Changes of Detrusor Contractility after Partial Bladder Outlet Obstruction and Relief of Obstruction in Rat: Long-term Evaluation

PURPOSE: The contraction of the bladder is biphasic in nature consisting of an initial phasic contraction followed by a prolonged tonic contraction that is responsible for evacuating the bladder. Previous study demonstrated that the relief of bladder outlet obstruction induced recovery of the ability to initiate contraction, but emptying ability was not recovered within a certain period of time. This study was designed to determine the ability of recovery in tonic contraction and changes of contraction to pharmacologic stimulation through longterm evaluation after relief of obstruction. MATERIALS AND METHODS: Forty eight female rats were used in this investigation. Normal bladder was used as control and experimental groups were classified into 6 weeks obstruction group and 3, 6, 9, 12 weeks groups after relief of obstruction. The phasic and tonic contractile response to field stimulation(2, 4, 8, 16, 32Hz) and the response to bethanechol(3x10-5M), ATP(1mM) and KCl(120mM) were estimated by polygraph. RESULTS: The weight of bladder increased in obstruction group and gradually decreased after relief of obstruction. The phasic and tonic contractile response to all frequency of stimulation were decreased in obstruction group and recovered after relief of obstruction. In low frequency of stimulation, the ratio of tonic to phasic contractile response was decreased in obstruction group and recovered from 9 weeks after relief of obstruction. The contractile response to bethanechol was decreased in obstruction group and rapidly recovered after relief of obstruction. However, there were no change in contractile response to ATP in all group. The contractile response to KCl was decreased in obstruction group, but there were no change after relief of obstruction. CONCLUIONS: These results indicate that the emptying ability is recovered slowly but not enough and the contractile response to cholinergic stimulation is rapidly recovered after relief of obstruction. Further study will be needed for response to ATP and KCl.

The Effect of Intracellular and Extracellular Ca++ on Biphasic Contraction of Bladder in Growing Rats / 대한비뇨기과학회지

No abstract available.

Role of Intracellular Ca++ in Contraction and Relaxation of Rabbit Corpus Cavernosal Smooth Muscle / 대한비뇨기과학회지

PURPOSE: To elucidate the role of intracellular Ca++ stores in rabbit corpus cavernosal tissue, we performed organ bath study using strips from rabbit corpus cavernosum. MATERIALS AND METHODS: The corpus cavernosal strips of New Zealand white rabbit (3.0-3.5kg) were mounted in organ chambers to measure isometric tension. Each rabbit corporal strips of 3x10mm in size was incubated for 12 hours to reduce spontaneous contractions. The effects of Ca++ free Tyrode solution and TMB-8 (intracellular Ca++ blocker) on electrically and adrenergically induced contractions were evaluated. And the effects of ATP, bethanechol, sodium nitroprusside(SNP) and electrical stimulation(ES) in the presence of phenylephrine(PE) prestimulation were determined prior to and following preincubation with TMB-8. The responses were monitored via an FT03 force transducer and recorded on a Grass 7D polygraph and expressed as the g tension per 100mg of tissue in contractile response and percent of maximum contraction in relaxation response. RESULTS: PE and ES induced contractions were reduced depending on time but were not disappeared in the Ca++ free solution after 30minutes. Preincubation for 15minutes with 20uM TMB-8 significantly reduced contractile response of corporal smooth muscle (p<0.05). Relaxation responses to bethanechol and ES in TMB-8 preincubated group were significantly reduced in comparison with non-preincubated group (p<0.05). But there is no statistical differences between responses to ATP and SNP in TMB-8 preincubated and non-preincubated group. CONCLUSIONS: PE and ES induced contraction and NO mediated relaxation(bethanechol, ES) of corporal smooth muscle depend, in part, on the bioavailability of intracellular Ca++ via release through TMB-8 sensitive channels.

Significance of 99mTc-dimercaptosuccinic Acid(DMSA) Renal Scan for Children with Urinary Tract Infection / 대한비뇨기과학회지

PURPOSE: Acute pyelonephritis in children may lead to permanent renal scarring with a risk of later hypertension and renal failure and so needs prompt diagnosis and appropriate treatment. The main aim of this study was to evaluate the value of 99mTc-dimercaptosuccinic acid(DMSA) renal scan in detecting renal involvement of acute urinary tract infection(UTI) and determining the sensitivity to find coexisting vesicoureteral reflux(VUR) in children. MATERIALS AND METHODS: A total of 192 children(97 males, 95 females) admitted with bacteriologically proven and symptomatic UTI between May 1994 and April 1997 were analysed. DMSA renal scan was performed in all cases. 70 children underwent VCUG. Findings of DMSA renal scan were analysed according to age, sex, previous history of UTI and VUR. RESULTS: 89 children(46%) were under the age of 1 year. There was a preponderance of UTI in boys under the age of 1 year(66.3%) and in girls over the age of 1 year(63.1%). Of the 192 children studied, 155 children(80.7%, 81 males, 74 females) had first episode and the remaining 37 children(19%, 16 males, 21 females) had previous history of symptomatic UTI. Abnormalities in DMSA renal scan were found in 67(43.2%) of 155 children with the first UTI and in 30(89%) of 37 children with recurrent UTI. Bilateral DMSA abnormalities were noted in 8(5.2%) of 155 children with the first UTI and in 11(29.7%) of 37 children with recurrent UTI. Of the 70 children who underwent VCUG, VUR was seen in 41(58.6%) children. Of the 41 children with VUR, 31(90.2%) children had abnormal DMSA images. VUR was demonstrated in 37(75.5%) of 49 children with abnormal DMSA images and especially in 100% of 14 children with bilateral abnormal DMSA images. CONCLUSIONS: A high proportion of abnormal DMSA images was found in children with recurrent UTI and children with VUR, especially high grade or bilateral reflux. DMSA renal scan is a sensitive method for evaluating the functional defect of involved kidney and predicting coexistent VUR according to its image appearance in patients with UTI.

Significance of 99mTc-dimercaptosuccinic Acid(DMSA) Renal Scan for Children with Urinary Tract Infection / 대한비뇨기과학회지

PURPOSE: Acute pyelonephritis in children may lead to permanent renal scarring with a risk of later hypertension and renal failure and so needs prompt diagnosis and appropriate treatment. The main aim of this study was to evaluate the value of 99mTc-dimercaptosuccinic acid(DMSA) renal scan in detecting renal involvement of acute urinary tract infection(UTI) and determining the sensitivity to find coexisting vesicoureteral reflux(VUR) in children. MATERIALS AND METHODS: A total of 192 children(97 males, 95 females) admitted with bacteriologically proven and symptomatic UTI between May 1994 and April 1997 were analysed. DMSA renal scan was performed in all cases. 70 children underwent VCUG. Findings of DMSA renal scan were analysed according to age, sex, previous history of UTI and VUR. RESULTS: 89 children(46%) were under the age of 1 year. There was a preponderance of UTI in boys under the age of 1 year(66.3%) and in girls over the age of 1 year(63.1%). Of the 192 children studied, 155 children(80.7%, 81 males, 74 females) had first episode and the remaining 37 children(19%, 16 males, 21 females) had previous history of symptomatic UTI. Abnormalities in DMSA renal scan were found in 67(43.2%) of 155 children with the first UTI and in 30(89%) of 37 children with recurrent UTI. Bilateral DMSA abnormalities were noted in 8(5.2%) of 155 children with the first UTI and in 11(29.7%) of 37 children with recurrent UTI. Of the 70 children who underwent VCUG, VUR was seen in 41(58.6%) children. Of the 41 children with VUR, 31(90.2%) children had abnormal DMSA images. VUR was demonstrated in 37(75.5%) of 49 children with abnormal DMSA images and especially in 100% of 14 children with bilateral abnormal DMSA images. CONCLUSIONS: A high proportion of abnormal DMSA images was found in children with recurrent UTI and children with VUR, especially high grade or bilateral reflux. DMSA renal scan is a sensitive method for evaluating the functional defect of involved kidney and predicting coexistent VUR according to its image appearance in patients with UTI.

Change of Collagen after Partial Ureteral Obstruction in Rat Kidney / 대한비뇨기과학회지

PURPOSE: Chronic ureteral obstruction results in changes in renal hemodynamics, tubular function, and subsequently fibrosis of the tubulointerstitium. The pathologic marker of irreversible renal injury is interstitial fibrosis. The degree of interstitial fibrosis is the most useful measure of the degree of renal injury. This study in rats with partial ureteral obstruction was performed to describe and quantify the changes in collagen deposition. MATERIALS AND METHODS: Female Sprague-Dawley rats weighing 300-400g were used. Individual kidneys were obtained from rats at 1, 2, 3, 4 weeks after partial ureteral obstruction and sham operation. The total amount of collagen was measured from its contents of hydroxyproline by assuming that hydroxyproline is 14% in weight of the collagen. Collagen types I, III, and IV were localized by immunohistochemical staining and the distribution of each collagen type was analized using differences of their staining densities. RESULTS: After 2 weeks of partial ureteral obstruction, the total amount of collagen in affected kidney was significantly increased compared to control and 1 week groups(P<0.05). All of the collagen types in the interstitium of the affected kidney was gradually increased parallel to the duration of partial ureteral obstruction. Collagen type IV was increased significantly in tubular basement membrane and interstitium after 2 weeks of partial obstruction compared to control and 1 week groups. CONCLUSIONS: The partial ureteral obstruction causes progressive increase of amount of collagen according to the duration of obstruction, especially after 2 weeks, and tubulointerstitial fibrosis of obstructive nephropathy is closely related to collagen type I, III, and IV. Infiltration of collagen type IV in tubular basement membrane may play a major role in obstructive nephropathy.

Change of Collagen after Partial Ureteral Obstruction in Rat Kidney / 대한비뇨기과학회지

PURPOSE: Chronic ureteral obstruction results in changes in renal hemodynamics, tubular function, and subsequently fibrosis of the tubulointerstitium. The pathologic marker of irreversible renal injury is interstitial fibrosis. The degree of interstitial fibrosis is the most useful measure of the degree of renal injury. This study in rats with partial ureteral obstruction was performed to describe and quantify the changes in collagen deposition. MATERIALS AND METHODS: Female Sprague-Dawley rats weighing 300-400g were used. Individual kidneys were obtained from rats at 1, 2, 3, 4 weeks after partial ureteral obstruction and sham operation. The total amount of collagen was measured from its contents of hydroxyproline by assuming that hydroxyproline is 14% in weight of the collagen. Collagen types I, III, and IV were localized by immunohistochemical staining and the distribution of each collagen type was analized using differences of their staining densities. RESULTS: After 2 weeks of partial ureteral obstruction, the total amount of collagen in affected kidney was significantly increased compared to control and 1 week groups(P<0.05). All of the collagen types in the interstitium of the affected kidney was gradually increased parallel to the duration of partial ureteral obstruction. Collagen type IV was increased significantly in tubular basement membrane and interstitium after 2 weeks of partial obstruction compared to control and 1 week groups. CONCLUSIONS: The partial ureteral obstruction causes progressive increase of amount of collagen according to the duration of obstruction, especially after 2 weeks, and tubulointerstitial fibrosis of obstructive nephropathy is closely related to collagen type I, III, and IV. Infiltration of collagen type IV in tubular basement membrane may play a major role in obstructive nephropathy.

Gubernacular Contractile Response to Testosterone and Calcitonin Gene-related Peptide in Rat / 대한비뇨기과학회지

PURPOSE: It was known that the gubernaculum contract by release of calcitonin gene-related peptide(CGRP) and androgens may control gubernacular migration indirectly via release of CGRP from the genitofemoral nerve in the inguinoscrotal region. To determine the direct effect of testosterone to the testicular descent and usefulness of polygraph for detecting the contractility of the gubernaculum, current study was designed. MATERIALS AND METHODS: Twenty four Sprague-Dawley male rats were used in this experiment after 3, 5, 7days and 2weeks of birth. Gubernaculums were mounted in organ baths and bathed in oxygenated Tyrode`s solution under 200mg of isotonic tension. The contractile response in vitro of testosterone(4.8x10(-3)M) and CGRP(10(-7)M) were monitored via an FT .03 force transducer and recorded on a Grass 7D polygraph. The recorded tension was expressed as mg tension per 10mg of gubernacular tissue. RESULTS: Both exogenous testosterone and CGRP increased isotonic tension and the degree of gubernacular contractility declined significantly with age(p<0.05). Testosterone and CGRP increased minimal spontaneous contraction of the gubernaculum. CONCLUSIONS: These results suggest that testosterone may directly act as one of the neurotransmitters for the contraction of the gubernaculum as well as CGRP and measuring the contractility using polygraph is a useful method for the study of testicular descent.

Uroflow Rate Nomograms related to Age and Voiced Volume in Korea Pediatric Males / 대한비뇨기과학회지

PURPOSE: To determine the uroflow rates of normal Korean pediatric male, uroflowmetry was peformed. MATERIALS AND METHODS: A total of the 237 normal children who ranged in age from 2 to 14 years(mean: 7.2+/-2.1years)was available for this study. Uroflow 1 data(peak and average flow) were plotted in volume-related nomograms in 3 different age groups : 2 to 4, 5 to7 and 8 to 14 years old. RESULTS: The mean peak flow(10.3+/-3.7, 12.2+/-4.9 and 14.3+/-5.2m1/sec) and average flow(6.4+/-2.6, 7.1)3.0 and 8.3+/-3.4m1/sec) were increased significantly with increasing age(p<0.05). In a same voided volume the peak and average flow rates were not increased significantly with increasing age but, in a same age group they were significantly increased according to the volume voided (p<0.05). Peak and average flow rates in the circumcision group(13.7+/-6.7, 8.3+/-4.7m1/sec) was not significantly different from non-circumcision group(10.9+/-5.0, 16.1+/-3.0ml/sec). CONCLUSIONS: These uroflow rate nomograms will be useful for the assessment of voiding action related to the voided volume and age in Korean pediatric males.

The Significance of Uroflowmetry after Repair of Hypospadias / 대한비뇨기과학회지

PURPOSE: To determine the role of uroflowmetry in the evaluation of the functional results of hypospadias repair we reviewed the asymptomatic patients who underwent hypospadias repair. MATERIALS AND METHODS: A total of the 34 patients was available for this study. Age of patient were ranged from 3 to 14 years(mean; 8.8+/-4.67 years) at the time of uroflowmetry and followup ranged from 7 months to 3.5 years(mean; 2.4+/-0.88 years) after repair of hypospadias. The peak uroflow were compared to age dependent nomograms that indicate the normal range of peak flows according to the voided volumes. Flow rates were defined as low if they decreased below 90 percentile of the expected normal range. RESULTS: The peak urine flow in hypospadias repair patients(12.1 +/-8.74m1/sec) was not significantly different from normal control(12.9+/-5.10 ml/sec). Five of the 34 patients had peak flow below the normal ranges. One of the 17 patients with chordee and one of the 11 without chordee showed low peak urine flow. One of the 14 patients with anterior hypospadias, one of the 8 with posterior hypospadias and none with mid hypospadias showed low peak urine flow. According to the methods of repair one of the 12 patients with onlay island flap, one of the 5 with pyramidal procedure and three of the 6 who had undergone previous attempts at hypospadias in other hospital showed low peak urine flow Two of the 5 patients who revealed low peak uroflow rate were managed with periodic meatal dilatation and the 3 were managed with internal urethrotomy for proximal urethral stricture. CONCLUSIONS: The uroflowmetry is an easy and noninvasive method to detect asymptomatic urethral stricture In hypospadias repair patients.

The Effect of Extracellular Calcium on the Contractile Response to Field Stimulation, Bethanechol and ATP in Rabbit Urinary Bladder / 대한비뇨기과학회지

PURPOSE: In a previous study increasing the extracellular clacium concentration enhanced the phasic contractile response to low frequency stimulation(2Hz) to a significantly greater degree than the enhancement of high frequency stimulation(16Hz). To investigate the sensitivity of the detrusor contractile responses to field stimulation, bethanechol and ATP in calcium free buffer, the current study was designed. MATERIALS AND METHODS: Each rabbit bladder strip of 5x10mm in size was incubated for 30 minutes in the Tyrode's solution. Individual strips were utilized to generate the response to field stimulation(2, 8 and 32Hz), bethanechol(1.0-250microM) or ATP(0.25-2mM). Upon completion of the first stimulation in Tyrode's solution, each tissue was washed 3 1.tomes at 15 minute intervals with fresh Tyrodes. At 15 minutes following the last wash, the Tyrode's solution was replaced with solution containing no calcium+1.0mM EGTA and incubated for ditional 5, 15 or 30 minutes. At the end of 5, 15 or 30-min period of tulibration a second round of field stimulation or dose-response curves to bethanechol or ATP were generated. The contractile responses were monitored via an FT03 force transducer and recorded on a Grass 7D polygraph and expressed as the g tension per 100mg of tissue. RESULTS: (1) Progressive decrease in both basal tension and spontaneous contractile activity (2) more rapid decrease in the contractile response to 2 and 8Hz field stimulation than to 32Hz stimulation (3) more rapid decrease in the contractile response to lower concentrations of bethanechol and ATP than to high concentrations (4) greater maximal inhibition of the contractile response to low concentrations of bethanechol and ATP than to high concentrations. CONCLUSIONS: These results indicated that detrusor contractility to a sub-maximal stimulation rather than maximal stimulation is more sensitive to extracellular calcium depletion.

The Effect of Insulin Therapy on the Collagen of the Corpus Cavernosum in Diabetic Rat / 대한비뇨기과학회지

PURPOSE: The purpose of this study was to investigate the changes of collagen and the effect of insulin therapy on the collagen of the corpus cavernosum in diabetes mellitus(DM). MATERIALS AND METHODS: Twenty seven rats were included for this study and divided into control, diabetic and insulin treated diabetic group. DM was induced by intravenous injection of streptozotocin 65mg/kg and NPH insulin (initially 4IU/d for 3 days and then 6IU/d) was administered for 4 weeks for insulin treatment. After 4 weeks of experiment, the collagen concentration was evaluated with hydroxyproline quantitative analysis and collagen distribution within the corpus cavernosum. Collagen(type I, III and IV) was obsened with Masson-trichrome and immunohistochemical staining. RESULTS: 1. Body weights of control, diabetic group and insulin treated diabetic group were 315.0 +/-14.2gm, 230.8+/-15.2gm and 310.1+/-15.4gm, respectively, at 4 weeks of experiment. Control and insulin treated diabetic group progressively increased in body weight(p<0.05), while diabetic group decreased in body weight. 2 Collagen concentration of control, diabetic and insulin treated diabetic group expressed 465.2+/-24microgram, 590.3+/-43.7microgramand 567.1+/-34.8microgram respectively. Collagen concentration in corpus cavemosum significantly increased in diabetic and insulin treated diabetic group compared with control group(p<0.05). No significant difference was noted between diabetic and insulin treated diabetic group. 3. Immunohistochemical staining revealed collagen types I and III were distributed evenly in the corporal interstitial tissue, but type IV collagen was noted along the basement membrane of the cavernosal sinusoid in the both control and experimental groups. Collagen type 1 of diabetic and insulin treated diabetic group, as compared with control group, was noted thin staining in the corporeal tissue. There were no significant differences in collagen type 111 among control, diabetic and insulin treated diabetic groups. Collagen type IV of diabetic and insulin treated diabetic group, as compared with control group, was noted dense staining in the basement membrane of the cavernosal sinusoidal space. And the intensity for collagen type IV was not significantly different between diabetic and insulin treated diabetic group. 4. Masson-trichrome staining showed no significant differences among control, diabetic and insulin treated diabetic groups. CONCLUSIONS: These results suggest that the DM changes quantitatively the collagen type IV of corpus cavernosum and the insulin treatment had no effect on the collagen alteration in DM.

The Factors Influencing on Insertion of Double-J Catheter in Ureteral Obstruction due to Malignancy / 대한비뇨기과학회지

PURPOSE: The aim of this presentation is to analyze the factors influencing on retrograde insertion of double-J catheter in urethral obstruction due to malignancy and to predict the possibility of stunting with double-J catheter. MATERIALS AND METHODS: A retrospective analysis of 43 patients who had underwent retrograde double-J catheter insertion for urethral obstruction secondary to pelvic malignancy, from January 1993 to April 1997, was performed to evaluate the success rates of double-J ureteral stenting according to the factors such as age, sex, presence or absence of flank pain, degree of hydronephrosis, renal function, stage of tumor, laterality of ureter, past history of radiotherapy, operation and chemotherapy. RESULTS: According to the degree of hydronephrosis, the success rate was 100, 73.7 and 50% in grade I II and III, respectively(p<0.05). According to the renal function, the success rate was 81.3% in the group with normal renal function and 45.5% in the group with abnormal venal function(p<0.05) According to the stage of disease, the success rate was 100, 70.7 and 58.3% in stage I, II and III, respectively. According to the absence or presence of flank pain, the success rate was 56.3% in the group with flank pain and 81.5% in the group without flank pain. According to the past history of radiotherapy, the success rate was 65.6% in the group treated with radiotherapy and 90.9% in the group not treated with radiotherapy. The age, sex, laterality of ureter, past history of operation and chemotherapy were not significantly correlated to the success rates. CONCLUSIONS: The factors influencing on double-J ureteral slanting were the degree of hydronephrosis, renal function, absence or presence of flank pain, stage of disease and past history of radiotherapy Further study will be needed to demonstrate the accurate timing of urethral stenting with doublets ureteral catheter.

Chromophobe Cell Renal Carcinoma: A Report of Four Cases with DNA Ploidy and Ultrastructural Study / 대한비뇨기과학회지

We present four cases of the recently characterized chromophobe cell renal carcinoma. Gross hematuria, palpable flank mass and flank pain were the main symptoms of patients. With chromophobe cell renal carcinoma all tumors were solitary pale brown or beige colored mass, ranging from 6.0 to 10.5cm in diameter. Microscopically two cases were typical type and the other two cases were eosiophilic type. All of them showed strong reactivity for Hale's colloidal iron stain, cytokeratin and epithelial membrane antigen, but negative for vimentin. Ultrastructually characteristic invaginated microvesicles, 180-440nm in diameter, were identified in the cytoplasm. DNA ploidy studies revealed an aneuploid cell population in two cases of eosinophilic type. No patients showed recurrent tumor during the follow up periods, ranging from 5 to 92months.

Three Cases of Renal Cell Carcinomas in Dialyzed Patients / 대한비뇨기과학회지

Patients with end stage renal disease who require chronic dialysis show a significantly increased risk of developing renal cell carcinomas, with a demonstrated incidence of 0.22-1.5%. Despite these impressive data, monitoring of patients with chronic renal failure is only briefly mentioned in the literature and there is only one report in korea. Herein, we report three cases of renal cell carcinomas developing in patients with chronic renal failure with a brief review of literature.

Contractile Response of the Rat Vas Deferens to Electrical Field Stimulation, Phenylephrine and Acetylcholine under Hypoxia / 대한비뇨기과학회지

PURPOSE: The proper functioning of all smooth muscle structures depends on the ability of normal blood to deliver oxygen and nutrients to the muscles. In addition, hypoxia has been shown to inhibit the contractile response to various forms of stimulation. The contractile response of the vas deferens can be divided into two phases: an initial rapid increase in tension(phasic contraction) and prolonged period of sustained tension(tonic contraction). The aim of this study was to determine the effect of hypoxia on the ability of the vas deferens to sustain tension . MATERIALS AND METHODS: The isolated strips of rat vas deferens were studied for Isometric tension measurement under normoxia and hypoxia in the organ chamber. Effects of phenylephrine(Phe) and acetylcholine(Ach) on the rat vas deferens tissue were monitored under normoxia and hypoxia. RESULTS: The results of these studies can be summerized as follows; (1) hypoxia induced time dependent decrease in both phasic and tonic contraction in response to electrical field stimulation(4 and 32Hz). The rate of inhibition of the tonic contraction was significantly and immediatly greater than that of the phasic contraction in both the prostatic and epididymal vas deferens, which was much prominent. (2) hypoxia(5min) increased the basal tension of prostatic vas deferens only to Phe(10(-3)M) and Ach(10(-3)M). But In the response of epididymal vas deferens to Phe(10(-3)M) and Ach(10(-3)M), rhythmic contractions disappeared. CONCLUSIONS: In conclusion, the contractile response of rat Vas deferens to electrical field stimulation under hypoxia were decreased and basal tension of prostatic vats deferens to Phe(10(-3)M) or Ach(10(-3)M) was increased This effect can interfere the sperm expulsion by changing normal contractability of the vas deferens.

The Pharmacological and Histological Comparison Between Detubularized and Tubularized Cystoplasty Ileum in the Rat / 대한비뇨기과학회지

Bowel segments are used either in a tubular or detubular configuration in bladder augmentation and substitutions. The majority of urologists agree that detubularized segments give better clinical results,but detailed studies were not investigated in animals. The present study compared the contractile response of autonomic agonists including carbachol, isoproterenol,alpha, beta-methylene ATP on detubularized and tubularized cystoplastic ileal segments. In addition, histological examinations of cystoplastic ileal segments were performed. Five rats underwent Sham operation as control and eight rats underwent detubularized ileocystoplasty and seven rats underwent tubularized ileocystoplasty. Analysis was done six weeks after surgery. The contractile responses of detubularized cystoplasty ileum to carbachol, alpha, beta-methylene ATP were significantly increased when compared to the responses of tubularized ileum and control ileum. The relaxation responses of detubularized cystoplasty ileum to isoproterenol were significantly higher than control ileum. However, in tubularized ileum, the responses to carbachol, alpha, beta-methylene ATP, isoproterenol were similar for control ileum. The responses of detubularized cystoplasty ileum to carbachol, alpha, beta -methylene ATP were significantly different from control bladder, but detubularized cystoplasty ileum showed responses that resemble control bladder more closely when compared to the responses of tubularized ileum.The histological examination showed urothelialization of cystoplastic ileum with transitional epithelium extending over and covering the junction margin of the cystoplastic ileum. These results suggest detubularized ileocystoplasty induced closer pharmacological changes in the ileal segment towards the bladder than tubularized ileocystoplasty and so we can expect detubularized ileocystoplasty gives better clinical outcome.

Effects of Relief of Bladder Outlet Obstruction on the Detrusor Contractility in Rat / 대한비뇨기과학회지

Contraction of the bladder can be divided into two phases. The initial phase (phasic contraction) is characterized by a rapid increase in pressure that results in a change of bladder shape. This phase is followed immediately by a plateau phase (tonic contraction) that maintains an increase in intravesical pressure that is responsible for evacuating the bladder. This study was designed to determine the effect of relief of bladder outlet obstruction on the phasic and tonic detrusor contractile response to field and pharmacologic stimulation in rat urinary bladder. Forty female rats were used in this investigation. Normal bladder was used as control(n=8) and experimental groups (n=32) were classified into 6 weeks obstruction group and 2, 4, and 6 weeks groups after relief of obstruction. The phasic and tonic contractile response to field stimulation (2, 4, 8, 16, 32 Hz) and bethanechol (3 x -100,000 M) was estimated by polygraph. Following results were obtained. 1) The weight of bladder was increased in obstruction group and gradually decreased after relief of obstruction (p0.05). 4) Detrusor contractile response to bethanechol was rapidly decreased in obstruction group and rapidly recovered after relief of obstruction. And the contractile response in 6 weeks after relief of obstruction was higher than control (p<0.05). As the results of above, we concluded that relief of bladder outlet obstruction induced recovery of the ability to initiate contraction2 However, emptying ability is not recovered within a certain period of time. And further study will be needed.

Sarcomatoid Transitional Cell Carcinoma in the Kidney: A Case Report

Sarcomatoid transitional cell carcinoma is a rare malignant epithelial neoplasm arising at the bladder, in which the tumor cells assume a spindle shape. This tumor accounts for approximately 0.3% of all bladder malignancies and has been reported in the renal pelvis and ureter. We encountered a case of histopathologically proven sarcomatoid transitional cell carcinoma of the left kidney in a 76-year-old male. Abdominal CT scans showed a large heterogeneous mass of solid and cystic components, with mural calcification and hematoma in the upper pole of the left kidney.

Impaired Endothelium-Dependent Relaxation by Alternating Protein Kinase C and Na+-K+ ATPase in Isolated Rabbit Corpus Cavernosum Exposed to Elevated Glucose / 대한비뇨기과학회지

Impaired endothelium dependent relaxation occurs in diabetic rabbit corpus cavernosum and normal corpus cavernosum exposed to elevated glucose. Elevation of glucose can change the activities of two key enzymes, protein kinase C (PKC) and Na+-K+ ATPase. This study addresses the question of whether impaired endothelium dependent relaxation in isolated corpus cavernosum from normal rabbit exposed to elevated glucose is related to PKC and Na+-K+ ATPase activities and, if so, whether it is associated with altered ouabain sensitive 86-Rb uptake, an index of Na+-K+ ATPase activity, and contractile response of corpus cavernosum tissue to ouabain. Corpus cavernosal tissue suspended for measurement of isometric tension were incubated for 6 hours in control (5.5mM) or elevated glucose (44mM) to mimic euglycemic and hyperglycemic conditions. Relaxations of corpus cavernosum tissue in response to the endothelium-dependent vasodilator acetylcholine (ACh)were unaffected in control groups while significantly inhibited in the elevated glucose group. Relaxations of corporeal tissue to endothelium-independent vasodilators, sodium nitroprusside (SNP) were similar in the control and elevated glucose groups. Corporeal tissue treated with 4-phorbol 12-myristate 13-acetate (PMA), a PKC activator, showed decreased relaxations to ACh, similar to normal corporeal tissue exposed to elevated glucose. Relaxations in response to SNP were unaffected by treatment with PMA or exposure to elevated glucose. 1(5-isoquinolinylsulfonyl)-2-methylpiperazine (H-7), PKC inhibitor, restored the abnormal Ach-induced relaxation in corporeal tissue exposed to elevated glucose. The contractions caused by ouabain, Na+-K+ ATPase inhibitor, were smaller in elevated glucose groups than control and elevated glucose groups treated with H-7. Ouabain sensitive 86-Rb uptake of elevated glucose groups was significantly less than that of control groups but ouabain sensitive 86-Rb uptake of elevated glucose groups treated with H-7 was similar to those of control groups. These results suggest that activation in PKC activity and inhibition in Na+-K+ ATPase activity caused by elevated glucose contribute to impaired endothelium dependent relaxation in corpus cavernosum smooth muscle.