Grey-Scale Ultrasound in the Imaging of Urinary Tract Disease

Grey-scale ultrasound defines smaller renal lesions that had previously been appreciated and is able to define associated lesions of the liver such as metastases and cysts. The appropriate technique to delineate the normal anatomy of the kidney is described. Ultrasound plays a central role in the identification and characterization of renal mass lesions thus leading to appropriate further work up. In renal transplant evaluation ultrasound is useful as a complementary modality to other imaging studies permitting the recognition of pelvic fluid collections, rejection, and hydronephrosis. Specific findings are present in renal abscess, perirenal abscess, and in several of the renal cystic diseases. Adrenal lesions can be identified and clarified. In the lower urinary tract, ultrasound can identify bladder and prostatic tumors.Ultrasound provides a rapid, safe and non-invasive modality which is complementary to other imaging techniques in the diagnosis of urinary tract disease.     

Abnormalities of the Urinary Tract in Association with Congenital Cardiovascular Disease

The incidence of urinary tract abnormalities in a group of infants and children with congenital cardiovascular disease was determined by assessing roentgenograms of the abdomen taken following angiocardiographic studies. The urinary tracts of 400 of these patients were so outlined, but in 50 others the tracts could not be outlined. In 21 of the latter the urinary tracts were assessed at autopsy.Of these 421 children, nine (approximately 2%) had serious urinary tract disease, and 15 (approximately 3.5%) had anomalies which were of no clinical significance.The incidence of four renal anomalies—bifid collecting system, rotated kidney, horsehoe kidney and ectopic kidney—was compared with that in another group of patients without cardiovascular disease. No significant difference was found in the incidence of these four anomalies in the two groups.     

Plasma and Urinary Luteinizing Hormone Levels in the Diagnosis of Endocrine Disease

The diagnostic value of measurements of plasma and urinary luteinizing hormone (LH) has been studied in 209 patients with endocrine disease. In 44 patients puberty was either delayed or had failed to occur. In those with chromosomal abnormalities the LH levels were often within the normal range, whereas those with a pituitary cause usually had low levels. In boys with delayed puberty plasma LH levels rose before physical changes occurred and had prognostic value. In patients with later gonadal failure, men with impotence or infertility, and women with secondary amenorrhoea LH assays proved of little value, although in one case a premature menopause was suspected and six patients with anorexia nervosa had low LH levels.Sixty patients with disorders of the hypothalamicpituitary area were studied. Levels of LH were measured and considered in relation to the other anterior pituitary hormones. Impairment of LH secretion was one of the first effects on hormone production of disease affecting this area, and this was, of course, most readily detected in postmenopausal women.The normal ranges of both plasma and urine LH are wide and there seems to be considerable day-to-day variation, especially of urinary output. Several samples should, therefore, be measured if therapeutic decisions are involved.     

Urinary Bladder Dysfunction in Transgenic Sickle Cell Disease Mice

Background

Urological complications associated with sickle cell disease (SCD), include nocturia, enuresis, urinary infections and urinary incontinence. However, scientific evidence to ascertain the underlying cause of the lower urinary tract symptoms in SCD is lacking.

Objective

Thus, the aim of this study was to evaluate urinary function, in vivo and ex vivo, in the Berkeley SCD murine model (SS).

Methods

Urine output was measured in metabolic cage for both wild type and SS mice (25-30 g). Bladder strips and urethra rings were dissected free and mounted in organ baths. In isolated detrusor smooth muscle (DSM), relaxant response to mirabegron and isoproterenol (1nM-10μM) and contractile response to (carbachol (CCh; 1 nM-100μM), KCl (1 mM-300mM), CaCl₂ (1μM-100mM), α,β-methylene ATP (1, 3 and 10 μM) and electrical field stimulation (EFS; 1-32 Hz) were measured. Phenylephrine (Phe; 10nM-100μM) was used to evaluate the contraction mechanism in the urethra rings. Cystometry and histomorphometry were also performed in the urinary bladder.

Results

SS mice present a reduced urine output and incapacity to produce typical bladder contractions and bladder emptying (ex vivo), compared to control animals. In DSM, relaxation in response to a selective β3-adrenergic agonist (mirabegron) and to a non-selective β-adrenergic (isoproterenol) agonist were lower in SS mice. Additionally, carbachol, α, β-methylene ATP, KCl, extracellular Ca²⁺ and electrical-field stimulation promoted smaller bladder contractions in SS group. Urethra contraction induced by phenylephrine was markedly reduced in SS mice. Histological analyses of SS mice bladder revealed severe structural abnormalities, such as reductions in detrusor thickness and bladder volume, and cell infiltration.

Conclusions

Taken together, our data demonstrate, for the first time, that SS mice display features of urinary bladder dysfunction, leading to impairment in urinary continence, which may have an important role in the pathogenesis of the enuresis and infections observed the SCD patients.     

Studies on the Mechanism of Activation of Pepsinogen

Experiments were carried out on the effects of substrate or competitive inhibitor on the rate of appearance of N-terminal isoleucine residue of pepsin and peptides released from pepsinogen in its conversion to pepsin. Assumptions were made from these experiments, that an active site is initially formed in pepsinogen by acidification of its solution, and that peptide bond between 41-glutamyl and 42-isoleucyl residues locates in the juxtaposition to the active site forming an intramolecular enzyme-substrate complex. Thus, N-terminal tail of pepsinogen is released by a hydrolysis catalyzed by its own active site.

It was Indeed ascertained in this study that neither a small amount of pepsin which could be accompanied by pepsinogen preparation used contributes to the initial step of hydrolysis of pepsinogen nor pepsin formed accelerates the following activation process.

Therefore, it was concluded that the conversion of pepsinogen to pepsin is self-degrad-ation process.     

An Appraisal of Tidal Activity Rhythms

Organisms of the marine littoral zone experience a much wider range of periodicities in their environment than do their terrestrial counterparts. Tidal cycles of semidiurnal, diurnal, lunar, and semilunar frequencies may all recur at the same locality, in addition to the diel cycle of light and darkness. The relationship of endogenous activity patterns to the prevailing geophysical variables thus poses problems for the temporal organization of the organism. The way in which intertidal animals synchronize their behaviour and physiology to such a diversely fluctuating environment, and the efficacy of different environmental factors as entraining agents is considered. Evidence pertaining to the endogenous control mechanisms, both physiological and behavioural, is reviewed, and the organization of the endogenous time-keeping system discussed in terms of identifiable oscillators of different frequencies.     

Pepsinogen B: the zymogen of pepsin B

1. Pepsinogen B, the precursor of pepsin B, has been isolated by ion-exchange chromatography and gel filtration from neutral extracts of pig gastric mucosa. The material possesses potential activity against acetyl-l-phenylalanyl-l-di-iodotyrosine and against gelatin but has little, if any, potential activity against haemoglobin. 2. The material appears homogeneous in the ultracentrifuge, but on gel filtration and on electrophoresis in starch gel it is shown to be contaminated with a small amount of material having potential activity against haemoglobin. On electrophoresis in starch gel also the material is shown to contain about equal amounts of two major components, both of which have potential activity against the synthetic substrate. Pepsin B has also been shown to contain two active components by electrophoresis under the same conditions. 3. The zymogen is similar to pepsinogen and pepsinogen C in its molecular weight and general physico-chemical properties, but differs from these zymogens in the nature of its N-terminal residues. It is possible that one of the components contains 1 mole of bound phosphate/mole. 4. The material is activated rapidly at pH2 and more slowly at pH4. At both pH values the kinetics of the activation reaction are complex.     

Pepsinogen activation: genesis of the binding site

Previous experiments have suggested that a substrate binding site may appear relatively early in the sequence of transformations that pepsinogen undergoes during its unimolecular activation. To test this possibility, tert-Boc-L-valyl-[3(S)-hydroxy-4(S)-amino-5-(2-naphthyl) pentanoyl]-L-alanylisoamylamide, a fluorescent analogue of pepstatin, has been used to measure the rate of appearance of the binding site. This probe is a potent inhibitor of pepsin, and its naphthyl group is an environmentally sensitive fluorophore that permits binding to be detected by fluorescence spectroscopy. In stopped-flow experiments, the fluorescence change following acidification of pepsinogen due to binding of the probe was found to obey a two-term exponential decay law. Analysis of the data obtained at various pH values permits us to rule out a sequential model for the kinetics. Rather, we were able to demonstrate that a concurrent model, with two species undergoing simultaneous transformation at different rates, is consistent with the results. The two species are related to each other by the protonation of a single site with a pKa of approximately 2.2. We obtained essentially identical results in an analysis of the early events observed in the acidification of pepsinogen labeled with 6-(p-toluidinyl)naphthalene-2-sulfonyl chloride (Auer & Glick, 1984). The protonic equilibrium probably occurs early after exposure to acid and is proposed to lead to a conformational change that freezes the distribution between the two species. It may be that these two conformers persist as identifiable entities at later stages of activation as well.(ABSTRACT TRUNCATED AT 250 WORDS)     

Pepsinogen C expression in tumors of extragastric origin

We have examined by immunohistochemistry the ability of human carcinomas of various origin to produce pepsinogen C, an aspartyl proteinase mainly involved in the digestion of proteins in the stomach and recently found to be associated with breast carcinomas. Of the 268 tumors analyzed 80 (29.8%) showed positive staining for pepsinogen C. These positive tumors included 12 gastric (38.7% of the 31 examined cases), nine pancreatic (42.8%), two renal (20%), 12 prostatic (40%), three bladder (27.3%), 14 endometrial (29.7%) and 18 ovarian (40%) carcinomas. We also detected 10 melanomas (50%) that were positive for pepsinogen C. By contrast, immunohistochemical staining for the proteinase was not detected in colorectal, cervical, lung and basal cell skin carcinomas. These results demonstrate that pepsinogen C, a proteolytic enzyme of highly restricted expression in human tissues, can also be expressed by a wide variety of human carcinomas. In addition, and similar to pepsinogen C expression in breast carcinomas, the production of this enzyme by different human tumors might be related to putative hormonal alterations associated with the development and progression of these tumors.     

Immunochemical Studies on the Components of the Pepsinogen System

Rabbit antisera to pepsin and pepsinogen were characterized by several immunological criteria. Both antisera inhibited the rennet activity of pepsin. Antipepsinogen protected pepsin from alkaline denaturation. Using antipepsinogen, precipitin analysis at pH 5.5 indicated that the native enzyme resembles the precursor more closely than did the denatured enzyme. However, all three proteins have some antigenic sites in common. Both antisera reacted more efficiently with their homologous antigens. When measured by C' fixation, the pepsinogen-antipepsinogen system was inhibited by pepsin and to a greater degree, by the activation mixture and the pepsin-inhibitor complex. Pepsin-antipepsin was inhibited by pepsinogen. The specificity of these two antibodies toward pepsin and pepsinogen conformation was used to measure the disappearance of pepsinogen and the concomitant appearance of pepsin during autocatalytic conversion at pH 4.6. The experimental results obtained during the conversion could be duplicated by using varying proportions of pepsin and pepsinogen in the model system. The potentialities of employing these antisera to detect conformational changes such as the unmasking of the pepsin moiety in pepsinogen molecules modified by physical or chemical reagents are discussed.