Urodynamic findings in chronic retention of urine and their relevance to results of surgery.

Fifty-five consecutive male patients aged 18-77 with chronic retention of urine were investigated urodynamically. All were shown to have obstructed micturition. Inflow cystometry defined two groups, one with high-pressure and one with low-pressure filling. Recent-onset enuresis and upper-tract dilatation as seen on radiography were significantly associated with high-pressure bladder filling. Postoperative studies showed that patients with high-pressure filling on preoperative cystometryhad a better response to outflow-tract surgery. The poor response of the patients with low-pressure filling was due to a high incidence of inadequate detrusor contraction leading to persistent residual urine. Thus urodynamic studies may be used to indicate which patients are likely to benefit from prostatectomy and, after the operation, whether the obstruction has been relieved.     

Urethral plugs and urine retention in male mice

Because MM male mice suffer from a high incidence of urinary tract infection, an assessment was made as to whether the urethral plugs, which occur in male rodents, might be involved in its aetiology. When killed, males more commonly retained urine in their bladders than females but there was no significant difference between strains or method of killing. Males also voided urine more often during stressful handling followed by abdominal pressure, but also retained some urine more often than females. The study of sexually immature mice demonstrated no sex differences and no urine was retained in any bladder. It was concluded that the high frequency of urine retention in mature males is attributable to the presence of urethral plugs but these could not be implicated in the cause of MM urinary tract infection because of comparable findings in the controls. However, the possibility was considered that the plugs might facilitate infection of the kidneys once a bladder infection had become established.     

Accurate mass tag retention time database for urine proteome analysis by chromatography-mass spectrometry

Information about peptides and proteins in urine can be used to search for biomarkers of early stages of various diseases. The main technology currently used for identification of peptides and proteins is tandem mass spectrometry, in which peptides are identified by mass spectra of their fragmentation products. However, the presence of the fragmentation stage decreases sensitivity of analysis and increases its duration. We have developed a method for identification of human urinary proteins and peptides. This method based on the accurate mass and time tag (AMT) method does not use tandem mass spectrometry. The database of AMT tags containing more than 1381 AMT tags of peptides has been constructed. The software for database filling with AMT tags, normalizing the chromatograms, database application for identification of proteins and peptides, and their quantitative estimation has been developed. The new procedures for peptide identification by tandem mass spectra and the AMT tag database are proposed. The paper also lists novel proteins that have been identified in human urine for the first time.     

Laboratory measurement of urine albumin and urine total protein in screening for proteinuria in chronic kidney disease

Laboratory measurement of urine total protein has been important for the diagnosis and monitoring of renal disease for decades, and since the late 1990s, urine albumin has been measured to determine whether a diabetic patient has incipient nephropathy. Evolving understanding of chronic kidney disease (CKD) and, in particular, the cardiovascular risks that CKD confers, demands more sensitive detection of protein in urine. As well, evidence is now emerging that cardiovascular and all-cause mortality risks are increased at levels within the current 'normal' range for urine albumin. Standardisation is essential to permit valid application of universal decision points, and a National Kidney Disease Education Program/International Federation of Clinical Chemistry and Laboratory Medicine (NKDEP/IFCC) Working Party is making progress towards a reference system for urine albumin. In the meantime, available data suggest that Australasian laboratory performance is adequate in terms of precision and accuracy above current decision limits for urine albumin. In contrast, the complexity of proteins in urine makes standardisation of urine total protein measurement impossible. As well, urine total protein measurement is insufficiently sensitive to detect clinically important concentrations of urine albumin. An Australasian Expert Group, the Proteinuria Albuminuria Working Group (PAWG) has proposed that urine albumin/creatinine ratio is measured in a fresh, first morning, spot sample to screen for proteinuria in CKD. Both NKDEP/IFCC and PAWG emphasise the need for standardisation of sample collection and handling.     

Role of oxidative stress and mitochondria in onset of urinary bladder dysfunction under acute urine retention

Acute urine retention is a frequent complication in patients with benign hyperplasia of the prostate gland. According to studies made on experimental animals and people, it is accompanied by the deterioration of the bladder blood supply. This study attempts to explore the relationship of intramural blood flow, production of reactive oxygen species, and functional state of the bladder detrusor in modeling of acute urine retention in rats, as well as the impact of mitochondria-targeted antioxidants (which are supposed to alleviate the effects of oxidative stress induced by experimental ischemia) on these parameters. The study showed beneficial effects of mitochondria-targeted antioxidant SkQR1 in preventing damage of the bladder caused by acute urinary retention, which suggests the therapeutic use of this type of compounds for the treatment of ischemic abnormalities of the urinary bladder.     

Isolation of Mycoplasma from the urine of patients with chronic pyelonephritis]

Bacteriological analysis of urine of 150 patients with chronic pyelonephritis was performed. As a result mycoplasma was isolated from urine of 25 patients. Mycoplasma and Coli bacteria or Proteus were isolated simultaneously from urine of 10 patients. Biochemical properties and sensitivity to antibiotics of 9 isolates were studied. The data provided recommendation of the urine analysis for the presence of mycoplasma.     

L-forms of bacteria in the urine of patients with chronic pyelonephritis]

The authors present the data concerning the study of 200 patients suffering from chronic pyelonephritis; in 28 of these L-forms of bacteria were revealed in the urine. Of 46 L-cultures isolated from these patients 13 reversed into bacterial forms, 8 failed to reverse and were referred to the stable L-forms; the rest 25 L-cultures perished during the 8th--10th passage. This led to a supposition that the relapses and exacerbations of the infectious process in pyelonephritis were associated with the change of the L-forms into bacterial ones, and that the persistence of the L-forms in the kidney tissue promoted the maintenance of the chronic process.     

Plasma and urine levels of resistin and adiponectin in chronic kidney disease

BACKGROUND: Subjects with chronic kidney disease (CKD) have an increased risk of developing coronary atherosclerosis. Adipocyte hormones, resistin and adiponectin are implicated in insulin resistance and atherosclerosis. However, few studies in the literature address the role of adipocyte hormones in CKD. The aim of this study was to compare the levels of resistin, adiponectin and other inflammatory markers in subjects with CKD with those of the control subjects. MATERIALS AND METHODS: In a cross-sectional study, we measured basal metabolic panel, fasting lipid panel and levels of glucose, resistin, adiponectin, insulin, C-reactive protein (CRP) and TNF-alpha in 43 subjects with CKD compared with those of 34 control subjects. We also measured the resistin and adiponectin levels in urine samples (16). RESULTS: Subjects with CKD have increased insulin levels and insulin resistance index (IRI). Compared with controls, subjects with CKD had increased levels of resistin (5.12+/-3.2 vs.7.5+/-5.9; p<0.05), CRP (1.7+/-2.2 vs. 5.97+/-6.0; p<0.0005), and TNF-alpha (3.4+/-2.0 vs. 5.2+/-3.5; p<0.005). Resistin levels correlate with CRP and TNF-alpha, even with BMI as a covariate. Although 60% of subjects with CKD have CAD, e plasma levels of adiponectin were not decreased in subjects with CKD compared with controls (17.02+/-9.8 vs. 16.40+/-9.0 with p value 0.78). Urinary adiponectin levels correlate inversely with GFR (r=-0.4; p<0.05) and plasma adiponectin levels (r=0.9; p<0.0001). CONCLUSIONS: Subjects with CKD had normal levels of plasma adiponectin despite the adverse metabolic environment for CAD. In addition, this study demonstrates the relationship between resistin and TNF-alpha in subjects with CKD and suggests that resistin may play a role in the sub-clinical inflammation associated with CKD, suggesting that adiponectin clearance may be decreased as shown by the inverse correlation of urinary adiponectin with GFR.     

Water retention and plasma and urine composition in toads (Bufo viridis Laur.) under burrowing conditions

Summary Osmoregulation in the terrestrial toad,Bufo viridis, was studied under burrowing conditions in the laboratory. The toads can live for over 3 months burrowed in soil containing 9–10% moisture, maintaining constant body volume due to a large increase in the plasma osmolality, contributed mainly by urea. Water content of the tissues remains constant. Relatively large volumes of urine are stored in the urinary bladder during water restriction. The osmolality of the urine does not exceed that of the plasma. Urea uptake across the skin was measured in vitro and was greatly elevated in skins from the burrowed toads. The increase in plasma osmolality enables greater water absorption from the soil under water restricted conditions while the water content of the tissues is maintained constant since cell membranes are highly permeable to urea. It is concluded that the urea accumulating ability and urea tolerance form the basis for both the terrestriality and salt adaptability of this and other amphibian species.