Atypical cells in the urinary sediment: a protocol for cytological analysis of the urinary sediment

Introduction:  The Department of Clinical Chemistry of the General Hospital of Móstoles (Madrid, Spain) has for many years diagnosed the presence of atypical cells in the urinary sediment (ACUS), but this finding only led to a comment in the final report of the urinalysis, informing the clinician of this fact in case he/she decided to perform further studies in these patients.
Methods:  Since 2004, the Clinical Chemistry Department has implemented a new protocol together with the Department of Surgical Pathology of the Hospital, according to which all the urinary sediment samples with ACUS are sent for cytological analysis. In this report, we comment on the results corresponding to 99 samples.
Results:  With this new strategy, we can directly diagnose if the ACUS correspond to a carcinoma or to another process, and this has allowed us to reduce time until diagnosis in our patients and also to avoid unnecessary studies in negative cases. We comment on our results with this new management strategy.     

High-throughput pretreatment system in automated urinary sediment analyzer

BACKGROUND: Urine contains microscopically observable particles that can indicate certain types of disease in the urinary tract system. Determining these various types of sediments by manual operation is a cumbersome and time-consuming task. To eliminate this labor, we developed an automated urinary sediment analyzer with high-throughput pretreatment system. METHODS: The pretreatment system mainly consists of four reaction vessels for dying samples (urine), a sheath flow chamber, and an unique sample carrier mechanism from the reaction vessel to the flow chamber, which enables overlapped processing, and rapid transfer of samples with small dispersion and a short buildup time. RESULTS: The buildup time was experimentally found to be 1.8 s, and the extra-sample volume beside that for measurement was only 4.9 microl (1/20 of the total sample volume). CONCLUSIONS: Short buildup time results in high throughput of 120 samples per hour, and relatively small extra-volume contributes to reduce carryover.     

Cytology of nephrogenic adenoma of the urinary bladder. A report of four cases

All urine cytology specimens of four patients with biopsy-proven nephrogenic adenoma were reviewed. The specimens revealed the presence of atypical or suspicious epithelial cells as long as one and one-half years before the diagnosis of nephrogenic adenoma was established. Most of the atypical cells were vacuolated, and some were considered suspicious for adenocarcinoma initially. Such suspicious cells in the urine of a patient at risk for development of nephrogenic adenoma should not be confused with those of an adenocarcinoma.     

Degeneration of adrenergic nerves in the urinary bladder during pregnancy

The adrenergic innervation of the urinary bladder of normal female and pregnant rats has been studied using a fluorescence histochemical method. The bladder is richly innervated by adrenergic nerve fibres as is evidenced by the presence of numerous adrenergic nerves in the adventitia, musculosa and submucosa. However, adrenergic nerve cells could not be observed. During pregnancy, adrenergic nerve fibres showed signs of degeneration, as most of the nerve fibres disappeared and the surviving fibres were much swollen. 10 days after parturition the pattern and density of adrenergic innervation became almost similar to those of the control animals.     

Cellular material in urinary sediment in retarded or precocious puberty]

The cellular material studied in the urinary sediment mainly obtained from exfolied alls the bladder trigone was submitted to hormonal stimulation. These cell changes constitute the basis of a cytologic method called the urocytogram. The urocytogram was followed up in six children with early puberty and ten young girls with backward puberty. These repeated examinations contribute to the diagnosis and help in the differential diagnosis. Whenever it is necessary to investigate a child' sex hormones the urocytogram, simple painless method is indicated.     

Increase in urinary thromboxane excretion during pregnancy and labor

Urinary TXB2 excretion was measured during pregnancy and labor using high pressure liquid chromatography and radioimmunoassay. From the first trimester onwards TXB2 levels in urine of pregnant women (n = 60) were significantly (p less than 0.001) higher than in non-pregnant women (n = 12) and they increased, albeit not significantly, with advancing gestation. Labor was associated with a two-fold increase in urinary TXB2 excretion. Levels in established labor were significantly higher than at any other time in pregnancy (p less than 0.001), but the levels in incipient labor showed considerable overlap with these in late pregnancy. Thus urinary TXB2, while not necessarily originating from the pregnant uterus, appears to reflect the uterine activity of labor and may be the expression of a general stimulation of prostanoid production during parturition.     

Increase in urinary thromboxane excretion during pregnancy and labor

Urinary TXB₂ excretion was measured during pregnancy and labor using high pressure liquid chromatography and radioimmunoassay. From the first trimester onwards TXB₂ levels in urine of pregnant women (n=60) were significantly (p <0.001) higher than in non-pregnant women (n=12) and they increased, albeit not significantly, with advancing gestation. Labor was associated with a two-fold increase in urinary TXB₂ excretion. Levels in established labor were significantly higher than at any other time in pregnancy (p <0.001), but the levels in incipient labor showed considerable overlap with these in late pregnancy. Thus urinary TXB₂, while not necessarily originating from the pregnant uterus, appears to reflect the uterine activity of labor and may be the expression of a general stimulation of prostanoid production during parturition.