Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 7-year-old boy was admitted for recurrent pyelonephritis. Intravenous pyelography IVP showed right hydronephrosis and normal left kidney and ureter. Cystourethroscopy revealed no ureteral orifices in the bladder but bilateral ureteral openings adjacent to the seminal colliculus. Right retrograde pyelography showed severe hydroureter and hydronephrosis. The diagnosis was bilateral ectopic ureteral opening into proximal urethra. His abnormality of ureteral opening was classified as type II in Thom's classification. Bilateral ureterocystoneostomy was performed. Only 3 cases of bilateral ectopic ureter in males have been reported in the Japanese literature.
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PMID:[A case of bilateral ectopic ureter in a male]. 846 May 88

The authors report their experience with an intraurethral prosthetic stent as an alternative treatment for detrusor-external urethral sphincter dyssynergia (DESD). A sphincter prosthesis was inserted into the membranous urethra of 25 men with spinal cord injuries, DESD, and elevated voiding pressure. Bladder voiding pressure decreased from 87 cm H2O +/- 23 to 27 cm H2O +/- 11 in 12 months (P < .001). There was a significant decrease in residual urine volume 12 months after prosthesis placement, from 122 mL +/- 77 to 33 mL +/- 19 (P < .01); bladder capacity remained relatively unchanged, from 174 mL +/- 84 to 230 mL +/- 92 (P < .57). No deleterious effects were seen in renal or erectile function. Migration of three prostheses occurred 1 day to 6 weeks after insertion. One additional complication, pyelonephritis, occurred in a patient with preexisting vesicoureteral reflux, necessitating reimplantation of bilateral ureters. The intraurethral wire mesh prosthesis, with its simplicity of placement and minimal associated morbidity, offers a potential alternative to external sphincterotomy.
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PMID:Placement of a wire mesh prosthesis in the external urinary sphincter of men with spinal cord injuries. 847 6

The aim of this study was to investigate the efficacy and morbidity of cutaneous ileocystostomy, as an alternative to cystectomy and ileal conduit urinary diversion, for patients with end-stage neurogenic vesical dysfunction. Three male and eight female patients, mean age 41 years (range 28-59), with a mean duration of a neuropathic bladder of 8 years (range 4-17 years) underwent evaluation for ileocystostomy urinary diversion. Indications for the procedure included a bladder capacity < or = 200 ml (10 patients), recurrent febrile urinary tract infection (nine patients), and urinary incontinence despite an indwelling urethral catheter (all eight women). Each was felt to be a poor candidate for, or refused, continent urinary diversion or bladder augmentation cystoplasty. All eight females required concomitant pubovaginal sling urethral compression to eliminate urinary leakage from a patulous, non-functional urethra. Two patients required bilateral ureteral reimplantation for grade III-IV/V reflux. Effective low-pressure urinary stomal drainage was achieved without the need for chronic catheterization in all of the patients with a mean duration of follow-up of 24 months (range 6-60 months). No patient has developed pyelonephritis since the procedure. Urethral urinary leakage was eliminated in all of the female patients, whilst vesicoureteral reflux resolved in those with reflux preoperatively.
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PMID:Cutaneous ileocystostomy (a bladder chimney) for the treatment of severe neurogenic vesical dysfunction. 852 6

Corneal opacities and urinary tract sepsis were previously observed by the authors in rats given muscarinic agonists mixed in the diet or by gavage. To explain the differential toxicity generated by each means of administration, toxicokinetics of the muscarinic agonist CI-979 were investigated. In addition, the muscarinic antagonist scopolamine was co-administered with CI-979 to evaluate the relationship of these effects to pharmacological mechanism of action of CI-979. Female rats were given CI-979 daily by gavage at 0, 1, 10 and 30 mg/kg body weight or in the diet at 0, 1, 10 and 50 mg/kg body weight for up to 14 days. Dose-related clinical signs of muscarinic stimulation, such as sialorrhoea and dacryorrhoea, were observed predominantly in rats given 10 and 30 mg/kg body weight CI-979 by gavage, and corresponded with the high plasma drug concentrations. In contrast, hydronephrosis, pyelonephritis, and inflammation and necrosis of the kidney, urinary bladder, urethra and urinary papilla were linked to sustained, albeit lower plasma drug concentrations attained by dietary administration of CI-979 at 10 and 50 mg/kg body weight. Comparable incidences of corneal opacities were induced by both means of administration, but lesions appeared more rapidly and were generally of greater severity when CI-979 was given in the diet. The induction of corneal lesions, as well as urinary sepsis, may not relate simply to maximum plasma concentrations or to areas under the curve per se, but rather may arise when plasma drug concentrations are sustained. Corneal opacification and development of urinary tract pathology were inhibited by scopolamine, suggesting that these effects were related to the muscarinic mechanism of action of CI-979.
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PMID:Toxicological comparison of a muscarinic agonist given to rats by gavage or in the diet. 864 67

To date transurethral laser ablation of the prostate (TULAP) in benign prostatic hyperplasia (BPH) is the commonest form of transurethral laser surgery. The invention of the so-called "sidefire" laser fibre was the prerequisite condition for effective transurethral laser ablation of the prostate. Since the first transurethral laser ablation in human BPH was performed by Costello in September 1990, a multitude of urologists have adopted this technique. In the meantime, a great many studies have been carried out and a lot of data have been published. The initial, to some extent euphoric, enthusiasm of some urologists as well as some patients, especially in the USA and Europe, has turned into a more critical reflection. There is no doubt at all that TULAP is a feasible alternative treatment method with reasonable results. Especially in the high-risk patient, there is neither severe blood loss nor an uptake of irrigation fluid. It is also beneficial to allow unlimited treatment in patients on anticoagulant medication. Nevertheless, the value of TULAP in comparison to transurethral electroresection of the prostate (TURP), generally accepted as the "gold-standard" in the surgical therapy of BPH, remains unclear. A final assessment will only be possible when further data on mortality, short and long term morbidity and outcome with this method have been presented. Strong evidence exists that the operation can be performed without blood loss and uptake of irrigation fluid. A further advantage seems to be preservation of sexual function, especially anterograde ejaculation in the majority of patients, in comparison to the "gold-standard" TURP. In most studies, the value of TULAP is further compared with regard to the elimination of obstruction by means of pressure-flow-studies. The aspect most frequently neglected by all investigators to date is the frequency and severity of urinary tract infections (UTI) in patients in whom TULAP is performed. Basically, UTI in the form of cystitis, ascending infections such as male adnexitis or pyelonephritis, prostatitis of the remaining parts of the prostate and catheter-induced urethritis are associated with transurethral surgery in general. Certain data indicate an age-related frequency of UTI. From a rate of approximately 1% of UTI in infants, the frequency rises to 30% in the 8th decade of life. According to these data, one can expect that in a study of TULAP in high risk patients, most of whom are elderly, a large number present for surgery with a preexisting UTI. Other data demonstrate that after 4.5 days 50% and more of patients with an indwelling catheter develop an ascending UTI, although a closed urinary drainage system has been used. In most cases enterobacteriaceae, in 80% Escherichia coli, are detected. Especially in TULAP, a period of prolonged catheterisation has to be expected in the majority of patients. The risk of UTI in the perioperative phase is therefore expected to be higher. There are several higher risks and possibilities of complications in transurethral surgery in patients with UTI. Taking this into account, all our patients routinely undergo low dose antibiotic prophylactic treatment. The frequency of infections of the remaining parts of the prostate after prostatic surgery is strongly correlated to the flow characteristics in the prostatic urethra and to the amount of destruction of the prostatic tissue. Here are further reasons for a higher risk of infection after TULAP. Due to the fact that the prostatic tissue is not removed by a clear cut, but coagulated by laser beam, a rough surface due to tissue necrosis results. This is an ideal culture medium for bacteria aggravated by the disturbed laminar flow in the prostatic urethra, which favours an intraprostatic reflux of infected urine. There is evidence that UTI are the most important factor of morbidity during the first weeks after TULAP because of their bothersome symptoms.(ABSTRACT TRUNCATED)
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PMID:Transurethral laser therapy and urinary tract infections. 876 50

Mycoplasma hominis and Ureaplasma urealyticum can be isolated with considerable frequency from the human urogenital tract and are thought to cause various syndromes such as nongonococcal urethritis, pelvic inflammatory disease, pyelonephritis or infertility. The aim of this study was the evaluation of the presence of different genital pathogens in patients with sexually transmitted diseases (STD) and, in particular, the detection of mycoplasmas in individuals infected with genital microbes and an assessment of the presence of genital microorganisms in patients harbouring Mycoplasma hominis or Ureaplasma urealyticum. Furthermore, the occurrence of mycoplasmas in women with bacterial vaginosis was established. Specimens were collected from a total of 41,980 persons attending the Outpatients' Centre for Infectious Venero-Dermatological Diseases in Vienna from 1994 to 1996. Of all genital pathogens, Ureaplasma urealyticum was cultured most frequently in men and women. Mycoplasma hominis and Ureaplasma urealyticum were detected more often in the vaginal fluid than in the male urethra. By contrast, infection rates with Neisseria gonorrhoeae and Chlamydia trachomatis were higher in men than in women. In both men and women, trichomoniasis increased colonisation with Mycoplasma hominis, while mycoplasmas occurred less frequently together with genital candidiasis. Mycoplasma hominis was cultivated significantly more often in women with bacterial vaginosis than in those without. In contrast to urethral infections in men, cervical infections with Neisseria gonorrhoeae or Chlamydia trachomatis raised the incidence of Mycoplasma hominis in the vaginal fluid.
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PMID:Mycoplasma hominis and Ureaplasma urealyticum in patients with sexually transmitted diseases. 928 64

A 2-year-old castrated male vietnamese pot-bellied pig examined because of stranguria was found to have severe dilatation and inflammation of the pelvic portion of the urethra accompanied by cystitis and pyelonephritis. The pig had apparently had chronic inflammation of the urinary tract that eventually progressed to incomplete obstruction of the urethra. However, the initial cause of the urinary tract inflammation could not be determined. Possible causes included chronic bacterial infection, traumatic injury during urethral catheterization, and injury to the urethral mucosa secondary to extreme acidification of the urine.
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PMID:Incomplete urethral obstruction associated with dilatation of the urethra, cystitis, and pyelonephritis in a Vietnamese pot-bellied pig. 944 33

As many as 90% of all community-acquired urinary tract infections (UTIs) and more than 30% of nosocomially acquired UTIs are caused by E coli. The migration of bacteria into proximal urethra and bladder mucosa requires that the organisms travel "upstream" and resist being carried away by the flow of urine. Colonisation requires binding of specific adhesions of the bacteria to appropriate receptors on the surfaces of the epithelial cells. P fimbrae are found in 80%, 30% and 20% of strains from patients with pyelonephritis, cystitis and asymptomatic bacteriura, respectively. P fimbrae are found in only 30% of strains isolated from patients with pyelonephritis associated with compromising host factors such as vesicoureteral reflux, urinary tract anatomical abnormalities and recent urinary tract instrumentation.
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PMID:[Escherichia coli virulence factors in pediatric urinary tract infections]. 975 18

Villous adenomas are rare tumors of the urinary tract. They are morphologically identical to their counterpart in the colon. The histogenesis and malignant potential are uncertain. We report on 2 cases, 1 each in the urethra and bladder. The first is a 57-year-old male who complained of an acute attack of urinary retention. A papillary tumor, measuring 3.0 x 2.0 cm, was found in the prostatic portion of the urethra by cystoscopy, and the tumor was removed transurethrally. The second case, a 33-year-old male, was a victim of chronic pyelonephritis with severe hydronephrosis resulting from a left renal staghorn stone. A papillary tumor was noted on the dome of the urinary bladder. The tumor, measuring 2.0 x 2.0 cm, was resected by transurethral resection. No recurrence or malignant transformation has been found during the follow-up period. The features of morphology, immunohistochemistry, and histochemistry were well studied. Staining by periodic acid-Schiff (PAS) stain, Alcian blue at pH 1.0, and Alcian blue at pH 2.5 were all positive. The carcinoembryonic antigen was strongly positive in the neoplastic glands, especially in the luminal border. We also review the previous literature and discuss the histogenesis, diagnosis, and treatment.
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PMID:Villous adenomas of the urinary tract: report of two cases. 1091 30

The aim of this study was to investigate the influence of IL-6 on mortality, bacterial growth and cytokine expression in experimental acute pyelonephritis. Female IL-6-deficient mice and their wild-type counterparts, 8-10 weeks old, were infected with Escherichia coli CFT 073 or injected with NaCl 0.9% (w/v) via the urethra and thereafter obstructed for 6 h. Animals were killed at 48 h, 6 days or 8 weeks and cytokine and bacterial renal levels were assessed at each time point. We found that IL-6-deficient mice had increased mortality and extensive renal bacterial growth on day 6, compared with wild-type mice (P < 0.05) and the histopathological changes were generally more severe and widespread in the IL-6-deficient mice. Peak mRNA expression of IL-1beta, IL-4, IL-10, IL-12 and interferon-gamma (IFN-gamma) occurred 48 h after infection in both IL-6 knock out and wild-type mice. Transforming growth factor-beta (TGF-beta) levels also peaked at 48 h in E. coli-infected wild-type mice, while in the IL-6-deficient strain both TGF-beta mRNA and protein levels were significantly lower at 48 h than wild-type levels (P < 0.0008 and P < 0.03, respectively) and remained stationary throughout the study period. Animals injected with NaCl 0.9% (w/v) displayed a similar decrease in TGF-beta expression (P < 0.02). When splenocytes from the IL-6-deficient mice were incubated with murine recombinant IL-6, TGF-beta levels increased to those of wild-type mice. No increase was observed when splenocytes from wild-type mice were incubated with the same doses of rIL-6. We therefore conclude that IL-6 plays an important role in bacterial clearance and directly influences the TGF-beta levels in experimental acute pyelonephritis. We also demonstrate that urethral obstruction per se induces an increase in TGF-beta the magnitude of which is decreased in IL-6-deficient mice.
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PMID:Renal cytokine responses in acute Escherichia coli pyelonephritis in IL-6-deficient mice. 1109 Dec 75


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