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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    World journal of surgery 24 (2000), S. 1197-1199 
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Prostatitis, the neglected third disease (after benign prostatic hypertrophy and prostate cancer) is the last frontier of prostate disease. Innovative new research and clinical initiatives have revived urologists' interest in this difficult and frustrating disease. New funding initiatives, industry interest and powerful patient lobby groups have put this long-neglected syndrome back on the urologic agenda. Presented here is an inventory of what is and is not known about prostatitis. It is based on a review of the literature, undisputed facts, solid hypotheses, and common sense. Also offered is a series of personal challenges to the urologic community. As we enter the twenty-first century we must develop a rational management strategy for patients who present with symptoms of prostatitis.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    World journal of urology 12 (1994), S. 49-51 
    ISSN: 1433-8726
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Glycosaminoglycans (GAGs) are suspended in urine and are present on tissue surfaces in the urinary tract. Consequently, they have the potential to influence any pathological disorder in this environment, including urinary tract infections by Proteus mirabilis and struvite (NH4MgPO4·6H2O) urolithiasis. Although GAGs, suspended in urine, may inhibit the formation of other types of calculus minerals, no such effect has been reported in struvite calculi. Nevertheless, GAGs are a major component of the organic matrix of all types of urinary calculi. In contrast, there is evidence that the GAG layer on the bladder surface may act as a defence mechanism against infection by inhibiting bacterial adhesion. More studies are needed to elucidate fully the role of GAGs in urinary infections and struvite urolithiasis.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1434-0879
    Keywords: Bladder mucous ; Uroepithelium ; Bacterial adherence ; Urinary tract infections
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Mucous within the urinary bladder appears to play a protective role in shielding the uroepithelium against pathogens. This present study employs specific anti-mucous, antisera stabilization techniques to visualize a thin, continuous layer of mucous closely adherent to the human bladder uroepithelium, in both scanning and transmission electron microscopic analyses.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1434-0879
    Keywords: Extracorporeal shock-wave lithotripsy ; Bacteria ; Stones
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The aim of this study was to determine whether extracorporeal shock wave lithotripsy (ESWL) affected the viability of the infecting bacteria within a simulated struvite stone matrix. A strain, Proteus mirabilis 28cii, was prepared in three forms: (1) suspended in saline and urine, (2) artificially encapsulated by suspending in agar beads and (3) artificially encapsulated and mineralised by suspending in agar beads with calcium carbonate crystals. The preparations were placed in capped vials partially immersed in degassed water and held in the focal point of the Siemens Lithostar and given 1,000 shocks. Subsequent viability testing showed that bacteria suspended in urine were greatly affected by shock treatments (55% loss in viability), but incorporation into agar beads negated this effect (even if the cells were exposed to 2000 shocks). Mineralisation of the beads with calcium carbonate crystals caused a decrease in viability of 82% that was significantly different from controls. However, this still left 2.3×108 viable organisms (82% of 2.8×108), easily enough to form the focus for further infections. A series of control experiments carried out using an ultrasonic cell sonicator probe gave comparable results to those obtained with ESWL. These results demonstrate that ESWL treatment of infected stones must be accompanied by antimicrobial coverage.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1434-0879
    Keywords: Citrate ; Crystallization ; Struvite ; Urease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effects of citrate on the different phases of urease-induced crystallization were studied using Coulter counter techniques and optical microscopy. Citrate increased urine pH and markedly delayed the initiation of the crystallization (nucleation) in both human and synthetic urine. In synthetic urine, particle aggregation and espicially particle growth were delayed and inhibited by citrate. In human urine, aggregation was distinctly inhibited by citrate. It appears that the susceptibility of urine to form crystals in the precense of urease activity is influenced by its citrate concentration.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    World journal of urology 3 (1986), S. 209-214 
    ISSN: 1433-8726
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Bacillus Calmette-Guérin (BCG) has achieved an important role in the prophylaxis and treatment of superficial bladder cancer. It has been found effective in the prevention of recurrences after endoscopic surgery as well as in the treatment of residual tumors. The most dramatic responses have been consistently demonstrated in the treatment of carcinoma in situ. Recent experience suggests that prolongation of treatment beyond the 6 weeks advocated in early protocols, significantly increases the anti-tumor activity of BCG. The side effects of intravesical administration of the vaccine are, in the vast majority of patients, well-tolerated, minimal and self-limiting. No permanent functional or structural damage of the bladder has been observed. The effectiveness of BCG is primarily dependent on the strain used as well as the dose, duration and frequency of its administration.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1434-0879
    Keywords: Struvite ; Urolithiasis ; Proteus mirabilis ; Crystallization ; Light microscopy ; Urease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Struvite urolithiasis forms as a consequence of a urinary tract infection by urease-producing species of bacteria such as Proteus mirabilis. Ammonia, produced by the enzymatic hydrolysis of urea, elevates urine pH causing a supersaturation and precipitation of Mg++ as struvite (NH4MgPO4). Calcium often precipitates as well, forming the mineral carbonate-apatite (Ca10(PO4)6CO3). We have developed a procedure based on direct observation by light microscopy whereby struvite crystal growth can be quickly monitored in response to chemical changes in urine. As struvite crystals assume a characteristic shape or crystal habit based on their growth rate, the effect of urine chemistry and the action of various crystallization or urease inhibitors on struvite formation can be quickly shown. In addition preliminary effects of alkaline pH, or the presence of toxic compounds on bacteria can also be shown through their loss of motility.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1434-0879
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Intraprostatic administration of live bacille Calmette-Guérin (BCG) in humans has been found to produce tumor necrosis; unfortunately, the number of severity of complications have made its clinical use prohibitive. Previous studies have shown that soluble and microparticulate components present in the supernatants obtained after centrifugation of a reconstituted BCG preparation exhibit similar immunogenicity to the one shown by live bacteria. The supernatants, however, are not associated with disseminated infection of the progressive regional tissue destruction observed with the use of viable vaccine. Experiments were conducted to determine the effect of intraprostatic injection of BCG and its supernatants. Adult dogs, after positive conversion to protein purified derivative (PPD), were randomly assigned to three groups. Under direct vision and with digital rectal control, intraprostatic injections of various agents were given as follows: group I, normal saline; group II, live BCG; group III, 200 μg of BCG supernatants. Two months later the animals were sacrificed, and the prostates removed in toto and submitted for a thorough histological examination. Extensive but variable tissue necrosis was noted in groups II and III. No histological alterations were present in group I. The histological picture of the animals receiving BCG supernatants conclusively demonstrated circumscribed necrosis of the gland. Side effects and complications were present in animals receiving live BCG but conspicuously absent in the ones receiving supernatants. The observed effectiveness and safety of BCG supernatants for intraprostatic administration in an experimental system may lead to a simple, safe, and efficacious therapeutic modality for localized carcinoma of the prostate in humans.
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  • 9
    ISSN: 1433-3023
    Keywords: Antibiotics ; Cystitis ; Urinary tract infections
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract An ecological approach to the pathogenesis of uncomplicated urinary tract infections allows awareness of the continual battle being waged in the vagina, urethra, and bladder between the bacterial invaders and the host defense mechanisms. Despite overwhelming odds, the bacteria must be able to persist, colonize, and finally adhere to these various battlefields on their ascent to the bladder itself. The large number of patients presenting to physician offices with acute simple cystitis attests to the fact that the bacteria occasionally win the battle of the bladder. An understanding of the pathophysiology of this constantly raging battle may help us modify our clinical approach to women with simple uncomplicated urinary tract infections.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1433-3023
    Keywords: Cystitis ; Interstitial ; Refractory
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Interstitial cystitis is the most therapeutically frustrating condition of the urinary tract. The vast array of treatments available clearly indicates that none is particularly effective. As the majority of patients fail to experience a significant and prolonged response to standard treatments, new options are frequently being developed. These include the oral administration of cimetidine, the intravesical use of hyaluronic acid and BCG, and total cystectomy with the formation of a continent urinary diversion. Unfortunately, the acceptance of many new treatments is based on incomplete evaluation, and this has resulted in a confusing array of disparate alternatives. Effective and durable treatment will not be available until the nature of the disease is better understood and the mechanisms of action of current therapies are elucidated.
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