THE MUSCULATURE OF THE HUMAN URETER<sup>1</sup>

Notley, F.R.C.S. Richard G.

doi:10.1111/j.1464-410x.1970.tb06797.x

Cited by 52 publications

(12 citation statements)

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“…However contraction frequency decreases with distance from the renal fornix as strips are dissected from the middle and lower calyces, renal pelvis and UPJ [14,[17][18][19][20][21][22][23]. Thus researchers have located the primary pacemaker in the most proximal calyceal regions of the renal pelvis, although there have been a few reports that have situated the primary pacemaker in the UPJ [24,25].…”

Section: Pelviureteric Contractilitymentioning

confidence: 99%

Interstitial cell of Cajal-like cells in the upper urinary tract

Lang

Klemm

2005

J Cellular Mol Med

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Autorhythmicity in the upper urinary tract (UUT) has long been considered to arise in specialized atypical smooth muscle cells (SMC) predominately situated in the most proximal regions of the pyeloureteric system. These atypical SMC pacemakers have been thought to trigger adjacent electrically-quiescent typical SMC to fire action potentials which allow an influx of Ca 2+ and the generation of muscle contraction. More recently, the presence of cells with many of the morphological, electrical and immunohistochemical characteristics of interstitial cells of Cajal (ICC), the pacemaker cells of the gastrointestinal tract, have been located in many regions of both the upper and lower urinary tract. This article reviews the evidence from the literature and from our laboratory supporting a role of both atypical SMC and ICC-like cells in the initiation and propagation of pyeloureteric peristalsis in the UUT. We propose a new model in which there are 2 populations of pacemaker cells, high frequency atypical SMC and lower frequency ICC-like cells, both of which can drive electrically-quiescent typical SMC. The relative presence of these 2 populations of pacemaker cells and the relatively-long refractoriness of typical SMC determines the decreasing frequency of contraction with distance from the renal fornix. In the absence of the proximal pacemaker drive from atypical SMC after pyeloureteral/ureteral obstruction or surgery, ICC-like cell pacemaking provides a compensatory mechanism allowing the ureter to maintain rudimentary peristaltic waves and movement of urine from the pyelon towards the bladder.

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Section: Pelviureteric Contractilitymentioning

confidence: 99%

Interstitial cell of Cajal-like cells in the upper urinary tract

Lang

Klemm

2005

J Cellular Mol Med

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“…Numerous bundles of nerve fibers are observable in the adventitia, the greatest number ofaxons being unmyelinated. The terminal axons in these large bundles are not readily observable, and no synapses between axons or ganglion cells are observable in the aventitia, nor in any layer of the ureter [30][31][32]34].…”

Section: The Adventitiamentioning

confidence: 99%

“…Regarding structure-function relationships in health and disease, the two papers by Notley [31,33] are quite interesting for further speculation regarding the musculature of the ureter. First, Notley's 1970 paper on the musculature of the ureter [31] attempts to elucidate certain thoughts regarding the mechanism for the propagation of ureteric peristalsis.…”

Section: The Adventitiamentioning

confidence: 99%

“…First, Notley's 1970 paper on the musculature of the ureter [31] attempts to elucidate certain thoughts regarding the mechanism for the propagation of ureteric peristalsis. His speculation seems to embrace the idea that there are pacemaker fibers originating in the pelviureteric segment that are largely responsible for the initiation of ureteric peristalsis.…”

Section: The Adventitiamentioning

confidence: 99%

“…Recent work demonstrates most clearly that all was not totally known. Witness the very articulate studies of Hicks [18][19][20], Monis and Zambrano [27], Hoyes et al [21,22], Notley [28][29][30][31][32][33], Aung-Khin [1], Dixon and Gosling [7,8], Gosling and Dixon [12][13][14][15], Kanczak et al [24], and Firth and Hicks [10,11]. These studies have brought to light numerous insights into the fine structure of the ureter, with specific highlights on biochemical, cytologic physiologic, and neural considerations.…”

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confidence: 99%

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Histology of the Ureter

Velardo¹

1981

The Ureter

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The ureter truly commands a rather unique position in anatomic studies, owing chiefly to its ever-changing intemallining and its highly specialized muscular coatings [4,16]. The groundbreaking work of Protopopow [35], Satani [39], and Stein and Weinberg [40] clearly showed that the ureter displays morphologic plasticity, physiologic accommodation, and anatomic change under different conditions, e.g., physiologic function, stress, obstruction, and aging. Until the recent developments of fine structure and microcirculatory studies combined with immunochemical analyses it appeared that knowledge pertaining to the ureter was "totally known. " Recent work demonstrates most clearly that all was not totally known. Witness the very articulate studies of Hicks [18-20], Monis and Zambrano [27], Hoyes et al. [21,22], Notley [28-33], Aung-Khin [1], Dixon and Gosling [7,8], Gosling and Dixon [12-15], Kanczak et al. [24], and Firth and Hicks [10,11]. These studies have brought to light numerous insights into the fine structure of the ureter, with specific highlights on biochemical, cytologic physiologic, and neural considerations. Thus, as a result, we are now in a position to better explain several structure-function relationships of the ureter in health and disease. The aforementioned findings and experimental results will be interdigitated in the appropriate sections following the basic considerations.In an effort to present a solid scaffold of information on the ureter, prior to discussing the more recent findings, it appears of primary interest to present a graphic prosection of the ureter so that one might better understand the mi-croscopic, electron microscopic, and the more recent basic findings.The ureters, viewed in situ, are the ducts that connect the kidneys to the urinary bladder. In the adult they are of a pale color, approximately 28 cm in length (oftentimes ranging between 28 and 34 cm), and are located in the extraperitoneal tissue behind the peritoneum, to which they closely adhere. The upper aspect of the ureter lies in the abdomen while its continuing lower part is in the pelvis. The upper aspect of the ureter, known as the pelvis of the ureter, is thinwalled and funnel-shaped in appearance. Emanating well within the sinus of the kidney, the pelvis of the ureter lies among the large renal vessels and is formed by the junction of usually two (and infrequently three) thin-walled tubes, the greater calyces. The greater calyces give off a number of small branches, the lesser calyces, that are short and increase in diameter as they approach the wall of the sinus to which they become attached. Their wide, funnel-like ends envelop the renal papillae and serve as a collecting area for urine. A longitudinal section of the kidney and pelvis of the ureter reveals that the lesser calyces are usually about eight in number, one calyx surrounding two to three papillae. Topographically viewed, the portion of the pelvis of the ureter that lies outside of the kidney has directly in front of it, in addition to the renal vesse...

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