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Query: UMLS:C0005684 (bladder cancer)
 16,431 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Forty-four patients undergoing radical cystectomy and urinary diversion for invasive bladder cancer were studied prospectively in order to evaluate the substitution of crystalline amino acids (A3W) for dextrose (D5W) in their postoperative fluid management. Nutritional assessment revealed 17 (39%) patients to be malnourished prior to operation; the postoperative complication rate in Group I (D5W) was 33% vs 17% in Group II (A3W). Nitrogen losses in both groups were low, secondary to the large amounts of albumin used postoperatively; however, more exogenous albumin was needed after operation to maintain serum albumin levels in Group I compared with Group II (77.5 +/- 3.1 gm vs 65 +/- 5.2gm). Cell-mediated immunity, determined by reactivity to a battery of recall antigens, revealed that 56% (5) of Group I patients were able to maintain their skin test reactivity throughout the postoperative course compared with 94% (17) in Group II. Four nutritionally depleted patients in Group I required conversion to a forced feeding regimen (IVH), while none of those in Group II required a change in nutritional regimen. Invasive bladder cancer represents a major injury, and preoperative x-ray therapy along with surgical extirpation is associated with considerable nutritional depletion. Early nutritional support in the management of these patients is mandatory, and where hypocaloric feeding regimens are appropriate, the use of A3W in place of D5W solutions would appear to be indicated.
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PMID:Protein-sparing in cystectomy patients. 10 61

Over a 7 year period, 85 cancer patients were managed by the nutrition service of St. Joseph's Hospital, Toronto. All these patients were nutritionally depleted, had obstruction to the gastrointestinal tract, or had postoperative complications such as enterocutaneous fistulas, evisceration or intraabdominal sepsis, which left total parenteral nutrition (TPN) as the only means of achieving positive nitrogen balance. A prospective study started in 1970 has found that when cancer was resectable and TPN was started preoperatively and continued postoperatively (24 patients-group 1) until the patient could take a normal diet, no deaths or significant complications occurred. When TPN was first started after life-threatening complications had occurred (53 depleted patients-group 2), the mortality was 17.0%. This mortality was only 4.5% after complications following operations for colon cancer, but was much higher with esophageal, pancreatic and bladder cancer, and especially after complications following surgery where radiotherapy had previously been given to abdomen or pelvis. When TPN was used in inoperable, cachectic patients (8 patients-group 3) to permit them to tolerate radiotherapy or chemotherapy, the mortality was 37.5%. This latter group is small, but TPN is worthwhile in selected patients where significant palliation and improvement in the quality of life can occur.
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PMID:Specialized nutritional support in the cancer patient: is it worthwhile? 41 70

Seventeen patients undergoing 19 major urological operations for bladder cancer or rectal leiomyosarcoma (1 case) were studied after randomization for 3 hypocaloric dietary regimens, preoperative keto-adaptation by a carbohydrate-free, oral protein diet continued in the postoperative period by isotonic amino acid infusions, postoperative amino acid infusions only and 5 per cent dextrose infusions. In these normally nourished patients serum transferrin (plus 13 mg./dl. minus 30 mg./dl., minus 69 mg./dl., p less than 0.05 for the first and combined amino acid groups against the third group) and 2 other short half-life hepatic secretory proteins, prealbumin and retinol-binding protein, represented sensitive indexes of visceral protein and nutritional support, superior to nitrogen balance, anthropometric assays, delayed hypersensitivity skin test reactivity and serum albumin. Near isotonic amino acid infusions were more effective in preserving visceral protein status than 5 per cent dextrose but preoperative keto-adaptation was not shown to have any increased benefit over protein-sparing therapy given only after an operation.
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PMID:Optimal nutritional support in surgery for bladder cancer: preservation of visceral protein by amino acid infusions. 56 18

Previously, we established an anti-androgen receptor (AR) monoclonal antibody. Using the antibody, we investigated immunohistological AR localization in human testes, epididymides, seminal vesicles and scrotal skins. The testes, epididymides and scrotal skins were obtained from a prostate cancer patient without pre-hormonal therapy undergoing bilateral orchiectomy. The seminal vesicles were obtained from a bladder cancer patient undergoing radical cystectomy. The tissues were immediately frozen in liquid nitrogen and kept at -80 degrees C until used. Cryostat-frozen sections were cut at 5 microns and stained by an indirect method. We obtained the following results. 1) In the testes, nuclei of Leydig cells were stained though Sertoli cells were not stained. AR localization in Leydig cells which produce testosterone suggests autocrine or intracrine mechanism in the testis. 2) In the epididymides, nuclei of epithelial cells of epididymal ducts were stained, while muscles and connective tissues were not stained. In the seminal vesicles, nuclei of glandular epithelial cells were stained. 3) In the scrotal skins, the cells of squamous cell layer have positive stainings. The cells in the upper portion of squamous cell layer were stained more intensely than the cells in the lower portion. The basal layer was not stained. The cells of the outer root sheath of hair follicles in the scrotal skins were also stained. 4) In androgen target organs, AR-positive cells and AR-negative cells were mixed in the epithelium of a glandular duct, which suggests heterogeneity of AR localization in the androgen target organs.
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PMID:[Localization of androgen receptor in male sex organ, accessory sex organs and external genital skin]. 147 18

Protein metabolism status was assessed by standard procedures versus tumor stage and nitrogen-excreting function of the kidneys in 250 cases of urinary bladder cancer. In addition, 18 amino acids in the blood were assayed in 63 patients. Standard methods of examination identified protein metabolism disturbances in patients with stage III-IV renal failure whereas amino acid profile showed changes at a much earlier stage. Patients with T3-4 tumors revealed decreased blood amino acid levels. Renal failure and surgical trauma caused the level of most amino acids checked to decrease. The need for correction of the amino acid profile of the blood before and after surgery is discussed.
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PMID:[Changes in protein metabolism and the free amino acid profile in bladder cancer]. 225 14

Urinary nitrite, a precursor of carcinogenic nitrosamines, and nitrate were measured in 73 Japanese patients with urinary tract infections (UTI) and in two control groups. Nitrite was detected in 12% of patients with uncomplicated UTI (226 +/- 161 mumol/l) and in 42% of those with complicated UTI (375 +/- 297 mumol/l). None of the subjects in the control groups excreted detectable amounts of nitrite. The excretion of nitrite in four out of five nitrite excretors continued for at least 14-55 days. The concentrations of urinary nitrite were significantly correlated with those of nitrate- plus nitrite-nitrogen, which reflect dietary nitrate ingestion. The results suggest the importance of close monitoring of nitrite excretor group in UTI patients, to clarify the mechanism of the association between UTI and bladder cancer.
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PMID:Urinary nitrite in Japanese patients with urinary tract infections. 276 99

Alkylating agents have caused acute nonlymphocytic leukemia (ANLL), probably bladder cancer, and possibly other solid tumors. Phenacetin also has enhanced risk of bladder cancer, and probably also carcinoma of the renal pelvis. Topical nitrogen mustard, potassium arsenite, tar ointments, and methoxsalene have been related to development of nonmelanotic skin cancers. Immunosuppression by azathioprine, usually with prednisone, has enhanced risks of non-Hodgkin's lymphomas, hepatobiliary cancers, and various mesenchymal tumors. Liver cancers have been reported in users of androgenic anabolic steroids, and both hepatic cell adenomas and carcinomas have been associated with use of combined oral contraceptives. These contraceptives reduce risks of endometrial and ovarian carcinomas. Estrogens increase risk of endometrial cancer. Exposure to diethylstilbestrol in utero can result in clear cell carcinomas of the vagina and cervix, and possibly testicular carcinomas.
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PMID:Steroid hormones and medications that alter cancer risks. 304 37

Previous studies done in animals have shown that significant prophylaxis against radiation injury could be afforded by feeding an elemental diet (ED) for three days before and during radiation. In the present study 20 patients were fed an ED for three days before and for the four days during radiotherapy (five fractions of 400 rad [4 Gy] each) prior to radical cystectomy and ileal conduit for invasive bladder cancer; ED feeding was recommenced 24 hours postoperatively via a feeding jejunostomy. The ED-fed patients exhibited positive nitrogen balance preoperatively and had an early return to positive nitrogen balance postoperatively (3.60 +/- 0.32 days). There was also prompt return of bowel sounds (3.00 +/- 0.32 days). Histologically and ultrastructurally, biopsy specimens of the ileal mucosa showed normal morphologic findings, with maintenance of normal levels of enzyme activity in the brush border. Severe or bloody diarrhea was absent in these patients. These data suggest that ED feeding provides prophylaxis against the acute phase of radiation injury in patients undergoing high-dose, short-course radiotherapy for invasive bladder cancer and that it is a safe and feasible means of postoperative nutritional support, even in the presence of a fresh bowel anastomosis.
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PMID:Prophylaxis against radiation injury. The use of elemental diet prior to and during radiotherapy for invasive bladder cancer and in early postoperative feeding following radical cystectomy and ileal conduit. 308 95

We investigated the possibility that variations of the metabolism of xenobiotic compounds might be involved in the process of bladder carcinogenesis, by studying activation reactions (phase I) and detoxification reactions (phase II) of xenobiotic compounds in a group of patients with transitional cell carcinoma of the bladder and in a group of controls hospitalised with other diseases. As an indirect estimate of activating reactions (phase I) we measured cortisol hydroxylation, expressed as the ratio between urinary 6-beta-OH-cortisol and 17-OH-corticosteroids. Cortisol hydroxylation was not increased in the group of patients when compared with controls. The variations of phase II conjugating enzymes were followed indirectly by administering paracetamol and measuring the urinary excretion of its main metabolites over a period of 12 h. The variations in the metabolic conjugation of paracetamol were expressed as a percentage of each metabolite, or of unmodified paracetamol excreted in the urine, or as the ratio between a given metabolite and unmodified paracetamol. The data were analyzed with a logistic regression model, analysing the effects of possible confounding variables such as age, smoking, alcohol, blood nitrogen, blood creatinine, glutamic-pyruvic (SGPT), glutamic-oxalacetic transaminases (SGOT) and percent recovery of paracetamol in the urine. Statistical analysis showed that the excretion of mercapturate derivatives of paracetamol was significantly increased in the group of patients. The levels of glucuronic, sulphate and cysteine metabolites were not varied significantly. Since mercapturate derivatives are formed as a consequence of the formation of short-lived metabolites of paracetamol which react with protein, nucleic acids or glutathione, the increased excretion of mercapturic acid derivatives in cancer patients might be an indication of a higher capability of forming reactive molecular species from xenobiotic compounds. We suggest that this factor might play a role in the induction of bladder cancer.
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PMID:Variations of cortisol hydroxylation and paracetamol metabolism in patients with bladder carcinoma. 320 22

The present study investigates the metabolic changes associated with cystectomy and the effects of nutritional support on the cystectomy patient. Twelve patients undergoing radical cystectomy and ileal conduit urinary diversion for invasive bladder cancer were randomly assigned to receive either a diet of 5 per cent dextrose (Group I) or total parenteral nutrition (Group II) given as glucose and amino acids. Group I demonstrated a marked negative nitrogen balance throughout the study while Group II had minimal losses for the first three days and achieved positive nitrogen balance by the fourth postoperative day. Over six postoperative days, cumulative nitrogen balance was -1.08 +/- 0.35 and -0.02 +/- 0.16 gm./kg. (p less than .001) in Groups I and II, respectively. Energy expenditure, compared to predicted values, was 15 percent higher (p less than .01) in Group II than in Group I. The respiratory quotient in the total parenteral nutrition group remained below 1.0, an indication of ongoing net fat oxidation despite hypercaloric glucose intake. Patients on total parenteral nutrition tended to show elevations in norepinephrine excretions as well as a transient rise in rectal temperature (p less than .05). The highest body temperature in both groups was recorded on the third postoperative day. The energy cost of radical cystectomy was similar to that in patients undergoing total hip replacement. However, lean tissue losses and norepinephrine concentrations were much higher than for hip patients and were comparable to changes seen in severe accidental injury. The tissue losses were completely abolished by total parenteral nutrition. The observation that nutrition affects temperature regulation in acutely ill patients has implications for interpreting increases in body temperature in injured patients receiving total parental nutrition. Fever may not necessarily indicate the development of infection.
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PMID:Metabolic changes associated with radical cystectomy. 393 77


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