoplasms observed were carcinoma in situ 4 (2%, papilloma 7 (3%, papillary urothelial neoplasm of low malignant potential 26 (11%, papillary urothelial carcinoma of low grade 107 (43%, papillary urothelial carcinoma of high grade 18 (7%, and non-papillary urothelial carcinoma of high grade 85 (34%, with 60 years mean age for males and 58 years for females; along with a male to female ratio of 4:1. The peak incidence was observed in the 61-70 years age group.Conclusion: This study documents a high frequency of urothelial neoplasms, mostly papillary urothelial carcinoma of low grade and non-papillary urothelial carcinoma of high grade with male preponderance and peak incidence in 6th decade of age.

  5. Reversible bladder denervation in acute polyradiculitis

    DEFF Research Database (Denmark)

    Kamper, A L; Andersen, J T

    1982-01-01

    A case of reversible bladder denervation in acute polyradiculitis is presented, in which both motor and sensory bladder involvement could be demonstrated using cystometry and denervation-hypersensitivity testing. Attention is drawn to the differential diagnosis to cauda equina syndromes of other...

  6. The Molecular Pathogenesis of Bladder Cancer

    NARCIS (Netherlands)

    A.G. van Tilborg (Angela)

    2001-01-01

    textabstractThe bladder is a hollow organ in the small pelvis. It stores urine that is produced when the kidneys filter the blood. Four different layers, the epithelium, lamina propria, muscularis, and connective tissue, define the bladder wall. The epithelium consists of 7 to 10 cell layers and res

  7. Inflammatory myofibroblastic tumor of the urinary bladder

    OpenAIRE

    Yagnik Vipul; Chadha Amit; Chaudhari Sanjay; Patel Keyuri

    2010-01-01

    Inflammatory myofibroblastic tumor (IMT) of bladder is an uncommon benign tumor of bladder, which is of unknown neoplastic potential, characterized by spindle cell proliferation with characteristic fibroinflammatory and pseudosarcomatous appearance. Essential criteria for the diagnosis of IMT are: spindle myoepithelial cell proliferation and lymphocytic infiltrate. Complete surgical resection is the treatment of choice.

  8. Isolated Primary Schwannoma of Urinary Bladder

    Science.gov (United States)

    Bhat, Suresh; Paul, Fredrick

    2016-01-01

    Primary schwannoma of urinary bladder is a very rare tumour. It usually occurs in association with Von Recklinghausen’s disease. It arises from Schwann’s cells in the nerve sheath. We report here a very rare case of primary schwannoma of urinary bladder managed by complete transurethral resection. PMID:27437301

  9. Overall survival and local control following combined modality therapy and selective bladder preservation for invasive bladder cancer

    International Nuclear Information System (INIS)

    Purpose/Objective: Bladder preservation, in the interest of quality of life, is secondary to the primary treatment goal of curing the patient. To evaluate the long term efficacy of a selective bladder preserving approach we updated our prospective series which now includes 40 patients surviving and under surveillance for 5 or more years. Materials and Methods: From 1986 through 1993, 106 patients (median age 68 years) with muscle-invading tumor (stages T2-T4a, Nx, M0) initiated a protocol of maximal transurethral resection followed by 2 cycles of methotrexate, cisplatin and vinblastine plus cisplatin x2 with 40Gy pelvic irradiation. Complete responders and all non-cystectomy candidates received consolidation by cisplatin and 24.8Gy. Incomplete responders underwent immediate radical cystectomy as did those who developed recurrent invasive tumor. Median follow-up is 53 months. Results: Of all 106 patients who initiated induction Combined Modality Treatment (CMT): 1) 83 patients or 78% completed CMT; 33% developed moderate or severe leukopenia, 2) 74 patients (70%) had a Complete Response (CR), 3) the 5 year actuarial overall survival is 52%; for clinical stage T2 and T3-T4a this is 63% and 45%, respectively, 4) 36 patients (34%) have had cystectomy, all for tumor (6 because CMT wasn't tolerated, 13 for < CR, 17 for recurrence); no patient required cystectomy for complications; the 5 year survival with an intact functioning bladder is 43%, 5) 31 patients (20%) have had relapse of a superficial TCC with 4 requiring cystectomy after failing conservative management with a subsequent median follow-up of 58 months. Conclusion: These data demonstrate 1) that induction CMT with transurethral surgery and chemo-radiotherapy and selection for organ-conservation by response have a 52% overall survival which is comparable to immediate cystectomy-based prospective studies of patients with similar age and clinical stages and 2) that the majority of long term survivors retain fully

  10. Conservative treatment planning in veneer replacement.

    Science.gov (United States)

    Guzmán-Armstrong, Sandra; Maia, Rodrigo Rocha

    2016-04-01

    This clinical report describes a conservative treatment in veneer replacement where diastemas, malalignment, and midline shift were the main modifying factors. When replacement veneers are indicated, the definitive results can only be accurately predicted after an esthetic reanalysis of the existing restorations. PMID:26602148

  11. Neurotransmitter replacement therapy in Alzheimer's disease.

    OpenAIRE

    Mohr, E; Mendis, T; Rusk, I N; Grimes, J. D.

    1994-01-01

    The relative success of symptomatic attenuation of motor dysfunction in Parkinson's disease with dopaminomimetics has spurred interest in neurotransmitter replacement therapy for treating Alzheimer's disease. While cholinergic dysfunction has been linked to various clinical parameters in Alzheimer's disease, cholinergic replacement, including precursor therapy, administration of direct-acting agonists and inhibition of enzymatic degradation has had only very modest success. The inhibition of ...

  12. Apoptosis, p53, bcl-2, and Ki-67 in invasive bladder carcinoma: possible predictors for response to radiochemotherapy and successful bladder preservation

    International Nuclear Information System (INIS)

    Purpose: Several groups have reported the value of bladder preservation by a combined treatment protocol, including transurethral resection (TUR-B) and radiochemotherapy (RCT). As more experience is acquired with organ-sparing treatment, patient selection should be optimized. The purpose of this study was to investigate the role of several biologic markers that may predict response to RCT in muscle-invasive bladder carcinoma. Methods and Materials: The apoptotic index (AI), Ki-67, p53, and bcl-2 were evaluated by immunohistochemistry on pretreatment biopsies from 70 patients treated for invasive bladder cancer by TUR-B and RCT. Expression of each marker was correlated with initial response, local control, and cancer-specific survival with preserved bladder. An exploratory multivariate analysis was also performed that included clinical and immunohistochemical variables. Results: A high AI (> median = 1.6%) and a high Ki-67 index (> median = 8.8%), but not the p53- and bcl-2 expression, were significantly related to initial complete response (CR) and local control with preserved bladder after 5 years. When the AI and Ki-67 expression were considered simultaneously, the association with initial CR (p < 0.001), local control (p = 0.0002), and cancer-specific survival with preserved bladder (p = 0.008) was highly significant. In an exploratory multivariate analysis (final model), only AI, Ki-67, and the combined AI/Ki-67 variable retained significance for local control with preserved bladder at 5 years. Conclusion: Patients with a high spontaneous AI and a high pretreatment Ki-67 index should be considered preferentially for treatment with RCT, whereas tumors with low proliferation and low levels of apoptosis are less likely to respond to RCT

  13. Spectroscopic Imaging of Bladder Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Demos, S G; Gandour-Edwards, R; Ramsamooj, R; deVere White, R

    2003-01-01

    The feasibility of developing bladder cancer detection methods using intrinsic tissue optical properties is the focus of this investigation. In vitro experiments have been performed using polarized elastic light scattering in combination with tissue autofluorescence in the NIR spectral region under laser excitation in the green and red spectral regions. The experimental results obtained from a set of tissue specimens from 25 patients reveal the presence of optical fingerprint characteristics suitable for cancer detection with high contrast and accuracy. These photonic methods are compatible with existing endoscopic imaging modalities which make them suitable for in-vivo application.

  14. Automatic bladder segmentation on CBCT for multiple plan ART of bladder cancer using a patient-specific bladder model

    International Nuclear Information System (INIS)

    In multiple plan adaptive radiotherapy (ART) strategies of bladder cancer, a library of plans corresponding to different bladder volumes is created based on images acquired in early treatment sessions. Subsequently, the plan for the smallest PTV safely covering the bladder on cone-beam CT (CBCT) is selected as the plan of the day. The aim of this study is to develop an automatic bladder segmentation approach suitable for CBCT scans and test its ability to select the appropriate plan from the library of plans for such an ART procedure. Twenty-three bladder cancer patients with a planning CT and on average 11.6 CBCT scans were included in our study. For each patient, all CBCT scans were matched to the planning CT on bony anatomy. Bladder contours were manually delineated for each planning CT (for model building) and CBCT (for model building and validation). The automatic segmentation method consisted of two steps. A patient-specific bladder deformation model was built from the training data set of each patient (the planning CT and the first five CBCT scans). Then, the model was applied to automatically segment bladders in the validation data of the same patient (the remaining CBCT scans). Principal component analysis (PCA) was applied to the training data to model patient-specific bladder deformation patterns. The number of PCA modes for each patient was chosen such that the bladder shapes in the training set could be represented by such number of PCA modes with less than 0.1 cm mean residual error. The automatic segmentation started from the bladder shape of a reference CBCT, which was adjusted by changing the weight of each PCA mode. As a result, the segmentation contour was deformed consistently with the training set to fit the bladder in the validation image. A cost function was defined by the absolute difference between the directional gradient field of reference CBCT sampled on the corresponding bladder contour and the directional gradient field of validation

  15. Partial knee replacement - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100225.htm Partial knee replacement - series To use the sharing features on ... A.M. Editorial team. Related MedlinePlus Health Topics Knee Replacement A.D.A.M., Inc. is accredited ...

  16. Shoulder Joint Replacement

    Science.gov (United States)

    ... en because of implant loosening, wear, infection, and dislocation. When this occurs, a second joint replacement surgery — called a revision surgery — may be necessary. Is Shoulder Joint Replacement for You? The decision to have ...

  17. Elbow replacement - discharge

    Science.gov (United States)

    Total elbow arthroplasty - discharge; Endoprosthetic elbow replacement - discharge ... You had surgery to replace your elbow joint with artificial joint parts (prosthetics). The surgeon made a cut (incision) in the back of your upper or lower arm and ...

  18. Breast metastasis from carcinoma of gall bladder

    Directory of Open Access Journals (Sweden)

    Ajaz Ahmad Malik

    2013-01-01

    Full Text Available Carcinoma of gall bladder has early lymphatic and haematogenous spread. Most common extra abdominal site of metastasis is the lung. Metastasis to breast from carcinoma of breast is very rare. Our case describes an interesting case of carcinoma of gall bladder metastising to breast. A 50-year-old female presented to our outpatient department with a small nodule on upper outer quadrant of left breast. Patient had a history of cholecystectomy done for symptomatic gall stones 2 years back. Histopathological examination of the gall bladder specimen showed adenocarcinoma of the gall bladder with invasion to lamina propria. No additional treatment was offered to the patient. The breast nodule was excised and sent for histopathological examination. Histopathological examination revealed metastising adenocarcinoma. Patient was subjected to palliative chemotherapy (Gamcitabine and carboplatin. However, patient died of hepatic encephalopathy after 5 months. Our case reports an unusual site of metastasis from carcinoma of gall bladder which is very rare.

  19. Full-thickness endometriosis of the bladder

    DEFF Research Database (Denmark)

    Kjer, Jens Jørgen; Kristensen, Jens; Hartwell, Dorthe; Jensen, Marianne Aamann

    2014-01-01

    OBJECTIVE: To draw attention to the rare condition of endometriosis in the bladder. This is correlated with symptoms not normally connected to endometriosis and therefore often remains underdiagnosed for years. DESIGN AND SETTING: Retrospective study in a university teaching hospital, one of two...... referral centres in Denmark for surgical treatment of stage III and IV endometriosis. POPULATION: Thirty-one women with deep infiltrating bladder endometriosis. METHODS: All women presenting in the Department of Obstetrics and Gynaecology with deep infiltrating bladder endometriosis between March 2002 and...... March 2011. We included only patients with symptomatic full-thickness bladder detrusor endometriosis and mucosal involvement. All patients had had bladder symptoms for two to seven years. MAIN OUTCOME MEASURES: Symptoms after surgery and recurrence rate. RESULTS: The main preoperative symptom was...

  20. An In Vivo Study of Low-Dose Intra-Articular Tranexamic Acid Application with Prolonged Clamping Drain Method in Total Knee Replacement: Clinical Efficacy and Safety

    Science.gov (United States)

    Sa-ngasoongsong, Paphon; Chanplakorn, Pongsthorn; Wongsak, Siwadol; Uthadorn, Krisorn; Panpikoon, Tanapong; Jittorntam, Paisan; Aryurachai, Katcharin; Angchaisukisiri, Pantap; Kawinwonggowit, Viroj

    2015-01-01

    Background. Recently, combined intra-articular tranexamic acid (IA-TXA) injection with clamping drain method showed efficacy for blood loss and transfusion reduction in total knee replacement (TKR). However, until now, none of previous studies revealed the effect of this technique on pharmacokinetics, coagulation, and fibrinolysis. Materials and Methods. An experimental study was conducted, during 2011-2012, in 30 patients undergoing unilateral TKR. Patients received IA-TXA application and then were allocated into six groups regarding clamping drain duration (2-, 4-, 6-, 8-, 10-, and 12-hours). Blood and drainage fluid were collected to measure tranexamic acid (TXA) level and related coagulation and fibrinolytic markers. Postoperative complication was followed for one year. Results. There was no significant difference of serum TXA level at 2 hour and 24 hour among groups (p < 0.05). Serum TXA level at time of clamp release was significantly different among groups with the highest level at 2 hour (p < 0.0001). There was no significant difference of TXA level in drainage fluid, postoperative blood loss, blood transfusion, and postoperative complications (p < 0.05).  Conclusions. Low-dose IA-TXA application in TKR with prolonged clamping drain method is a safe and effective blood conservative technique with only minimal systemic absorption and without significant increase in systemic absorption over time. PMID:26583092

  1. 探讨接受外科手术治疗的膀胱癌患者实施系统化综合护理干预的临床效果%Clinical Efficacy of Comprehensive Nursing Intervention for Bladder Cancer Patients With Surgical Operation Treatment

    Institute of Scientific and Technical Information of China (English)

    董翠萍

    2015-01-01

    目的:探讨系统化综合护理干预的护理方法在对外科手术治疗的膀胱癌患者进行护理的临床疗效。方法收集62例外科手术治疗的膀胱癌患者,随机分为观察组和对照组,每组31例。结果两组患者在经过护理完成后均有一定的效果,但观察组患者的护理效果优于对照组患者,差异均有统计学意义(P<0.05)。结论在对外科手术进行治疗的膀胱癌患者进行护理的过程中,使用系统化综合护理干预的方法能够提升患者的实际护理效果。%ObjectiveTo explore the clinical curative efficacy of the systematic comprehensive nursing intervention in the nursing methods in the surgical treatment of patients with bladder cancer care.Methods The data of 100 patients with surgical operation in the treatment of bladder cancer patients,randomly divided into observation group and control group,50 cases in each group.Results The two groups of patients after nursing after the completion of al have certain effect,but the effect observation of nursing care group were significantly better than the control group,the differences were significant difference(P< 0.05),with statistical significance.ConclusionIn the process of nursing on the use of surgical operation for treatment of patients with bladder cancer,using the method of systematic comprehensive nursing intervention can significantly improve the nursing effect of patients.

  2. Lymphoma of the Urinary Bladder

    Directory of Open Access Journals (Sweden)

    Anthony Kodzo-Grey Venyo

    2014-01-01

    Full Text Available Background. Lymphoma of the urinary bladder (LUB is rare. Aims. To review the literature on LUB. Methods. Various internet databases were used. Results. LUB can be either primary or secondary. The tumour has female predominance; most cases occur in middle-age women. Secondary LUB occurs in 10% to 25% of leukemias/lymphomas and in advanced-stage systemic lymphoma. Less than 100 cases have been reported. MALT typically affects adults older than 60 years; 75% are female. Diffuse large B-cell lymphoma is also common and may arise from transformation of MALT. LUB presents with haematuria, dysuria, urinary frequency, nocturia, and abdominal or back pain. Macroscopic examination of LUBs show large discrete tumours centred in the dome or lateral walls of the bladder. Positive staining of LUB varies by the subtype of lymphoma; B-cell lymphomas are CD20 positive. MALT lymphoma is positively stained for CD20, CD19, and FMC7 and negatively stained for CD5, CD10, and CD11c. LUB stains negatively with Pan-keratin, vimentin, CK20, and CK7. MALT lymphoma exhibits t(11; 18(q21: 21. Radiotherapy is an effective treatment for the MALT type of LUB with no recurrence. Conclusions. LUB is diagnosed by its characteristic morphology and immunohistochemical characteristics. Radiotherapy is a useful treatment.

  3. DNA methylation patterns in bladder cancer and washing cell sediments: a perspective for tumor recurrence detection

    International Nuclear Information System (INIS)

    Epigenetic alterations are a hallmark of human cancer. In this study, we aimed to investigate whether aberrant DNA methylation of cancer-associated genes is related to urinary bladder cancer recurrence. A set of 4 genes, including CDH1 (E-cadherin), SFN (stratifin), RARB (retinoic acid receptor, beta) and RASSF1A (Ras association (RalGDS/AF-6) domain family 1), had their methylation patterns evaluated by MSP (Methylation-Specific Polymerase Chain Reaction) analysis in 49 fresh urinary bladder carcinoma tissues (including 14 cases paired with adjacent normal bladder epithelium, 3 squamous cell carcinomas and 2 adenocarcinomas) and 24 cell sediment samples from bladder washings of patients classified as cancer-free by cytological analysis (control group). A third set of samples included 39 archived tumor fragments and 23 matched washouts from 20 urinary bladder cancer patients in post-surgical monitoring. After genomic DNA isolation and sodium bisulfite modification, methylation patterns were determined and correlated with standard clinic-histopathological parameters. CDH1 and SFN genes were methylated at high frequencies in bladder cancer as well as in paired normal adjacent tissue and exfoliated cells from cancer-free patients. Although no statistically significant differences were found between RARB and RASSF1A methylation and the clinical and histopathological parameters in bladder cancer, a sensitivity of 95% and a specificity of 71% were observed for RARB methylation (Fisher's Exact test (p < 0.0001; OR = 48.89) and, 58% and 17% (p < 0.05; OR = 0.29) for RASSF1A gene, respectively, in relation to the control group. Indistinct DNA hypermethylation of CDH1 and SFN genes between tumoral and normal urinary bladder samples suggests that these epigenetic features are not suitable biomarkers for urinary bladder cancer. However, RARB and RASSF1A gene methylation appears to be an initial event in urinary bladder carcinogenesis and should be considered as defining a

  4. The Potential Value of EGFR and P53 Immunostaining in Tumors of the Urinary Bladder

    Directory of Open Access Journals (Sweden)

    Ibrahim N

    2009-01-01

    Full Text Available The expression of EGFR and p53 has not been adequately studied as a prognostic tool in urinary bladder tumors. We analyzed 74 bladder cancer samples from Egypt for EGFR and p53 expression using immunohistochemistry. The tumors were of different histological types, grades and clinical stages, and with established lymph node status. Almost 61% of the tumors showed positive membranous EGFR expression and 74.3% had positive nuclear staining of p53. Analysis of correlation of the IHC staining with clinical variables showed a significant correlation only between EGFR expression and histological type (p=0.002, ANOVA, in that the expression was higher in squamous cell carcinomas than in other histological types. There were no significant correlations between p53 or EGFR with the other clinicopathological variables, including age, sex, staging, grading, and lymph node status. Further studies are needed to determine if EGFR and p53 might be used as prognostic tools in bladder cancer.

  5. Prognostic factors in invasive bladder carcinoma treated by combined modality protocol (organ-sparing approach)

    International Nuclear Information System (INIS)

    Purpose: The results of bladder sparing approach for the treatment of muscle-invasive bladder cancer, using a combination of transurethral resection (TUR), chemotherapy, and radiotherapy, are encouraging. The survival of patients treated by this method is similar to the survival of patients treated by radical cystectomy. The aim of our study was to find out which pretreatment characteristics influence the survival of patients treated by organ sparing approach that would enable us to identify the patients most suitable for this type of treatment. Methods and Materials: The prognostic value of different factors, such as age, gender, performance status, hemoglobin level, clinical stage, histologic grade, presence of obstructive uropathy, and completeness of TUR, has been studied in 105 patients with invasive bladder cancer, who received a bladder sparing treatment in the period from 1988 to 1995. They were treated with a combination of TUR, followed by 2-4 cycles of methotrexate, cisplatinum, and vinblastine polychemotherapy. In complete responders the treatment was completed by radiotherapy (50 Gy to the bladder and 40 Gy to the regional lymph nodes), whereas nonresponders underwent cystectomy whenever feasible. Results: Our study has confirmed an independent prognostic value of performance status, histologic grade, and obstructive uropathy, for the disease-specific survival (DSS) of bladder cancer patients treated by a conservative approach. We believe that performance status best reflects the extent of disease and exerts significant influence on the extent and course of treatment, while obstructive uropathy is a good indicator of local spread of the disease, better than clinical T-stage. Our finding that histologic grade is one of the strongest prognostic factors shows that tumor biology also is a very important prognostic factor in patients treated by conservative approach. Conclusion: Patients with muscle-invasive bladder cancer who are most likely to benefit

  6. Can Frequency of Nocturnal Enuresis in Bladder Diary Predict the Efficacy of Urotherapy?

    Directory of Open Access Journals (Sweden)

    Cenk Yazici

    2014-03-01

    Full Text Available Aim: Nocturnal enuresis is one of the most common urinary system disorders of childhood. Urotherapy(behavioral therapy is the primary method for treatment of nocturnal enuresis. In this study, we aimed to evaluate the efficacy of nocturnal enuresis frequency during 3 days bladder diary for estimating the success of urotherapy. Material and Method: Patients with monosymptomatic nocturnal enuresis in an age group of 5 to 18 years were prospectively included to study. They were given a 3 days bladder diary and re-evaluated 1 week later and urotherapy strategies were told to both patients and parents. They were evaluated after 3 months later and success rate of urotherapy was compared with the nocturnal enuresis frequency in 3 days bladder diary. Results: A total of 66 patients were evaluated. There were 26(39.4% patients with nocturnal enuresis in >3 nights/week and 40(60.6% patients with nocturnal enuresis in every night. At the end of the third month of urotherapy, 50(75.7% patients had >%50 decrease in clinical nocturnal enuresis frequency, whereas 16(24.3% had no clinical improvement. Among the patients who did not have enuresis during bladder diary, 21(91.3% had improvement with urotherapy. All of the patients with 1 day nocturnal enuresis in bladder diary had improved by conservative strategies, whereas 53.3% with 2 days enuresis and 22.2% with 3 days enuresis was able to improve by urotherapy. Discussions: We observed a direct relation between nocturnal enuresis frequency in bladder diary and urotherapy success. Clinician may predict urotherapy success by an attentive bladder diary evaluation.

  7. The effect of education and supervised exercise vs. education alone on the time to total hip replacement in patients with severe hip osteoarthritis. A randomized clinical trial protocol

    DEFF Research Database (Denmark)

    Jensen, Carsten; Roos, Ewa M.; Kjærsgaard-Andersen, Per;

    2013-01-01

    receive 3 months of supervised exercise consisting of 12 sessions of individualized, goal-based neuromuscular training, and 12 sessions of intensive resistance training plus patient education (3 sessions). The control group will receive only patient education (3 sessions). The primary end-point for...... muscle function and performance in physical tests. A cost-effectiveness analysis will also be performed. Discussion: To our knowledge, this is the first randomized clinical trial comparing a patient education plus supervised exercise program to patient education alone in hip osteoarthritis patients with...

  8. Evaluation of the response chemotherapy for penile metastasis of bladder cancer using 18F-fluorodeoxyglucose-PET/CT

    OpenAIRE

    Hakan Öztürk

    2015-01-01

    Background: Metachronous penile metastasis of bladder cancer occurs very rarely. The clinical management of the disease involves complex problems, and the disease is associated with a poor prognosis. The common mode of spread to the penis is by the retrograde venous route. Patients and methods: A 68-year-old patient who was diagnosed with invasive bladder cancer underwent 18F-fluorodeoxyglucose (FDG)-positron-emission tomography/computed tomography (PET/CT) for staging purposes. An 18 mm i...

  9. Genetic Variant as a Selection Marker for Anti–Prostate Stem Cell Antigen Immunotherapy of Bladder Cancer

    OpenAIRE

    Kohaar, Indu; Porter-Gill, Patricia; Lenz, Petra; Fu, Yi-Ping; Mumy, Adam; Tang, Wei; Apolo, Andrea B.; Rothman, Nathaniel; Baris, Dalsu; Schned, Alan R.; Ylaya, Kris; Schwenn, Molly; Johnson, Alison; Jones, Michael; Kida, Masatoshi

    2012-01-01

    A monoclonal antibody against prostate stem cell antigen (PSCA) has emerged as a novel cancer therapy currently being tested in clinical trials for prostate and pancreatic cancers, but this treatment is likely to be efficient only in patients with PSCA-expressing tumors. The present study demonstrates that a genetic variant (rs2294008) discovered by bladder cancer genome-wide association studies is a strong predictor of PSCA protein expression in bladder tumors, as measured by two-sided multi...

  10. Combined RASSF1A and RASSF2A Promoter Methylation Analysis as Diagnostic Biomarker for Bladder Cancer

    OpenAIRE

    Wei Meng; Alexander Huebner; Ahmad Shabsigh; Arnab Chakravarti; Tim Lautenschlaeger

    2012-01-01

    Promoter hypermethylation, a widely studied epigenetic event known to influence gene expression levels, has been proposed as a potential biomarker in multiple types of cancer. Clinical diagnostic biomarkers are needed for reliable prediction of bladder cancer recurrence. In this paper, DNA promoter methylation of five C-terminal Ras-association family members (RASSF1A, RASSF2A, RASSF4, RASSF5, and RASSF6) was studied in 64 formalin-fixed paraffin-embedded (FFPE) bladder cancer and normal adja...

  11. Synchronous papillary urothelial carcinoma of urinary bladder and adenocarcinoma of stomach in a middle-aged man: An extremely rare association with therapeutic dilemma

    Directory of Open Access Journals (Sweden)

    Dodul Mondal

    2013-01-01

    Full Text Available Synchronous occurrence of urinary bladder carcinoma and gastric carcinoma is very rare. A middle-aged Asian man presented with complaints of hematuria which was diagnosed due to muscle invasive papillary urothelial carcinoma of urinary bladder. Metastatic work-up revealed simultaneous presence of locally advanced gastric adenocarcinoma. He was treated with TURBT for the bladder cancer and was planned for radical gastric resection followed by radiation to urinary bladder and stomach with concurrent chemotherapy. However, due to very advanced nature of the gastric tumor patient was treated only with palliative gastric resection followed by palliative radiation to both urinary bladder and stomach due to his poor performance status. Lack of published English literature and evidence related to such clinical entity made this an extremely rare clinical entity and treatment decision difficult.

  12. An adaptive radiotherapy planning strategy for bladder cancer using deformation vector fields

    International Nuclear Information System (INIS)

    Purpose: Adaptive radiotherapy (ART) has considerable potential in treatment of bladder cancer due to large inter-fractional changes in shape and size of the target. The aim of this study was to compare our clinically applied method for plan library creation that involves manual bladder delineations (Clin-ART) with a method using the deformation vector fields (DVFs) resulting from intensity-based deformable image registrations (DVF-based ART). Materials and methods: The study included thirteen patients with urinary bladder cancer who had daily cone beam CTs (CBCTs) acquired for set-up. In both ART strategies investigated, three plan selection volumes were generated using the CBCTs from the first four fractions; in Clin-ART boolean combinations of delineated bladders were used, while the DVF-based strategy applied combinations of the mean and standard deviation of patient-specific DVFs. The volume ratios (VRs) of the course-averaged PTV for the two ART strategies relative the non-adaptive PTV were calculated. Results: Both Clin-ART and DVF-based ART considerably reduced the course-averaged PTV, compared to non-adaptive RT. The VR for DVF-based ART was lower than for Clin-ART (0.65 vs. 0.73; p < 0.01). Conclusions: DVF-based ART for bladder irradiation has a considerable normal tissue sparing potential surpassing our already highly conformal clinically applied ART strategy

  13. Gall bladder function test with Ceruletid

    Energy Technology Data Exchange (ETDEWEB)

    Schindler, G.

    1981-04-15

    Compared with the stimulating food given orally in the gall bladder function test the administration of the decapeptide Ceruletid which is related with Cholecystokinin has the advantage of avoiding resorption disturbances in the upper gastrointestinal tract. To 100 patients with positive peroral cholecystography, Ceruletid was injected i.m. in a dose of 0.4 ..mu..g/kg body weight. The contrasting of the main bile duct was thus increased from 10% to 86%. The oral stimulating food brings an increase to appr. 20%. A special importance is assigned to the frequent diagnosis of adenomyomatoses which, with 6%, lies significantly above the 0.8% achieved by means of the oral stimulating food. More contractile segments of the gall bladder wall can cause pain symptoms which are typical for the biliary tract. Adenomyomatoses in the region of the infundibulum of the gall bladder cause colicky pains and are, as generally accepted, an absolute indication for a surgical intervention. The finding of small gall bladder concrements is often connected with a strong diminution of the gall bladder in order to prevent the small concrements from being overlapped by the non-contrasting bladder bile. Therefore, the application of Ceruletid should be considered also within the frame of the intravenous cholegraphy, thinking of the large number of normal gall bladder findings which were obtained with the oral stimulating food as the only diagnostical help.

  14. Urinary bladder cancer: role of MR imaging.

    Science.gov (United States)

    Verma, Sadhna; Rajesh, Arumugam; Prasad, Srinivasa R; Gaitonde, Krishnanath; Lall, Chandana G; Mouraviev, Vladimir; Aeron, Gunjan; Bracken, Robert B; Sandrasegaran, Kumaresan

    2012-01-01

    Urinary bladder cancer is a heterogeneous disease with a variety of pathologic features, cytogenetic characteristics, and natural histories. It is the fourth most common cancer in males and the tenth most common cancer in females. Urinary bladder cancer has a high recurrence rate, necessitating long-term surveillance after initial therapy. Early detection is important, since up to 47% of bladder cancer-related deaths may have been avoided. Conventional computed tomography (CT) and magnetic resonance (MR) imaging are only moderately accurate in the diagnosis and local staging of bladder cancer, with cystoscopy and pathologic staging remaining the standards of reference. However, the role of newer MR imaging sequences (eg, diffusion-weighted imaging) in the diagnosis and local staging of bladder cancer is still evolving. Substantial advances in MR imaging technology have made multiparametric MR imaging a feasible and reasonably accurate technique for the local staging of bladder cancer to optimize treatment. In addition, whole-body CT is the primary imaging technique for the detection of metastases in bladder cancer patients, especially those with disease that invades muscle. PMID:22411938

  15. Analysis of the Clinical Value of Different MRI Sequences in the Diagnosis of Muscular Layer Invasion of Bladder Cancer%不同MRI序列检查在诊断膀胱癌肌层浸润的临床价值分析

    Institute of Scientific and Technical Information of China (English)

    许平; 王贵荣; 李华

    2015-01-01

    Objective To investigate the application value of different magnetic resonance imaging (MRI) sequence examinations in the evaluation and diagnosis of T staging of patients with bladder cancer.Methods 128 patients with bladder cancer confirmed by surgery and pathology who were treated in the hospital during May 2013 to October 2014 were selected as the research objects. The patients raceived different MRI sequence examinations. The surgical or pathological examination results were taken as the gold standard to evaluate the differences in specificity, sensitivity and accuracy of conventional MR scan, conventional MR scan with diffusion weighted imaging (DW-MRI) scan, conventional MR scan with DW-MRI scan and dynamic contrast enhanced (DCE-MRI) scan of three kinds of MRI sequence examinations in the diagnosis of T staging of patients with bladder cancer.Results Among the 128 cases of patients with bladder cancer who received surgical or pathological examination, there were 83 cases (64.8%) diagnosed as without bladder wall muscular layer invasion and 45 cases (35.2%) with bladder wall muscular layer invasion . 43 cases with muscular layer invasion were correctly diagnosed by routine MR with DWI and DCE-MRI. 75 cases without muscular layer invasion were diagnosed correctly, including 8 cases with false muscular layer invasion and 2 cases without. The diagnostic accuracy, specificity and sensitivity were 92.2%, 90.4% and 83.6%, respectively, which were significantly higher than 77.3%, 75.9%, 80.0% of conventional MR and 83.6%, 81.9%, 86.7% of conventional MR with DWI (81.9%/86.7%), and the differences were statistically significant (P<0.05).Conclusion To apply conventional MR scan with DW-MRI scan and DCE-MRI in the evaluation and diagnosis of T staging of patients with bladder cancer can effectively improve the diagnostic accuracy and effectiveness, which has positive effect on saving consultation hours, improving the efficiency of diagnosis and treatment and

  16. Radiology of total hip replacement

    Energy Technology Data Exchange (ETDEWEB)

    Griffiths, H.J.; Lovelock, J.E.; McCollister Evarts, C.; Geyer, D.

    1984-06-01

    The radiology of total hip replacement (THR) and its complications is reviewed in conjunction with a long-term follow-up study on 402 patients with 501 prostheses. The indications, contraindications, biomechanics, and operative management of these patients is discussed. Clinical complications such as deep vein thrombosis, pulmonary embolism, and hemorrhage are mentioned. Postoperative infections including granulomatous pseudotumors, dislocations and fractures, true loosening of the prosthesis, and heterotopic bone formation (HBF) are discussed and illustrated. The importance of differentiating the lucent line from true loosening is stressed. Mechanical and other clinical complications which are largely ignored by radiologists are also discussed. The uses of arthrography and bone scanning are included.

  17. Different effects of bladder distention on point A-based and 3D-conformal intracavitary brachytherapy planning for cervical cancer

    International Nuclear Information System (INIS)

    This study sought to evaluate the differential effects of bladder distention on point A-based (AICBT) and three-dimensional conformal intracavitary brachytherapy (3D-ICBT) planning for cervical cancer. Two sets of CT scans were obtained for ten patients to evaluate the effect of bladder distention. After the first CT scan, with an empty bladder, a second set of CT scans was obtained with the bladder filled. The clinical target volume (CTV), bladder, rectum, and small bowel were delineated on each image set. The AICBT and 3D-ICBT plans were generated, and we compared the different planning techniques with respect to the dose characteristics of CTV and organs at risk. As a result of bladder distention, the mean dose (D50) was decreased significantly and geometrical variations were observed in the bladder and small bowel, with acceptable minor changes in the CTV and rectum. The average D2cm3 and D1cm3 showed a significant change in the bladder and small bowel with AICBT; however, no change was detected with the 3D-ICBT planning. No significant dose change in the CTV or rectum was observed with either the AICBT or the 3D-ICBT plan. The effect of bladder distention on dosimetrical change in 3D-ICBT planning appears to be minimal, in comparison with AICBT planning. (author)

  18. Urinary Bladder Leiomyosarcoma: Primary Surgical Treatment.

    Science.gov (United States)

    Slaoui, Hakim; Sanchez-Salas, Rafael; Validire, Pierre; Barret, Eric; Rozet, François; Galiano, Marc; Cathelineau, Xavier

    2014-07-01

    Cases of bladder leiomyosarcoma represent 0.1% of all nonurothelial tumors. We present a case report of a 73-year-old man who underwent a radical cystoprostatectomy for a high-grade bladder leiomyosarcoma with an ileal diversion. The patient recovered uneventfully and no surgical margins were verified in final pathology. Early follow-up at 3 months shows no signs of computed tomography recurrence and adequate adaptation to ileal diversion. Although bladder sarcomas were once thought to have a grim prognosis, recent studies suggest that adequate surgical treatment is able to achieve optimal cancer control outcomes. PMID:26839792

  19. Urinary Bladder Leiomyosarcoma: Primary Surgical Treatment

    Directory of Open Access Journals (Sweden)

    Hakim Slaoui

    2014-07-01

    Full Text Available Cases of bladder leiomyosarcoma represent 0.1% of all nonurothelial tumors. We present a case report of a 73-year-old man who underwent a radical cystoprostatectomy for a high-grade bladder leiomyosarcoma with an ileal diversion. The patient recovered uneventfully and no surgical margins were verified in final pathology. Early follow-up at 3 months shows no signs of computed tomography recurrence and adequate adaptation to ileal diversion. Although bladder sarcomas were once thought to have a grim prognosis, recent studies suggest that adequate surgical treatment is able to achieve optimal cancer control outcomes.

  20. Bladder exstrophy: current management and postoperative imaging

    Energy Technology Data Exchange (ETDEWEB)

    Pierre, Ketsia [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); Borer, Joseph [Boston Children' s Hospital, Department of Urology, Boston, MA (United States); Phelps, Andrew [University of California, San Francisco, Department of Pediatric Radiology, San Francisco, CA (United States); Chow, Jeanne S. [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); Boston Children' s Hospital, Department of Urology, Boston, MA (United States)

    2014-07-15

    Bladder exstrophy is a rare malformation characterized by an infra-umbilical abdominal wall defect, incomplete closure of the bladder with mucosa continuous with the abdominal wall, epispadias, and alterations in the pelvic bones and muscles. It is part of the exstrophy-epispadias complex, with cloacal exstrophy on the severe and epispadias on the mild ends of the spectrum. Bladder exstrophy is the most common of these entities and is more common in boys. The goal of this paper is to describe common methods of repair and to provide an imaging review of the postoperative appearances. (orig.)

  1. Increased Bladder Wall Thickness in Diabetic and Nondiabetic Women With Overactive Bladder

    OpenAIRE

    UZUN, Hakkı; Ogullar, Sabri; Şahin, Serap Baydur; Zorba, Orhan Ünal; Akça, Görkem; Sümer, Fatih; Güney, Ülkü Mete; Balık, Gülşah

    2013-01-01

    Purpose Bladder wall thickness has been reported to be associated with overactive bladder (OAB) in women. Diabetic women have an increased risk for OAB syndrome and may have an increased risk for bladder wall thickness. Methods A total of 235 female patients aged 40 to 75 years were categorized into four groups. The first group consisted of women free of urgency or urge urinary incontinence. The second group included nondiabetic women with idiopathic OAB. The third group consisted of women wi...

  2. A case–control study on the association between bladder cancer and prior bladder calculus

    OpenAIRE

    Chung, Shiu-Dong; Tsai, Ming-Chieh; Lin, Ching-Chun; Lin, Herng-Ching

    2013-01-01

    Background Bladder calculus is associated with chronic irritation and inflammation. As there is substantial documentation that inflammation can play a direct role in carcinogenesis, to date the relationship between stone formation and bladder cancer (BC) remains unclear. This study aimed to examine the association between BC and prior bladder calculus using a population-based dataset. Methods This case–control study included 2,086 cases who had received their first-time diagnosis of BC betwee...

  3. 经尿道钬激光治疗非肌层浸润性膀胱肿瘤的临床疗效分析%A clinical analysis of transurethral holmium laser therapy for non-muscle invasive bladder cancer

    Institute of Scientific and Technical Information of China (English)

    白云金; 唐寅; 韩平; 员海超; 王晓明; 魏强; 李金洪; 蒲春晓

    2015-01-01

    目的 比较经尿道钬激光膀胱肿瘤切除术和经尿道膀胱肿瘤电切术治疗非肌层浸润性膀胱癌的疗效和安全性.方法 回顾性分析我院于2011年10月到2013年1月收治行手术治疗的71例非肌层浸润性膀胱癌患者的临床资料,钬激光组31例和电切组40例.比较两组患者手术时间、膀胱冲洗率、尿管留置时间、住院时间、手术并发症以及术后复发率等指标.结果 钬激光组手术时间、膀胱冲洗率、尿管留置时间、住院时间及膀胱穿孔率明显低于电切组,差异有统计学意义( P<0.05 ).随访24~37月,中位31月,两组患者2年累积复发率分别为19.35% 和27.50%,钬激光组复发率明显低于电切组,差异有统计学意义( P<0.05 ).结论 钬激光治疗非肌层浸润性膀胱癌疗效显著,安全可靠,并发症少,复发率低,值得临床推广使用.%Objective To compare the safety and efficacy of holmium laser and transurethral resection of bladder tumors (TURBT) for treating non-muscle invasive bladder cancer (NMIBC).Methods Clinical data of 71 patients with NMIBC treated during Nov.2011 and Jan.2013 were retrospectively analyzed.There were 31 cases which underwent transurethral hol-mium laser therapy and 40 which received TURBT.The operation time,bladder irrigation rate,catheterization time,hospital stay,complications,and the rate of tumor recurrence between the two groups were compared.Results The mean operation time,bladder irrigation rate,catheterization time,hospital stay of the holmium laser group were statistically shorter or lower compared with those of the TURBT group.During the follow-up of 24-37 months (median 31 months),the 2-year cumulative recurrence rate of the holmium laser and TURBT group was 19.35% and 27.50%,respectively.There was significant differ-ence between the two groups.Conclusions Compared with TURBT,transurethral holmium laser therapy is more safe and ef-fective with fewer complications for NMIBC.

  4. Pathologic bladder microenvironment attenuates smooth muscle differentiation of skin derived precursor cells: implications for tissue regeneration.

    Directory of Open Access Journals (Sweden)

    Cornelia Tolg

    Full Text Available Smooth muscle cell containing organs (bladder, heart, blood vessels are damaged by a variety of pathological conditions necessitating surgery or organ replacement. Currently, regeneration of contractile tissues is hampered by lack of functional smooth muscle cells. Multipotent skin derived progenitor cells (SKPs can easily be isolated from adult skin and can be differentiated in vitro into contractile smooth muscle cells by exposure to FBS. Here we demonstrate an inhibitory effect of a pathologic contractile organ microenvironment on smooth muscle cell differentiation of SKPs. In vivo, urinary bladder strain induces microenvironmental changes leading to de-differentiation of fully differentiated bladder smooth muscle cells. Co-culture of SKPs with organoids isolated from ex vivo stretched bladders or exposure of SKPs to diffusible factors released by stretched bladders (e.g. bFGF suppresses expression of smooth muscle markers (alpha SMactin, calponin, myocardin, myosin heavy chain as demonstrated by qPCR and immunofluorescent staining. Rapamycin, an inhibitor of mTOR signalling, previously observed to prevent bladder strain induced de-differentiation of fully differentiated smooth muscle cells in vitro, inhibits FBS-induced smooth muscle cell differentiation of undifferentiated SKPs. These results suggest that intended precursor cell differentiation may be paradoxically suppressed by the disease context for which regeneration may be required. Organ-specific microenvironment contexts, particularly prevailing disease, may play a significant role in modulating or attenuating an intended stem cell phenotypic fate, possibly explaining the variable and inefficient differentiation of stem cell constructs in in vivo settings. These observations must be considered in drafting any regeneration strategies.

  5. Bladder filling variation during radiation treatment of prostate cancer: Can the use of a bladder ultrasound scanner and biofeedback optimize bladder filling?

    International Nuclear Information System (INIS)

    Purpose: To investigate the use of a bladder ultrasound scanner in achieving a better reproducible bladder filling during irradiation of pelvic tumors, specifically prostate cancer. Methods and Materials: First, the accuracy of the bladder ultrasound scanner relative to computed tomography was validated in a group of 26 patients. Next, daily bladder volume variation was evaluated in a group of 18 patients. Another 16 patients participated in a biofeedback protocol, aiming at a more constant bladder volume. The last objective was to study correlations between prostate motion and bladder filling, by using electronic portal imaging device data on implanted gold markers. Results: A strong correlation between bladder scanner volume and computed tomography volume (r = 0.95) was found. Daily bladder volume variation was very high (1 Sd = 47.2%). Bladder filling and daily variation did not significantly differ between the control and the feedback group (47.2% and 40.1%, respectively). Furthermore, no linear correlations between bladder volume variation and prostate motion were found. Conclusions: This study shows large variations in daily bladder volume. The use of a biofeedback protocol yields little reduction in bladder volume variation. Even so, the bladder scanner is an easy to use and accurate tool to register these variations

  6. What is new in bladder pain syndrome/interstitial cystitis?

    DEFF Research Database (Denmark)

    Hanno, P.; Nordling, J.; Ophoven, A. van

    2008-01-01

    . Recent findings The perspective from which we view bladder pain syndrome/interstitial cystitis is evolving, as is apparent in the literature this year. It is best perceived as one of many chronic pain syndromes, some of which may be related. International efforts aimed at consistent definition and...... nomenclature are ongoing. Some new treatments have been reported that may be of benefit. Summary In the age of the internet, it is incumbent upon the clinician to keep up with current ideas, epidemiology, and treatment findings to be able to discuss these with well informed patients who come to clinics around...

  7. The inclusion of a partial meal replacement with or without inulin to a calorie restricted diet contributes to reach recommended intakes of micronutrients and decrease plasma triglycerides: A randomized clinical trial in obese Mexican women.

    Directory of Open Access Journals (Sweden)

    Tovar Alma

    2012-06-01

    Full Text Available Abstract Background Obesity is a major public health problem in many poor countries where micronutrient deficiencies are prevalent. A partial meal replacement may be an effective strategy to decrease obesity and increase micronutrient intake in such populations. The objective was to evaluate the efficacy of a partial meal replacement with and without inulin on weight reduction, blood lipids and micronutrients intake in obese Mexican women. Methods In a randomized controlled clinical trial 144 women (18–50 y with BMI ≥ 25 kg/m2, were allocated into one of the following treatments during 3 months: 1 Two doses/d of a partial meal replacement (PMR, 2 Two doses/d of PMR with inulin (PMR + I , 3 Two doses/d of 5 g of inulin (INU and 4 Control group (CON. All groups received a low calorie diet (LCD. Weight, height, hip and waist circumference were measured every 2 weeks and body composition, lipids and glucose concentration and nutrient intake were assessed at baseline and after 3 months. Results All groups significantly reduced weight, BMI, waist and hip circumference. Differences between groups were only observed in BMI and weight adjusted changes: At 45 days PMR group lost more weight than INU and CON groups by 0.9 and 1.2Kg, respectively. At 60 days, PMR + I and PMR groups lost more weight than in INU by 0.7 and 1Kg, respectively. Subjects in PMR, PMR + I and INU significantly decreased triglycerides. Energy intake was reduced in all groups. Fiber intake increased in PMR + I and INU groups. Some minerals and vitamins intakes were higher in PMR and PMR + I compared with INU and CON groups. Conclusion Inclusion of PMR with and without inulin to a LCD had no additional effect on weight reduction than a LCD alone but reduced triglycerides and improved intake of micronutrients during caloric restriction. PMR could be a good alternative for obese populations with micronutrient deficiencies. ClinicalTrials.Gov ID

  8. Recent advances in high-throughput molecular marker identification for superficial and invasive bladder cancers

    DEFF Research Database (Denmark)

    Andersen, Lars Dyrskjøt; Zieger, Karsten; Ørntoft, Torben Falck

    2007-01-01

    individually contributed to the management of the disease. However, the development of high-throughput techniques for simultaneous assessment of a large number of markers has allowed classification of tumors into clinically relevant molecular subgroups beyond those possible by pathological classification. Here......, we review the recent advances in high-throughput molecular marker identification for superficial and invasive bladder cancers....

  9. The prognostic role of lymphovascular invasion in urothelial carcinoma of the bladder.

    Science.gov (United States)

    Mathieu, Romain; Lucca, Ilaria; Rouprêt, Morgan; Briganti, Alberto; Shariat, Shahrokh F

    2016-08-01

    Outcome prediction in patients with bladder cancer has improved through the development of nomograms and predictive models. However, integration of further characteristics such as lymphovascular invasion (LVI) might increase the accuracy and clinical utility of these instruments. Assessment and reporting of LVI in specimens from transurethral resection of the bladder tumour (TURBT) or biopsy in patients with non-muscle-invasive bladder cancer (NMIBC) or muscle-invasive bladder cancer (MIBC) might enable improved staging, prognostication and clinical decision-making. In NMIBC, presence of LVI in TURBT and biopsy samples seems to be associated with understaging and increased risks of disease recurrence and progression. In MIBC, presence of LVI is associated with features of aggressive disease and predicts recurrence and survival. Integration of LVI status into predictive models might aid clinical decision-making regarding intravesical instillation schedules and regimens, early radical cystectomy in patients with high-grade T1 disease and perioperative chemotherapy. However, LVI assessment is hampered by insufficient reproducibility and reliability, lack of routine evaluation and limited concordance between findings in TURBT and radical cystectomy specimens. Standardization of the pathological criteria defining LVI is warranted to improve its reporting in routine clinical practice and its utility as a care-changing prognostic marker. PMID:27431340

  10. Pharmacological treatment of overactive bladder: report from the International Consultation on Incontinence

    NARCIS (Netherlands)

    K.E. Andersson; C.R. Chapple; L. Cardozo; F. Cruz; H. Hashim; M.C. Michel; C. Tannenbaum; A.J. Wein

    2009-01-01

    Purpose of review Treatment options for the overactive bladder were recently discussed at the 4th International Consultation on Incontinence (ICI) held in Paris, 5-8 July 2008. This article will overview current thoughts on the pharmacological and clinical basis for the different classes of drugs cu

  11. Transurethral microwave needle ablation for bladder cancer

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@To investigate the role of transurethral microwave needle ablation (TUMWNA) in the management of bladder cancer,TUMWNA was carried out in 24 patients with bladder cancer since 1989. From January 1989 to December 1997, 24 patients with bladder cancer were treated with TUMWNA. The 15 men and 9 women were 42 to 67 years old (mean, 58). There were 18 cases with a single tumor and 6 with multiple tumors (4 with 2 tumors, 1 with 3 and 1 with 4). Tumor diameter ranged from 0.3 to 2.5 cm. The lesions grew in different bladder regions: 13 tumors arose from the fundus, 3 tumors from the dome, 9 from the lateral wall, 5 from the anterior wall, 1 from the triangle region and 2 tumors were situated in the obturator nerve reflex sensitive region.

  12. CHEMOTHERAPY FOR MUSCLE INVASIVE BLADDER CANCER

    Directory of Open Access Journals (Sweden)

    I. G. Rusakov

    2014-08-01

    Full Text Available The paper considers treatment regimens for metastatic bladder cancer (MBC and gives the data of trials of the efficiency of using different chemotherapy schemes and regimens in patients with MBC.

  13. Tetrachloroethylene exposure and bladder cancer risk

    DEFF Research Database (Denmark)

    Vlaanderen, Jelle; Straif, Kurt; Ruder, Avima; Blair, Aaron; Hansen, Johnni; Lynge, Elsebeth; Charbotel, Barbara; Loomis, Dana; Kauppinen, Timo; Kyyronen, Pentti; Pukkala, Eero; Weiderpass, Elisabete; Guha, Neela

    2014-01-01

    BACKGROUND: In 2012, the International Agency for Research on Cancer classified tetrachloroethylene, used in the production of chemicals and the primary solvent used in dry cleaning, as "probably carcinogenic to humans" based on limited evidence of an increased risk of bladder cancer in dry...... cleaners. OBJECTIVES: We assessed the epidemiological evidence for the association between tetrachloroethylene exposure and bladder cancer from published studies estimating occupational exposure to tetrachloroethylene or in workers in the dry-cleaning industry. METHODS: Random-effects meta-analyses were......-analysis demonstrates an increased risk of bladder cancer in dry cleaners, reported in both cohort and case-control studies, and some evidence for an exposure-response relationship. Although dry cleaners incur mixed exposures, tetrachloroethylene could be responsible for the excess risk of bladder cancer because it is...

  14. Aging changes in the kidneys and bladder

    Science.gov (United States)

    ... and urethra. Muscle changes and changes in the reproductive system can affect bladder control. Aging Changes and Their ... the bones, muscles, and joints In the male reproductive system In the female reproductive system In organs, tissues, ...

  15. SMP Bladder Tooling for Manufacturing Composites Project

    Data.gov (United States)

    National Aeronautics and Space Administration — CRG's shape memory polymer (SMP) Bladder Tooling is a cutting-edge manufacturing technology that can meet the manufacturing needs of the Ares launch vehicles. This...

  16. Bladder Control: What Men Need to Know

    Science.gov (United States)

    ... about bladder control problems? Just changing some daily habits may help. For example, you could limit fluids at certain times of the day or plan regular trips to the bathroom to avoid an accident. Don’t be embarrassed ...

  17. MANAGEMENT OF CARCINOMA BLADDER: A REVIEW LITERATURE

    Directory of Open Access Journals (Sweden)

    Gurinderjit Singh

    2014-12-01

    Full Text Available Carcinoma of the bladder is a disease of the elderly. Bladder cancer is three times more common in males than in females and more common in whites than in blacks. Patients with bladder cancer have a 1% to 4% incidence of synchronous or metachronous upper t ract urothelial tumors. There are many risk factors for urothelial cancer, classified into (1 Genetic (2 chemical exposure, and (3 chronic irritation. Genetic abnormalities associated with CIS include alterations in the retinoblastoma gene (Rb, p53, an d PTEN. Chemical exposure has the most epidemiologic evidence to support it as an inciting agent (Aromatic amines, aniline dyes, and nitrites and nitrates. Chronic irritants include catheters, recurrent urinary track infections, Schistosoma haematobium, a nd irradiation. There are many studies that suggest high water consumption, vitamin intake, and various diets that are beneficial in preventing bladder cancer. However, none of these have shown any clear benefit with respect to prevention.

  18. Bladder Diseases - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Bladder Diseases URL of this page: https://medlineplus.gov/languages/bladderdiseases.html Other topics A-Z A B ...

  19. Urinary bladder hypersensitivity and dysfunction in female mice following early life and adult stress.

    Science.gov (United States)

    Pierce, Angela N; Di Silvestro, Elizabeth R; Eller, Olivia C; Wang, Ruipeng; Ryals, Janelle M; Christianson, Julie A

    2016-05-15

    Early adverse events have been shown to increase the incidence of interstitial cystitis/painful bladder syndrome in adulthood. Despite high clinical relevance and reports of stress-related symptom exacerbation, animal models investigating the contribution of early life stress to female urological pain are lacking. We examined the impact of neonatal maternal separation (NMS) on bladder sensitivity and visceral neuroimmune status both prior-to, and following, water avoidance stress (WAS) in adult female mice. The visceromotor response to urinary bladder distension was increased at baseline and 8d post-WAS in NMS mice, while colorectal sensitivity was transiently increased 1d post-WAS only in naïve mice. Bladder micturition rate and output, but not fecal output, were also significantly increased following WAS in NMS mice. Changes in gene expression involved in regulating the stress response system were observed at baseline and following WAS in NMS mice, and WAS reduced serum corticosterone levels. Cytokine and growth factor mRNA levels in the bladder, and to a lesser extent in the colon, were significantly impacted by NMS and WAS. Peripheral mRNA levels of stress-responsive receptors were differentially influenced by early life and adult stress in bladder, but not colon, of naïve and NMS mice. Histological evidence of mast cell degranulation was increased in NMS bladder, while protein levels of protease activated receptor 2 (PAR2) and transient receptor potential ankyrin 1 (TRPA1) were increased by WAS. Together, this study provides new insight into mechanisms contributing to stress associated symptom onset or exacerbation in patients exposed to early life stress. PMID:26940840

  20. Multilayered disease-mimicking bladder phantom with realistic surface topology for optical coherence tomography

    Science.gov (United States)

    Smith, Gennifer T.; Lurie, Kristen L.; Khan, Saara A.; Liao, Joseph C.; Ellerbee, Audrey K.

    2014-03-01

    Optical coherence tomography (OCT) has shown potential as a complementary modality to white light cystoscopy (WLC), the gold standard for imaging bladder cancer. OCT can visualize sub-surface details of the bladder wall, which enables it to stage cancers and detect tumors that are otherwise invisible to WLC. Currently, OCT systems have too slow a speed and too small a field of view for comprehensive bladder imaging, which limits its clinical utility. Validation and feasibility testing of technological refinements aimed to provide faster imaging and wider fields of view necessitates a realistic bladder phantom. We present a novel process to fabricate the first such phantom that mimics both the optical and morphological properties of layers of the healthy and pathologic bladder wall as they characteristically appear with OCT. The healthy regions of the silicone-based phantom comprises three layers: the urothelium, lamina propria and muscularis propria, each containing an appropriate concentration of titanium dioxide to mimic its distinct scattering properties. As well, the layers each possess a unique surface appearance imposed by a textured mold. Within this phantom, pathologic tissue-mimicking regions are created by thickening specific layers or creating inclusions that disrupt the layered appearance of the bladder wall, as is characteristic of bladder carcinomas. This phantom can help to evaluate the efficacy of new OCT systems and software for tumor localization. Moreover, the procedure we have developed is highly generalizable for the creation of OCT-relevant, multi-layer phantoms for tissues that incorporate diseased states characterized by the loss of layered structures.

  1. The clinical course of non-muscle invasive bladder cancer after transuretral resection of the tumor with or without subsequent intravesical application of bacillus Calmette-Guérin: The influence of patients gender and age

    Directory of Open Access Journals (Sweden)

    Milošević Radovan

    2015-01-01

    Full Text Available Bacground/Aim. The therapy with intravesical instillation of bacillus Calmette-Guérin (BCG after transurethral resection (TUR of tumor is the gold standard of treatment of non-muscle invasive bladder cancer (NMIBC. The role and importance of BCG intravesical therapy in various shape of tumors, were confirmed by our previous investigation. The aim of this study was to examine whether incidence of recurrence and tumor regression differs depending on sex and age of patients. Methods. This study included a total of 899 patients suffering from NIMBC, treated at our institution from January 1, 2007 to March 1, 2013. Two groups of patients were formed: patients underwent TUR + BCG therapy (the group I and the group II with patients in whom TUR was performed as only therapy. These two groups of patients were divided into subgroups of respondents male and female, age 60 years or younger and older than 60 years. Statistical analysis was performed using χ2 test and the Kolmogorov-Smirnov test. Results. This research suggests that if the frequency of recurrence is seen as the only parameter, considering all the subjects, the lowest recurrence rate was determined in the male subjects, aged 60 years and younger who had received BCG after TUR. A high statistical significance was found in the incidence of recurrence in patients younger than 60 years, depending on the response to the therapy, while in those older than 60 years, the difference was at the level of statistical significance. This can be attributed to a certain degree of infravesical obstruction in older men. Conclusions. Sex and age of patients may have a significant influence on the course and outcome of NMIBC. The disease has the most malignant and most aggressive behavior when present in males older than 60 years.

  2. Clinical outcome of Bryan artificial cervical disc replacement for the treatment of cervical spondylosis: A midterm follow-up%Bryan人工颈椎间盘置换治疗颈椎病的中期临床随访

    Institute of Scientific and Technical Information of China (English)

    丁琛; 孔清泉; 刘浩; 胡韬; 石锐; 李涛; 洪瑛; 宋跃明; 刘立岷; 曾建成

    2011-01-01

    BACKGROUND: Although the short-term clinical efficacy of Bryan artificial cervical disc replacement is generally acknowledged by most spinal surgeons, the midterm and long term clinical results and complications are still unclear.OBJECTIVE: To summarize midterm term clinical results of Bryan artificial cervical disc replacement for the treatment of cervical spondylosis.METHOD: From November 2004 to December 2007, 34 patients had Bryan cervical disc replacement in Department of Orthopedics, West China Hospital were selected, including 30 cases with single replacement and 4 cases with bi-level replacement. Clinical result was evaluated by SF-36 score, JOA score, and neck/arm pain VAS scores. And the data was collected before surgery and at 7 days, 3, 6, 12, 24, 36 and 48 months after surgery. Neutral lateral and dynamic cervical radiographs were made to measure the flexion-extension range of motion (ROM) of operative segment, adjacent segments and C2-7 segment, the intervertebral height of operative and adjacent segments, and the translation of operative level. The intraoperative and postoperative complications were recorded and analyzed.RESULTS AND CONCLUSION: The neurological symptoms of each patient were alleviated notably. The postoperative SF-36physical component score and SF-36 mental component score, JOA score, NDI score and neck/arm pain VAS scores were significantly improved compared with those of the preoperative (P < 0.05), but no statistical significance were noted between each time point after 3-month follow-up (P > 0.05). Each implanted prosthesis preserved the ROM>2° at each follow-up time point,and no heterotopic ossification or spontaneous fusion was found at the operative segment. At 48-month follow-up,flexion-extension ROM of operative segment and C2-7 segment slightly increased but showed no statistical significance compared with the preoperative counterparts (P > 0.05); ROM of upper and lower adjacent segments also showed no statistical

  3. Robotic surgery: review of prostate and bladder cancer.

    Science.gov (United States)

    Sohn, William; Lee, Hak J; Ahlering, Thomas E

    2013-01-01

    Minimally invasive laparoscopic surgery has become to replace many of the open procedures in urology because of the obvious benefits in perioperative morbidity. However, because of the technical challenges and steep learning curve, the adoption of laparoscopy has been limited to only highly skilled laparoscopic surgeons. The introduction of the da Vinci surgical system (Intuitive Surgical Inc, Sunnyvale, Calif) has offered significant technical advantages over laparoscopic surgery. Because of the wide acceptance of robotic-assisted radical prostatectomy over the past decade, it has paved the way for urologists to tackle other complex operations, such as a radical cystectomy to decrease the morbidity of the operation. The goal of this article was to review the history and discuss the application and current status of the robot in both prostate and bladder cancer management. We present our technique of performing a robotic-assisted radical prostatectomy and the application of the robust prostate experience to robotic cystectomy. PMID:23528721

  4. Holmium laser lithotripsy of bladder calculi

    Science.gov (United States)

    Beaghler, Marc A.; Poon, Michael W.

    1998-07-01

    Although the overall incidence of bladder calculi has been decreasing, it is still a significant disease affecting adults and children. Prior treatment options have included open cystolitholapaxy, blind lithotripsy, extracorporeal shock wave lithotripsy, and visual lithotripsy with ultrasonic or electrohydraulic probes. The holmium laser has been found to be extremely effective in the treatment of upper tract calculi. This technology has also been applied to the treatment of bladder calculi. We report our experience with the holmium laser in the treatment of bladder calculi. Twenty- five patients over a year and a half had their bladder calculi treated with the Holmium laser. This study was retrospective in nature. Patient demographics, stone burden, and intraoperative and post-operative complications were noted. The mean stone burden was 31 mm with a range of 10 to 60 mm. Preoperative diagnosis was made with either an ultrasound, plain film of the abdomen or intravenous pyelogram. Cystoscopy was then performed to confirm the presence and determine the size of the stone. The patients were then taken to the operating room and given a regional or general anesthetic. A rigid cystoscope was placed into the bladder and the bladder stone was then vaporized using the holmium laser. Remaining fragments were washed out. Adjunctive procedures were performed on 10 patients. These included transurethral resection of the prostate, transurethral incision of the prostate, optic internal urethrotomy, and incision of ureteroceles. No major complications occurred and all patients were rendered stone free. We conclude that the Holmium laser is an effective and safe modality for the treatment of bladder calculi. It was able to vaporize all bladder calculi and provides a single modality of treating other associated genitourinary pathology.

  5. Narrow band imaging for bladder cancer

    OpenAIRE

    Thomas Y. Hsueh; Allen W. Chiu

    2016-01-01

    Narrow band imaging (NBI) is a newly developed technology aiming to provide additional endoscopic information for patients with bladder cancer. This review focuses on the diagnostic accuracy and treatment outcome using NBI cystoscopy for the treatment of non-muscle invasive bladder cancer. Current results showed improved sensitivity of NBI cystoscopy compared to conventional white light cystoscopy, although lower specificity and increased false-positive results were reported using NBI cystosc...

  6. Intracavitary cobalt-60 irradiation in the prophylactic treatment of bladder cancer

    Energy Technology Data Exchange (ETDEWEB)

    Harada, Tadashi; Kigure, Teruaki; Miyagata, Shigeru (Akita Univ. (Japan). School of Medicine) (and others)

    1992-05-01

    This paper describes the technique and preliminary clinical results of transurethral intracavitary whole bladder mucosal irradiation (IWI) for the prophylaxis of bladder cancer. In this procedure, first, the balloon catheter (22 Fr.) is inserted into the bladder, and next the balloon is inflated with 100 ml of air. Then a Co-60 pellet with about 110 GBq of activity is driven into the center of the bladder. With this method, we can irradiate the whole bladder mucosa almost equally. From April 1985, 36 patients with recurrent tumor and 26 patients with primary and multiple tumors of the bladder have been treated with IWI after transurethral resection or microwave coagulation of the tumors. Tumor stage and grade were as follows: Tis (7), T{sub a}, T{sub 1} (41), T{sub 2} (14), G1 (16), G2 (30) and G3 (16). The tumors were transitional cell carcinoma in all patients. IWI was performed once a week, usually 3 to 5 times, depending on the patients. The total dose to the bladder mucosa ranged from 20 to 58.5 Gy with an average dose of 37.6 Gy. Recurrence rates before and after IWI were calculated using the following formula: recurrence rates (RR)=(total number of recurrences/total months of follow up)x100. RR in the 36 patients with recurrent tumor was 14.0 before IWI and 1.8 after IWI (mean follow up 37.6 mos.). RR in the 26 patients with multiple tumors was 1.4 after IWI (mean follow up 34.8 mos.). RR in patients with G1, G2 and G3 tumors were 1.2, 1.7 and 2.2. The most common side effect was temporary urinary frequency observed in 36 patients (52.9%). Three patients had contracted bladder, and two had hydronephrosis. However, proctitis or incontinence was not evident. Although the preliminary clinical results suggest that our new technique is an effective prophylactic treatment for bladder cancer, further investigation is needed to determine its efficacy. (author).

  7. Bovine papillomavirus type 2 detection in the urinary bladder of cattle with chronic enzootic haematuria

    Directory of Open Access Journals (Sweden)

    Sheila R Wosiacki

    2006-09-01

    Full Text Available The bovine papillomavirus type 2 (BPV-2 involvement in the aetiology of chronic enzootic haematuria associated to bracken fern ingestion has been suggested for a long time. However, a few reports have shown the presence of the BPV-2 in urinary bladder tumors of cattle. The aim of this study was to investigate the presence of the BPV-2 infection in the urinary bladder of cattle with chronic enzootic haematuria in Brazilian cattle herds. Sixty-two urinary bladders were collected from adult cattle in beef herds from the north region of the state of Paraná, Brazil. According to clinical and pathological finds the specimens were distributed in three groups: the group A was constituted by 22 urinary bladders with macroscopic lesions collected at necropsy of cattle with clinical signs of chronic enzootic haematuria; the group B by 30 urinary bladders with macroscopic lesions collected in a slaughterhouse of cows coming from bracken fern-endemic geographical region; and the group C (control by 10 urinary bladders without macroscopic lesions collected from asymptomatic cattle in a bracken fern-free geographical region. By a semi-nested polymerase chain reaction (PCR assay, with an internal control, a fragment of the BPV-2 L1 gene with 386 bp length was amplified in 36 (58% urinary bladder. The rate of BPV-2 positive urinary bladders was 50% (11/22 for group A, 80% (24/30 for group B, and 10% (1/10 for group C (control. The rate of the positive results found in groups A and B that included urinary bladder samples with macroscopic lesions was 67% (35/52 and the detection of the BPV-2 in both groups was significantly higher (P < 0.05 than in the control group. RFLP with Rsa I and Hae III enzymes evaluated the specificity of the BPV-2 amplicons. The PCR internal control that amplified a 626 bp fragment of the ND5 gene of the bovine mitochondrial genome was amplified in all analyzed samples and excluded false-negatives or invalid results in the semi

  8. Urinary bladder metastasis from lung adenocarcinoma: A rare cause of hematuria

    Directory of Open Access Journals (Sweden)

    Kan Wai Man Raymond

    2014-01-01

    Full Text Available We presented an unusual case of hematuria caused by a solitary bladder metastasis from lung adenocarcinoma. A confident diagnosis of secondary adenocarcinoma of the bladder was made by clinical suspicion based on patient′s past history, careful examination of tumor morphology, and a directed panel (cytokeratin [CK] 7/CK20/thyroid transcription factor 1 of immunohistochemistry. We sought, through sharing our experience in the investigative and diagnostic process, to contribute to the better understanding of this unusual cause of hematuria.

  9. An Unexpected Foreign Body (a Thermometer in the Bladder: A Case Report

    Directory of Open Access Journals (Sweden)

    M. Dardamanis

    2014-03-01

    Full Text Available Foreign bodies in the bladder are rarely observed because of difficult access. These patients usually have a mental disorder, a background of intense sexual perversion, or inquisitiveness. A 48-year-old, deaf, and mentally retarded woman was referred to the nephrology clinic for severe anemia and impaired renal function. Imaging tests showed a mercury thermometer positioned in the bladder and a stone, 5 cm in diameter, around it. This had caused bilateral ureteral obstruction. The patient underwent an open cysteotomy. Obstructive uropathy is one of the causes of kidney failure; therefore, foreign bodies should be included in the differential diagnosis.

  10. Sensory dysfunction of bladder mucosa and bladder oversensitivity in a rat model of metabolic syndrome.

    Directory of Open Access Journals (Sweden)

    Wei-Chia Lee

    Full Text Available PURPOSE: To study the role of sensory dysfunction of bladder mucosa in bladder oversensitivity of rats with metabolic syndrome. MATERIALS AND METHODS: Female Wistar rats were fed a fructose-rich diet (60% or a normal diet for 3 months. Based on cystometry, the fructose-fed rats (FFRs were divided into a group with normal detrusor function or detrusor overactivity (DO. Acidic adenosine triphosphate (ATP solution (5mM, pH 3.3 was used to elicit reflex micturition. Cystometric parameters were evaluated before and after drug administration. Functional proteins of the bladder mucosa were assessed by western blotting. RESULTS: Compared to the controls, intravesical acidic ATP solution instillation induced a significant increase in provoked phasic contractions in both FFR groups and a significant decrease in the mean functional bladder capacity of group DO. Pretreatment with capsaicin for C-fiber desentization, intravesical liposome for mucosal protection, or intravenous pyridoxal 5-phosphate 6-azophenyl-2',4'-disulfonic acid for antagonized purinergic receptors can interfere with the urodynamic effects of intravesical ATP in FFRs and controls. Over-expression of TRPV1, P2X(3, and iNOS proteins, and down-regulation of eNOS proteins were observed in the bladder mucosa of both fructose-fed groups. CONCLUSIONS: Alterations of sensory receptors and enzymes in the bladder mucosa, including over-expression of TRPV1, P2X(3, and iNOS proteins, can precipitate the emergence of bladder phasic contractions and oversensitivity through the activation of C-afferents during acidic ATP solution stimulation in FFRs. The down-regulation of eNOS protein in the bladder mucosa of FFRs may lead to a failure to suppress bladder oversensitivity and phasic contractions. Sensory dysfunction of bladder mucosa and DO causing by metabolic syndrome are easier to elicit bladder oversensitivity to certain urothelium stimuli.

  11. Effects of mild bladder outlet obstruction on rabbit bladder structure and function.

    Science.gov (United States)

    Kuo, H C

    1995-09-01

    Mild bladder outlet obstruction was created in 42 New Zealand white rabbits by placing a 5-mm inner diameter polyethylene tube around the urethra. Periods of obstruction lasted for 1 day (7 rabbits), 3 days (7 rabbits), 1 week (7 rabbits), 2 weeks (6 rabbits), 4 weeks (7 rabbits), 6 weeks (4 rabbits) and 8 weeks (4 rabbits). Whole bladder functional study was performed in control (5 rabbits) and the obstructed bladders. The obstructed bladders increased in weight two-to threefold. There was no significant difference in bladder weight after different periods of obstruction. Electric stimulation showed a diminished response after 3 days of obstruction. Pharmacologic stimulation with 500 microM carbachol revealed a decreased response after obstruction, but intravesical pressure returned to the control level at 6 and 8 weeks of obstruction. However, the bladder weight and the expelling function of the obstructed bladders remained the same as on day 1 of obstruction. Histologic study of control and obstructed bladders revealed that: 1) dense submucosal fibrous tissue developed after 3 days of obstruction, 2) detrusor muscle hypertrophy and hyperplasia were noted with intermuscular collagenous fiber deposition after 2 weeks of obstruction, 3) trabeculation of the bladder wall with hyperplasia of muscular bundles was noted after 2 weeks of obstruction, 4) acute edematous and inflammatory reaction were apparent after 3 days and 1 week of obstruction, but resolved later and 5) degenerative changes of muscular cells were noted at 8 weeks of obstruction. The results show that despite apparent morphologic changes after outlet obstruction, no significant difference was observed in bladder expelling between short-term and long-term infravesical mild outlet obstruction. The bladder contractile apparatus appears to have a compensatory ability after mild outlet obstruction. PMID:8696170

  12. The role of imaging in pediatric bladder augmentation

    Energy Technology Data Exchange (ETDEWEB)

    Breen, Micheal; Chow, Jeanne S. [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); Phelps, Andrew [UCSF Benioff Children' s Hospital San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Estrada, Carlos [Boston Children' s Hospital, Department of Urology, Boston, MA (United States)

    2015-09-15

    Bladder augmentation (also called augmentation cystoplasty) refers to a number of surgical methods that increase the capacity and compliance of the urinary bladder. Imaging has an important role in the postoperative evaluation of bladder augmentation. The most common augmentation procedures utilize enteric segments to augment the bladder. The various types of bladder augmentation have characteristic appearances on different imaging modalities. Spontaneous bladder perforation is a complication that is seen in both early and late post-operative periods and it is one of the most important complications for radiologists to be aware of as it is life-threatening. We review the indications for bladder augmentation in children, the surgical techniques employed, the normal postoperative appearances on imaging studies and the role of imaging complications of bladder augmentation including delayed spontaneous bladder rupture, which is life-threatening. (orig.)

  13. Knee joint replacement

    Science.gov (United States)

    Knee joint replacement is a surgery to replace a knee joint with a man-made joint. The artificial joint is called a prosthesis . ... cartilage and bone are removed from the knee joint. Man-made pieces are then placed in the ...

  14. Replacement nuclear steam generators

    International Nuclear Information System (INIS)

    This paper reviews past and current practices in the replacement of nuclear steam generators. Plants where steam generator replacement has occurred are reviewed to see what changes have been made, and how the evolving technology has significantly reduced outage time and man-rem exposures. Current preferences in design and material are reviewed. 3 refs., 3 tabs., 2 figs

  15. Radiation Source Replacement Workshop

    Energy Technology Data Exchange (ETDEWEB)

    Griffin, Jeffrey W.; Moran, Traci L.; Bond, Leonard J.

    2010-12-01

    This report summarizes a Radiation Source Replacement Workshop in Houston Texas on October 27-28, 2010, which provided a forum for industry and researchers to exchange information and to discuss the issues relating to replacement of AmBe, and potentially other isotope sources used in well logging.

  16. Partially wedged beams improve radiotherapy treatment of urinary bladder cancer

    International Nuclear Information System (INIS)

    Background and purpose: Partially wedged beams (PWBs) having wedge in one part of the field only, can be shaped using dynamic jaw intensity modulation. The possible clinical benefit of PWBs was tested in treatment plans for muscle-infiltrating bladder cancer. Material and methods: Three-dimensional treatment plans for 25 bladder cancer patients were analyzed. The originally prescribed standard conformal four-field box technique, which includes the use of lateral ordinary wedge beams, was compared to a modified conformal treatment using customized lateral PWBs. In these modified treatment plans, only the anterior parts of the two lateral beams had a wedge. To analyze the potential clinical benefit of treatment with PWBs, treatment plans were scored and compared using both physical parameters and biological dose response models. One tumour control probability model and two normal tissue complication probability (NTCP) models were applied. Different parameters for normal tissue radiation tolerance presented in the literature were used. Results: By PWBs the dose homogeneity throughout the target volume was improved for all patients, reducing the average relative standard deviation of the target dose distribution from 2.3 to 1.8%. A consistent reduction in the maximum doses to surrounding normal tissue volumes was also found. The most notable improvement was demonstrated in the rectum where the volume receiving more than the prescribed tumour dose was halved. Treatment with PWBs would permit a target dose escalation of 2-6 Gy in several of the patients analyzed, without increasing the overall risk for complications. The number of patients suitable for dose escalation ranged from 3 to 15, depending on whether support from all or only one of the five applied NTCP model/parameter combinations were required in each case to recommend dose escalation. Conclusion: PWBs represent a simple dose conformation tool that may allow radiation dose escalation in the treatment of muscle

  17. Bladder Wall Telangiectasia in a Patient with Ataxia-Telangiectasia and How to Manage?

    Directory of Open Access Journals (Sweden)

    Fatma Deniz Aygün

    2015-01-01

    Full Text Available Ataxia-telangiectasia (A-T is a rare neurodegenerative, inherited disease causing severe morbidity. Oculocutaneous telangiectasias are almost constant findings among the affected cases as telangiectasia is considered the main clinical finding for diagnosis. Vascular abnormalities in organs have been reported infrequently but bladder wall telangiectasias are extremely rare. We aimed to report recurrent hemorrhage from bladder wall telangiectasia in a 9-year-old boy with A-T who had received intravenous cyclophosphamide for non-Hodgkin’s lymphoma. Since A-T patients are known to be more susceptible to chemical agents, we suggested that possibly cyclophosphamide was the drug which induced bladder wall injury in this patient.

  18. A contribution to improved radiotherapy for muscle invading urinary bladder cancer

    International Nuclear Information System (INIS)

    Cystectomy has traditionally been regarded the treatment of choice for muscle invading urinary bladder cancer in most countries. Radiotherapy has been offered patients considered unfit for cystectomy. Since the contraindications of surgery are frequent among bladder cancer patients, a substantial amount of patients with muscle invading bladder cancer (typically 50%) are still managed primarily with radiation. Recently, a tri-modality, organsparing treatment (trans-urethral resection and radio-chemotherapy) has been proposed for bladder cancer, like in the management of a range of other common malignancies. This approach may provide as high control rates as cystectomy yet maintain a higher quality of life for selected patient groups. In both the radical radiotherapy and the combined modality approach, high radiation doses are needed to improve local disease control. Radiation dose escalation requires improved conformation of dose distributions. This PhD programme aimed to develop improved conformal radiotherapy procedures in the management of patients with muscle invading urinary bladder cancer. In the initial phase of this work, computer-controlled movement of the linear accelerator collimator jaws during beam delivery was applied to shape so-called partially wedged beams (PWBs), that were designed specifically to tailor the dose distribution in bladder irradiation closer to the defined bladder target. The dosimetric verification and treatment planning implementation of this beam delivery concept were addressed, and we documented that these dynamic beams were delivered as accurately as standard beams. Particular attention was given to the BMS-96 diode array system, as it was adapted to dynamic beam dosimetry. Next, the potential clinical impact of these beams was analysed. In a retrospectively study of a set of urinary bladder treatment plans, the PWBs were seen to improve the dose homogeneity inside the bladder target as well as to reduce normal tissue (small

  19. A contribution to improved radiotherapy for muscle invading urinary bladder cancer

    Energy Technology Data Exchange (ETDEWEB)

    Muren, Ludvig PAul

    2002-07-01

    Cystectomy has traditionally been regarded the treatment of choice for muscle invading urinary bladder cancer in most countries. Radiotherapy has been offered patients considered unfit for cystectomy. Since the contraindications of surgery are frequent among bladder cancer patients, a substantial amount of patients with muscle invading bladder cancer (typically 50%) are still managed primarily with radiation. Recently, a tri-modality, organsparing treatment (trans-urethral resection and radio-chemotherapy) has been proposed for bladder cancer, like in the management of a range of other common malignancies. This approach may provide as high control rates as cystectomy yet maintain a higher quality of life for selected patient groups. In both the radical radiotherapy and the combined modality approach, high radiation doses are needed to improve local disease control. Radiation dose escalation requires improved conformation of dose distributions. This PhD programme aimed to develop improved conformal radiotherapy procedures in the management of patients with muscle invading urinary bladder cancer. In the initial phase of this work, computer-controlled movement of the linear accelerator collimator jaws during beam delivery was applied to shape so-called partially wedged beams (PWBs), that were designed specifically to tailor the dose distribution in bladder irradiation closer to the defined bladder target. The dosimetric verification and treatment planning implementation of this beam delivery concept were addressed, and we documented that these dynamic beams were delivered as accurately as standard beams. Particular attention was given to the BMS-96 diode array system, as it was adapted to dynamic beam dosimetry. Next, the potential clinical impact of these beams was analysed. In a retrospectively study of a set of urinary bladder treatment plans, the PWBs were seen to improve the dose homogeneity inside the bladder target as well as to reduce normal tissue (small

  20. Small cell carcinoma of the urinary bladder diverticulum: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Wu Xu Dong

    2013-01-01

    Full Text Available Small cell carcinoma of the urinary bladder is very rare. Small cell carcinoma of the urinary bladder is a mass with swiftly aggressive and metastatic, and with a poor prognosis. Due to its scarcity, no forward-looking researches assessing the most effective treatment have been issued in the medical literature. It can happen either in connection with urothelial (transitional cell carcinoma or in a pure form. Its treatment should include surgery, chemotherapy and radiotherapy. In this article,we report a case occurring in a mixed form in the urinary bladder diverticulum and we concisely review the published literature with respect to the clinical manifestation, pathology,differential diagnosis, treatment and prognosis.

  1. Endoscopic molecular imaging of human bladder cancer using a CD47 antibody.

    Science.gov (United States)

    Pan, Ying; Volkmer, Jens-Peter; Mach, Kathleen E; Rouse, Robert V; Liu, Jen-Jane; Sahoo, Debashis; Chang, Timothy C; Metzner, Thomas J; Kang, Lei; van de Rijn, Matt; Skinner, Eila C; Gambhir, Sanjiv S; Weissman, Irving L; Liao, Joseph C

    2014-10-29

    A combination of optical imaging technologies with cancer-specific molecular imaging agents is a potentially powerful strategy to improve cancer detection and enable image-guided surgery. Bladder cancer is primarily managed endoscopically by white light cystoscopy with suboptimal diagnostic accuracy. Emerging optical imaging technologies hold great potential for improved diagnostic accuracy but lack imaging agents for molecular specificity. Using fluorescently labeled CD47 antibody (anti-CD47) as molecular imaging agent, we demonstrated consistent identification of bladder cancer with clinical grade fluorescence imaging systems, confocal endomicroscopy, and blue light cystoscopy in fresh surgically removed human bladders. With blue light cystoscopy, the sensitivity and specificity for CD47-targeted imaging were 82.9 and 90.5%, respectively. We detected variants of bladder cancers, which are diagnostic challenges, including carcinoma in situ, residual carcinoma in tumor resection bed, recurrent carcinoma following prior intravesical immunotherapy with Bacillus Calmette-Guérin (BCG), and excluded cancer from benign but suspicious-appearing mucosa. CD47-targeted molecular imaging could improve diagnosis and resection thoroughness for bladder cancer. PMID:25355698

  2. Preliminary assessment of fluorine-18 fluorodeoxyglucose positron emission tomography in patients with bladder cancer

    International Nuclear Information System (INIS)

    The purpose of this study was to assess the feasibility of imaging of bladder cancer with fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) scanning. We studied 12 patients with histologically proven bladder cancer who had undergone surgical procedures and/or radiotherapy. Retrograde irrigation of the urinary bladder with 1000-3710 ml saline was performed during nine of the studies. Dynamic and static PET images were obtained, and standardized uptake value images were reconstructed. FDG-PET scanning was true-positive in eight patients (66.7%), but false-negative in four (33.3%). Of 20 organs with tumor mass lesions confirmed pathologically or clinically, 16 (80%) were detected by FDG-PET scanning. FDG-PET scanning detected all of 17 distant metastatic lesions and two of three proven regional lymph node metastases. FDG-PET was also capable of differentiating viable recurrent bladder cancer from radiation-induced alterations in two patients. In conclusion, these preliminary data indicate the feasibility of FDG-PET imaging in patients with bladder cancer, although a major remaining pitfall is intense FDG accumulation in the urine. (orig.). With 3 figs., 1 tab

  3. Next generation of optical diagnostics for bladder cancer using probe-based confocal laser endomicroscopy

    Science.gov (United States)

    Liu, Jen-Jane; Chang, Timothy C.; Pan, Ying; Hsiao, Shelly T.; Mach, Kathleen E.; Jensen, Kristin C.; Liao, Joseph C.

    2012-02-01

    Real-time imaging with confocal laser endomicroscopy (CLE) probes that fit in standard endoscopes has emerged as a clinically feasible technology for optical biopsy of bladder cancer. Confocal images of normal, inflammatory, and neoplastic urothelium obtained with intravesical fluorescein can be differentiated by morphologic characteristics. We compiled a confocal atlas of the urinary tract using these diagnostic criteria to be used in a prospective diagnostic accuracy study. Patients scheduled to undergo transurethral resection of bladder tumor underwent white light cystoscopy (WLC), followed by CLE, and histologic confirmation of resected tissue. Areas that appeared normal by WLC were imaged and biopsied as controls. We imaged and prospectively analyzed 135 areas in 57 patients. We show that CLE improves the diagnostic accuracy of WLC for diagnosing benign tissue, low and high grade cancer. Interobserver studies showed a moderate level of agreement by urologists and nonclinical researchers. Despite morphologic differences between inflammation and cancer, real-time differentiation can still be challenging. Identification of bladder cancer-specific contrast agents could provide molecular specificity to CLE. By using fluorescently-labeled antibodies or peptides that bind to proteins expressed in bladder cancer, we have identified putative molecular contrast agents for targeted imaging with CLE. We describe one candidate agent - anti-CD47 - that was instilled into bladder specimens. The tumor and normal urothelium were imaged with CLE, with increased fluorescent signal demonstrated in areas of tumor compared to normal areas. Thus, cancer-specificity can be achieved using molecular contrast agents ex vivo in conjunction with CLE.

  4. Use of a self-designed bladder controller for restoring bladder function in paraplegic dogs

    Institute of Scientific and Technical Information of China (English)

    王诗波; 侯春林; 刁颖敏; 陈爱民; 张世民; 雷波; 尹承慧; 张伟

    2003-01-01

    Objective: To evaluate the results of a self-designed bladder controller for restoring micturition function in paraplegic dogs.Methods: The spinal cords of 4 dogs were transected above the cone. Electrodes were implanted in S2 bilaterally and connected to the subcutaneous receivers for external activation. Microsurgical technique was employed to perform dorsal rhizotomy of S1-3 intradurally. The dogs were stimulated daily to observe micturition. Urodynamic testing and vesicography were performed. Results: All the dogs acquired micturition under the control of electric stimulation, with urine volume 80-140 ml per time. The mode of micturition was post-stimulus voiding. Vesicography revealed that the bladder was filled well and the bladder neck was open in the micturition course of electric stimulation. Residual urine volume was 15-20 ml. Urodynamic testing found that the bladder pressure and intraurethral pressure increased simultaneously, but when the intraurethral pressure was greater than the bladder pressure, no micturition occurred. The pressure decreased to baseline rapidly and the bladder pressure decreased slowly between two bursts. Micturition occurred when the bladder pressure was greater than the intraurethral pressure.Conclusions: The self-designed bladder controller together with a sacral deafferentation procedure can restore micturition function of paraplegic dogs.

  5. An experimental study of artificial murine bladder reflex arc established by abdominal reflex

    Institute of Scientific and Technical Information of China (English)

    WANG Jin-wu; ZHAO Yu-wu; HOU Chun-lin; NI Wei-feng; RUI Bi-yu; GUO Shang-chun; ZHENG Xian-you; DAI Ke-rong

    2011-01-01

    Background The neurogenic bladder dysfunction caused by spinal cord injury is difficult to treat clinically. The aim of this research was to establish an artificial bladder reflex arc in rats through abdominal reflex pathway above the level of spinal cord injury, reinnervate the neurogenic bladder and restore bladder micturition.Methods The outcome was achieved by intradural microanastomosis of the right T13 ventral root to S2 ventral root with autogenous nerve grafting, leaving the right T13 dorsal root intact. Long-term function of the reflex arc was assessed from nerve electrophysiological data and intravesical pressure tests during 8 months postoperation. Horseradish peroxidase (HRP) tracing was performed to observe the effectiveness of the artificial reflex.Results Single stimulus (3 mA, 0.3 ms pulses, 20 Hz, 5-second duration) on the right T13 dorsal root resulted in evoked action potentials, raised intravesical pressures and bladder smooth muscle, compound action potential recorded from the right vesical plexus before and after the spinal cord transaction injury between L5 and S4 segmental in 12 Sprague-Dawley rats. There were HRP labelled cells in T13 ventral horn on the experimental side and in the intermediolateral nucleus on both sides of the L6-S4 segments after HRP injection. There was no HRP labelled cell in T13 ventral horn on the control side.Conclusion Using the surviving somatic reflex above the level of spinal cord injury to reconstruct the bladder autonomous reflex arc by intradural microanastomosis of ventral root with a segment of autologous nerve grafting is practical in rats and may have clinical applications for humans.

  6. Plasmacytoid Transitional Cell Carcinoma of Bladder: A Clinico-pathological Study and Review of Literatures

    Institute of Scientific and Technical Information of China (English)

    FENG Xiaoli; ZHANG Hongtu; SUN Yuntian; LIU Xiuyun

    2006-01-01

    Objective: To study the pathologic features of plasmacytoid transitional cell carcinoma of the bladder, and to analyze the diagnostic features, criteria for differential diagnosis and the clinical significance of the tumor. Methods: Two cases of bladder plasmacytoid transitional cell carcinoma were studied. Routine paraffin sections with HE staining, Pap smear and immunohistochemistry by S-P method were observed under a light microscope. Pathological and clinical data were analyzed by comparison with early reported cases in literatures. Results: A characteristic feature of this tumor was of deep invasion in the lamina propria and/or muscularis propria, in addition to the component of carcinoma in situ in the mucosa, when tumors were diagnosed. The histological pattern and cytological features showed similarity to a plasmacytoid tumor. The tumor cells were strongly positive for AE1/AE3, CEA and CK18. The prognosis appeared to be worse than ordinary transitional cell carcinoma. Conclusion: The plasmacytoid transitional cell carcinoma of bladder is rare but has typical pathological, immunohistological and clinical features. Pathologists should be aware of this kind of primary tumor of bladder.

  7. Clinical application of minimally invasive Brachypodium hip replacement in treatment of avascular necrosis of femoral head%微创短柄人工髋关节置换术治疗股骨头坏死的临床应用

    Institute of Scientific and Technical Information of China (English)

    张明辉; 李国军; 陈欣欣; 王晓

    2015-01-01

    目的::评价微创短柄人工髋关节置换术治疗股骨头坏死的临床效果。方法:对我院2008年3月~2010年3月23例无菌性股骨头坏死病人行微创短柄人工髋关节置换术治疗,术后进行临床结果分析和评价。结果:23例均获得随访,平均随访36个月,按照Harris[1]评分标准评分:优18,良4,可1,差0.优良率为95.6%。结论:保留了股骨颈的短柄人工髋关节置换术,更符合人体生物力学特点,术后并发症低,为中青年股骨头坏死患者的治疗提供了一个新方法。%Objective:To evaluate the clinical effect of minimally invasive Brachypodium hip replacement in the treatment of avascular necrosis of the femoral head. Methods:23 aseptic osteonecrosis cases were treated with Brachypodium hip replacement surgery from March 2008 to March 2010, and analysis and evaluate the operation outcomes. Results:All cases were followed up for an average 36 months, ac-cording to Harris[1] Grading rating:18 excellent, 4 good,1 ok, no poor, excellent rate 95. 6%. Conclusion:The minimally invasive Brachypodium hip arthroplasty could retain femoral neck, which conform to biomechanics, reduce postoperative complications. It might be a new approach for young patients with osteonecrosis.

  8. Adaptive radiotherapy for bladder cancer using deformable image registration of empty and full bladder

    DEFF Research Database (Denmark)

    Juneja, Prabhjot; Caine, H.; Hunt, P.;

    2015-01-01

    mm) for bladder planning target volume (PTV). The goal of this retrospective study is to define, evaluate and optimize new patient-specific anisotropic PTVs (a-PTVs) using deformable image registration (DIR) between empty and full bladder computed tomography (CT) scans. This will provide an ART that...... incorporates the extreme deformations of the bladder, and is applicable from the first day of treatment. Deformation vector fields (DVFs), measured from the deformable image registration between empty and full bladder CTs, were scaled and constrained to construct the a-PTVs. For each patient, four a-PTVs were...... conv-PTV. In conclusion, the results of this pilot study indicate that the use of a-PTVs could result in substantial decrease in the course averaged planning target volume. This reduction in the PTV is likely to decrease the radiation related toxicity and benefit bladder cancer patients. Currently...

  9. Image-guided radiotherapy of bladder cancer: bladder volume variation and its relation to margins

    DEFF Research Database (Denmark)

    Muren, Ludvig; Redpath, Anthony Thomas; Lord, Hannah;

    2007-01-01

    : The correlation between the relative bladder volume (RBV, defined as repeat scan volume/planning scan volume) and the margins required to account for internal motion was first studied using a series of 20 bladder cancer patients with weekly repeat CT scanning during treatment. Both conformal RT (CRT) and IGRT...... these patients were given fluid intake restrictions on alternating weeks during treatment. RESULTS: IGRT gave the strongest correlation between the RBV and margin size (R(2)=0.75; p10mm were required in only 1% of the situations when the RBV1, whereas isotropic margins >10......BACKGROUND AND PURPOSE: To control and account for bladder motion is a major challenge in radiotherapy (RT) of bladder cancer. This study investigates the relation between bladder volume variation and margins in conformal and image-guided RT (IGRT) for this disease. MATERIALS AND METHODS...

  10. Work Capacity of the Bladder During Voiding: A Novel Method to Evaluate Bladder Contractile Function and Bladder Outlet Obstruction

    Directory of Open Access Journals (Sweden)

    Ning Liu

    2015-01-01

    Full Text Available Background: Work in voiding (WIV of the bladder may be used to evaluate bladder status throughout urination rather than at a single time point. Few studies, however, have assessed WIV owing to the complexity of its calculations. We have developed a method of calculating work capacity of the bladder while voiding and analyzed the associations of bladder work parameters with bladder contractile function and bladder outlet obstruction (BOO. Methods: The study retrospectively evaluated 160 men and 23 women, aged >40 years and with a detrusor pressure at maximal flow rate (P det Q max of ≥40 cmH 2 O in men, who underwent urodynamic testing. The bladder power integration method was used to calculate WIV; WIV per second (WIV/t and WIV per liter of urine voided (WIV/v were also calculated. In men, the relationships between these work capacity parameters and P det Q max and Abrams-Griffiths (AG number were determined using linear-by-linear association tests, and relationships between work capacity parameters and BOO grade were investigated using Spearman′s association test. Results: The mean WIV was 1.15 ± 0.78 J and 1.30 ± 0.88 J, mean WIV/t was 22.95 ± 14.45 mW and 23.78 ± 17.02 mW, and mean WIV/v was 5.59 ± 2.32 J/L and 2.83 ± 1.87 J/L in men and women, respectively. In men, WIV/v showed significant positive associations with P det Q max (r = 0.845, P = 0.000, AG number (r = 0.814, P = 0.000, and Schafer class (r = 0.726, P = 0.000. Conversely, WIV and WIV/t showed no associations with P det Q max or AG number. In patients with BOO (Schafer class > II, WIV/v correlated positively with increasing BOO grade. Conclusions: WIV can be calculated from simple urodynamic parameters using the bladder power integration method. WIV/v may be a marker of BOO grade, and the bladder contractile function can be evaluated by WIV and WIV/t.

  11. Postoperative Autologous Reinfusion in Total Knee Replacement

    OpenAIRE

    A. Crescibene; Martire, F.; Gigliotti, P.; Rende, A.; Candela, M

    2015-01-01

    Surgeries for total knee replacement (TKR) are increasing and in this context there is a need to develop new protocols for management and use of blood transfusion therapy. Autologous blood reduces the need for allogeneic blood transfusion and the aim of the present study was to verify the safety and the clinical efficacy. An observational retrospective study has been conducted on 124 patients, undergoing cemented total knee prosthesis replacement. Observed population was stratified into two g...

  12. Afatinib inhibits proliferation and invasion and promotes apoptosis of the T24 bladder cancer cell line

    OpenAIRE

    Tang, Yunhua; Zhang, XiangYang; QI, FAN; CHEN, MINGFENG; Li, Yuan; Liu, Longfei; He, Wei; Li, Zhuo; Zu, Xiongbing

    2015-01-01

    Afatinib is a highly selective, irreversible inhibitor of the epidermal growth factor receptor (EGFR) and human EGFR 2 (HER-2). Although preclinical and clinical studies have indicated that afatinib has antitumor activity and clinical efficacy in non-small cell lung carcinoma, head and neck squamous cell carcinoma and breast cancer, there are few studies investigating its inhibitory effect on human bladder carcinoma cells. In this study, the antitumor effect of afatinib was investigated on th...

  13. Occult Pelvic Lymph Node Involvement in Bladder Cancer: Implications for Definitive Radiation

    Energy Technology Data Exchange (ETDEWEB)

    Goldsmith, Benjamin; Baumann, Brian C.; He, Jiwei; Tucker, Kai; Bekelman, Justin; Deville, Curtiland; Vapiwala, Neha [Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania (United States); Vaughn, David; Keefe, Stephen M. [Department of Medical Oncology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania (United States); Guzzo, Thomas; Malkowicz, S. Bruce [Department of Urology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania (United States); Christodouleas, John P., E-mail: christojo@uphs.upenn.edu [Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania (United States)

    2014-03-01

    Purpose: To inform radiation treatment planning for clinically staged, node-negative bladder cancer patients by identifying clinical factors associated with the presence and location of occult pathologic pelvic lymph nodes. Methods and Materials: The records of patients with clinically staged T1-T4N0 urothelial carcinoma of the bladder undergoing radical cystectomy and pelvic lymphadenectomy at a single institution were reviewed. Logistic regression was used to evaluate associations between preoperative clinical variables and occult pathologic pelvic or common iliac lymph nodes. Percentages of patient with involved lymph node regions entirely encompassed within whole bladder (perivesicular nodal region), small pelvic (perivesicular, obturator, internal iliac, and external iliac nodal regions), and extended pelvic clinical target volume (CTV) (small pelvic CTV plus common iliac regions) were calculated. Results: Among 315 eligible patients, 81 (26%) were found to have involved pelvic lymph nodes at the time of surgery, with 38 (12%) having involved common iliac lymph nodes. Risk of occult pathologically involved lymph nodes did not vary with clinical T stage. On multivariate analysis, the presence of lymphovascular invasion (LVI) on preoperative biopsy was significantly associated with occult pelvic nodal involvement (odds ratio 3.740, 95% confidence interval 1.865-7.499, P<.001) and marginally associated with occult common iliac nodal involvement (odds ratio 2.307, 95% confidence interval 0.978-5.441, P=.056). The percentages of patients with involved lymph node regions entirely encompassed by whole bladder, small pelvic, and extended pelvic CTVs varied with clinical risk factors, ranging from 85.4%, 95.1%, and 100% in non-muscle-invasive patients to 44.7%, 71.1%, and 94.8% in patients with muscle-invasive disease and biopsy LVI. Conclusions: Occult pelvic lymph node rates are substantial for all clinical subgroups, especially patients with LVI on biopsy. Extended

  14. Occult Pelvic Lymph Node Involvement in Bladder Cancer: Implications for Definitive Radiation

    International Nuclear Information System (INIS)

    Purpose: To inform radiation treatment planning for clinically staged, node-negative bladder cancer patients by identifying clinical factors associated with the presence and location of occult pathologic pelvic lymph nodes. Methods and Materials: The records of patients with clinically staged T1-T4N0 urothelial carcinoma of the bladder undergoing radical cystectomy and pelvic lymphadenectomy at a single institution were reviewed. Logistic regression was used to evaluate associations between preoperative clinical variables and occult pathologic pelvic or common iliac lymph nodes. Percentages of patient with involved lymph node regions entirely encompassed within whole bladder (perivesicular nodal region), small pelvic (perivesicular, obturator, internal iliac, and external iliac nodal regions), and extended pelvic clinical target volume (CTV) (small pelvic CTV plus common iliac regions) were calculated. Results: Among 315 eligible patients, 81 (26%) were found to have involved pelvic lymph nodes at the time of surgery, with 38 (12%) having involved common iliac lymph nodes. Risk of occult pathologically involved lymph nodes did not vary with clinical T stage. On multivariate analysis, the presence of lymphovascular invasion (LVI) on preoperative biopsy was significantly associated with occult pelvic nodal involvement (odds ratio 3.740, 95% confidence interval 1.865-7.499, P<.001) and marginally associated with occult common iliac nodal involvement (odds ratio 2.307, 95% confidence interval 0.978-5.441, P=.056). The percentages of patients with involved lymph node regions entirely encompassed by whole bladder, small pelvic, and extended pelvic CTVs varied with clinical risk factors, ranging from 85.4%, 95.1%, and 100% in non-muscle-invasive patients to 44.7%, 71.1%, and 94.8% in patients with muscle-invasive disease and biopsy LVI. Conclusions: Occult pelvic lymph node rates are substantial for all clinical subgroups, especially patients with LVI on biopsy. Extended

  15. Temporal Artery versus Bladder Thermometry during Adult Medical-Surgical Intensive Care Monitoring: An Observational Study

    OpenAIRE

    Stelfox Henry T; Straus Sharon E; Ghali William A; Conly John; Laupland Kevin; Lewin Adriane

    2010-01-01

    Abstract Background We sought to evaluate agreement between a new and widely implemented method of temperature measurement in critical care, temporal artery thermometry and an established method of core temperature measurement, bladder thermometry as performed in clinical practice. Methods Temperatures were simultaneously recorded hourly (n = 736 observations) using both devices as part of routine clinical monitoring in 14 critically ill adult patients with temperatures ranging ≥1°C prior to ...

  16. Quick note on tissue engineering-based surgical measures to treat patients with neurogenic bladder-due detrusor/sphincter dyssynergia.

    Science.gov (United States)

    Alberti, Contardo

    2015-01-01

    To treat the neurogenic bladder-due detrusor/urethral rhabdosphincter dyssynergia, early combined clean intermittent catheterization/ pharmacotherapy (anticholinergic-, β3-adrenoceptor agonist drugs) management may be at times crowned with success of preserving an adequate bladder compliance and renal safe conditions.The persistence, instead, of elevated bladder filling pressure levels with high voiding pressure/uroflow values, together with aberrant urethral rhabdosphincter electromyographic findings, make necessary the resort to surgery strategies, among which - a part from rhabdosphincterotomy or alternatively intrasphincteric botulinum A toxin injection or urethral stent insertion - the bladder augmentation cystoplasty, with either reconfigurated bowel- or gastric segment, is today the most efficacious surgical measure to increase the bladder urinary storage meanwhile lowering bladder filling pressure. Given the enterocistoplasty-dependent both potential systemic metabolic imbalances - such as hyperchloremic acidosis/hypokaliemia, hyperoxaluria, bone demineralization, chologenic diarrhoea/steatorrhoea, vit B12 deficiency - together with bowel prosthetic mucus overproduction-due recurrent stone formation, and, sometimes, malignant complications particularly at the intestinal-urinary tract suture line, tissue engineering techniques have been taken into consideration, more than twenty years ago, as alternative measure for bladder augmentation cystoplasty, until to reach successful clinical validation just in patients suffering from either congenital dysraphism- or acquired spinal cord injury-dependent neurogenic bladder. Nevertheless, also the tissue engineering-made augmentation cistoplasty, as well as that bowel-based one, unfortunately remains influenced by spinal cord neuropathydue dysfunctional effects, hence the tissue engineering research could be today directed to suitably overcome such disadvantageous conditions. PMID:26042661

  17. Hip replacement - precautions

    Science.gov (United States)

    ... Barker KL, Dewey ME, Sackley CM. Effectiveness of physiotherapy exercise following hip arthroplasty for osteoarthritis: a systematic ... to ask your doctor Hip replacement - discharge Preventing falls - what to ask your doctor Update Date 11/ ...

  18. Total Knee Replacement

    Science.gov (United States)

    ... following total knee replacement include unlimited walking, swimming, golf, driving, light hiking, biking, ballroom dancing, and other ... to the final success of your surgery. To learn more about the full value of total knee ...

  19. Hormone Replacement Therapy

    Science.gov (United States)

    ... before and during menopause, the levels of female hormones can go up and down. This can cause ... hot flashes and vaginal dryness. Some women take hormone replacement therapy (HRT), also called menopausal hormone therapy, ...

  20. Knee joint replacement - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100088.htm Knee joint replacement - series To use the sharing features ... 4 out of 4 Normal anatomy Overview The knee is a complex joint. It contains the distal ...

  1. The replacement research reactor

    International Nuclear Information System (INIS)

    As a consequences of the government decision in September 1997. ANSTO established a replacement research reactor project to manage the procurement of the replacement reactor through the necessary approval, tendering and contract management stages This paper provides an update of the status of the project including the completion of the Environmental Impact Statement. Prequalification and Public Works Committee processes. The aims of the project, management organisation, reactor type and expected capabilities are also described

  2. Transcatheter Pulmonary Valve Replacement

    OpenAIRE

    Ghawi, Hani; Kenny, Damien; Hijazi, Ziyad M.

    2012-01-01

    Transcatheter pulmonary valve replacement (tPVR) has evolved into a viable alternative to surgical conduit or bioprosthetic valve replacement. This procedure has paved the way for a more advanced approach to congenital and structural interventional cardiology. Although many successes have been noted, there are still a number of challenges with this procedure, including large delivery systems, the need for a conduit or a bioprosthetic valve as a landing zone for the valve, optimal timing of th...

  3. Prodisc-C人工颈椎椎间盘置换的临床疗效观察和运动功能评估%Clinical efficiency and motor function assessment of Prodisc-C artificial cervical disc replacement

    Institute of Scientific and Technical Information of China (English)

    陈道森; 施荣茂; 周强; 罗飞; 代飞; 张劲松; 许建中

    2011-01-01

    目的 通过术后随访评价Prodisc-C人工颈椎椎间盘置换术(artificial cervical disc replacement,ACDR)治疗颈椎病的临床疗效及其对颈椎置换节段、邻近节段运动功能的影响.方法 回顾性分析2009年8月~2011年2月行Prodisc-C ACDR治疗20例颈椎病患者,其中脊髓型9例、神经根型8例、混合型3例,单椎间盘置换17例、双椎间盘置换3例.患者术前行CT、MRI检查明确诊断,术前和术后定期行疼痛视觉模拟量表(visual analogue scale,VAS)和日本骨科学会(Japanese Orthopaedic Association,JOA)及摄颈椎X线片.结果 13例患者获得6~18个月随访.患者术前颈肩背疼痛、上下肢麻木、肌力减弱等不适症状均明显改善.术后VAS及JOA评分均较术前明显改善,差异有统计学意义(P<0.01);置换节段椎间活动度( range of motion,ROM)在术后1、3、6个月显著增大,与术前相比差异有统计学意义(P<0.01);在末次随访时仍大于术前,差异有统计学意义(P<0.05);上下位邻近节段椎间隙高度和椎间ROM与术前相比,差异无统计学意义(P>0.05).所有病例未见假体松动、移位和异位骨化.结论 Prodisc-C ACDR短期随访疗效优良,置换节段ROM增大,邻近节段椎间隙高度和椎间ROM维持在正常水平,但远期疗效还有待进一步随访观察.%Objective To evaluate the clinical efficacy of artificial cervical disc replacement (ACDR) with Prodisc-C and its effects on the motor function of the replaced level and adjacent segments. Methods A total of 20 patients who received ACDR with Prodisc-C from April 2009 to February 2011 were retrospectively analyzed. There were 9 patients with myelopathy, 8 with radiculopa-thy, and the left 3 with both symptoms. There were 17 participators received single level replacement, and the other 3 had 2 levels replaced. All the patients received CT and MRI preoperatively for accurate diagnosis. Visual analogue scale ( VAS) scores for neck and arm

  4. Sympathetic β-adrenergic mechanism in pudendal inhibition of nociceptive and non-nociceptive reflex bladder activity.

    Science.gov (United States)

    Kadow, Brian T; Lyon, Timothy D; Zhang, Zhaocun; Lamm, Vladimir; Shen, Bing; Wang, Jicheng; Roppolo, James R; de Groat, William C; Tai, Changfeng

    2016-07-01

    This study investigated the role of the hypogastric nerve and β-adrenergic mechanisms in the inhibition of nociceptive and non-nociceptive reflex bladder activity induced by pudendal nerve stimulation (PNS). In α-chloralose-anesthetized cats, non-nociceptive reflex bladder activity was induced by slowly infusing saline into the bladder, whereas nociceptive reflex bladder activity was induced by replacing saline with 0.25% acetic acid (AA) to irritate the bladder. PNS was applied at multiple threshold (T) intensities for inducing anal sphincter twitching. During saline infusion, PNS at 2T and 4T significantly (P < 0.01) increased bladder capacity to 184.7 ± 12.6% and 214.5 ± 10.4% of the control capacity. Propranolol (3 mg/kg iv) had no effect on PNS inhibition, but 3-[(2-methyl-4-thiazolyl)ethynyl]pyridine (MTEP; 1-3 mg/kg iv) significantly (P < 0.05) reduced the inhibition. During AA irritation, the control bladder capacity was significantly (P < 0.05) reduced to ∼22% of the saline control capacity. PNS at 2T and 4T significantly (P < 0.01) increased bladder capacity to 406.8 ± 47% and 415.8 ± 46% of the AA control capacity. Propranolol significantly (P < 0.05) reduced the bladder capacity to 276.3% ± 53.2% (at 2T PNS) and 266.5 ± 72.4% (at 4T PNS) of the AA control capacity, whereas MTEP (a metabotropic glutamate 5 receptor antagonist) removed the residual PNS inhibition. Bilateral transection of the hypogastric nerves produced an effect similar to that produced by propranolol. This study indicates that hypogastric nerves and a β-adrenergic mechanism in the detrusor play an important role in PNS inhibition of nociceptive but not non-nociceptive reflex bladder activity. In addition to this peripheral mechanism, a central nervous system mechanism involving metabotropic glutamate 5 receptors also has a role in PNS inhibition. PMID:27170683

  5. Effects of urinary bladder distention on location of the urinary bladder and urethra of healthy dogs and cats

    International Nuclear Information System (INIS)

    Evaluation of the anatomic location of the distended and empty urinary bladders and urethras of healthy adult male and female dogs and cats by retrograde urethrocystography revealed substantial variations. In 15 dogs in lateral recumbency with empty bladder lumens, the caudal portion of the urinary bladder was within the pelvic canal in 5 of 7 male and 5 of 8 female dogs. In female dogs examined in ventrodorsal recumbency, only 4 of 8 had the empty urinary bladders in part within the pelvic canal. After luminal distention, 3 of 7 male and 3 of 8 female dogs, while in lateral recumbency, had the urinary bladders in part intrapelvically. However, when female dogs were placed in ventrodorsal recumbency, only 1 of 7 urinary bladders was in part within the pelvis. The urinary bladders of 14 cats were consistently within the abdominal cavity, irrespective of whether the bladder lumen was distended or empty. Urethral flexures occurred in dogs with intrapelvic bladders that were distended or empty. Urethral flexures were not found in cats. The urethras of dogs and cats in lateral recumbency were generally closer to the floor of the pelvis after urinary bladder distention than when the bladder was empty. The urethra of the dogs and cats in ventrodorsal recumbency was to the left or right of or on the midsagittal plane, whether the urinary bladder was empty or distended. A greater degree of lateral displacement was encountered in ventrodorsal recumbency after urinary bladder distention

  6. 5-Hydroxytryptamine-induced bladder hyperactivity via the 5-HT2A receptor in partial bladder outlet obstruction in rats.

    Science.gov (United States)

    Sakai, Takumi; Kasahara, Ken-ichi; Tomita, Ken-ichi; Ikegaki, Ichiro; Kuriyama, Hiroshi

    2013-04-01

    We investigated the effects of partial bladder outlet obstruction (BOO) on the function and gene expression of 5-hydroxytryptamine (5-HT) receptor subtypes in rat bladder. Isometric contractions of the isolated bladders from sham-operated control and BOO rats were examined. The contractile responses to 5-HT were significantly increased in BOO rat bladder strips, while the responses to KCl, carbachol, or phenylephrine were not different from the control. The 5-HT-induced hypercontraction in BOO rat bladder strips was inhibited by ketanserin, a 5-HT(2A) receptor antagonist. The contractile responses to 5-HT in bladder strips were not affected by urothelium removal from the intact bladder. The gene expression of 5-HT receptor subtypes in the bladders was analyzed by RT-PCR. The mRNA expression of the 5-HT(2A), 5-HT(2B), 5-HT(2C), 5-HT(4), and 5-HT(7) receptors was detected in both the control and BOO rat bladders. Quantitative RT-PCR analysis showed there was a significant increase of 5-HT(2A) receptor mRNA in the BOO rat bladder compared with the control bladder. On the other hand, the gene expression of the 5-HT(4) receptor was not changed in the BOO rat bladder. These results suggest that the increased contractile responses to 5-HT in BOO rat bladder may be partly caused by 5-HT(2A) receptor upregulation in the detrusor smooth muscles. PMID:23344575

  7. Results of Austin Moore replacement.

    Directory of Open Access Journals (Sweden)

    Jadhav A

    1996-04-01

    Full Text Available Forty cases of Austin Moore Replacement done for transcervical fractures of the femur in patients were reviewed after a period of 12 to 48 months postoperatively (mean 26 mth. 30 cases (75% had mild to severe pain of non-infective origin, starting as early as 6 months postoperatively. This was irrespective of the make, size or position (varus/valgus of the prosthesis. Though the Aufranc and Sweet clinical scoring was satisfactory in 65% cases, radiological evidence of complications like sinking, protrusion, etc. were seen in majority of the cases. Calcar resorption was seen in 34 cases (85% as early as 4 months postoperatively. Results of THR and bipolar replacement done for transcervical fractures in recent literature show 85% pain-free cases at 5 years. We feel that Austin Moore Replacement should be reserved for patients more than 65 years of age and those who are less active or debilitated because of other factors, because of increased acetabular wear with time in the younger individual. This is corroborated by unsatisfactory results in patients less than 65 years of age (p < 0.05.

  8. Bladder emptying by intermittent electrical stimulation of the pudendal nerve

    Science.gov (United States)

    Boggs, Joseph W.; Wenzel, Brian J.; Gustafson, Kenneth J.; Grill, Warren M.

    2006-03-01

    Persons with a suprasacral spinal cord injury cannot empty their bladder voluntarily. Bladder emptying can be restored by intermittent electrical stimulation of the sacral nerve roots (SR) to cause bladder contraction. However, this therapy requires sensory nerve transection to prevent dyssynergic contraction of the external urethral sphincter (EUS). Stimulation of the compound pudendal nerve trunk (PN) activates spinal micturition circuitry, leading to a reflex bladder contraction without a reflex EUS contraction. The present study determined if PN stimulation could produce bladder emptying without nerve transection in cats anesthetized with α-chloralose. With all nerves intact, intermittent PN stimulation emptied the bladder (64 ± 14% of initial volume, n = 37 across six cats) more effectively than either distention-evoked micturition (40 ± 19%, p 0.10), indicating that PN stimulation was not limited by bladder-sphincter dyssynergia. Intermittent PN stimulation holds promise for restoring bladder emptying following spinal injury without requiring nerve transection.

  9. FDG-PET for preoperative staging of bladder cancer

    International Nuclear Information System (INIS)

    The presence of lymph node involvement (N) and distant metastasis (M) in patients with invasive bladder carcinoma is a major determinant of survival and, therefore, a pivotal element in the therapeutic management. The aim of this prospective study was to evaluate the use of18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in this indication. Whole-body FDG-PET and computed tomography (CT) were performed in 55 patients with non-metastatic invasive bladder cancer for preoperative staging. Correlative imaging of PET with CT was performed, leading to a PET(CT) result. The imaging results were compared with the gold standard, consisting of histopathology (lymphadenectomy, guided biopsy) or clinical follow-up for 12 months, and related to overall survival using the Kaplan-Meier method. The gold standard was available in 40 patients and indicated NM-positive disease in 15 patients (12 N lesions, 8 M lesions), and NM-negative disease in 25 patients. For the diagnosis of NM-positive disease, the sensitivity, specificity and accuracy of PET(CT) were 60%, 88% and 78%, respectively. Diagnostic discordances between PET(CT) and CT alone were found in 9/40 patients, among whom PET was correct in six (15%): three with true-positive and one with true-negative distant metastases, and two with true-negative lymph nodes. Median survival time of patients in whom PET(CT) indicated NM-positive disease was 13.5 months, compared with 32.0 months in the patients with a NM-negative PET(CT) (p=0.003). Addition of metabolism-based information provided by FDG-PET to CT in the preoperative staging of invasive bladder carcinoma yields a high diagnostic and prognostic accuracy. (orig.)

  10. Aspectos clínico-hematológicos e lesões vesicais na intoxicação crônica espontânea por Pteridium aquilinum em bovinos Clinical and hematological aspects and urinary bladder lesions in chronic spontaneous poisoning by Pteridium aquilinum in cattle

    Directory of Open Access Journals (Sweden)

    Adriane L. Gabriel

    2009-07-01

    ão-neoplásicas (6/17, alterações gerais na lâmina própria (6/22 e alterações inflamatórias (5/17. Os achados histológicos das bexigas dos casos de HEB foram classificados da mesma forma, resultando em 19 tipos diferentes de alterações morfológicas. Dessas, 5/19 eram alterações neoplásicas e 14/20, alterações não-neoplásicas (9/14 alterações epiteliais não neoplásicas, 3/14 alterações gerais na lâmina própria e 2/14 alterações inflamatórias. Na HEB, os neoplasmas mesenquimais foram mais freqüentemente observados que os epiteliais, e a maior parte era maligna. A técnica de imuno-histoquímica foi utilizada para caracterizar os aspectos morfológicos, principalmente dos neoplasmas. Através do estudo morfológico concluiu-se que é muito freqüente a ocorrência de lesões vesicais em bovinos com a forma crônica de CCEs no TAS e que essas lesões são idênticas às encontradas nos bovinos com HEB.Spontaneous cases of chronic poisoning by Pteridium aquilinum in cattle were studied. The clinical forms of the disease were squamous cell carcinoma (SCCs of the upper digestive tract (UDT and bovine enzootic hematuria (BEH. The cases were from the midland Region of the Midwest of Rio Grande do Sul State, Brazil, and were submitted to the Laboratório de Patologia Veterinária of the Universidade Federal de Santa Maria. Clinical signs and blood work were evaluated at terminal phase of disease. Cattle with UDT SCCs had progressive weigth loss, ruminal atony, cough, dysphagia, bloating, and regurgitation. In cattle with BEH, hematuria was observed in all cases, followed by progressive weight loss. Non-regenerative anemia was detected in 33.33% of the cattle with UDT SCCs form and in 66.66% of the cattle with BEH form. Changes in white blood count occurred in some cases but drop in lymphocyte numbers was uncommon in both forms of disease. For the morphological study, urinary bladders from 46 cattle with UDT SCCs and 11 cattle with BEH were analyzed. Grossly, 16

  11. Social stress induces changes in urinary bladder function, bladder NGF content, and generalized bladder inflammation in mice

    OpenAIRE

    Mingin, Gerald C.; Peterson, Abbey; Erickson, Cuixia Shi; Nelson, Mark T.; Vizzard, Margaret A.

    2014-01-01

    Social stress may play a role in urinary bladder dysfunction in humans, but the underlying mechanisms are unknown. In the present study, we explored changes in bladder function caused by social stress using mouse models of stress and increasing stress. In the stress paradigm, individual submissive FVB mice were exposed to C57BL/6 aggressor mice directly/indirectly for 1 h/day for 2 or 4 wk. Increased stress was induced by continuous, direct/indirect exposure of FVB mice to aggressor mice for ...

  12. Type rotating hinge knee replacement treatment knee bone tumor clinical curative effect analysis%旋转铰链型膝关节置换术治疗膝部骨肿瘤临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    马伟; 于金华; 曲成明

    2015-01-01

    目的:分析旋转铰链型膝关节置换术治疗膝部骨肿瘤临床疗效。方法随机选取2011年2月至2014年2月在我院采用旋转铰链型膝关节置换术治疗膝部骨肿瘤的40例患者作为研究对象,对术后患者进行随访和Enneking肢体功能评分,分析旋转铰链型膝关节置换术治疗膝部骨肿瘤的临床治疗效果。结果40例患者经过治疗后,有2例患者出现肢体麻木,不敢行走的现象,有3例肿患者出现伤口感染现象;通过6个月的随访,所有患者的膝关节运动良好,行走时未出现跛行状况,与正常肢体无大差异;Enneking肢体功能评分,在胫骨上端行旋转铰链型膝关节置换术的患者评分为优的有29例,在股骨下端行旋转铰链型膝关节置换术的患者评分为优的有32例,对所有患者进行X片检查,未出现假体松动、下沉等异样。结论旋转铰链型膝关节置换术治疗膝部骨肿瘤效果良好,是膝部骨肿瘤保肢的良好方法。%Objective Analysis of the rotating hinge knee replacement treatment of bone tumors of the knee clinical curative effect. Methods Randomly selected from February 2011 to February 2014 in our hospital USES the rotating hinge knee replacement treatment of bone tumors of the knee of 40 patients as the research object, follow-up and Enneking limb function in patients with postoperative scores, type analysis of rotating hinge knee arthroplasty clinical treatment effect for the treatment of bone tumors of the knee. Results 40 patients after treatment, 2 cases with numbness, dare not walk phenomenon, there are 3 cases of patients with wound infection;Through six months of follow-up, all patients with knee joint movement is good, does not appear when walking limp, and normal body no big difference;Enneking limb function score, at the upper tibia type line of rotating hinge knee arthroplasty patients score for optimal in 29 cases, the bottom line of femoral

  13. Impact of diabetes mellitus on bladder uroepithelial cells

    OpenAIRE

    Hanna-Mitchell, Ann T.; Ruiz, Giovanni W.; Daneshgari, Firouz; Liu, Guiming; Apodaca, Gerard; Birder, Lori A.

    2012-01-01

    Diabetic bladder dysfunction (DBD), a prevalent complication of diabetes mellitus (DM), is characterized by a broad spectrum of symptoms including urinary urgency, frequency, and incontinence. As DBD is commonly diagnosed late, it is important to understand the chronic impact of DM on bladder tissues. While changes in bladder smooth muscle and innervation have been reported in diabetic patients, the impact of DM on the specialized epithelial lining of the urinary bladder, the urothelium (UT),...

  14. A pure microcytic bladder carcinoma synchronous to prostatic adenocarcinoma.

    OpenAIRE

    Vasileios Sakalis; Anastasia Gkotsi; Efrosyni Mylonaki; Aphroditi Pantzaki; Vasileios Rombis

    2011-01-01

    Small cell carcinoma (SCC) or microcytic carcinoma of the urinary bladder is a rare entity comprising approximately 0.5% of all bladder tumors. Due to its rarity, no prospective studies evaluating the most effective treatment have been published in the medical literature. Several cases of bladder SCC have been presented so far. We describe our case report and we revise the recent literature. Our patient was diagnosed with pure bladder SCC and prostatic adenocarcinoma. After the initial and co...

  15. Methylenetetrahydrofolate Reductase Polymorphisms at Familial Bladder Cancer: Case Report

    OpenAIRE

    Gulay Ceylan

    2016-01-01

    Bladder cancer is the seventh most common cancer in men in the world, it is the second most seen cancer after lung cancer and the first in urogenital tumours in Turkey. Many molecular epidemiologic studies have been reported to investigate the associations between the MTHFR C677T and A1298C polymorphisms and bladder cancer risk. In this report, a family with transitional bladder cancer have also MTHFR A1298C heterozygosity which supports the association between MTHFR variants and bladder canc...

  16. [Modern approaches to the treatment of patients with overactive bladder and urge urinary incontinence].

    Science.gov (United States)

    Razdorskaia, M V; Neĭmark, A I; Aliev, R T

    2013-01-01

    Overactive bladder (OAB) is found in 20% of patients with various disorders of urination, and the imperative urinary incontinence diagnosed in one third of these patients. The study was aimed to improvement the treatment outcomes in OAB women with imperative incontinence and obstructive urination disorders by using a combination of alpha1-adrenoblockers and PDE-5 inhibitors, and to evaluation of relationship between clinical and urodynamic manifestations of the disease. The state of the microcirculation of the bladder mucosa before and after treatment was also evaluated. We have examined and treated 40 women aged 17 to 69 years with disease duration ranged from 1 to 20 years. Patients received combination of al-adrenoblocker alfuzosin (dalfaz) 5 mg at night and reversible selective PDE5 inhibitor tadalafil (Cialis) 5 mg daily in the morning for a month. After treatment, according to the uroflowmetry and cystometry data, the time of urination was reduced, urinary volume and maximum urinary flow rate, as well as cystometric capacity have increased; involuntary detrusor contractions in the bladder filling phase (spontaneous or provoked) became less, or absent. According to the results of ultrasound examination, residual urine volume has decreased. Laser Doppler flowmetry showed an increase of neurogenic tone in precapillary, bypass coefficient and microcirculation effectiveness index, increase in microcirculation index and the coefficient of variation, indicating an improvement of microcirculation in the bladder mucosa. As a result of treatment, the clinical effect was seen in 29 (73%) patients, urinary incontinence was noted only in 6 (15%) patients. PMID:23662495

  17. 18F-FDG PET/CT Findings of Metastasis to Spongy Body of Penis From Urothelial Carcinoma of Bladder.

    Science.gov (United States)

    Wang, Yan-Li; Fang, Na; Zeng, Lei; Wu, Zeng-Jie; Cui, Xin-Jian

    2016-05-01

    The spongy body of the penis metastasis from other primary sites is a rare clinical entity. It is frequently associated with widespread metastatic disease and poor prognosis clinically. We report a case of a 61-year-old man with a previous history of cystectomy due to infiltrating urothelial carcinoma of the bladder 12 months ago and presented with penile shaft swelling pain and hematuria for 3 months. The restaging F-FDG PET/CT scan demonstrated a hypermetabolic mass at his penile shaft. This lesion was confirmed on phallectomy to be infiltrating urothelial carcinoma metastasis from the known primary bladder tumor. PMID:26359570

  18. Initial Results of Bladder Preserving Approach by Chemo-Radiotherapy in Patients with Muscle Invading Transitional Cell Carcinoma

    International Nuclear Information System (INIS)

    This study was conducted to test the efficacy and tolerability of trimodality treatment for invasive bladder cancer and to test the possibility of bladder sparing. Methods: This study had been carried out on 50 patients with transitional cell carcinoma (TCC) stage T2- T3 tumors with adequate performance status and renal function. All patients were subjected to maximum transurethral resection of bladder tumors (TURBT). Patients were then subjected to chemo-radiation that was executed in two treatment phases. Phase I was external radiotherapy in the form of 46 Gy /23 fractions /5 weeks to whole pelvis with concurrent cisplatin 40 mg/m2 weekly. Phase II was 20 Gy /10 fractions /2 weeks to the bladder tumor with concurrent cisplatin 40 mg/m2 weekly. After phase I, patients who had complete response (CR) or partial response (PR) were subjected to phase II and patients who had stationary disease (SD) were subjected to salvage cystectomy. After the end of treatment, patients who had CR were subjected to bladder preservation. Radiological and cystoscopic reevaluation was done to assess the tumor response after phase I and phase II. After completion of the scheduled treatment, patients were under follow up for clinical examination, radiological, and cystoscopic assessment. Results: The treatment schedule was tolerable and was associated with infrequent incidence of moderate toxicity that was easily controlled without interruption of treatment. Bladder preservation was achieved in 72% of patients. The actuarial relapse free survival and overall survival at a median follow up 18 months for patients who were candidate for bladder preservation were 81% and 100%; respectively. Invasive recurrence (16%) sal-Jvaged with cystectomy and superficial recurrence (6%) successfully treated with Bacilles bilie de Calmette- Guerin. Conclusions: This study indicates that in spite of a relatively small number of patients and short follow-up period; the trimodality treatment could be an

  19. The relationship between the bladder volume and optimal treatment planning in definitive radiotherapy for localized prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, Naoki; Sekiguchi, Kenji; Akahane, Keiko [Dept. of Radiation Oncology, St. Luke' s International Hospital, Tokyo (Japan)], e-mail: nnakamur-tky@umin.ac.jp; Shikama, Naoto [Dept. of Radiation Oncology, Saitama Medical Univ., Hidaka (Japan); Takahashi, Osamu [Div. of General Internal Medicine, Dept. of Medicine, St. Luke' s International Hospital, Tokyo (Japan); Hama, Yukihiro [Dept. of Radiology, Edogawa Hospital, Tokyo (Japan); Nakagawa, Keiichi [Dept. of Radiology, Tokyo Univ. School of Medicine, Tokyo (Japan)

    2012-07-15

    Background and purpose: There is no current consensus regarding the optimal bladder volumes in definitive radiotherapy for localized prostate cancer. The aim of this study was to clarify the relationship between the bladder volume and optimal treatment planning in radiotherapy for localized prostate cancer. Material and methods: Two hundred and forty-three patients underwent definitive radiotherapy with helical tomotherapy for intermediate- and high-risk localized prostate cancer. The prescribed dose defined as 95 % of the planning target volume (PTV) receiving 100 % of the prescription dose was 76 Gy in 38 fractions. The clinical target volume (CTV) was defined as the prostate with a 5-mm margin and 2 cm of the proximal seminal vesicle. The PTV was defined as the CTV with a 5-mm margin. Treatment plans were optimized to satisfy the dose constraints defined by in-house protocols for PTV and organs at risk (rectum wall, bladder wall, sigmoid colon and small intestine). If all dose constraints were satisfied, the plan was defined as an optimal plan (OP). Results: An OP was achieved with 203 patients (84%). Mean bladder volume ({+-} 1 SD) was 266 ml ({+-} 130 ml) among those with an OP and 214 ml ({+-}130 ml) among those without an OP (p = 0.02). Logistic regression analysis also showed that bladder volumes below 150 ml decreased the possibility of achieving an OP. However, the percentage of patients with an OP showed a plateau effect at bladder volumes above 150 ml. Conclusions. Bladder volume is a significant factor affecting OP rates. However, our results suggest that bladder volumes exceeding 150 ml may not help meet planning dose constraints.

  20. The conceptualization and development of a patient-reported neurogenic bladder symptom score

    Directory of Open Access Journals (Sweden)

    Welk B

    2013-10-01

    Full Text Available Blayne Welk,1 Sarah A Morrow,2 Wendy Madarasz,3 Patrick Potter,4 Keith Sequeira41Department of Surgery, Division of Urology, 2Department of Clinical Neurosciences, Western University, London, ON, Canada; 3St Joseph's Health Care, London Ontario, Canada; 4Department of Physical Medicine and Rehabilitation, Western University, London, ON, CanadaBackground: There is no single patient-reported instrument that was developed specifically to assess symptoms and bladder-related consequences for neurogenic bladder dysfunction. The purpose of this study was to identify and consolidate items for a novel measurement tool for this population.Methods: Item generation was based on a literature review of existing instruments, open-ended semistructured interviews with patients, and expert opinion. Judgment-based item reduction was performed by a multidisciplinary expert group. The proposed questionnaire was sent to external experts for review.Results: Eight neurogenic quality of life measures and 29 urinary symptom-specific instruments were identified. From these, 266 relevant items were extracted and used in the creation of the new neurogenic symptom score. Qualitative interviews with 16 adult patients with neurogenic bladder dysfunction as a result of spinal cord injury, multiple sclerosis, or spina bifida were completed. Dominant themes included urinary incontinence, urinary tract infections, urgency, and bladder spasms. Using the literature review and interview data, 25 proposed items were reviewed by 12 external experts, and the questions evaluated based on importance on a scale of 1 (not important to 5 (very important. Retained question domains had high mean importance ratings of 3.1 to 4.3 and good agreement with answer hierarchy.Conclusion: The proposed neurogenic bladder symptom score is a novel patient-reported outcome measure. Further work is underway to perform a data-based item reduction and to assess the validity and reliability of this instrument

  1. Synchronous triple urogenital cancer (renal cancer, bladder cancer, prostatic cancer). A case report

    Energy Technology Data Exchange (ETDEWEB)

    Takada, Tsuyoshi; Honda, Masahito; Momohara, Chikahiro; Komori, Kazuhiko; Fujioka, Hideki [Osaka Police Hospital (Japan)

    2002-04-01

    A case of synchronous triple urogenital cancer, which was comprised of renal cell carcinoma of the left kidney, transitional cell carcinoma of the urinary bladder, and adenocarcinoma of the prostate, is reported. A 72-year-old Japanese male patient was referred to our outpatient clinic with the complaint of asymptomatic hematuria. At that time, his serum of level of PSA was elevated to 20 ng/ml. Cystourethroscopy showed a papillary bladder tumor and coagula through the left urinary orifice. Ultrasonography, computed tomography and magnetic resonance imaging showed a mass lesion measuring about 6 cm by 5 cm in the left kidney. Angiography showed a hypervascular lesion measuring about 6 cm by 5 cm at the same site. Double cancer, consisting of renal cell carcinoma and transitional cell carcinoma of the urinary bladder, was suspected and we performed left total nephroureterectomy, hilar lymphadenectomy, and transurethral rection of the bladder tumor, one month later. At the same time, we performed a biopsy of the prostate. Histological diagnosis was renal cell carcinoma, clear cell carcinoma and transitional cell carcinoma of urinary bladder. Histological diagnosis of the prostate biopsy was moderately differentiated adenocarcinoma. Since this case fulfilled the criteria of Warren and Gates, it was classified as synchronous triple urogenital cancer. A review of the literature revealed 17 authentic cases of triple urogenital cancer, of which 14 and 10 cases were reported as a combination of renal cancer, bladder cancer and prostatic cancer, in the world and in Japan, respectively. Furthermore, he had been exposed to the atomic bomb explosion in Hiroshima in 1945. This carcinogenic precursor may be related to the development of the triple cancer. (author)

  2. Synchronous triple urogenital cancer (renal cancer, bladder cancer, prostatic cancer). A case report

    International Nuclear Information System (INIS)

    A case of synchronous triple urogenital cancer, which was comprised of renal cell carcinoma of the left kidney, transitional cell carcinoma of the urinary bladder, and adenocarcinoma of the prostate, is reported. A 72-year-old Japanese male patient was referred to our outpatient clinic with the complaint of asymptomatic hematuria. At that time, his serum of level of PSA was elevated to 20 ng/ml. Cystourethroscopy showed a papillary bladder tumor and coagula through the left urinary orifice. Ultrasonography, computed tomography and magnetic resonance imaging showed a mass lesion measuring about 6 cm by 5 cm in the left kidney. Angiography showed a hypervascular lesion measuring about 6 cm by 5 cm at the same site. Double cancer, consisting of renal cell carcinoma and transitional cell carcinoma of the urinary bladder, was suspected and we performed left total nephroureterectomy, hilar lymphadenectomy, and transurethral rection of the bladder tumor, one month later. At the same time, we performed a biopsy of the prostate. Histological diagnosis was renal cell carcinoma, clear cell carcinoma and transitional cell carcinoma of urinary bladder. Histological diagnosis of the prostate biopsy was moderately differentiated adenocarcinoma. Since this case fulfilled the criteria of Warren and Gates, it was classified as synchronous triple urogenital cancer. A review of the literature revealed 17 authentic cases of triple urogenital cancer, of which 14 and 10 cases were reported as a combination of renal cancer, bladder cancer and prostatic cancer, in the world and in Japan, respectively. Furthermore, he had been exposed to the atomic bomb explosion in Hiroshima in 1945. This carcinogenic precursor may be related to the development of the triple cancer. (author)

  3. Contemporary management of low-risk bladder cancer

    NARCIS (Netherlands)

    Falke, J.; Witjes, J.A.

    2011-01-01

    Bladder cancer comprises a heterogeneous group of tumors, the majority of which are non-muscle-invasive bladder cancer (NMIBC) at initial presentation. Low-risk bladder cancer--defined as pTa low-grade papillary tumors--is the type of NMIBC with the most favorable oncologic outcome. Although the ris

  4. Chemotherapy and Targeted Therapy for Gall Bladder Cancer

    OpenAIRE

    Sirohi, Bhawna; Singh, Ashish; Jagannath, P.; Shrikhande, Shailesh V.

    2014-01-01

    Gall bladder cancer is a common cancer in the Ganges belt of North-eastern India. In view of incidental diagnosis of gall bladder cancer by physicians and surgeons, the treatment is not optimised. Most patients present in advanced stages and surgery remains the only option to cure. This review highlights the current evidence in advances in systemic therapy of gall bladder cancer.

  5. Cases of a Borderline Pathology That Can Mimic Bladder Cancer: Primary Amyloidosis of Urinary Bladder

    Directory of Open Access Journals (Sweden)

    Cemal Selçuk İşoğlu

    2015-06-01

    Full Text Available Amyloidosis is a disease characterised by accumulation of a fibrillar protein called amyloid in the extracellular space. The kidneys, ureters and the bladder can be affected in the urinary tract. However, primary amyloidosis of bladder is a rare entity. Macroscopic hematuria could be the first and only symptom of primary amyloidosis of the bladder; therefore, it has similar findings with urinary tract malignancies. Histopathological evaluation is mandatory for the diagnosis. Follow-up should always include cystoscopic evaluation as recurrence is expected in the natural course.

  6. Chemotherapy for bladder cancer: treatment guidelines for neoadjuvant chemotherapy, bladder preservation, adjuvant chemotherapy, and metastatic cancer

    DEFF Research Database (Denmark)

    Sternberg, Cora N; Donat, S Machele; Bellmunt, Joaquim;

    2007-01-01

    To determine the optimal use of chemotherapy in the neoadjuvant, adjuvant, and metastatic setting in patients with advanced urothelial cell carcinoma, a consensus conference was convened by the World Health Organization (WHO) and the Société Internationale d'Urologie (SIU) to critically review the...... published literature on chemotherapy for patients with locally advanced bladder cancer. This article reports the development of international guidelines for the treatment of patients with locally advanced bladder cancer with neoadjuvant and adjuvant chemotherapy. Bladder preservation is also discussed, as...

  7. Bladder cancer and occupational exposure to leather.

    OpenAIRE

    Marrett, L D; Hartge, P; Meigs, J W

    1986-01-01

    A large case-control study of bladder cancer (2982 cases; 5782 controls) included information about occupational exposure to leather. Occupational histories of exposed white study subjects were reviewed and 150 were determined to have had "true" on the job exposure to leather. The odds ratio estimate (OR) of bladder cancer associated with such exposure in white subjects (n = 8063) was 1.4 (95% confidence limits = 1.0, 1.9) after adjustment for sex, age, and cigarette smoking. The risk was hig...

  8. Synchronous Rectovaginal, Urinary Bladder, and Pulmonary Endometriosis

    OpenAIRE

    Hilaris, Georgios E.; Payne, Christopher K.; Osias, Joelle; Cannon, Walter; Nezhat, Camran R.

    2005-01-01

    Background: Extragenital endometriosis is an uncommon condition that can affect almost any organ system and tissue in the human body. Disease involving multiple distant sites is extremely uncommon. Methods: We report a rare case of synchronous rectovaginal, urinary bladder, and pulmonary endometriosis. We performed a Medline literature search using keywords “endometriosis,” “rectovaginal,” “pulmonary,” “bladder,” “ureteral,” “bowel,” “extrapelvic,” and “extragenital” and were unable to find a...

  9. Bladder Pain Syndrome International Consultation on Incontinence

    DEFF Research Database (Denmark)

    Hanno, P.; Lin, A.; Nordling, J.;

    2010-01-01

    Aims of Study: The Bladder Pain Syndrome Committee of the International Consultation on Incontinence was assigned the task by the consultation of reviewing the syndrome, formerly known as interstitial cystitis, in a comprehensive fashion. This included the topics of definition, nomenclature...... to the bladder with at least one urinary symptom, such as frequency not obviously related to high fluid intake, or a persistent urge to void should be evaluated for possible BPS. The initial assessment consists of a frequency/volume chart, focused physical examination, urinalysis, and urine culture. Urine...

  10. Somatic mutation of PTEN in bladder carcinoma

    OpenAIRE

    Aveyard, J S; Skilleter, A; Habuchi, T; Knowles, M A

    1999-01-01

    The tumour suppressor gene PTEN/MMAC1, which is mutated or homozygously deleted in glioma, breast and prostate cancer, is mapped to a region of 10q which shows loss of heterozygosity (LOH) in bladder cancer. We screened 123 bladder tumours for LOH in the region of PTEN. In 53 informative muscle invasive tumours (≥ pT2), allele loss was detected in 13 (24.5%) and allelic imbalance in four tumours (overall frequency 32%). LOH was found in four of 60 (6.6%) informative, non-invasive tumours (pTa...

  11. Bladder Perforation Secondary to Primary Systemic Amyloidosis

    Directory of Open Access Journals (Sweden)

    Christopher J. Dru

    2014-01-01

    Full Text Available Amyloidosis is a disorder of protein folding characterized by extracellular aggregation and deposition of amyloid protein fibrils. Light-chain amyloidosis, also known as primary systemic amyloidosis, is the most common form of the disease. We present a case of an 84-year-old male with a history of systemic primary amyloidosis causing genitourinary, cardiac, and autonomic dysfunction who presented with hematuria and hypotension secondary to bladder perforation. He underwent open repair of a large extraperitoneal bladder defect. He ultimately died as a result of medical complications from his disease.

  12. Magnetic resonace appearance of Gall Bladder Ascariasis

    Directory of Open Access Journals (Sweden)

    Arya Prafull

    2005-05-01

    Full Text Available Ascariasis is a common disease in many developing countries and is a common cause of biliary and pancreatic diseases in endemic areas. Numerous studies have been published on biliary tract ascariasis. All these have documented ultrasonography as the primary imaging modality for biliary tract ascariasis. Magnetic Resonance Cholangiopancreatography (MRCP has been the latest entrant for the study of bilary tract. MRCP findings of biliary tract ascariasis have been scarcely documented. MRCP is a unique non-invasive investigation for demonstrating ascariasis in Gall bladder and bilary tract clearly. We present MR appearances of Gall bladder and biliary tract in a proven case of biliary ascariasis.

  13. Preliminary Clinical Studying of Using Intercostal Nerve with Vascular Shift to Reconstruct Spinal Cord Injury with Bladder Dysfunction%带血管肋间神经移位重建截瘫膀胱功能的初步临床应用

    Institute of Scientific and Technical Information of China (English)

    张健; 王文军; 姚女兆; 李学林

    2013-01-01

      目的:探讨带血管肋间神经移位、腓肠神经移植桥接吻合骶神经根重建脊髓损伤后膀胱功能障碍的可行性及初步临床疗效。方法:胸腰段脊髓损伤后膀胱功能障碍7例患者,选择截瘫平面以上最近位2条正常的肋间神经,完整游离后移位到腰后,显露骶2、3神经根起始部,选择性切断每条神经根的大部分神经束;取同侧等长度的带血管腓肠神经;行2股电缆式移植桥接吻合移位的肋间神经近端与骶2、3神经根远端,每股缝合2~3针,吻合肋间血管与腓肠神经血管、腓肠神经血管与臀下动脉。分析本组病例的临床资料及随访资料。结果:手术时间为120~180分钟,平均150分钟;术中出血量为350~550ml,平均400ml;住院时间10~14天,平均12天;随访8~12个月,平均9个月,1例术后12个月有排尿、排便反射及主动排尿功能的恢复,但仍存在轻度的尿失禁,会阴部S1~2级的感觉恢复,右提睾反射恢复,2例术后10个月有排尿便意改善,1例术后9个月出现会阴部S1~2级的感觉恢复,1例术后6个月无明显改善。结论:应用截瘫平面以上正常的带血管肋间神经移位、带血管腓肠神经移植吻合骶神经根重建脊髓损伤后膀胱功能障碍的可控性排尿功能是可行的和有效的,重建的排尿功能最接近生理性,可能是目前重建弛缓性膀胱功能的理想方法之一。%Objective:To explore the feasibility and preliminary clinical curative effects of using intercostal nerve with vascular shift and sural nerve transplantation bridging to suture sacral nerve root reconstruction after spinal cord injury with bladder dysfunction. Methods: 7 bladder dysfunction patients with spinal cord injury in thoracic and lumbar segment, choosed 2 normal intercostal nerves above the nearest paraplegia level, shifted to the waist after complete freed;exposed the second and

  14. Interleukin-4 receptor alpha overexpression in human bladder cancer correlates with the pathological grade and stage of the disease

    International Nuclear Information System (INIS)

    Previously, we have demonstrated that interleukin-4 receptor α (IL-4Rα) is overexpressed on a variety of human cancers and can serve as target for IL-4 immunotoxin comprised of IL-4 and a mutated Pseudomonas exotoxin. However, its expression and association with grade and clinical stage of bladder cancer has not been studied. IL-4Rα expression was examined in human bladder cancer cell lines, mouse xenografts, and biopsy specimens at mRNA and protein levels by real-time RT-PCR and IHC/ISH techniques. We also examined the effect of IL-4 on proliferation and invasion of bladder carcinoma cell lines. For tissue microarray (TMA) results, we analyzed the precision data using exact binomial proportion with exact two-sided P-values. We used Cochran–Armitage Statistics with exact two-sided P-values to examine the trend analysis of IL-4Rα over grade or stage of the bladder cancer specimens. The influence of age and gender covariates was also analyzed using multiple logistic regression models. IL-4Rα is overexpressed in five bladder cancer cell lines, while normal bladder and human umbilical vein cell lines (HUVEC) expressed at low levels. Two other chains of IL-4 receptor complex, IL-2RγC and IL-13Rα1, were absent or weakly expressed. IL-4 modestly inhibited the cell proliferation, but enhanced cell invasion of bladder cancer cell lines in a concentration-dependent manner. Bladder cancer xenografts in immunodeficient mice also maintained IL-4Rα overexpression in vivo. Analysis of tumor biopsy specimens in TMAs revealed significantly higher IL-4Rα immunostaining (≥2+) in Grade 2 (85%) and Grade 3 (97%) compared to Grade 1 tumors (0%) (P ≤ 0.0001). Similarly, 9% stage I tumors were positive for IL-4Rα (≥2+) compared to 84% stage II (P ≤ 0.0001) and 100% stages III–IV tumors (P ≤ 0.0001). IL-13Rα1 was also expressed in tumor tissues but at low levels and it did not show any correlation with the grade and stage of disease. However, the IL-2RγC was not

  15. Primary small cell neuroendocrine carcinoma of the urinary bladder with coexisting high-grade urothelial carcinoma: a case report and a review of the literature

    Directory of Open Access Journals (Sweden)

    Khalbuss Walid

    2005-01-01

    Full Text Available Abstract Primary neuroendocrine carcinomas of the urinary bladder are rare. Here, we report a case of an 82-year-old man who presented with hematuria and was found to have an ulcerated lesion in the bladder. A diagnosis of small neuroendocrine cell carcinoma with coexisting minor high-grade urothelial components was rendered. In this report, the clinical, cytological, histological, and immunohistochemical features of this case are described, and a review of the literature about this neoplasm is presented. The differential diagnoses of small cell tumor in urinary bladder washing specimens are discussed.

  16. Staphylococcus saprophyticus native valve endocarditis in a diabetic patient with neurogenic bladder: A case report.

    Science.gov (United States)

    Magarifuchi, Hiroki; Kusaba, Koji; Yamakuchi, Hiroki; Hamada, Yohei; Urakami, Toshiharu; Aoki, Yosuke

    2015-09-01

    A 61-year-old man was admitted to our hospital with 2-day history of malaise and dyspnea. He had mitral prolapse and type II diabetes mellitus with neurogenic bladder, which was cared for by catheterization on his own. On arrival the patient was in septic condition with hypoxemia, and physical examination revealed systolic murmur at the apex. Transthoracic echocardiography revealed vegetation of the mitral and the aortic valve. The presence of continuous bacteremia was confirmed by multiple sets of blood culture, whereby gram-positive cocci was retrieved and identified as Staphylococcus saprophyticus (S. saprophyticus) both phenotypically and genetically. Because two major criteria of the Modified Duke Criteria were met, the patient was diagnosed with native valve endocarditis due to S. saprophyticus. The urine culture was also positive for gram-positive cocci, phenotypically identified as Staphylococcus warneri, which was subsequently identified as S. saprophyticus with the use of 16S rRNA gene sequence analysis and MALDI-TOF MS (matrix-assisted laser desorption ionization time of flight mass spectrometry), indicating strongly that the intermittent catheterization-associated urinary tract infection resulted in bacteremia that eventually lead to infective endocarditis. This patient was treated with vancomycin and clindamycin. Because of multiple cerebral infarctions, the patient underwent mitral and aortic valve replacement on hospital day 5. Blood culture turned negative at 6th hospital day. Antibiotic therapy was continued for six weeks after surgery. The patient's clinical course was uneventful thereafter, and was discharged home. This is the first case report of native valve endocarditis caused by S. saprophyticus of confirmed urinary origin. PMID:26184852

  17. Relevance of prostate cancer in patients with synchronous invasive bladder urothelial carcinoma: a monocentric retrospective analysis

    Directory of Open Access Journals (Sweden)

    Lucio Dell’Atti

    2015-03-01

    Full Text Available Objectives: We retrospectively reviewed data of patients with incidental prostate cancer (PCa who underwent radical cystoprostatectomy (RCP for invasive bladder cancer and we analyzed their features with regard to incidence, pathologic characteristics, clinical significance, and implications for management. Material and Methods: Clinical data and pathological features of 64 patients who underwent standard RCP for bladder cancer were included in this study. Besides the urothelial carcinoma of the urinary bladder, the location and tumor volume of the PCa, prostate apex involvement, Gleason score, pathological staging and surgical margins were evaluated. Clinically significant PCa was defined as a tumor with a Gleason 4 or 5 pattern, stage ≥ pT3, lymph node involvement, positive surgical margin or multifocality of three or more lesions. Postoperative follow-up was scheduled every 3 months in the first year, every 6 months in the second and third year, annually thereafter. Results: 11 out of 64 patients (17.2% who underwent RCP had incidentally diagnosed PCa. 3 cases (27.3% were diagnosed as significant PCa, while 8 cases (72.7% were clinically insignificant. The positive surgical margin of PCa was detected in 1 patient with significant disease. The prostate apex involvement was present in 1 patient of the significant PCa group. Median follow-up period was 47.8 ± 29.2 (range 4-79. During the follow-up, biochemical recurrence occurred in 1 patient (9%. Concernig the cancer specific survival there was no statistical significance (P = 0.326 between the clinically significant and clinical insignificant cancer group. Conclusions: In line with published studies, incidental PCa does not impact on the prognosis of bladder cancer of patients undergoing RCP.

  18. Product Platform Replacements

    DEFF Research Database (Denmark)

    Sköld, Martin; Karlsson, Christer

    2012-01-01

    shed light on this unexplored and growing managerial concern, the purpose of this explorative study is to identify operational challenges to management when product platforms are replaced. Design/methodology/approach – The study uses a longitudinal field-study approach. Two companies, Gamma and Omega......Purpose – It is argued in this article that too little is known about product platforms and how to deal with them from a manager's point of view. Specifically, little information exists regarding when old established platforms are replaced by new generations in R&D and production environments. To...... distinguishing between platform replacement “height” and “width”. Seven groups of managerial measures for dealing with the issues are recommended. Originality/value – The study aims to contribute to the existing literature by taking a managers' perspective of product platform development. Its specific...

  19. Preoperative radiation therapy for muscle-invading bladder carcinoma

    International Nuclear Information System (INIS)

    This paper reports on low-dose and high-dose radiation therapy (RT) followed by cystectomy for bladder carcinoma that was evaluated for survival, failure patterns, and complications as these outcomes have been incompletely documented in the past. One hundred five patients with clinical stages T2-T4 (muscle-invading) transitional cell carcinoma of the bladder who completed preoperative RT followed by total cystectomy were evaluated. Eighty-five patients received 20-27 Gy in 4-7 fractions (group A). Twenty patients received 40-50 Gy in 20-28 fractions (group B). Actuarial 5-year survival was 45% and 29% (P = .06) for groups A and B, respectively; 6% of group A was stage T4 compared with 30% of group B. Five-year actuarial survival for patients with stages T2-T3 in groups A and B was 46% and 42%, respectively, while that for T4 was 33% and 0% in groups A and B, respectively. Multivariate analysis revealed that stage, grade, and presence of hydronephrosis independently affected survival. Five-year actuarial local control rates for T2, T3, and T4 were 93%, 93%, and 22%, respectively, with no significant difference between RT groups. Rates of distant metastasis and complications versus preoperative regime and stage were similar

  20. Marker evaluation of human breast and bladder cancers

    Energy Technology Data Exchange (ETDEWEB)

    Mayall, B.H.; Carroll, P.R.; Chen, Ling-Chun; Cohen, M.B.; Goodson, W.H. III; Smith, H.S.; Waldman, F.M. (California Univ., San Francisco, CA (USA))

    1990-11-02

    We are investigating multiple markers in human breast and bladder cancers. Our aim is to identify markers that are clinically relevant and that contribute to our understanding of the disease process in individual patients. Good markers accurately assess the malignant potential of a cancer in an individual patient. Thus, they help identify those cancers that will recur, and they may be used to predict more accurately time to recurrence, response to treatment, and overall prognosis. Therapy and patient management may then be optimized to the individual patient. Relevant markers reflect the underlying pathobiology of individual tumors. As a tissue undergoes transformation from benign to malignant, the cells lose their differentiated phenotype. As a generalization, the more the cellular phenotype, cellular proliferation and cellular genotype depart from normal, the more advanced is the tumor in its biological evolution and the more likely it is that the patient has a poor prognosis. We use three studies to illustrate our investigation of potential tumor markers. Breast cancers are labeled in vivo with 5-bromodeoxyuridine (BrdUrd) to give a direct measure of the tumor labeling index. Bladder cancers are analyzed immunocytochemically using an antibody against proliferation. Finally, the techniques of molecular genetics are used to detect allelic loss in breast cancers. 6 refs., 3 figs.