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Sample records for giant renal angiomyolipoma

  1. A Giant Intra Abdominal Mass Mimicking Renal Cell Carcinoma: A Rare Presentation of Renal Angiomyolipoma.

    PubMed

    Haque, M E; Rahman, M A; Kaisar, I; Islam, M F; Salam, M A

    2016-07-01

    Angiomyolipoma (AML) is a benign tumor commonly found in kidney than extra renal sites. Most of the small renal angiomyolipomas are diagnosed incidentally on ultrasound and other imaging studies. Some renal AMLs present clinically when become very big, giant renal angiomyolipoma. Although almost all cases are benign, a relatively rare variant of epitheloid angiomyolipoma has got malignant potential and can even metastasize. Ultrasonography, CT and MRI scan are usually used for diagnosis of angiomyolipoma with high level of accuracy; even though some lesions may be confused as renal cell carcinoma on imaging studies. Here, a 48 year old man presented with a large intra-abdominal mass preoperatively diagnosed as a case of right renal cell carcinoma and radical nephrectomy was performed. Histopathology revealed epitheloid angiomyolipoma (EAML). PMID:27612907

  2. Anaesthesia for autotransplantation after extracorporeal nephron sparing surgery for bilateral giant renal angiomyolipoma.

    PubMed

    Rajmohan, Nisha; Neeta, S; Das, Hk

    2014-01-01

    Extracorporeal 'work bench surgery' with subsequent autotransplantation is a challenge from both anaesthetic and surgical point of view when performed bilaterally or in a solitary kidney. A 28-year-old female with bilateral giant angiomyolipoma of kidneys was taken up for renal autotransplantation. Patient had a huge tumour, which was the largest reported exophytic tumour to be excised by this technique. Both kidneys were operated at an interval of 1 month, under combined general and epidural anaesthesia. Anaesthetic challenges faced during the procedure were maintenance of adequate perfusion of the grafted kidneys, containment of massive blood loss and coagulopathy during the perioperative period. Patient recovered in due course with functioning autotransplanted kidney. A careful pre-operative preparation with intraoperative maintenance of adequate blood volume and blood pressure is the key for graft survival. PMID:24700904

  3. Anaesthesia for autotransplantation after extracorporeal nephron sparing surgery for bilateral giant renal angiomyolipoma

    PubMed Central

    Rajmohan, Nisha; Neeta, S; Das, HK

    2014-01-01

    Extracorporeal ‘work bench surgery’ with subsequent autotransplantation is a challenge from both anaesthetic and surgical point of view when performed bilaterally or in a solitary kidney. A 28-year-old female with bilateral giant angiomyolipoma of kidneys was taken up for renal autotransplantation. Patient had a huge tumour, which was the largest reported exophytic tumour to be excised by this technique. Both kidneys were operated at an interval of 1 month, under combined general and epidural anaesthesia. Anaesthetic challenges faced during the procedure were maintenance of adequate perfusion of the grafted kidneys, containment of massive blood loss and coagulopathy during the perioperative period. Patient recovered in due course with functioning autotransplanted kidney. A careful pre-operative preparation with intraoperative maintenance of adequate blood volume and blood pressure is the key for graft survival. PMID:24700904

  4. The Role of Partial Nephrectomy without Arterial Embolization in Giant Renal Angiomyolipoma.

    PubMed

    Coskuner, Enis Rauf; Ozkan, Burak; Yalcin, Veli

    2012-01-01

    Angiomyolipoma is a benign neoplasm composed of varying admixtures of blood vessels, smooth muscle cells, and adipose tissue. Because of an increased risk of spontaneous haemorrhage, surgical approach is needed greater than 4-8 cm size. We here report our partial nephrectomy experience in the 24 cm size giant angiomyolipoma. 26-year-old woman referred to our clinic with a 24 cm size angiomyolipoma in her lower pole of right kidney. The inferior vena cava was deviated to the left by the mass. All the blood tests were normal and we offered her the choices of partial nephrectomy or nephrectomy. Right subcostal approach was used. The patient underwent resection of the mass with a safety region of 1 cm. Frozen section evaluation was consistent with angiomyolipoma and free for surgical margin. Warm ischemia time was 35 min. and intraoperative bleeding volume was 200 cc. Postoperative 2nd day the drain was taken and hospital stay was 4 days. In literature we observed very rare angiomyolipoma cases with such a large dimension treated by partial nephrectomy without arterial embolization. If technically suitable partial nephrectomy is the main chioce in this kind of benign lesions in young patients. PMID:22536263

  5. [Giant renal angiomyolipoma disclosed by mild lumbar trauma and treated with nephrectomy: report of a case].

    PubMed

    Rosselló Barbará, M; Mus Malleu, A; Rebassa Llul, M; Casals Armada, J

    2004-02-01

    A case of giant angiomyolipoma of the kidney discovered during the study of a light lumbar trauma is presented. Disseminated tuberous sclerosis lesions are demonstrated at the brain, cerebellum, liver and contralateral kidney. External cutaneous stigmas of this illness are shown at the face. The size of the viscera and the loss of function of the left kidney conditioned the nephrectomy. The piece weighed upon extracting 6300 g, without malignant signs. To the microscopic exam atrophic sclerosis for compression was demonstrated. The postoperative course was satisfactory. Actually his arterial tension is controlled by medical treatment. PMID:15074062

  6. Combination of Superselective Arterial Embolization and Radiofrequency Ablation for the Treatment of a Giant Renal Angiomyolipoma Complicated with Caval Thrombus

    PubMed Central

    Stamatiou, Konstantinos N.; Moschouris, Hippocrates; Marmaridou, Kiriaki; Kiltenis, Michail; Kladis-Kalentzis, Konstantinos; Malagari, Katerina

    2016-01-01

    This is a case of a 78-year-old male patient with multiple angiomyolipomas of a solitary right kidney. The largest of these tumors (maximum diameter: 13.4 cm) caused significant extrinsic compression of the inferior vena cava complicated by thrombosis of this vessel. Treatment of thrombosis with anticoagulants had been ineffective and the patient had experienced a bleeding episode from the largest right renal angiomyolipoma, which had been treated by transarterial embolization in another institution, 4 months prior to our intervention. Our approach included superselective transarterial embolization of the dominant, right kidney angiomyolipoma with hydrogel microspheres, which was combined, 20 days later, with ultrasonographically guided radiofrequency ablation. Both interventions were uneventful. Computed tomography 2 months after ablation showed a 53% reduction in tumor volume, reduced space-occupying effect on inferior vena cava, and resolution of caval thrombus. Nine months after intervention the patient has had no recurrence of thrombosis or hemorrhage and no tumor regrowth has been observed. The combination of superselective transarterial embolization and radiofrequency ablation seems to be a feasible, safe, and efficient treatment of large renal angiomyolipomas. PMID:27293932

  7. Combination of Superselective Arterial Embolization and Radiofrequency Ablation for the Treatment of a Giant Renal Angiomyolipoma Complicated with Caval Thrombus.

    PubMed

    Stamatiou, Konstantinos N; Moschouris, Hippocrates; Marmaridou, Kiriaki; Kiltenis, Michail; Kladis-Kalentzis, Konstantinos; Malagari, Katerina

    2016-01-01

    This is a case of a 78-year-old male patient with multiple angiomyolipomas of a solitary right kidney. The largest of these tumors (maximum diameter: 13.4 cm) caused significant extrinsic compression of the inferior vena cava complicated by thrombosis of this vessel. Treatment of thrombosis with anticoagulants had been ineffective and the patient had experienced a bleeding episode from the largest right renal angiomyolipoma, which had been treated by transarterial embolization in another institution, 4 months prior to our intervention. Our approach included superselective transarterial embolization of the dominant, right kidney angiomyolipoma with hydrogel microspheres, which was combined, 20 days later, with ultrasonographically guided radiofrequency ablation. Both interventions were uneventful. Computed tomography 2 months after ablation showed a 53% reduction in tumor volume, reduced space-occupying effect on inferior vena cava, and resolution of caval thrombus. Nine months after intervention the patient has had no recurrence of thrombosis or hemorrhage and no tumor regrowth has been observed. The combination of superselective transarterial embolization and radiofrequency ablation seems to be a feasible, safe, and efficient treatment of large renal angiomyolipomas. PMID:27293932

  8. Anterior mediastinal presentation of a giant angiomyolipoma.

    PubMed

    Amir, Afzal M I; Zeebregts, Clark J; Mulder, H Jan

    2004-12-01

    Angiomyolipomas are benign, solitary, noninvasive lesions that most often arise in the kidney. Extrarenal manifestations of these tumors include the skin, oropharynx, the abdominal wall, retroperitoneum, gastrointestinal tract, heart, lung, liver, uterus, penis, and spinal cord. We report a patient with a giant angiomyolipoma located in the anterior mediastinum. We believe this is the seventh reported case of mediastinal angiomyolipoma and the largest reported by size. It is the second reported lesion to arise in the anterior mediastinum. Distinction from other pulmonary or thoracic masses relies on the appreciation of the unique and characteristic histologic features of these mediastinal angiomyolipomas. We conclude that, although rare, angiomyolipoma should be considered in the differential diagnosis of a mediastinal tumor. PMID:15561061

  9. The scintigraphic pattern of renal angiomyolipoma

    SciTech Connect

    Jaikishen, P.; Oster, Z.H.; Atkins, H.L. )

    1990-03-01

    The patterns of renal and gallium scintigraphy in a patient with renal angiomyolipoma are presented. Renal study with Tc-99m DTPA demonstrated a photopenic area in the flow and delayed images. Ga-67 citrate imaging did not show any evidence of increased activity. Although this pattern is also seen in renal cysts, scintigraphy seems to be valuable in the evaluation of angiomyolipoma. It helps differentiate it from renal carcinoma or renal abscess (which may be gallium avid), especially when the tumor is characterized by a paucity of adipose tissue and complicated by hemorrhage, in which case CT and ultrasonographic patterns are not diagnostic.

  10. [Renal angiomyolipoma: diagnosis and treatment].

    PubMed

    Arima, K; Kise, H; Yamashita, A; Yanagawa, M; Tochigi, H; Kawamura, J; Horiuchi, E; Sugimura, Y

    1995-09-01

    In 10 years the diagnosis of renal angiomyolipoma (RAML) was made in 14 patients (male-to female ratio 1:3.7) at our institution; 1 case was associated with tuberous sclerosis (TS) and 1 case had regional lymph node involvement. A statistical study was done on data taken from 739 cases of RAML in the Japanese literature, including our cases. The male to female ratio was 1 to 3. Twenty eight percent of the cases were associated with TS. The ratio of bilateral cases to the unilateral one was 1 to 3. The main clinical signs were flank pain, abdominal mass, hematuria and fever elevation. Recently the ratio of nephrectomy has decreased to 30%. The percentage of detecting the fat component by ultrasonography (US), computed tomography (CT) and magnetic resonance imaging were 88.1%, 86.5% and 80.8% respectively. The percentages of visualizing hypervascularity, aneurysms, absence of arterio-venous shunt and onion peel appearance by selective renal angiography were 77.3%, 71.4%, 48.1% and 4.9% respectively. Small (less than 3 cm), asymptomatic, simple lesions with adipose component may be observed annually by CT and US until more experiences is gained with surveillance of these patients. Embolization was useful for emergency cases or pre-treatment of nephron sparing surgery, but insufficient by itself. As there still remain problems in the diagnosis of RAML, especially in the case of very small tumors, in the case with almost no adipose component and in the case associated with renal cell carcinoma, the diagnosis of RAML should be made synthetically including angiography. PMID:7484542

  11. Renal Angiomyolipoma With Sarcoid Granulomas: Report of a Unique Case.

    PubMed

    Tarjan, Gabor; Kim, George J; Haroon Al Rasheed, Mohamed Rizwan

    2016-05-01

    Angiomyolipoma is a mesenchymal neoplasm characterized by the coexpression of melanocytic and smooth muscle markers. Sarcoidosis is a multisystem disorder of unknown etiology, which presents with characteristic nonnecrotizing granulomas and rarely involves the kidney. The coexistence of renal sarcoidosis with renal neoplasms is exceedingly rare and was reported only with renal cell carcinoma. Renal sarcoidosis associated with a nonepithelial renal neoplasm, such as an angiomyolipoma has never been reported. We present the first reported case of sarcoid granulomas in a renal angiomyolipoma, including morphologic and immunohistochemical features. PMID:26582772

  12. Segmental neurofibromatosis associated with renal angiomyolipomas.

    PubMed

    Nguyen, Kim-Tan; Chiu, Melvin

    2008-07-01

    Segmental neurofibromatosis (SN) is a rare disorder characterized by neurofibromas or neurofibromas with café-au-lait spots limited to one region of the body without crossing the midline. Renal angiomyolipomas (AMLs) are rare benign neoplasms usually found in association with tuberous sclerosis (TS). Similar to neurofibromatosis (NF), TS has a high spontaneous mutation rate and a family history often is absent. Although both are autosomal dominant diseases with neural involvement, there are few reports in the literature demonstrating a link between the 2 disorders. We report a case of SN associated with renal AMLs. To our knowledge, there has been only 1 prior report of renal AML associated with NF type 1 (NF1), and there have been no prior reports of SN associated with AML. PMID:18712027

  13. Characterization of renal angiomyolipoma by scanning acoustic microscopy.

    PubMed

    Sasaki, H; Saijo, Y; Tanaka, M; Nitta, S; Yambe, T; Terasawa, Y

    1997-04-01

    A scanning acoustic microscope system was used to differentiate renal angiomyolipoma from renal cell carcinoma. The ultrasonic frequency used ranged from 100 to 200 MHz, and the attenuation constant and sound speed were measured on a two-dimensional distribution. The sound speed was significantly lower for lipoma cells than for vessels, smooth muscle fibres, clear cell renal cancer or granular cell renal cancer. The attenuation constant was significantly lower for lipoma cells than for vessels or clear cells. Both acoustic parameters for smooth muscle fibres were significantly lower than for vessels. The heterogeneity of the microacoustic field in renal angiomyolipoma is closely related to the high intensity echo observed on clinical echography. Renal angiomyolipoma and renal cell carcinoma can thus be distinguished by acoustic examination. PMID:9196446

  14. Aneurysm in a Large Sporadic Renal Angiomyolipoma

    PubMed Central

    Al Omran, Bedoor; Ansari, Naseem

    2016-01-01

    Angiomyolipomas (AMLs) are the most common mesenchymal renal neoplasms and are classified as neoplasms of perivascular epithelioid cells (PEComa). AML is usually a benign neoplasm arising most often in the kidney although it has been described in a wide variety of sites. Most patients are adults, and one-third suffer from tuberous sclerosis. We describe a case of renal AML in a 54-year-old Bahraini woman who presented to the Bahrain Defence Force Hospital with right flank pain and hematuria, and who was known to have rheumatoid arthritis but had no cutaneous or other stigmata of tuberous sclerosis. It is the largest AML reported in Bahrain and is also striking for the fact that it contained an intratumoral aneurysm that ruptured causing symptoms leading to the radiological diagnosis of renal mass. Furthermore, the occurrence of an aneurysm in sporadic AML, as in our case, is rare since the large majority tend to be seen in association with tuberous sclerosis. PMID:27162594

  15. Renoduodenal Fistula After Transcatheter Embolization of Renal Angiomyolipoma

    SciTech Connect

    Sheth, Rahul A.; Feldman, Adam S.; Walker, T. Gregory

    2015-02-15

    Transcatheter embolization of renal angiomyolipomas is a routinely performed, nephron-sparing procedure with a favorable safety profile. Complications from this procedure are typically minor in severity, with postembolization syndrome the most common minor complication. Abscess formation is a recognized but uncommon major complication of this procedure and is presumably due to superinfection of the infarcted tissue after arterial embolization. In this case report, we describe the formation of a renoduodenal fistula after embolization of an angiomyolipoma, complicated by intracranial abscess formation and requiring multiple percutaneous drainage procedures and eventual partial nephrectomy.

  16. The effect of everolimus on renal angiomyolipoma in patients with tuberous sclerosis complex being treated for subependymal giant cell astrocytoma: subgroup results from the randomized, placebo-controlled, Phase 3 trial EXIST-1

    PubMed Central

    Kingswood, J. Chris; Jozwiak, Sergiusz; Belousova, Elena D.; Frost, Michael D.; Kuperman, Rachel A.; Bebin, E. Martina; Korf, Bruce R.; Flamini, J. Robert; Kohrman, Michael H.; Sparagana, Steven P.; Wu, Joyce Y.; Brechenmacher, Thomas; Stein, Karen; Berkowitz, Noah; Bissler, John J.; Franz, David N.

    2014-01-01

    Background Tuberous sclerosis complex (TSC) is characterized by benign tumours in multiple organs, including the brain, kidneys, skin, lungs and heart. Our objective was to evaluate everolimus, an mTOR inhibitor, in the treatment of angiomyolipoma in patients with subependymal giant cell astrocytoma (SEGA) associated with TSC. Methods EXamining everolimus In a Study of Tuberous Sclerosis Complex-1 (NCT00789828), a prospective, double-blind, randomized, placebo-controlled, Phase 3 study, examined everolimus in treating SEGA associated with TSC. Patients with serial SEGA growth from pre-baseline to baseline scans were randomly assigned (2:1) to receive 4.5 mg/m2/day everolimus (target blood trough: 5–15 ng/mL; n = 78) or placebo (n = 39). Angiomyolipoma response rates were analysed in patients (n = 44) with target baseline angiomyolipoma lesions (≥1 angiomyolipoma; longest diameter ≥1.0 cm). An angiomyolipoma response rate, defined as the proportion of patients with confirmed angiomyolipoma response, was assessed by kidney CT or MRI screening at baseline, at 12, 24 and 48 weeks and annually. Results Angiomyolipoma response rates were 53.3% (16/30) and 0% (0/14) for everolimus- and placebo-treated patients, respectively. Angiomyolipoma reductions ≥50% in the sum of volumes of all target lesions were seen only in everolimus-treated patients (56.5, 78.3 and 80.0%) compared with placebo-treated patients (0% at each time point) at Weeks 12, 24 and 48, respectively. Greater percentages of everolimus-treated patients had angiomyolipoma reductions ≥30% at these same time points (82.6, 100 and 100% versus 8.3, 18.2 and 16.7% for everolimus versus placebo, respectively). Conclusions Everolimus showed efficacy in reducing angiomyolipoma lesion volume in patients with SEGA associated with TSC. The trial is registered with ClinicalTrials.gov, number NCT00789828; http://clinicaltrials.gov/ct2/show/NCT00789828?term=EXIST-1&rank=1. PMID:24729041

  17. A Case of Lipiduria After Arterial Embolization for Renal Angiomyolipomas

    SciTech Connect

    Ishibashi, Naoya; Mochizuki, Takao; Tanaka, Hiroshi; Okada, Yasuhiro; Kobayashi, Masaki; Takahashi, Motoichiro

    2010-06-15

    We report the case of a 31-year-old woman who suffered lipiduria after selective transcatheter arterial embolization for renal angiomyolipoma (AML). Computed tomography confirmed cystic liquefactive necrosis with fat-fluid level in AML. Although the process by which AML fat tissue excretion occurs is not clear, we speculated that the infarcted AML was connected to the urinary collection duct system and subsequently its adipose component was excreted into the urine.

  18. An Unusual Combination of Biliary Cystadenoma and Renal Angiomyolipoma- A Case Report

    PubMed Central

    Thambi, Renu; Syriac, Sylvia; Kumar, Anil

    2016-01-01

    Hepatobiliary cystadenomas are mucinous cystic neoplasms arising in the liver, extrahepatic bile ducts or gall bladder. Extrahepatic cystadenomas are rare neoplasms requiring complete excision as there is a chance for recurrence and malignant transformation. Angiomyolipoma (AML) belongs to the perivascular epithelioid cell group of neoplasms, and kidney is the commonest site involved. We report a case of an unusual combination of extrahepatic biliary cystadenoma with angiomyolipoma in an adult female without evidence of tuberous sclerosis. The patient presented with abdominal discomfort and on ultrasonological examination showed a cyst close to liver suggestive of hydatid disease and an incidental mass in kidney which was diagnosed as angiomyolipoma. Histopathological examination revealed biliary cystadenoma of liver and renal angiomyolipoma. Clinical and radiological evaluation did not show any manifestations of tuberous sclerosis. Such an unusual incidence of two separate neoplasms in a patient without syndromic association was not obtained even after extensive literature search.

  19. Management of a renal calculus larger than 4 cm in a patient with tuberous sclerosis complex-associated angiomyolipoma

    PubMed Central

    Kodama, Koichi; Takase, Yasukazu; Motoi, Isamu

    2012-01-01

    Renal calculi in patients with renal angiomyolipomas are difficult to treat because of the hemorrhagic potential of these tumors. We describe the case of a 65-year-old man having tuberous sclerosis complex-associated multifocal renal angiomyolipomas with a large renal calculus. The patient presented with left flank dullness and a previous history of spontaneous angiomyolipoma rupture. Intravenous pyelography revealed a 43 × 16 mm calculus in the pelvis and lower calyx of the left kidney. The calculus was successfully removed by retrograde flexible ureterorenoscopy and holmium-YAG lithotripsy. Flexible ureterorenoscopy is an effective, minimally invasive therapy for patients at high risk of renal hemorrhage. PMID:23450153

  20. Hemorrhagic Renal Angiomyolipoma in Pregnancy Effectively Managed by Immediate Cesarean Section and Elective Transcatheter Arterial Embolization: A Case Report

    PubMed Central

    Sawada, Norifumi; Miyamoto, Tatsuya; Mitsui, Takahiko; Zakoji, Hidenori; Takeda, Masayuki

    2016-01-01

    Abstract Renal angiomyolipoma (AML) is a benign renal tumor with a risk of rupture in intratumoral aneurysms. Although renal AML in pregnancy is rare, risk of rupture is greater. Management for AML and childbirth is important during pregnancy; however, it is undefined yet. We present a case of hemorrhagic angiomyolipoma in pregnancy that is effectively managed by immediate cesarean section and elective transcatheter arterial embolization.

  1. Hemorrhagic Renal Angiomyolipoma in Pregnancy Effectively Managed by Immediate Cesarean Section and Elective Transcatheter Arterial Embolization: A Case Report.

    PubMed

    Kira, Satoru; Sawada, Norifumi; Miyamoto, Tatsuya; Mitsui, Takahiko; Zakoji, Hidenori; Takeda, Masayuki

    2016-01-01

    Renal angiomyolipoma (AML) is a benign renal tumor with a risk of rupture in intratumoral aneurysms. Although renal AML in pregnancy is rare, risk of rupture is greater. Management for AML and childbirth is important during pregnancy; however, it is undefined yet. We present a case of hemorrhagic angiomyolipoma in pregnancy that is effectively managed by immediate cesarean section and elective transcatheter arterial embolization. PMID:27579420

  2. Recurrent renal giant leiomyosarcoma

    PubMed Central

    Öziş, Salih Erpulat; Gülpınar, Kamil; Şahlı, Zafer; Konak, Baha Burak; Keskin, Mete; Özdemir, Süleyman; Ataoğlu, Ömür

    2016-01-01

    Primary renal leiomyosarcomas are rare, aggressive tumors. They constitute 1–2% of adult malignant renal tumors. Although leiomyosarcomas are the most common histological type (50–60%) of renal sarcomas, information on renal leiomyosarcoma is limited. Local or systemic recurrences are common. The radiological appearance of renal leiomyosarcomas is not specific, therefore renal leiomyosarcoma cannot be distinguished from renal cell carcinoma by imaging methods in all patients. A 74-year-old female patient presented to our clinic complaining of a palpable mass on the right side of her abdomen in November 2012. The abdominal magnetic resonance imaging revealed a mass, 25 × 24 × 23 cm in size. Her past medical history revealed that she has undergone right radical nephrectomy in 2007, due to a 11 × 12 × 13 cm renal mass that was then reported as renal cell carcinoma on abdominal magnetic resonance imaging, but the pathological diagnosis was low-grade renal leiomyosarcoma. The most recent follow-up of the patient was in 2011, with no signs of local recurrence or distant metastases within this four-year period. The patient underwent laparotomy on November 2012, and a 35 cm retroperitoneal mass was excised. The pathological examination of the mass was reported as high-grade leiomyosarcoma. The formation of this giant retroperitoneal mass in 1 year can be explained by the transformation of the lesion’s pathology from low-grade to a high-grade tumor.

  3. [Renal angiomyolipoma rupture as a cause of lumbar pain: report of one case].

    PubMed

    Cifuentes, Melissa; Calleja, Félix; Hola, José; Daviú, Antonio; Jara, Danilo; Vallejos, Humberto

    2008-08-01

    Renal angiomyolipoma is a benign tumor formed by smooth muscle, adipose tissue and blood vessels. It is commonly found incidentally and its clinical manifestations are pain and abdominal mass or spontaneous tumor rupture with retroperitoneal bleeding. The clinical presentation of a hemorrhagic shock secondary to a retroperitoneal hematoma is uncommon. We report a 40 year-old male who presented to the emergency room with lumbar pain and deterioration of hemodynamic parameters. The CT scan showed a left renal injury associated to an expansive retroperitoneal process. The abdominal exploration, vascular control of the renal pedicle and nephrectomy allowed a successful outcome. PMID:18949188

  4. Embolization of a Bleeding Renal Angiomyolipoma in Pregnancy: Case Report and Review

    SciTech Connect

    Morales, Jose P.; Georganas, Marios; Khan, Mohammad S.; Dasgupta, Prokar; Reidy, John F.

    2005-04-15

    A case is described of a woman 10 weeks pregnant who had severe bleeding, secondary to a renal angiomyolipoma (AML), that was treated with embolization. Subsequent pregnancy was uneventful and she delivered a normal female infant 28 weeks after the procedure. One month after delivery, liquefaction of the AML occurred, which eventually required surgical drainage. We review and discuss AML during pregnancy, its management and post-embolization complication000.

  5. Evidence for pericyte origin of TSC-associated renal angiomyolipomas and implications for angiotensin receptor inhibition therapy

    PubMed Central

    Siroky, Brian J.; Yin, Hong; Dixon, Bradley P.; Reichert, Ryan J.; Hellmann, Anna R.; Ramkumar, Thiruvamoor; Tsuchihashi, Zenta; Bunni, Marlene; Dillon, Joshua; Bell, P. Darwin; Sampson, Julian R.

    2014-01-01

    Nearly all patients with tuberous sclerosis complex (TSC) develop renal angiomyolipomas, although the tumor cell of origin is unknown. We observed decreased renal angiomyolipoma development in patients with TSC2- polycystic kidney disease 1 deletion syndrome and hypertension that were treated from an early age with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers compared with patients who did not receive this therapy. TSC-associated renal angiomyolipomas expressed ANG II type 1 receptors, platelet-derived growth factor receptor-β, desmin, α-smooth muscle actin, and VEGF receptor 2 but did not express the adipocyte marker S100 or the endothelial marker CD31. Sera of TSC patients exhibited increased vascular mural cell-secreted peptides, such as VEGF-A, VEGF-D, soluble VEGF receptor 2, and collagen type IV. These findings suggest that angiomyolipomas may arise from renal pericytes. ANG II treatment of angiomyolipoma cells in vitro resulted in an exaggerated intracellular Ca2+ response and increased proliferation, which were blocked by the ANG II type 2 receptor antagonist valsartan. Blockade of ANG II signaling may have preventative therapeutic potential for angiomyolipomas. PMID:24920756

  6. Tuberous Sclerosis and Bilateral Renal Angiomyolipomas: A Case Report and Literature Review of Emerging Treatment Strategies

    PubMed Central

    James, Leighton R.

    2016-01-01

    Tuberous sclerosis complex is a rare multisystemic genetic disorder associated with the development of benign hamartomas. Angiomyolipomas are one such characteristic finding that may be seen in 55–80% of tuberous sclerosis complex patients. While being normally asymptomatic, they can also cause significant morbidity and mortality. We present the case of a patient with tuberous sclerosis complex and recently discovered bilateral renal angiomyolipomas, admitted for hematuria who underwent left renal artery embolization; however, worsening renal function necessitated subsequent nephrectomy. Despite still being mainstays of treatment, invasive interventions are now being recommended for specific patient populations as demonstrated in our case. Emerging strategies targeting the PI3K/AKT/mTOR pathway have been shown to reduce the size of angiomyolipomas and are now used to treat asymptomatic cases >3 cm. Our review discusses these treatment options with the intention of increasing awareness of current recommendations and hopefully leading to increased application of these novel therapies that will reduce the need for invasive interventions. PMID:27525138

  7. Multidetector Computed Tomography Features in Differentiating Exophytic Renal Angiomyolipoma from Retroperitoneal Liposarcoma

    PubMed Central

    Wang, Qiushi; Juan, Yu-Hsiang; Li, Yong; Xie, Jia-Jun; Liu, Hui; Huang, Hongfei; Liu, Zaiyi; Zheng, Junhui; Saboo, Ujwala S.; Saboo, Sachin S.; Liang, Changhong

    2015-01-01

    Abstract This study aims to evaluate the multidetector computed tomography (CT) imaging features in differentiating exophytic renal angiomyolipoma (AML) from retroperitoneal liposarcoma. We retrospectively enrolled 42 patients with confirmed exophytic renal AML (31 patients) or retroperitoneal liposarcoma (11 patients) during 8 years period to assess: renal parenchymal defect at site of tumor contact, supply from branches of renal artery, tumoral vessel extending through the renal parenchyma, dilated intratumoral vessels, hemorrhage, non–fat-containing intratumoral nodules with postcontrast enhancement, calcification, renal sinus enlargement, anterior displacement of kidneys, and other associated AML. Renal parenchymal defect, renal arterial blood supply, tumoral vessel through the renal parenchyma, dilated intratumoral vessels, intratumoral/perirenal hemorrhage, renal sinus enlargement, and associated AML were seen only or mainly in exophytic renal AML (all P value < 0.05); however, non–fat-attenuating enhancing intratumoral nodules, intratumoral calcification, and anterior displacement of the kidney were more common in liposarcoma (all P value < 0.05). AMLs reveal renal parenchymal defect at the site of tumor contact, supply from renal artery, tumoral vessel extending through the renal parenchyma, dilated intratumoral vessels, intratumoral and/or perirenal hemorrhage, renal sinus enlargement, and associated AML. Non–fat-attenuating enhancing intratumoral nodules, intratumoral calcifications, and anterior displacement of kidney were more commonly seen in liposarcoma. PMID:26376398

  8. Tuberous sclerosis complex-associated renal angiomyolipomas: A single center study of 17 consecutive cases

    PubMed Central

    Wang, Hang; Long, Qilai; Wang, Yiwei; Liu, Li; Zhou, Lin; Guo, Jianming

    2016-01-01

    The aim of the present study was to investigate the treatment options for patients with tuberous sclerosis complex (TSC)-associated renal angiomyolipomas (AMLs). A total of 17 patients who were consecutively diagnosed with TSC-associated renal AMLs at the Department of Urology of Zhongshan Hospital between 1998 and 2012 were included in the study. The patient cohort included 7 males and 10 females with a mean age of 37.6 years (range, 18–62 years). A total of 12 patients were diagnosed with renal AML with TSC during physical examination (PE), while 5 patients were admitted to the Emergency Department of Zhongshan Hospital due to spontaneous rupture of renal AMLs. All renal lesions were examined by ultrasonography and abdominal computed tomography prior to treatment. The primary outcome measure was the kidney reservation rate (patients that had not received nephrectomies) in the rupture group and PE group. Both abdominal ultrasonography and CT revealed AMLs in all patients and the mean tumor size was 10.0±4.0 cm (range, 3.0–17.5 cm). Overall, 9 patients underwent surgery, which included unilateral nephrectomy in 4 patients and unilateral partial nephrectomy/tumor enucleation in 5 patients. The remaining 8 patients received medical treatment. All patients were followed-up for between 10 and 67 months. One patient succumbed as a result of multiple organ failure, which was caused by hypovolemic shock due to the spontaneous rupture of renal AML. The kidney reservation rate during surgery was 87.5% (7/8) in the PE group and 25% (1/4) in the spontaneous rupture group. The management of TSC-associated renal AMLs differs from that of solitary sporadic AMLs. Surgical therapy is recommended following careful risk-benefit analysis. PMID:27446460

  9. Radiofrequency Ablation of Large Renal Angiomyolipoma: Median-Term Follow-Up

    SciTech Connect

    Gregory, S. M. Anderson, C. J.; Patel, U.

    2013-06-15

    Purpose. To study the feasibility of percutaneous radiofrequency ablation (RFA) of large angiomyolipomas (AMLs) using saline-cooled electrodes. Materials and Methods. Institutional Review Board approval for the study was received. Four patients (all female, age range 33-67 years) with large AMLs (maximal axis 6.1-32.4 cm) not suitable for embolotherapy or surgery consented to a trial of RFA. Procedures were performed under computerized tomographic guidance using 14G saline-infused electrodes. Two ablations (diameter 4-7 cm) were undertaken in each patient. Variables studied were technical success, treatment safety, alteration of tumor consistency, tumor size, effect on renal function, and medium-term freedom from haemorrhage. Results. All four patients underwent successful RFA without any intraprocedural complications. There has been no haemorrhage, or new renal specific symptom, during a minimum 48-month period, and normal renal function has been normal. On follow-up radiological imaging, the tumors have become fattier with involution of the soft-tissue elements (soft tissue-to-total tumor ratio decreased mean [range] of 0.26 [0.14-0.48] to 0.17 [0.04-0.34] U; p = 0.04 [paired Student t test]). Further evidence of treatment effect was the development of a capsule around the ablation zone, but there was no change in overall tumor volume (mean [range] 1,120 [118-2,845] to 1150 [90-3,013] ml; p = 1 [paired Student t test]). Conclusion. RFA of large AMLs is technically feasible using saline-infused electrodes. The soft-tissue elements decreased in volume; the tumors become fattier; and there has been no renal haemorrhage during a 48-month period.

  10. Whole Exome Sequencing Identifies TSC1/TSC2 Biallelic Loss as the Primary and Sufficient Driver Event for Renal Angiomyolipoma Development.

    PubMed

    Giannikou, Krinio; Malinowska, Izabela A; Pugh, Trevor J; Yan, Rachel; Tseng, Yuen-Yi; Oh, Coyin; Kim, Jaegil; Tyburczy, Magdalena E; Chekaluk, Yvonne; Liu, Yang; Alesi, Nicola; Finlay, Geraldine A; Wu, Chin-Lee; Signoretti, Sabina; Meyerson, Matthew; Getz, Gad; Boehm, Jesse S; Henske, Elizabeth P; Kwiatkowski, David J

    2016-08-01

    Renal angiomyolipoma is a kidney tumor in the perivascular epithelioid (PEComa) family that is common in patients with Tuberous Sclerosis Complex (TSC) and Lymphangioleiomyomatosis (LAM) but occurs rarely sporadically. Though histologically benign, renal angiomyolipoma can cause life-threatening hemorrhage and kidney failure. Both angiomyolipoma and LAM have mutations in TSC2 or TSC1. However, the frequency and contribution of other somatic events in tumor development is unknown. We performed whole exome sequencing in 32 resected tumor samples (n = 30 angiomyolipoma, n = 2 LAM) from 15 subjects, including three with TSC. Two germline and 22 somatic inactivating mutations in TSC2 were identified, and one germline TSC1 mutation. Twenty of 32 (62%) samples showed copy neutral LOH (CN-LOH) in TSC2 or TSC1 with at least 8 different LOH regions, and 30 of 32 (94%) had biallelic loss of either TSC2 or TSC1. Whole exome sequencing identified a median of 4 somatic non-synonymous coding region mutations (other than in TSC2/TSC1), a mutation rate lower than nearly all other cancer types. Three genes with mutations were known cancer associated genes (BAP1, ARHGAP35 and SPEN), but they were mutated in a single sample each, and were missense variants with uncertain functional effects. Analysis of sixteen angiomyolipomas from a TSC subject showed both second hit point mutations and CN-LOH in TSC2, many of which were distinct, indicating that they were of independent clonal origin. However, three tumors had two shared mutations in addition to private somatic mutations, suggesting a branching evolutionary pattern of tumor development following initiating loss of TSC2. Our results indicate that TSC2 and less commonly TSC1 alterations are the primary essential driver event in angiomyolipoma/LAM, whereas other somatic mutations are rare and likely do not contribute to tumor development. PMID:27494029

  11. Whole Exome Sequencing Identifies TSC1/TSC2 Biallelic Loss as the Primary and Sufficient Driver Event for Renal Angiomyolipoma Development

    PubMed Central

    Tseng, Yuen-Yi; Oh, Coyin; Kim, Jaegil; Tyburczy, Magdalena E.; Chekaluk, Yvonne; Liu, Yang; Alesi, Nicola; Finlay, Geraldine A.; Wu, Chin-Lee; Signoretti, Sabina; Meyerson, Matthew; Getz, Gad; Kwiatkowski, David J.

    2016-01-01

    Renal angiomyolipoma is a kidney tumor in the perivascular epithelioid (PEComa) family that is common in patients with Tuberous Sclerosis Complex (TSC) and Lymphangioleiomyomatosis (LAM) but occurs rarely sporadically. Though histologically benign, renal angiomyolipoma can cause life-threatening hemorrhage and kidney failure. Both angiomyolipoma and LAM have mutations in TSC2 or TSC1. However, the frequency and contribution of other somatic events in tumor development is unknown. We performed whole exome sequencing in 32 resected tumor samples (n = 30 angiomyolipoma, n = 2 LAM) from 15 subjects, including three with TSC. Two germline and 22 somatic inactivating mutations in TSC2 were identified, and one germline TSC1 mutation. Twenty of 32 (62%) samples showed copy neutral LOH (CN-LOH) in TSC2 or TSC1 with at least 8 different LOH regions, and 30 of 32 (94%) had biallelic loss of either TSC2 or TSC1. Whole exome sequencing identified a median of 4 somatic non-synonymous coding region mutations (other than in TSC2/TSC1), a mutation rate lower than nearly all other cancer types. Three genes with mutations were known cancer associated genes (BAP1, ARHGAP35 and SPEN), but they were mutated in a single sample each, and were missense variants with uncertain functional effects. Analysis of sixteen angiomyolipomas from a TSC subject showed both second hit point mutations and CN-LOH in TSC2, many of which were distinct, indicating that they were of independent clonal origin. However, three tumors had two shared mutations in addition to private somatic mutations, suggesting a branching evolutionary pattern of tumor development following initiating loss of TSC2. Our results indicate that TSC2 and less commonly TSC1 alterations are the primary essential driver event in angiomyolipoma/LAM, whereas other somatic mutations are rare and likely do not contribute to tumor development. PMID:27494029

  12. Spontaneous rupture of a renal angiomyolipoma at 25 weeks of pregnancy treated with transarterial embolization: A case report and review of the literature.

    PubMed

    Myoen, Shingo; Mitsuzuka, Koji; Saito, Hideo; Ota, Hideki; Takase, Kei; Arai, Yoichi

    2015-07-01

    Treatment for ruptured renal angiomyolipoma in pregnancy requires immediate and appropriate decision-making based on the condition of the mother and fetus, and gestational age. A 37-year-old woman at 25 weeks of pregnancy presented with severe right flank pain. Computed tomography showed a ruptured right renal angiomyolipoma (8 cm in diameter). The maternal and fetal conditions were stable. Transcatheter arterial embolization was carried out electively 4 days after the rupture. Minimization of radiation exposure to the fetus was achieved by X-ray shielding for the fetus, low-dose-rate fluoroscopy, minimal angiography imaging and a color Doppler ultrasonography-guided procedure. Although threatened premature labor occurred because of post-embolization syndrome, the pregnancy was continued until cesarean section at 37 weeks of pregnancy. PMID:25881870

  13. Angiomyolipoma With Epithelial Cysts.

    PubMed

    LeRoy, Michael A; Rao, Priya

    2016-06-01

    Angiomyolipoma with epithelial cysts is a rare mesenchymal tumor of the kidney that enters in the differential diagnosis of adult cystic renal neoplasms. These tumors demonstrate a slight female predominance and can present either incidentally or with symptoms, commonly flank pain and hematuria. Unlike conventional angiomyolipoma, this variant is characterized grossly by both solid and cystic areas, and histologically by the presence of single or multiple cysts lined by epithelial cells, a subepithelial "cambium-like" layer of small stromal cells with a prominent capillary vasculature, and a thick exterior wall composed of poorly formed fascicles of smooth muscle and thick-walled dysplastic blood vessels. Tumors show a distinct immunohistochemical profile and are often reactive for melanocytic markers (HMB-45 and Melan-A), as well as estrogen receptor and progesterone receptor. These tumors have an indolent clinical course, with no reports of progression or metastasis in reported cases thus far. PMID:27232352

  14. Role of 64 slice multidetector computed tomography and angiography to establish relationship between tumor size, aneurysm formation and spontaneous rupture of renal angiomyolipomas: Single center experience

    PubMed Central

    Gandhi, Shruti P.; Pal, Bipin Chandra; Patel, Kajal N.; Sutariya, Harsh; Trivedi, Hargovind L.

    2016-01-01

    Objective: To evaluate the role of computed tomography (CT) angiography using 64 slice multidetector CT scan to establish relationships among tumor size, aneurysm formation, and spontaneous rupture of renal angiomyolipomas (AML). Materials and Methods: Total 27 patients were diagnosed as having renal angiomyolipoma (AML) at institute of kidney disease and research center from June 2008 to June 2015. All patients with renal AML underwent contrast-enhanced CT (CECT) with CT angiography with 64 slice multidetector CT scan. Results: Total 34 kidneys were found to be affected by AML. Out of which 6 AML were ruptured and remaining 28 were unruptured. If tumor size of 4 cm or larger is used as predictor of rupture; sensitivity 20%, specificity 89%, positive predictive value 83.3%, and negative predictive value 28.5%; and If aneurysm size >5 mm is used as predictor of rupture; sensitivity 75%, specificity 90%, positive predictive value 50%, and negative predictive value 96.4% was found. Conclusion: Tumor size, aneurysm size and tumor multiplicity cannot use as a predictor of spontaneous rupture of the tumor. PMID:27141187

  15. Recurrent bleeding of angiomyolipomas in tuberous sclerosis.

    PubMed

    Chatterjee, T; Heindel, W; Vorreuther, R; Engelmann, U; Lackner, K

    1996-01-01

    The diagnostic and therapeutic problems of renal hamartomas are illustrated by a case of recurrence of bleeding angiomyolipomas associated with tuberous sclerosis. Ultrasound and computed tomography provide clear evidence of lipomatous formation while, in rare instances, angiography can demonstrate the existence of multiple vascular tumor compartments. In view of the risk of bleeding, multiple or very large angiomyolipomas should be treated by interventional radiology in the form of superselective tumor embolization or by the most conservative surgery possible. PMID:8903555

  16. Clear cell renal cell carcinoma with a syncytial-type multinucleated giant tumor cell component: implications for differential diagnosis.

    PubMed

    Williamson, Sean R; Kum, Jennifer B; Goheen, Michael P; Cheng, Liang; Grignon, David J; Idrees, Muhammad T

    2014-04-01

    A component of syncytial-type multinucleated tumor giant cells is uncommon in clear cell renal cell carcinoma, and the histogenesis, incidence, and clinical implications of this finding are not well understood. We retrieved 13 such tumors from our pathology archives in patients with a median age of 60years, comprising 1.5% of clear cell renal cell carcinomas. Stage was typically pT4 or pT3 (each 38%). Microscopically, all tumors included a component of low-grade clear cell renal cell carcinoma with usual features. Syncytial-type giant tumor cells possessed voluminous cytoplasm, usually granular and eosinophilic, and numerous nuclei similar to those of the mononuclear tumor cells. Transition between areas of mononuclear and multinucleated cells was sometimes abrupt. Other findings included necrosis (77%), hyaline globules (46%), emperipolesis (46%), and intranuclear cytoplasmic invaginations (23%). Immunohistochemical staining typically revealed both mononuclear and multinucleated cells to be positive for carbonic anhydrase IX, CD10, epithelial membrane antigen, vimentin, and cytokeratin AE1/AE3 and negative for β human chorionic gonadotropin, TFE3, cathepsin K, cytokeratin 7, cytokeratin 20, HMB45, CD68, smooth muscle actin, and S100. Most patients with available information (7/9) were alive with metastatic disease at the most recent follow-up. Syncytial-type giant cells are an uncommon finding associated with aggressive clear cell renal cell carcinomas. Despite the unusual appearance of this tumor component, its immunoprofile supports an epithelial lineage and argues against trophoblastic, osteoclast-like, or histiocytic differentiation. Reactivity for typical clear cell renal cell carcinoma antigens facilitates discrimination from giant cells of epithelioid angiomyolipoma or other tumors, particularly in a biopsy specimen or a metastatic tumor. PMID:24499686

  17. Usefulness of the Ice-Cream Cone Pattern in Computed Tomography for Prediction of Angiomyolipoma in Patients With a Small Renal Mass

    PubMed Central

    Kim, Kwang Ho; Yun, Bu Hyeon; Hwang, In Sang; Hwang, Eu Chang; Kang, Taek Won; Kwon, Dong Deuk; Park, Kwangsung; Kim, Jin Woong

    2013-01-01

    Purpose A morphologic contour method for assessing an exophytic renal mass as benign versus malignant on the basis of the shape of the interface with the renal parenchyma was recently developed. We investigated the usefulness of this morphologic contour method for predicting angiomyolipoma (AML) in patients who underwent partial nephrectomy for small renal masses (SRMs). Materials and Methods From January 2004 to March 2013, among 197 patients who underwent partial nephrectomy for suspicious renal cell carcinoma (RCC), the medical records of 153 patients with tumors (AML or RCC) ≤3 cm in diameter were retrospectively reviewed. Patient characteristics including age, gender, type of surgery, size and location of tumor, pathologic results, and specific findings of the imaging study ("ice-cream cone" shape) were compared between the AML and RCC groups. Results AML was diagnosed in 18 patients and RCC was diagnosed in 135 patients. Gender (p=0.001), tumor size (p=0.032), and presence of the ice-cream cone shape (p=0.001) showed statistically significant differences between the AML group and the RCC group. In the multivariate logistic regression analysis, female gender (odds ratio [OR], 5.20; 95% confidence interval [CI], 1.45 to 18.57; p=0.011), tumor size (OR, 0.34; 95% CI, 0.12 to 0.92; p=0.034), and presence of the ice-cream cone shape (OR, 18.12; 95% CI, 4.97 to 66.06; p=0.001) were predictors of AML. Conclusions This study confirmed a high incidence of AML in females. Also, the ice-cream cone shape and small tumor size were significant predictors of AML in SRMs. These finding could be beneficial for counseling patients with SRMs. PMID:23956824

  18. A Review of the Literature on Extrarenal Retroperitoneal Angiomyolipoma

    PubMed Central

    Venyo, Anthony Kodzo-Grey

    2016-01-01

    Background. Extrarenal retroperitoneal angiomyolipomas are rare. Aim. To review the literature. Results. Angiomyolipomas, previously classified as hamartomas, are now classified as benign tumours. Thirty cases of primary retroperitoneal angiomyolipomas have been reported. Diagnosis of the disease upon is based radiological and pathological findings of triphasic features of (a) fat and (b) blood vessels and myoid tissue. Immunohistochemistry tends to be positive for HMB45, MART1, HHF35, calponin, NKI-C3, and CD117. The lesion is common in women. Treatment options have included the following: (a) radical surgical excision of the lesion with renal sparing surgery or radical nephrectomy in cases where malignant tumours could not be excluded and (b) selective embolization of the lesion alone or prior to surgical excision. One case of retroperitoneal angiomyolipoma was reported in a patient 15 years after undergoing radical nephrectomy for angiomyolipoma of kidney and two cases of distant metastases of angiomyolipoma have been reported following radical resection of the tumour. Conclusions. With the report of two cases of metastases ensuing surgical resection of the primary lesions there is need for academic pathologists to debate and review angiomyolipomas to decide whether to reclassify angiomyolipomas as slow-growing malignant tumours or whether the reported cases of metastases were de novo tumours or metastatic lesions. PMID:26989509

  19. Bilateral asymptomatic giant renal artery aneurysm

    PubMed Central

    Özkan, G; Ulusoy, Ş; Dinç, H; Kaynar, K; Sönmez, B; Akagündüz, K

    2011-01-01

    The incidence of renal artery aneurysm is very low. Approximately in 20% of these patients hypertension is observed. The diameter of aneurysm increases with accompanying complication rates. The most feared complication is rupture. The risk of rupture also increases with the diameter of aneurysm. We report an aneurysm with the biggest diameter reported in the literature. The patient had a 12 cm-diameter of aneurysm in one kidney and did not show any symptoms including hypertension until she was seventy years old. PMID:22435028

  20. Not All Acute Abdomen Cases in Early Pregnancy Are Ectopic; Expect the Unexpected: Renal Angiomyolipoma Causing Massive Retroperitoneal Haemorrhage.

    PubMed

    Rana, Muhammad Asim; Mady, Ahmed F; Jakaraddi, Nagesh; Mumtaz, Shahzad A; Ahmad, Habib; Naser, Kamal

    2016-01-01

    Retroperitoneal haemorrhage (or retroperitoneal haematoma) refers to an accumulation of blood found in the retroperitoneal space. It is a rare clinical entity with variable aetiology including anticoagulation, ruptured aortic aneurysm, acute pancreatitis, malignancy, and bleeding from renal aneurysm. Diagnosis of retroperitoneal bleed is sometimes missed or delayed as presentation is often nonspecific. Multislice CT and arteriography are important for diagnosis. There is no consensus about the best management plan for patients with retroperitoneal haematoma. Stable patients can be managed with fluid resuscitation, correction of coagulopathy if any, and blood transfusion. Endovascular options involving selective intra-arterial embolisation or stent-grafts are clearly getting more and more popularity. Open repair is usually reserved for cases when there is failure of conservative or endovascular measures to control the bleeding or expertise is unavailable and in cases where the patient is unstable. Mortality of patients with retroperitoneal haematoma remains high if appropriate and timely measures are not taken. Haemorrhage from a benign renal tumour is a rarer entity which is described in this case report which emphasizes that physicians should have a wide index of suspicion when dealing with patients presenting with significant groin, flank, abdominal, or back pain, or haemodynamic instability of unclear cause. Our patient presented with features of acute abdomen and, being pregnant, was thought of having a ruptured ectopic pregnancy. PMID:27429809

  1. Not All Acute Abdomen Cases in Early Pregnancy Are Ectopic; Expect the Unexpected: Renal Angiomyolipoma Causing Massive Retroperitoneal Haemorrhage

    PubMed Central

    Mady, Ahmed F.; Jakaraddi, Nagesh; Naser, Kamal

    2016-01-01

    Retroperitoneal haemorrhage (or retroperitoneal haematoma) refers to an accumulation of blood found in the retroperitoneal space. It is a rare clinical entity with variable aetiology including anticoagulation, ruptured aortic aneurysm, acute pancreatitis, malignancy, and bleeding from renal aneurysm. Diagnosis of retroperitoneal bleed is sometimes missed or delayed as presentation is often nonspecific. Multislice CT and arteriography are important for diagnosis. There is no consensus about the best management plan for patients with retroperitoneal haematoma. Stable patients can be managed with fluid resuscitation, correction of coagulopathy if any, and blood transfusion. Endovascular options involving selective intra-arterial embolisation or stent-grafts are clearly getting more and more popularity. Open repair is usually reserved for cases when there is failure of conservative or endovascular measures to control the bleeding or expertise is unavailable and in cases where the patient is unstable. Mortality of patients with retroperitoneal haematoma remains high if appropriate and timely measures are not taken. Haemorrhage from a benign renal tumour is a rarer entity which is described in this case report which emphasizes that physicians should have a wide index of suspicion when dealing with patients presenting with significant groin, flank, abdominal, or back pain, or haemodynamic instability of unclear cause. Our patient presented with features of acute abdomen and, being pregnant, was thought of having a ruptured ectopic pregnancy. PMID:27429809

  2. [Giant renal cyst as cause of colic obstruction].

    PubMed

    Vos, B; Laureys, M

    2009-01-01

    A 97-year old woman presented with a 2-months history of asthenia, loss of appetite, nauseas and intermittent diarrhea. She presented an important colic distension associated to an inflammatory syndrome. Microbiological documentation (blood, urine, saddles stool) was negative. Abdominal computed tomography (CT) showed a 15 cm of diameter (giant) right cortical renal cyst with colic obstruction by external colic compression. A percutaneous cyst drainage was performed allowing the evacuation of 1,500 cc. The fluid culture was positive for Raoultella ornithinolytica and Enterococcus faecalis. No antibiotics were given but inflammatory syndrome remained within normal value. Colic function remained normal. PMID:19517907

  3. [ANEURYSMAL TYPE RENAL ARTERIOVENOUS FISTULA WITH GIANT VENOUS ANEURYSM, MIMICKING RENAL CELL CARCINOMA: A CASE REPORT].

    PubMed

    Nagumo, Yoshiyuki; Komori, Hiroka; Rii, Jyunryo; Ochi, Atsuhiko; Suzuki, Koichiro; Shiga, Naoki; Ota, Tomonori

    2015-04-01

    A 39-year-old man was referred to our clinic for a 7 cm tumor in the right kidney, found by simple CT scan. It was suspected as renal cell carcinoma accompanying tumor emboli in the inferior vena cava by enhanced CT scan. For further evaluation of the tumor emboli, color Doppler ultrasound and enhanced MRI was performed. They showed a large cystic lesion with high velocity turbulent flow and flow voids in T2-weighted imaging, it seemed as giant venous aneurysm of the right renal vein. Subsequently, angiography revealed aneurysmal type renal arteriovenous fistula (AVF), transarterial embolization (TAE) of the arterial feeder with coils was performed on the same day. After 6 months from embolization, there was no recurrences or reinterventions. Color Doppler ultrasound and MRI are beneficial in distinguishing vascular disease from neoplastic disease which may sometimes mimick in other diagnostic imaging studies. In addition TAE seems to be an effective treatment for the AVF. PMID:26415363

  4. Aggressive Angiomyolipomas: the Clandestine Epithelioid Variant.

    PubMed

    Maré, Anton; Wickramasinghe, Shehan; Ilie, Victor; Mulcahy, Maurice

    2016-02-01

    Epithelioid angiomyolipoma is a rare mesenchymal derived neoplasm of the kidney. Thought to be a variant of classical angiomyolipoma, a benign tumour, its malignant potential has been highlighted by case reports of loco-regional and distant metastasis. Given the potentially adverse clinical course associated with epithelioid angiomyolipoma compared to classical angiomyolipoma, the distinction and comprehensive histological characterisation of this rare entity is essential. PMID:26989374

  5. Evolving Strategies in the Treatment of Tuberous Sclerosis Complex-associated Angiomyolipomas (TSC-AML).

    PubMed

    Kapoor, Anil; Girard, Louis; Lattouf, Jean-Baptiste; Pei, York; Rendon, Ricardo; Card, Paul; So, Alan

    2016-03-01

    Tuberous sclerosis complex (TSC) is a rare autosomal dominant genetic disorder characterized by the development of numerous benign tumors that occur in multiple organ systems throughout the lifetime of the affected individuals. Renal angiomyolipomas occur in up to 80% of TSC patients, and chronic kidney disease from increasing tumor burden is the primary cause of TSC-related mortality. Our review evaluates evidence for localized and systemic therapy in the management of TSC-angiomyolipomas. Urologists or nephrologists experienced in TSC disease should coordinate the care of TSC patients with renal involvement to improve care and reduce costs. PMID:26723178

  6. [Postbiopsy giant pseudoaneurysm in renal transplant: treatment with embolization].

    PubMed

    Zaragozano Guillén, R; García Díez, A I; Cobos Hernández, M V; Yagüe Romeo, D

    1998-03-01

    Pseudoaneurism in renal grafts is a well known complication of the percutaneous biopsy. Colour Doppler has been shown to be the choice technique for their diagnosis and subsequent control, the most effective treatment being embolization. This paper presents an unusual form of pseudoaneurism in terms of its size (up to 8 cm diameter) in a renal graft, following performance of a percutaneous biopsy with automatic needle. The findings of the colour Doppler study and the angiography are shown and discussed, as well as the treatment by embolization with metal spirals which achieved the stable, complete occlusion of the lesion after six months control. PMID:9616940

  7. [Stauffer syndrome associated with a giant renal tumor].

    PubMed

    Sarf, Ismail; el Mejjad, Amine; Dakir, Mohamed; Meziane, Anas; Badre, Latifa; Aboutaieb, Rachid; Meziane, Fethi

    2003-04-01

    The authors report a new case of Stauffer syndrome characterized by cholestatic jaundice in a 54-year-old patient with renal tumour. This paraneoplastic syndrome resolved after nephrectomy. The authors discuss the pathophysiological, diagnostic and therapeutic aspects in the light of a review of the literature. PMID:12765066

  8. Primary giant cell malignant fibrous histiocytoma-associated with renal calculus

    PubMed Central

    Altunkol, Adem; Savas, Murat; Ciftci, Halil; Gulum, Mehmet; Yagmur, Ismail; Bitiren, Muharrem

    2014-01-01

    Malignant fibrous histiocytomas (MFH) are the most commonly seen soft tissue sarcomas in adults. It is rarely seen in some visceral organs. Kidneys are the parenchymal organs in which MFHs are most frequently seen. More than 50 cases of primary renal MFH have been reported. Among these cases, only 1 was reported as primary giant cell subtype in association with urolithiasis. This case report is the second such case with the these characteristics. PMID:24678364

  9. Angiomyolipoma of donor kidney: Successful transplantation and 5-year follow-up

    PubMed Central

    Gopalakrishnan, N.; Dhanapriya, J.; Sakthirajan, R.; Dineshkumar, T.; Balasubramaniyan, T.; Haris, Md.

    2016-01-01

    Angiomyolipomas (AML) of the kidney are non-encapsulated benign neoplasms with the incidence of 45-80% in patients with tuberous sclerosis and 1-3% in sporadic cases. There are very few case reports in the literature in which kidneys with AML have been used for transplantation. We report here a 27-year-old female patient who received a live related renal transplant from her mother with isolated angiomyolipoma in donor kidney and on follow-up after 5 years, has stable graft function and tumor size. PMID:27051138

  10. Spatial and temporal differences in giant kidney worm, dictophyma renale, prevalence in Minnesota Mink, Mustela vison

    USGS Publications Warehouse

    Mech, L.D.

    2008-01-01

    Examination of 110 Mink (Mustela vison) carcasses from 1998 through 2007 indicated that the giant kidney worm, Dioctophyma renale, occurred in Pine and Kanabec Counties of eastern Minnesota with annual prevalences of 0-92%. Worm prevalence increased from 20% in 1999 to 92% in 2001 and decreased to 6% in 2005. During 2000 to 2007, no worms were found in Mink from Anoka and Chisago Counties (n = 54), and in 2000, none in 107 Mink from LeSeur, Freeborn, Redwood, Brown and Watonwan Counties. Changes in kidney worm prevalence were positively related to trapping success, considered an index of Mink density.

  11. Small (< 1.5 cm) angiomyolipomas of the kidney: characterization by the combined use of in-phase and fat-attenuated MR techniques.

    PubMed

    Burdeny, D A; Semelka, R C; Kelekis, N L; Reinhold, C; Ascher, S M

    1997-01-01

    The purpose of this study was to evaluate the ability of in-phase spoiled gradient echo combined with chemically selective fat suppression or out-of-phase spoiled gradient echo MR images to characterize small renal masses as angiomyolipomas. Eleven patients with a total of 35 small (< 1.5 cm) angiomyolipomas underwent MR examination at 1.5T. Eight patients had solitary and three patients had multiple angiomyolipomas. One of the patients with multiple angiomyolipomas had tuberous sclerosis and the number of angiomyolipomas were quantified as 20. MR examinations included in-phase spoiled gradient echo (all patients), chemically selective fat suppressed spin echo (six patients), chemically selective fat suppressed spoiled gradient echo (three patients), selective water excitation spoiled gradient echo (one patient) and out-of-phase spoiled gradient echo (seven patients). Angiomyolipomas were minimally (4 lesions) or moderately (31 lesions) high in signal intensity relative to renal cortex on in-phase spoiled gradient echo images. On out-of-phase spoiled gradient echo images, demonstration of signal void fat-water phase cancellation was present in all eight lesions in the seven patients who were imaged with this sequence. Small lesion size rendered the entire angiomyolipoma signal void in seven of these eight lesions due to phase cancellation artifact. Signal void phase cancellation of lesion border or signal void of the entire angiomyolipoma resulted in high lesion conspicuity in all lesions. Mild loss of signal intensity was observed in 7 lesions and moderate loss of signal intensity noted in 25 lesions on chemically selective fat suppressed images. On chemically selective fat-suppressed images, seven lesions were difficult to identify due to limited signal differences between medium intensity cortex and low intensity angiomyolipomas (six lesions in two patients) and moderate breathing artifact (one lesion in one patient). Characterization of small renal masses as

  12. [Extrarenal Retroperitoneal Angiomyolipoma Masquerading as Retroperitoneal Liposarcoma : A Report of Two Cases].

    PubMed

    Yamamoto, Ryohei; Inoue, Takamitsu; Numakura, Kazuyuki; Tsuruta, Hiroshi; Maeno, Atsushi; Saito, Mitsuru; Narita, Shintaro; Tsuchiya, Norihiko; Satoh, Shigeru; Habuchi, Tomonori

    2016-06-01

    We report two patients with extrarenal retroperitoneal angiomyolipoma masquerading as perinephric liposarcoma. Patient 1 : A 66-year-old man was diagnosed with a retroperitoneal tumor near the right renal hilum on an abdominal computed tomography (CT) performed before surgery for gastric cancer. A diagnosis of extrarenal retroperitoneal angiomyolipoma was made on the basis of negative uptake of fluorine- 18 2-deoxy-2-fluoro-D-glucose positron emission tomography (18F-FDG PET)/CT. However, because the tumor was found to have gradually enlarged at 18 months afterward, he underwent resection of the extrarenal fat tissue together with the right kidney. Patient 2 : A 56-year-old man underwent abdominal ultrasound during a periodic medical examination, which revealed a right retroperitoneal tumor. Because of the findings in the contrast-enhanced CT and positive uptake of 18F-FDG PET/CT, he underwent resection of the extrarenal fat tissue together with the right kidney. The pathological examination of the two tumors confirmed extrarenal angiomyolipoma. The differential diagnosis of extrarenal retroperitoneal angiomyolipoma from retroperitoneal liposarcoma is difficult even with the use of 18F-FDG PET/CT. PMID:27452495

  13. Malignant epitheloid angiomyolipoma of the kidney in a child treated with sunitinib, everolimus and axitinib

    PubMed Central

    Citak, Elvan Caglar; Yilmaz, Eda Bengi; Yaman, Emel; Kaya, Simge; Taskinlar, Hakan; Arpaci, Rabia Bozdogan; Apaydin, Demir

    2015-01-01

    The malignant variant of epithelioid angiomyolipoma (EAML) of the kidney is uncommon, extremely aggressive and behaves like a renal cell carcinoma. We present a case of a 12-year-old male with malignant EAML who was treated according to adult treatment protocols. To our knowledge, axitinib has not been used before in children. We conclude that adult protocols, in this rare case, could be safely used in rare childhood malignancies. PMID:26279736

  14. Renal

    MedlinePlus

    ... term "renal" refers to the kidney. For example, renal failure means kidney failure. Related topics: Kidney disease Kidney disease - diet Kidney failure Kidney function tests Renal scan Kidney transplant

  15. Simultaneous Renal Cell Carcinoma and Giant Retroperitoneal Liposarcoma Involving Small Intestine.

    PubMed

    Reznichenko, Aleksandr A

    2016-01-01

    Background. The concomitant occurrence of a renal cell carcinoma and retroperitoneal sarcoma is extremely rare with only few cases being reported. Methods. We present a case of simultaneous renal cell carcinoma and exceptionally large size retroperitoneal sarcoma involving small intestine. Surgical resection of retroperitoneal sarcoma and simultaneous right nephrectomy were performed. Results. Patient developed recurrent and metastatic disease and underwent debulking surgery following by chemotherapy. Despite aggressive behavior of the retroperitoneal sarcomas, patient is currently (7 years after simultaneous resection and nephrectomy) recurrence-free. Conclusions. Complete surgical resection is the mainstay of therapy for both renal cell carcinoma and retroperitoneal sarcoma. We present a case of simultaneous renal cell carcinoma and exceptionally large size retroperitoneal sarcoma. Debulking surgery and chemotherapy were helpful in our case. PMID:27595033

  16. Simultaneous Renal Cell Carcinoma and Giant Retroperitoneal Liposarcoma Involving Small Intestine

    PubMed Central

    2016-01-01

    Background. The concomitant occurrence of a renal cell carcinoma and retroperitoneal sarcoma is extremely rare with only few cases being reported. Methods. We present a case of simultaneous renal cell carcinoma and exceptionally large size retroperitoneal sarcoma involving small intestine. Surgical resection of retroperitoneal sarcoma and simultaneous right nephrectomy were performed. Results. Patient developed recurrent and metastatic disease and underwent debulking surgery following by chemotherapy. Despite aggressive behavior of the retroperitoneal sarcomas, patient is currently (7 years after simultaneous resection and nephrectomy) recurrence-free. Conclusions. Complete surgical resection is the mainstay of therapy for both renal cell carcinoma and retroperitoneal sarcoma. We present a case of simultaneous renal cell carcinoma and exceptionally large size retroperitoneal sarcoma. Debulking surgery and chemotherapy were helpful in our case. PMID:27595033

  17. Prevalence of giant kidney worm (Dioctophyma renale) in wild mink (Mustela vison) in Minnesota

    USGS Publications Warehouse

    Mech, L.D.; Tracy, S.P.

    2001-01-01

    Of 138 wild mink (Mustela vison) from eastern Minnesota, 27% contained Dioctophyma renale, primarily in the right kidney. No significant difference between prevalence in adult male and immature male mink was found, nor between the prevalence in males versus female mink. Thirteen worms were found in one male mink, representing the highest documented infection intensity of a single wild mink.

  18. Renal Artery Embolization

    PubMed Central

    Sauk, Steven; Zuckerman, Darryl A.

    2011-01-01

    Renal artery embolization (RAE) is an effective minimally invasive alternative procedure for the treatment of a variety of conditions. Since the 1970s when RAE was first developed, technical advances and growing experience have expanded the indications to not only include treatment of conditions such as symptomatic hematuria and palliation for metastatic renal cancer, but also preoperative infarction of renal tumors, treatment of angiomyolipomas, vascular malformations, medical renal disease, and complications following renal transplantation. With the drastically improved morbidity associated with this technique in part due to the introduction of more precise embolic agents and smaller delivery catheters, RAE continues to gain popularity for various urologic conditions. The indications and techniques for renal artery embolization are reviewed in the following sections. PMID:23204638

  19. Hereditary Renal Cancer Syndromes

    PubMed Central

    Haas, Naomi B.

    2013-01-01

    Inherited susceptibility to kidney cancer is a fascinating and complex topic. Our knowledge about types of genetic syndromes associated with an increased risk of disease is continually expanding. Currently, there are 10 syndromes associated with an increased risk of all types of renal cancer, which are reviewed herein. Clear cell renal cancer is associated with von Hippel Lindau disease, chromosome 3 translocations, PTEN hamartomatous syndrome and mutations in BAP1, as well as several of the genes encoding the proteins comprising the succinate dehydrogenase complex (SDHB/C/D). Type 1 papillary renal cancers arise in conjunction with germline mutations in MET and type 2 as part of Hereditary Leiomyomatosis and Renal Cell Cancer (FH mutations). Chromophone and oncocytic renal cancers are predominantly associated with Birt Hogg Dubé syndrome. Angiomyolipomas are commonly and their malignant counterpart epitheliod angiomyolipomas rarely are found in patients with Tuberous Sclerosis Complex. The targeted therapeutic options for the renal cancer associated with these diseases are just starting to expand, and are an area of active clinical research. PMID:24359990

  20. Angiomyolipoma and Malignant PEComa: Discussion of Two Rare Adrenal Tumors

    PubMed Central

    Kwazneski II, Douglas; Merrill, Megan; Young, Jessica; Sell, Harry

    2016-01-01

    Angiomyolipoma and PEComa are rare tumors descending from perivascular epithelial cells (PECs), with distinctive IHC, morphological, and ultrastructural features. The kidney is the most frequent site of origin, but not the only one; however, adrenal gland angiomyolipomas are extremely rare. We describe two cases being found in the adrenal glands. Given the paucity of literature on the subject, more information on this disease is necessary for diagnosis and treatment. Here, we describe two complete case reports, from presentation to treatment and follow-up, along with imaging and microscopic pathology samples, and provide a comprehensive review as to the history and current literature available regarding these extremely rare tumors. PMID:26998374

  1. Response to everolimus is seen in TSC-associated SEGAs and angiomyolipomas independent of mutation type and site in TSC1 and TSC2

    PubMed Central

    Kwiatkowski, David J; Palmer, Michael R; Jozwiak, Sergiusz; Bissler, John; Franz, David; Segal, Scott; Chen, David; Sampson, Julian R

    2015-01-01

    Tuberous sclerosis complex is an autosomal dominant disorder that occurs owing to inactivating mutations in either TSC1 or TSC2. Tuberous sclerosis complex-related tumors in the brain, such as subependymal giant cell astrocytoma, and in the kidney, such as angiomyolipoma, can cause significant morbidity and mortality. Recently, randomized clinical trials (EXIST-1 and EXIST-2) of everolimus for each of these tuberous sclerosis complex-associated tumors demonstrated the benefit of this drug, which blocks activated mammalian target of rapamycin complex 1. Here we report on the spectrum of mutations seen in patients treated during these trials and the association between mutation and response. TSC2 mutations were predominant among patients in both trials and were present in nearly all subjects with angiomyolipoma in whom a mutation was identified (97%), whereas TSC1 mutations were rare in those subjects (3%). The spectrum of mutations seen in each gene was similar to those previously reported. In both trials, there was no apparent association between mutation type or location within each gene and response to everolimus. Everolimus responses were also seen at a similar frequency for the 16–18% of patients in each trial in whom no mutation in either gene was identified. These observations confirm the strong association between TSC2 mutation and angiomyolipoma burden seen in previous studies, and they indicate that everolimus response occurs regardless of mutation type or location or when no mutation in TSC1 or TSC2 has been identified. PMID:25782670

  2. Granulomatous reaction in hepatic inflammatory angiomyolipoma after chemoembolization and spontaneous rupture

    PubMed Central

    Kai, Keita; Miyosh, Atsushi; Aishima, Shinichi; Wakiyama, Kota; Nakashita, Shunya; Iwane, Shinji; Azama, Shinya; Irie, Hiroyuki; Noshiro, Hirokazu

    2015-01-01

    A 77-year-old Japanese woman was transported to a nearby hospital due to sudden abdominal pain and transient loss of consciousness. Abdominal computed tomography (CT) suggested hemoperitoneum and hepatic nodule. She was conservatively treated. Contrast-enhanced CT two months later revealed an increased mass size, and the enhancement pattern suggested the possibility of hepatocellular carcinoma (HCC). Under a clinical diagnosis of HCC, transcatheter arterial chemoembolization (TACE) was performed. A subsequent imaging study revealed that most of the lipiodol used for the embolization was washed out. Therefore, surgical resection was performed. Histologically, the nodule contained numerous inflammatory cells including small lymphocytes, plasma cells and macrophages. Notably, epithelioid granulomatous features with multinucleated giant cells were observed in both the nodule and background liver. Some of the multinucleated giant cells contained oil lipid. Among the infiltrating inflammatory cells, spindle-shaped, histiocytoid or myoid tumor cells with eosinophilic cytoplasm were found. The tumor cells were positive for Melan A and HMB45. The nodule contained many IgG4-positive plasma cells; these were counted and found to number 72.6 cells/HPF (range: 61-80). The calculated IgG4:IgG ratio was 33.2%. The nodule was finally diagnosed as previously ruptured inflammatory angiomyolipoma modified by granulomatous reaction after TACE. PMID:26327777

  3. URETERIC ANGIOMYOLIPOMA CAUSING UNILATERAL PELVI-URETERIC JUNCTION OBSTRUCTION.

    PubMed

    Khan, Iftikhar Ali; Shahab, Durre; Rehman, Asad; Jamil, Imran; Akhter, Saeed

    2015-01-01

    A 63-year-old lady, presented to us with nonspecific abdominal pain. Ultrasonography (USG) and CT scan abdomen and pelvis, showed right moderate hydronephrosis, with no evidence of mass at pelvi-ureteric junction (PUJ) obstruction. Per-operatively mass upper ureter was found obstructing PUJ. Mass was excised and pyeloplasty done, with Double J (DJ) Stenting. Stent was removed after a week. Histopathology of specimen showed upper ureteric Angiomyolipoma. PMID:26182785

  4. Hepatic angiomyolipoma: a series of six cases with emphasis on pathological-radiological correlations and unusual variants diagnosed by core needle biopsy

    PubMed Central

    Agaimy, Abbas; Vassos, Nikolaos; Croner, Roland S; Strobel, Deike; Lell, Michael

    2012-01-01

    Hepatic angiomyolipoma is rare and may pose differential diagnostic difficulty, particularly if encountered in core needle biopsy. We studied 6 cases from 5 males and one female (median age, 48.6 yrs). All presented with non-specific symptoms or an incidentally discovered tumor mass. Two patients had a remote history of chemotherapy for hematological neoplasms (acute lymphoblastic leukemia and Hodgkin lymphoma respectively) and another had clear cell renal cell carcinoma and anaplastic pancreatic carcinoma diagnosed at autopsy without definable syndrome. None of the patients had evidence of the tuberous sclerosis complex or renal or other extra-renal angiomyolipoma. Three tumors were resected completely and three have been only biopsied and followed up. None of the resected cases recurred at a mean follow-up of 35 months. Histologically, tumors were classified as classical triphasic (1), lipomatous (2), epithelioid/oncocytoid (1), epithelioid trabecular (1) and myelolipoma-like (1). The adjacent liver parenchyma was normal in 3 cases, showed pigment cirrhosis in one case and mild fatty change in another case. One case had clinically diagnosed but histologically unverified cirrhosis. The initial diagnostic impression/frozen section was misleading in 5 of the cases and included vascular lesion, focal fatty change, myelolipoma, hepatocellular tumor and oncocytic neoplasm. All tumors expressed HMB45 and variably desmin. One epithelioid lesion expressed HMB45 and TFE3, but lacked desmin expression. In conclusion, hepatic angiomyolipomas are increasingly recognized as incidental findings during surveillance for cirrhosis or investigations for unrelated conditions. Awareness of their diverse morphological spectrum in liver biopsy is necessary to avoid misdiagnosis as hepatocellular carcinoma, metastatic melanoma or other malignant neoplasms. PMID:22949933

  5. Diagnostic utility of diffusion-weighted magnetic resonance imaging in two common renal tumors

    PubMed Central

    WEN, ZHAOXIA; SUN, ZHENCHAO; WANG, YUXING

    2015-01-01

    The aim of the present study was to evaluate the utility of diffusion-weighted magnetic resonance imaging (DWI) in the diagnosis of common renal tumors. Conventional magnetic resonance imaging and DWI were performed on 85 patients with renal lesions (54 renal carcinoma and 31 renal angiomyolipoma cases). The apparent diffusion coefficient (ADC) values in each case at b=800 sec/mm2 were measured in the ADC maps using a statistical software package. The 54 cases of renal cell carcinoma showed a high signal intensity in the parenchyma, and the 31 renal angiomyolipoma cases showed a well-defined mixed signal intensity on DWI. The soft-tissue component showed a high signal intensity and the fat tissue showed a low signal intensity on DWI. When the b-value was set to 800 sec/mm2, the mean ADC was significantly lower in the renal carcinoma cases than in the renal angiomyolipoma cases. In conclusion, the measurement of ADC on DWI can reveal the structure of renal tumors, which is beneficial in diagnosing and determining the prognosis of benign and malignant renal tumors. PMID:26622890

  6. Angiomyolipoma in a Patient with Situs Inversus Totalis: Managing Two Rare Diseases

    PubMed Central

    Heaton, Nigel

    2016-01-01

    Hepatic angiomyolipoma is an extremely rare benign hamartomatous lesion. Situs inversus totalis is a genetic condition occurring in 0.01% of the population. Following the kidney, the liver is the second most common site of angiomyolipoma. No consensus on the treatment of hepatic angiomyolipoma has been reached. However, the majority of these tumours are managed conservatively. Situs inversus totalis presents difficulties for procedures and is most commonly an incidental finding. These two conditions have not previously been reported and no genetic link has been established between them. This paper reports the association of both conditions in a 74-year-old female, reviews the literature, and presents CT imaging of the case.

  7. Hepatic epithelioid angiomyolipoma with trabecular growth pattern: a mimic of hepatocellular carcinoma on fine needle aspiration cytology.

    PubMed

    Xie, Linjun; Jessurun, Jose; Manivel, J Carlos; Pambuccian, Stefan E

    2012-07-01

    Epithelioid angiomyolipomas (AMLs) of the liver are rare tumors with imaging and cytologic features overlapping with those of hepatocellular carcinomas. We report the fine needle aspiration and core biopsy findings of an epithelioid AML in the right hepatic lobe of a 32-year-old female with tuberous sclerosis. She had undergone renal transplantation 8 years previously after bilateral nephrectomy for renal AMLs and a 3-cm chromophobe renal cell carcinoma. Hepatocellular carcinoma was suspected during the initial cytologic and histologic examination based on the presence of numerous large polygonal cells with ample finely vacuolated or granular cytoplasm, low nucleocytoplasmic ratio, and mild nuclear pleomorphism in the smears, as well as a distinctive trabecular histologic pattern in the core biopsies. Immunoperoxidase stains showed that the neoplastic cells were negative for cytokeratins and positive for HMB45, Melan-A, and smooth muscle actin, establishing the diagnosis of epithelioid AML. To determine the distinguishing cytomorphologic features between epithelioid AML and HCC, we have compared the cytologic features of 15 cases of hepatic AML reported in the literature, including the present case, to the FNA cytologic findings of 38 consecutive cases of HCC diagnosed at out institution. PMID:21563318

  8. Angiographic and volumetric effects of mammalian target of rapamycin inhibitors on angiomyolipomas in tuberous sclerosis

    PubMed Central

    Sheth, Rahul A; Feldman, Adam S; Paul, Elahna; Thiele, Elizabeth A; Walker, T Gregory

    2016-01-01

    AIM: To investigate the angiographic and volumetric effects of mammalian target of rapamycin (mTOR) inhibitors on angiomyolipomas (AMLs) in a case series of patients with tuberous sclerosis complex. METHODS: All patients who underwent catheter angiography prior to and following mTOR inhibitor therapy (n = 3) were evaluated. All cross-sectional imaging studies were analyzed with three-dimensional volumetrics, and tumor volume curves for all three tissue compartments (soft tissue, vascular, and fat) were generated. Segmentation analysis tools were used to automatically create a region of interest (ROI) circumscribing the AML. On magnetic resonance images, the “fat only” map calculated from the in- and opposed-phase gradient recalled echo sequences was used to quantify fat volume within tumors. Tumor vascularity was measured by applying a thresholding tool within the ROI on post-contrast subtraction images. On computed tomography images, volume histogram analysis of Hounsfield unit was performed to quantify tumor tissue composition. The angiography procedures were also reviewed, and tumor vascularity based on pre-embolization angiography was characterized in a semi-quantitative manner. RESULTS: Patient 1 presented at the age of 15 with a 6.8 cm right lower pole AML and a 4.0 cm right upper pole AML. Embolization was performed of both tumors, and after a few years of size control, the tumors began to grow, and the patient was initiated on mTOR inhibitor therapy. There was an immediate reduction in the size of both lesions. The patient then underwent repeat embolization and discontinuation of mTOR inhibition, after which point there was a substantial regrowth in both tumors across all tissue compartments. Patient 2 presented at the age of 18 with a right renal AML. Following a brief period of tumor reduction after embolization, she was initiated on mTOR inhibitor therapy, with successful reduction in tumor size across all tissue compartments. As with patient 1

  9. Pericyte antigens in angiomyolipoma and PEComa family tumors.

    PubMed

    Shen, Jia; Shrestha, Swati; Yen, Yu-Hsin; Scott, Michelle A; Asatrian, Greg; Barnhill, Raymond; Lugassy, Claire; Soo, Chia; Ting, Kang; Peault, Bruno; Dry, Sarah M; James, Aaron W

    2015-08-01

    Perivascular epithelioid cell tumors (PEComas) are an uncommon family of soft tissue tumors with dual myoid-melanocytic differentiation. Although PEComa family tumors commonly demonstrate a perivascular growth pattern, pericyte antigen expression has not yet been examined among this unique tumor group. Previously, we demonstrated that a subset of perivascular soft tissue tumors exhibit a striking pericytic immunophenotype, with diffuse expression of αSMA, CD146, and PDGFRβ. Here, we describe the presence of pericyte antigens across a diverse group of PEComa family tumors (n = 19 specimens). Results showed that pericyte antigens differed extensively by histological appearance. Typical angiomyolipoma (AML) specimens showed variable expression of pericyte antigens among both perivascular and myoid-appearing cells. In contrast, AML specimens with a predominant spindled morphology showed diffuse expression of pericyte markers, including αSMA, CD146, and PDGFRβ. AML samples with predominant epithelioid morphology showed a marked reduction in or the absence of immunoreactivity for pericyte markers. Lymphangiomyoma samples showed more variable and partial pericyte marker expression. In summary, pericyte antigen expression is variable among PEComa family tumors and largely varies by tumor morphology. Pericytic marker expression in PEComa may represent a true pericytic cell of origin, or alternatively aberrant pericyte marker adoption. Markers of pericytic differentiation may be of future diagnostic utility for the evaluation of mesenchymal tumors, or identify actionable signaling pathways for future therapeutic intervention. PMID:26123600

  10. [Renal failure and cystic kidney diseases].

    PubMed

    Correas, J-M; Joly, D; Chauveau, D; Richard, S; Hélénon, O

    2011-04-01

    Cystic kidney diseases often are discovered at the time of initial work-up of renal failure through ultrasound or family history, or incidentally at the time of an imaging test. Hereditary diseases include autosomal dominant or recessive polycystic kidney disease (PKD), tuberous sclerosis (TS) and medullary cystic kidney disease (MCKD). Autosomal dominant PKD is characterized by large renal cysts developing in young adults. Renal failure is progressive and becomes severe around 50-60 years of age. Atypical cysts (hemorrhagic or hyperdense) are frequent on CT and MRI examinations. Imaging plays a valuable role in the management of acute complications such as cyst hemorrhage or infection. Autosomal recessive PKD is often detected in neonates, infants or young adults. It is characterized by renal enlargement due to the presence of small cysts and liver disease (fibrosis and biliary ductal dilatation). Late manifestation or slow progression of autosomal recessive PKD may be more difficult to distinguish from autosomal dominant PKD. These cystic kidney diseases should not be confused with non-hereditary incidental multiple renal cysts. In tuberous sclerosis, renal cysts are associated with angiomyolipomas and sometimes pulmonary lymphangioleiomyomatosis. Renal failure is inconstant. Other hereditary cystic kidney diseases, including MCKD and nephronophtisis, are usually associated with renal failure. Non-hereditary cystic kidney diseases include multicystic renal dysplasia (due to complete pelvi-ureteric atresia or hydronephrosis), acquired multicystic kidney disease (chronic renal failure, chronic hemodialysis) and varied cystic kidney diseases (multicystic renal disease, glomerulocystic kidney disease, microcystic kidney disease). PMID:21549887

  11. [Hereditary renal cancer].

    PubMed

    Sanz-Ortega, Julián; Olivier, Carlos; Pérez Segura, Pedro; Galante Romo, Isabel; San José Mansó, Luis; Saez, Mamen

    2009-02-01

    Kidney cancer is the tenth most common cause of cancer death. There are a growing number of genes known to be associated with an increased risk of specific types of kidney cancer. People with Von Hippel-Lindau syndrome have about a 40% risk of developing multiple bilateral clear cell kidney cancers. They can also develop retinal and brain hemangioblastoma, kidneys or pancreas cysts, pheochromocytoma and endolymphatic sac tumor. Four phenotypes with different renal cancer and pheocromocitoma risk have been described depending on the germline mutation. Hereditary papillary renal cell carcinoma syndrome has type 1 papillary renal cell carcinomas associated with protooncogene c-MET germline mutations. Birt-Hogg-Dubé syndrome has FLCN gene mutations associated with fibrofolliculomas, lung cysts with a high risk for spontaneous pneumothorax, and a 15% to 30% risk of kidney cancer (most classified as chromophobe carcinoma, oncocytoma or oncocytic hybrid, but clear cell and papillary kidney cancers have also been reported). Histopathological findings such as oncocytosis and oncocytic hybrids are very unusual outside the syndrome. Hereditary leiomyomatosis and renal cell cancer syndrome shows mutations of Fumarate hydratase gene and cutaneous leiomyomata in 76% of affected individuals, uterine leiomyomata in 100% of females, and unilateral, solitary, and aggressive papillary renal cancer in 10 to 16% of patients. A specific histopathological change is eosinophilic prominent nucleoli with a perinucleolar halo. Tuberous sclerosis complex is one of the most prevalent (1/5.800) hereditary syndromes where renal disease is the second leading cause of death, associated with angiomyolipomas (70%), renal cysts, oncocytomas or clear cell cancer. PMID:19418834

  12. Molecular Classification of Renal Tumors by Gene Expression Profiling

    PubMed Central

    Schuetz, Audrey N.; Yin-Goen, Qiqin; Amin, Mahul B.; Moreno, Carlos S.; Cohen, Cynthia; Hornsby, Christopher D.; Yang, Wen Li; Petros, John A.; Issa, Muta M.; Pattaras, John G.; Ogan, Kenneth; Marshall, Fray F.; Young, Andrew N.

    2005-01-01

    Renal tumor classification is important because histopathological subtypes are associated with distinct clinical behavior. However, diagnosis is difficult because tumor subtypes have overlapping microscopic characteristics. Therefore, ancillary methods are needed to optimize classification. We used oligonucleotide microarrays to analyze 31 adult renal tumors, including clear cell renal cell carcinoma (RCC), papillary RCC, chromophobe RCC, oncocytoma, and angiomyolipoma. Expression profiles correlated with histopathology; unsupervised algorithms clustered 30 of 31 tumors according to appropriate diagnostic subtypes while supervised analyses identified significant, subtype-specific expression markers. Clear cell RCC overexpressed proximal nephron, angiogenic, and immune response genes, chromophobe RCC oncocytoma overexpressed distal nephron and oxidative phosphorylation genes, papillary RCC overexpressed serine protease inhibitors, and extracellular matrix products, and angiomyolipoma overexpressed muscle developmental, lipid biosynthetic, melanocytic, and distinct angiogenic factors. Quantitative reverse transcriptase-polymerase chain reaction and immunohistochemistry of formalin-fixed renal tumors confirmed overexpression of proximal nephron markers (megalin/low-density lipoprotein-related protein 2, α-methylacyl CoA racemase) in clear cell and papillary RCC and distal nephron markers (β-defensin 1, claudin 7) in chromophobe RCC/oncocytoma. In summary, renal tumor subtypes were classified by distinct gene expression profiles, illustrating tumor pathobiology and translating into novel molecular bioassays using fixed tissue. PMID:15858144

  13. Idiopathic renal replacement lipomatosis: a case report and review of literature.

    PubMed

    Shah, Vinaya B; Rupani, Asha B; Deokar, Madhavi S; Pathak, Hemant R

    2009-01-01

    Idiopathic renal replacement lipomatosis is a rare condition in which the renal parenchyma, especially the renal sinus is replaced with adipose tissue with increase in perirenal fat. We report a case of renal replacement lipomatosis presenting as a renal mass clinically. The computed tomography scan revealed low density and nodular masses of adipose tissue within the renal parenchyma. The differential diagnosis before surgery was angiomyolipoma, lipoma, and xanthogranulomatous pyelonephritis. After the histological examination and extensive literature search, the diagnosis of renal replacement lipomatosis was made. It is a rare entity and may be missed if not considered due to lack of experience, so we hope that more urologists, radiologists, and pathologists become aware of this entity and recognize it. PMID:19805971

  14. Three-Dimensional Printing as an Interdisciplinary Communication Tool: Preparing for Removal of a Giant Renal Tumor and Atrium Neoplastic Mass.

    PubMed

    Golab, Adam; Slojewski, Marcin; Brykczynski, Miroslaw; Lukowiak, Magdalena; Boehlke, Marek; Matias, Daniel; Smektala, Tomasz

    2016-01-01

    Three-dimensional (3D) printing involves preparing 3D objects from a digital model. These models can be used to plan and practice surgery. We used 3D printing to plan for a rare complicated surgery involving the removal of a renal tumor and neoplastic mass, which reached the heart atrium. A printed kidney model was an essential element of communication for physicians with different specializations. PMID:27585198

  15. Imaging Findings of Common Benign Renal Tumors in the Era of Small Renal Masses: Differential Diagnosis from Small Renal Cell Carcinoma: Current Status and Future Perspectives

    PubMed Central

    Woo, Sungmin

    2015-01-01

    The prevalence of small renal masses (SRM) has risen, paralleling the increased usage of cross-sectional imaging. A large proportion of these SRMs are not malignant, and do not require invasive treatment such as nephrectomy. Therefore, differentation between early renal cell carcinoma (RCC) and benign SRM is critical to achieve proper management. This article reviews the radiological features of benign SRMs, with focus on two of the most common benign entities, angiomyolipoma and oncocytoma, in terms of their common imaging findings and differential features from RCC. Furthermore, the role of percutaneous biopsy is discussed as imaging is yet imperfect, therefore necessitating biopsy in certain circumstances to confirm the benignity of SRMs. PMID:25598678

  16. A case of cutaneous angiolipoleiomyoma (angiomyolipoma) in a budgerigar (Melopsittacus undulatus).

    PubMed

    Jakab, Csaba; Balka, Gyula; Szabára, Agnes; Csaba, Csintalan; Pazár, Péter

    2013-12-01

    We report a case of cutaneous angiolipoleiomyoma (angiomyolipoma) found on the anterior wall of the ventral part of the abdomen of a three-year-old female budgerigar (Melopsittacus undulatus). Histologic examination of the well-circumscribed, surgically removed tumour (1.5 cm in diameter) showed a benign admixed proliferation of blood vessels of different size, smooth muscle bundles, and mature adipose tissue, without evidence of malignancy. Endothelial cells of the haemangioma component were positive for claudin-5 endothelium-specific immunohistochemical marker, and the leiomyoma component was positive for α-smooth muscle actin. The differentiated lipocytes showed S-100 protein positivity. The Ki-67 labelling index was 2 to 3%. The mesenchymal tumour was negative for HMB45 melanocytic immunhistochemical marker. To the best of our knowledge, this is the first report describing a cutaneous angiolipoleiomyoma in a budgerigar with histological and immunohistochemical analyses. PMID:24106747

  17. Premelanosome-negative inflammatory angiomyolipoma of liver with expression of cathepsin K and TFE3

    PubMed Central

    Sun, Ke; Zhao, Ming; Yao, Hongtian; Wang, Lijun; Wei, Jianfeng

    2014-01-01

    We report the first case of inflammatory variant of hepatic angiomyolipoma (AML) with expression of transcription factor E3 (TFE3) protein but negativity for HMB45 and melan A in a 62-year-old female. Imaging studies revealed a tumor in the left lobe of liver, sized 5.8 cm in maximum diameter. Microscopically, the lesion was composed of large polygonal or epithelioid cells with copious eosinophilic granular cytoplasm. There was a very prominent stromal lymphoplasmacytic infiltrate. Immunohistochemically, the tumor cells showed very strong and diffuse positivity for smooth muscle actin, and cathepsin K, while S-100 protein, keratin, desmin, HMB45 and Melan-A are negative. However, there was multifocal and very convincing nuclear positivity for TFE3, thus confirms the diagnosis. PMID:25550868

  18. Imaging of adrenal and renal hemorrhage.

    PubMed

    Hammond, Nancy A; Lostumbo, Antonella; Adam, Sharon Z; Remer, Erick M; Nikolaidis, Paul; Yaghmai, Vahid; Berggruen, Senta M; Miller, Frank H

    2015-10-01

    Hemorrhage of the kidneys and adrenal glands has many etiologies. In the adrenal glands, trauma, anticoagulation, stress, sepsis, surgery, and neoplasms are common causes of hemorrhage. In the kidneys, reasons for hemorrhage include trauma, bleeding diathesis, vascular diseases, infection, infarction, hemorrhagic cyst rupture, the Antopol-Goldman lesion, and neoplasms. Angiomyolipoma and renal cell carcinoma are the neoplasms most commonly associated with hemorrhage in the kidneys and adrenal cortical carcinoma, metastases, and pheochromocytoma are associated with hemorrhage in the adrenal glands. Understanding the computed tomography and magnetic resonance imaging features, and causes of hemorrhage in the kidneys and adrenal glands is critical. It is also important to keep in mind that mimickers of hemorrhage exist, including lymphoma in both the kidneys and adrenal glands, and melanoma metastases in the adrenal glands. Appropriate imaging follow-up of renal and adrenal hemorrhage should occur to exclude an underlying malignancy as the cause. If there is suspicion for malignancy that cannot be definitively diagnosed on imaging, surgery or biopsy may be warranted. Angiography may be indicated when there is a suspected underlying vascular disease. Unnecessary intervention, such as nephrectomy, may be avoided in patients with benign causes or no underlying disease. Appropriate management is dependent on accurate diagnosis of the cause of renal or adrenal hemorrhage and it is incumbent upon the radiologist to determine the etiology. PMID:26036792

  19. [International Society of Urological Pathology (ISUP) Vancouver Classification of Renal Neoplasia 2012].

    PubMed

    Hes, Ondřej

    2014-01-01

    Kidney tumours form a broad spectrum of distinguished histopathological and molecular genetic entities. The last WHO classification is dated to 2004. Current classification has been published in October 2013 by ISUP (International Society of Urological Pathology). There were 5 new epithelials tumours: tubulocystic renal cell carcinoma (RCC), acquired cystic disease-associated RCC, clear cell (tubulo-)papillary RCC, the MiT family translocation RCCs (in particular t(6;11) RCC), and hereditary leiomyomatosis RCC syndrome-associated RCC. Another 3 subtypes of RCC were added as "provisional" entities: thyroid-like follicular RCC; succinate dehydrogenase B deficiency-associated RCC; and ALK translocation RCC. Modifications were performed in already existing entities: multicystic clear cell RCC (formerly multilocular cystic RCC) is newly included as a subcategory of clear cell RCC with low malignant potential. Oncocytic papillary RCC (PRCC) has not been recognized as a distinctive subcategory of PRCC yet. Hybrid oncocytic-chromophobe tumour was placed within the chromophobe RCC category. Recent advances related to collecting duct carcinoma, renal medullary carcinoma, and mucinous spindle cell and tubular RCC were elucidated. Outside of the epithelial category, current approach to our understanding of angiomyolipoma, including the epithelioid variant and angiomyolipoma with epithelial cysts was clarified. Cystic nephroma and mixed epithelial and stromal tumour were considered as a spectrum of one entity. Synovial sarcoma was placed within the sarcoma group. The new classification is to be referred to as the International Society of Urological Pathology Vancouver Classification of Renal Neoplasia. PMID:25418900

  20. Evidence Supporting a Lymphatic Endothelium Origin for Angiomyolipoma, a TSC2(-) Tumor Related to Lymphangioleiomyomatosis.

    PubMed

    Yue, Michael; Pacheco, Gustavo; Cheng, Tao; Li, Jefferine; Wang, Yitang; Henske, Elizabeth P; Schuger, Lucia

    2016-07-01

    Angiomyolipoma (AML) is a tumor closely related to lymphangioleiomyomatosis (LAM). Both entities are characterized by the proliferation of smooth muscle actin and melanocytic glycoprotein 100 (recognized by antibody HMB-45)-positive spindle-shaped and epithelioid cells. AML and LAM are etiologically linked to mutations in the tsc2 and tsc1 genes in the case of LAM. These genes encode the proteins tuberous sclerosis complex (TSC)-1 and TSC2, which are directly involved in suppressing the mechanistic target of rapamycin cell growth signaling pathway. Although significant progress has been made in characterizing and pharmacologically slowing the progression of AML and LAM with rapamycin, our understanding of their pathogenesis lacks an identified cell of origin. We used an AML-derived cell line to determine whether TSC2 restitution brings about the cell type from which AML arises. We found that AML cells express lymphatic endothelial cell markers consistent with lymphatic endothelial cell precursors in vivo and in vitro. Moreover, on TSC2 correction, AML cells mature into adult lymphatic endothelial cells and have functional attributes characteristic of this cell lineage, suggesting a lymphatic endothelial cell of origin for AML. These effects are dependent on TSC2-mediated mechanistic target of rapamycin inactivation. Finally, we demonstrate the in vitro effectiveness of norcantharidin, a lymphangiogenesis inhibitor, as a potential co-adjuvant therapy in the treatment of AML. PMID:27289491

  1. Giant Axonal Neuropathy

    MedlinePlus

    ... Diversity Find People About NINDS NINDS Giant Axonal Neuropathy Information Page Table of Contents (click to jump ... done? Clinical Trials Organizations What is Giant Axonal Neuropathy? Giant axonal neuropathy (GAN) is a rare inherited ...

  2. Diagnostic Approach to Eosinophilic Renal Neoplasms

    PubMed Central

    Kryvenko, Oleksandr N.; Jorda, Merce; Argani, Pedram; Epstein, Jonathan I.

    2015-01-01

    Context Eosinophilic renal neoplasms include a spectrum of solid and papillary tumors ranging from indolent benign oncocytoma to highly aggressive malignancies. Recognition of the correct nature of the tumor, especially in biopsy specimens, is paramount for patient management. Objective To review the diagnostic approach to eosinophilic renal neoplasms with light microscopy and ancillary techniques. Data Sources Review of the published literature and personal experience. Conclusions The following tumors are in the differential diagnosis of oncocytic renal cell neoplasm: oncocytoma, chromophobe renal cell carcinoma (RCC), hybrid tumor, tubulocystic carcinoma, papillary RCC, clear cell RCC with predominant eosinophilic cell morphology, follicular thyroid-like RCC, hereditary leiomyomatosis–associated RCC, acquired cystic disease–associated RCC, rhabdoid RCC, microphthalmia transcription factor translocation RCC, epithelioid angiomyolipoma, and unclassified RCC. In low-grade nonpapillary eosinophilic neoplasms, distinction between oncocytoma and low-grade RCC mostly rests on histomorphology; however, cytokeratin 7 immunostain may be helpful. In high-grade nonpapillary lesions, there is more of a role for ancillary techniques, including immunohistochemistry for cytokeratin 7, CA9, CD10, racemase, HMB45, and Melan-A. In papillary eosinophilic neoplasms, it is important to distinguish sporadic type 2 papillary RCC from microphthalmia transcription factor translocation and hereditary leiomyomatosis–associated RCC. Histologic and cytologic features along with immunohistochemistry and fluorescence in situ hybridization tests for TFE3 (Xp11.2) and TFEB [t(6;11)] are reliable confirmatory tests. Eosinophilic epithelial neoplasms with architecture, cytology, and/or immunoprofile not qualifying for either of the established types of RCC should be classified as unclassified eosinophilic RCC and arbitrarily assigned a grade (low or high). PMID:25357116

  3. Renal arteriography

    MedlinePlus

    ... Read More Acute arterial occlusion - kidney Acute kidney failure Aneurysm Atheroembolic renal disease Blood clots Renal cell carcinoma Renal venogram X-ray Update Date 4/7/2014 Updated by: Jason ... Failure Kidney Tests X-Rays Browse the Encyclopedia A. ...

  4. Renal venogram

    MedlinePlus

    ... 2008:chap 6. Rankin S. Renal parenchymal disease, including renal failure, renovascular disease and transportation. In: Grainger RC, Allison D, Adam, Dixon AK, eds. Diagnostic Radiology: A Textbook of Medical Imaging . 5th ed. New York, NY: Churchill Livingstone; 2008:chap 39. Read ... arteriography Renal vein thrombosis Tumor Venogram Wilms ...

  5. Intrarenal mature cystic teratoma associated with renal dysplasia: case report and literature review.

    PubMed

    Otani, M; Tsujimoto, S; Miura, M; Nagashima, Y

    2001-07-01

    We report a case of intrarenal teratoma in a 6-year-old boy. Two years before his operation, multicystic masses had been found in the left side of his abdomen. In the operation, three main cystic masses were located in the upper and lower poles of the left kidney, which were removed in pieces. Histologically, the cyst wall was lined mainly with keratinizing squamous epithelium with hair follicles, shafts and sebaceous glands. The adjacent renal parenchyma showed atrophy, with partially dysplastic and angiomyolipoma-like lesions. Based on these findings, the lesion was diagnosed as mature cystic teratoma of dermoid cyst type. Extragonadal teratoma occurs predominantly along the median line of the body. Intrarenal teratoma is extremely rare; however, it should be distinguished from teratoid Wilms' tumor and other renal cystic lesions. PMID:11472570

  6. Giant Magnons Meet Giant Gravitons

    SciTech Connect

    Hofman, Diego M.

    2008-07-28

    We study the worldsheet reflection matrix of a string attached to a D-brane in AdS{sub 5}xS{sup 5}. The D-brane corresponds to a maximal giant graviton that wraps an S{sup 3} inside S{sup 5}. In the gauge theory, the open string is described by a spin chain with boundaries. We focus on open strings with a large SO(6) charge and define an asymptotic boundary reflection matrix. Using the symmetries of the problem, we review the computation of the boundary reflection matrix, up to a phase. We also discuss weak and strong coupling computations where we obtain the overall phase factor and test our exact results.

  7. Primary hepatic epithelioid angiomyolipoma: A malignant potential tumor which should be recognized

    PubMed Central

    Liu, Jie; Zhang, Cheng-Wu; Hong, De-Fei; Tao, Ran; Chen, Yuan; Shang, Min-Jie; Zhang, Yu-Hua

    2016-01-01

    AIM: To improve the clinical diagnosis and recognition of hepatic epithelioid angiomyolipoma (HEAML). METHODS: Four cases of primary HEAML were confirmed based on the pathology archive system in our hospital from January 2009 to November 2015. The general state, clinical symptoms, imaging manifestations, histological results and immunohistochemistry of these patients were retrospectively reviewed and analyzed. Studies of HEAML published in the last 15 years were collected from PubMed and MEDLINE to summarize the clinical symptoms, imaging characteristics, pathological features and management of HEAML. RESULTS: Four cases of primary HEAML were retrieved from our archives. These included three female patients and one male patient, with a mean age of 41.8 ± 11.5 years (ranging from 31 to 56 years). The mean tumor size was 7.3 ± 5.5 cm (ranging from 3.0 to 15 cm). In the contrast-enhanced imaging, the tumor was obviously enhanced in the arterial phase, but enhanced continuously or exhibited a slow-density masse during the venous and delayed phases. Histologically, the tumors mainly consisted of epithelioid cells that comprised approximately 95% of the total neoplastic mass. Although no metastases occurred in our patients, pathological studies revealed necrosis, mitotic figures and liver invasion in two patients, which indicates aggressive behavior. Immunohistochemical staining revealed that human melanoma black 45 (HMB-45) and Melan-A were positive in 4 cases. We only identified 81 cases with primary HEAML, including our present patients, from 26 articles available from PubMed and MEDLINE. The majority of the papers were published as case reports. Only 5 (5/75, 6%) cases were associated with tuberous sclerosis complex (TSC). More than half (35/66) were discovered incidentally upon physical examination. Approximately 65% (22/34) of the patients were misdiagnosed with HCC or other tumors before surgery. Approximately 10% (8/81) of the patients with HEAML had recurrence

  8. Chaunus ictericus (Spix, 1824) as paratenic host of the giant kidney worm Dioctophyme renale (Goeze, 1782) (Nematoda: Enoplida) in São Cristóvão district, Três Barras county, Santa Catarina state, Brazil.

    PubMed

    Pedrassani, Daniela; Hoppe, Estevam Guilherme Lux; Tebaldi, José Hairton; do Nascimento, Adjair Antonio

    2009-10-28

    Dioctophyme renale larvae have been found in cysts in the gastric wall of 5.17% (3/58) Chaunus ictericus specimens from São Cristóvão district, Três Barras municipality, Santa Catarina state, Brazil. However, larvae of this nematode were not found in sympatric Chaunus schneideri. The larvae caused a mild granulomatous reaction. This is the first report of paratenic hosts for D. renale in Brazil, and probably is also the first in the Neotropical region. PMID:19664882

  9. [Giant haemangioma of the liver: diagnosis and treatment].

    PubMed

    Hoekstra, Lisette T; Bieze, Matthanja; Erdogan, Deha; Roelofs, Joris J T H; Beuers, Ulrich H W; van Gulik, Thomas M

    2012-01-01

    A liver haemangioma is a benign, usually small tumour comprised of blood vessels, which is often discovered coincidentally; giant haemangiomas are defined as haemangiomas larger than 5 cm. The differential diagnosis includes other hypervascular tumours, such as hepatocellular adenoma, hepatocellular carcinoma, metastasis of a neuro-endocrine tumour or renal cell carcinoma.- The diagnosis is based on abdominal ultrasonography and can be confirmed by a CT or MR scan. A wait-and-see approach is justified in patients without symptoms or with minimal symptoms, even in the presence of a giant haemangioma. Surgical resection of a giant haemangioma is only necessary when the preoperative diagnosis is inconclusive, or when the haemangioma leads to mechanical symptoms or complications. Extirpation is the only effective form of treatment of the giant haemangioma; enucleation is preferred over partial liver resection. A known complication of a giant haemangioma is the occurrence of disseminated intravascular coagulation, the Kasabach-Merritt syndrome; intervention is then demanded. PMID:22853763

  10. Giant Urinary Bladder and Bilateral Giant Hydronephrosis due to Bladder Neck Obstruction: One Case Report and Literature Review

    PubMed Central

    Tazi, Mohammed Fadl; Riyach, Omar; Ahallal, Youness; Mellas, Soufiane; Khallouk, Abdelhak; El Fassi, Mohammed Jamal; Farih, Moulay Hassan

    2012-01-01

    Bilateral hydronephrosis secondary to urinary obstruction leads to a buildup of back pressure in the urinary tract and may lead to impairment of renal function. Cases of giant hydronephrosis are rare and usually contain no more than 1-2 litres of fluid in the collecting system. Here, we report a rarely seen case with giant urinary bladder and bilateral giant hydronephrosis due to bladder neck obstruction which contains 4000 mL fluid in the collecting system of the kidney mimicking an ascites in an adult male. PMID:22606637

  11. Giant Cell Arteritis

    MedlinePlus

    Giant cell arteritis is a disorder that causes inflammation of your arteries, usually in the scalp, neck, and arms. ... arteries, which keeps blood from flowing well. Giant cell arteritis often occurs with another disorder called polymyalgia ...

  12. Hepatic angiomyolipoma: differential diagnosis from other liver tumors in a special reference to vascular imaging - importance of early drainage vein.

    PubMed

    Yoshioka, Masato; Watanabe, Go; Uchinami, Hiroshi; Kudoh, Kazuhiro; Hiroshima, Yuko; Yoshioka, Toshiaki; Nanjo, Hiroshi; Funaoka, Masato; Yamamoto, Yuzo

    2015-12-01

    A 51-year-old female had been diagnosed with a hemangioma in the hepatic segment 6 (S6). After a 6-year follow-up, enlargement of the tumor was detected. The tumor was clearly enhanced in the arterial phase, and the enhancement remained in the portal phase on computed tomography (CT). Although the primary differential diagnosis on CT was hepatocellular carcinoma (HCC), we worried about the possibility of other vessel system tumors because the tumor remained to be enhanced at the portal phase for HCC and all tumor markers of HCC were negative. We performed angiography to determine the tumor nature and to seek other tumors. Angiography showed tumor stain at the hepatic S6 with an early obvious drainage vein from the tumor flowing through the right hepatic vein into the inferior vena cava. In addition to tumor stain and the drainage vein, there were many small poolings of contrast medium in the whole liver, which were suspected as dilatation of the hepatic peripheral artery. We suspected the tumor as a benign tumor such as hepatocellular adenoma or focal nodular hyperplasia, but the possibility of HCC could not be ruled out. Hepatic posterior sectionectomy was done to completely remove the drainage vein with the tumor. Intraoperative histological examination revealed the tumor as not malignant and not HCC. Later, immunohistochemical analysis uncovered that the tumor had high expression of HMB-45 and, therefore, the final diagnosis was angiomyolipoma. We think that detecting an early drainage vein from the tumor would be a key point for diagnosing hepatic angiomyolipoma. PMID:26943379

  13. Giant impacts on giant planets

    NASA Astrophysics Data System (ADS)

    de Pater, Imke

    2012-10-01

    The 2009 impact on Jupiter caught the world by surprise and cast doubt on impactor flux estimates for the outer solar system. Enhanced amateur planetary imaging techniques yield both high spatial resolution {enabling the 2009 impact debris field detection} and rapid frame rates {enabling the 2010 impact flash detections and lightcurve measurements}.We propose a Target of Opportunity program to image future impacts on Jupiter and Saturn. To remove the possibility of impact cloud non-detections, the program will be triggered only if an existing impact debris field is seen, an object on a collision course with Jupiter or Saturn is discovered, or an impact light curve is measured with an estimated total energy large enough to generate an impact cloud in a giant planet atmosphere.HST provides the only way to image these events in the ultraviolet, providing information on aerosol altitudes and on smaller particles that are less visible to ground-based infrared observations. High-resolution imaging with proper timing {not achievable from the ground} is required to measure precisely both the velocity fields of impact sites and the optical spectrum of impact debris. HST observations of past impacts on Jupiter have also served both as cornerstones of science investigations at other wavelengths and as vehicles for effective public outreach.Large outer solar system impacts are governed by the same physics as in the terrestrial events that dominate the impact threat to humans. Studying the behavior of impactors of various sizes and compositions, as they enter the atmosphere at varying angles and speeds, will better quantify terrestrial impact hazards.

  14. Giant impacts on giant planets

    NASA Astrophysics Data System (ADS)

    de Pater, Imke

    2014-10-01

    The 2009 impact and recent superbolides on Jupiter caught the world by surprise and cast doubt on impactor flux estimates for the outer solar system. Enhanced amateur planetary imaging techniques yield both high spatial resolution (enabling the 2009 impact debris field detection) and rapid frame rates (enabling the 2010/2012 impact flash detections and lightcurve measurements).We propose a ToO program to image future impacts on Jupiter and Saturn. To remove the possibility of impact cloud non-detections, the program will be triggered only if an existing impact debris field is seen, an object on a collision course with Jupiter or Saturn is discovered, or an impact light curve is measured with an estimated total energy large enough to generate an impact cloud in a giant planet atmosphere (10^20 J).HST provides the only way to image these events in the ultraviolet, providing information on aerosol altitudes and on smaller particles that are less visible to ground-based infrared observations. High-resolution imaging with proper timing (not achievable from the ground) is required to measure precisely both the velocity fields of impact sites and the optical spectrum of impact debris. HST observations of past impacts on Jupiter have also served both as cornerstones of science investigations at other wavelengths and as vehicles for effective public outreach.Large outer solar system impacts are governed by the same physics as in the terrestrial events that dominate the impact threat to humans. Studying the behavior of impactors of various sizes and compositions, as they enter the atmosphere at varying angles and speeds, will better quantify terrestrial impact hazards.

  15. Giant impacts on giant planets

    NASA Astrophysics Data System (ADS)

    de Pater, Imke

    2013-10-01

    The 2009 impact and recent superbolides on Jupiter caught the world by surprise and cast doubt on impactor flux estimates for the outer solar system. Enhanced amateur planetary imaging techniques yield both high spatial resolution {enabling the 2009 impact debris field detection} and rapid frame rates {enabling the 2010/2012 impact flash detections and lightcurve measurements}.We propose a ToO program to image future impacts on Jupiter and Saturn. To remove the possibility of impact cloud non-detections, the program will be triggered only if an existing impact debris field is seen, an object on a collision course with Jupiter or Saturn is discovered, or an impact light curve is measured with an estimated total energy large enough to generate an impact cloud in a giant planet atmosphere {10^20 J}.HST provides the only way to image these events in the ultraviolet, providing information on aerosol altitudes and on smaller particles that are less visible to ground-based infrared observations. High-resolution imaging with proper timing {not achievable from the ground} is required to measure precisely both the velocity fields of impact sites and the optical spectrum of impact debris. HST observations of past impacts on Jupiter have also served both as cornerstones of science investigations at other wavelengths and as vehicles for effective public outreach.Large outer solar system impacts are governed by the same physics as in the terrestrial events that dominate the impact threat to humans. Studying the behavior of impactors of various sizes and compositions, as they enter the atmosphere at varying angles and speeds, will better quantify terrestrial impact hazards.

  16. [Renal elastography].

    PubMed

    Correas, Jean-Michel; Anglicheau, Dany; Gennisson, Jean-Luc; Tanter, Mickael

    2016-04-01

    Renal elastography has become available with the development of noninvasive quantitative techniques (including shear-wave elastography), following the rapidly growing field of diagnosis and quantification of liver fibrosis, which has a demonstrated major clinical impact. Ultrasound or even magnetic resonance techniques are leaving the pure research area to reach the routine clinical use. With the increased incidence of chronic kidney disease and its specific morbidity and mortality, the noninvasive diagnosis of renal fibrosis can be of critical value. However, it is difficult to simply extend the application from one organ to the other due to a large number of anatomical and technical issues. Indeed, the kidney exhibits various features that make stiffness assessment more complex, such as the presence of various tissue types (cortex, medulla), high spatial orientation (anisotropy), local blood flow, fatty sinus with variable volume and echotexture, perirenal space with variable fatty content, and the variable depth of the organ. Furthermore, the stiffness changes of the renal parenchyma are not exclusively related to fibrosis, as renal perfusion or hydronephrosis will impact the local elasticity. Renal elastography might be able to diagnose acute or chronic obstruction, or to renal tumor or pseudotumor characterization. Today, renal elastography appears as a promising application that still requires optimization and validation, which is the contrary for liver stiffness assessment. PMID:26976058

  17. Correlating Preoperative Imaging with Histologic Subtypes of Renal Cell Carcinoma and Common Mimickers.

    PubMed

    Gordetsky, Jennifer; Zarzour, Jessica

    2016-07-01

    Renal cell carcinoma (RCC) consists of distinct subtypes that have unique pathologic and imaging features as well as specific cytogenetic and molecular characteristics. As the prognosis and therapeutic strategies may differ for each subtype, correlation of the preoperative imaging with the pathologic findings is of great clinical relevance. In addition, differentiation of RCC from benign entities is ideal in order to prevent overtreatment. However, a noninvasive diagnosis with imaging alone is not always straightforward due to the overlapping appearance of RCC with benign lesions such as fat-poor angiomyolipoma and oncocytoma. With new imaging modalities, there have been significant improvements in correlating preoperative imaging with pathologic characteristics. These new discoveries are able to aid in a more specific, noninvasive, diagnosis that in turn helps direct patient management. PMID:27154238

  18. [Renal disease].

    PubMed

    Espinosa-Cuevas, María de Los Ángeles

    2016-09-01

    Chronic renal failure in its various stages, requires certain nutritional restrictions associated with the accumulation of minerals and waste products that cannot be easily eliminated by the kidneys. Some of these restrictions modify the intake of proteins, sodium, and phosphorus. Milk and dairy products are sources of these nutrients. This article aims to inform the reader about the benefits including milk and dairy products relying on a scientific and critical view according to the clinical conditions and the stage of renal disease in which the patient is. PMID:27603894

  19. Renal organogenesis

    PubMed Central

    2011-01-01

    The increasing prevalence of chronic kidney disease in the absence of new treatment modalities has become a strong driver for innovation in nephrology. An increasing understanding of stem cell biology has kindled the prospects of regenerative options for kidney disease. However, the kidney itself is not a regenerative organ, as all the nephrons are formed during embryonic development. Here, we will investigate advances in the molecular genetics of renal organogenesis, including what this can tell us about lineage relationships, and discuss how this may serve to inform us about both the normal processes of renal repair and options for regenerative therapies. PMID:22198432

  20. [Renal colic].

    PubMed

    Pinheiro, J M

    1999-01-01

    The appropriate approach to renal colic, which should be known by the family doctor, is presented. The incidence of this condition in the emergency department of a large general hospital is described as well as the physiopathology of pain, its clinical aspects and the therapeutic attitudes. Renal colic is frequent, it is often possible to diagnose the clinical aspects and general practitioners have the competence for treatment. The use of analgesic drugs, in the correct dosage, is enough to relieve pain and suffering in most of the patients. PMID:10423866

  1. Peripheral giant cell granuloma.

    PubMed

    Adlakha, V K; Chandna, P; Rehani, U; Rana, V; Malik, P

    2010-01-01

    Peripheral giant cell granuloma is a benign reactive lesion of gingiva. It manifests as a firm, soft, bright nodule or as a sessile or pedunculate mass. This article reports the management of peripheral giant cell granuloma in a 12-year-old boy by surgical excision. PMID:21273719

  2. Unstable giant gravitons

    SciTech Connect

    Mello Koch, Robert de; Ives, Norman; Smolic, Jelena; Smolic, Milena

    2006-03-15

    We find giant graviton solutions in Frolov's three parameter generalization of the Lunin-Maldacena background. The background we study has {gamma}-tilde{sub 1}=0 and {gamma}-tilde{sub 2}={gamma}-tilde{sub 3}={gamma}-tilde. This class of backgrounds provides a nonsupersymmetric example of the gauge theory/gravity correspondence that can be tested quantitatively, as recently shown by Frolov, Roiban, and Tseytlin. The giant graviton solutions we find have a greater energy than the point gravitons, making them unstable states. Despite this, we find striking quantitative agreement between the gauge theory and gravity descriptions of open strings attached to the giant.

  3. Everolimus for the treatment of subependymal giant cell astrocytoma probably causing seizure aggravation in a child with tuberous sclerosis complex: a case report.

    PubMed

    Wiemer-Kruel, Adelheid; Woerle, H; Strobl, K; Bast, T

    2014-04-01

    We are reporting on a 13.5-year-old girl with tuberous sclerosis complex (TSC) who was treated with everolimus because of giant cell astrocytoma and bilateral angiomyolipoma. She suffered from pharmacoresistant partial epilepsy with clusters of tonic and tonic-clonic seizures. Treatment with carbamazepine and sulthiame had led to a stable situation for more than 2.5 years. The dosage of everolimus had to be increased and refractory status epilepticus followed after 12 days. In the absence of any other possible cause, we believe that the status epilepticus was provoked by everolimus. So far, only a few cases of possible seizure aggravation by everolimus have been reported. The clinical relevance of possible negative effects in epileptic patients remains unclear. Similar observations should be documented and reported. PMID:24293099

  4. Renal Fibrosis

    PubMed Central

    Zeisberg, Michael; Maeshima, Yohei; Mosterman, Barbara; Kalluri, Raghu

    2002-01-01

    During progression of chronic renal disease, qualitative and quantitative changes in the composition of tubular basement membranes (TBMs) and interstitial matrix occur. Transforming growth factor (TGF)-β1-mediated activation of tubular epithelial cells (TECs) is speculated to be a key contributor to the progression of tubulointerstitial fibrosis. To further understand the pathogenesis associated with renal fibrosis, we developed an in vitro Boyden chamber system using renal basement membranes that partially mimics in vivo conditions of TECs during health and disease. Direct stimulation of TECs with TGF-β1/epithelial growth factor results in an increased migratory capacity across bovine TBM preparations. This is associated with increased matrix metalloproteinase (MMP) production, namely MMP-2 and MMP-9. Indirect chemotactic stimulation by TGF-β1/EGF or collagen type I was insufficient in inducing migration of untreated TECs across bovine TBM preparation, suggesting that basement membrane integrity and composition play an important role in protecting TECs from interstitial fibrotic stimuli. Additionally, neutralization of MMPs by COL-3 inhibitor dramatically decreases the capacity of TGF-β1-stimulated TECs to migrate through bovine TBM preparation. Collectively, these results demonstrate that basement membrane structure, integrity, and composition play an important role in determining interstitial influences on TECs and subsequent impact on potential aberrant cell-matrix interactions. PMID:12057905

  5. Renal Calculi

    PubMed Central

    Yendt, E. R.

    1970-01-01

    The pathogenesis of renal calculi is reviewed in general terms followed by the results of investigation of 439 patients with renal calculi studied by the author at Toronto General Hospital over a 13-year period. Abnormalities of probable pathogenetic significance were encountered in 76% of patients. Idiopathic hypercalciuria was encountered in 42% of patients, primary hyperparathyroidism in 11%, urinary infection in 8% and miscellaneous disorders in 8%. The incidence of uric acid stones and cystinuria was 5% and 2% respectively. In the remaining 24% of patients in whom no definite abnormalities were encountered the mean urinary magnesium excretion was less than normal. Of 180 patients with idiopathic hypercalciuria, only 24 were females. In the diagnosis of hyperparathyroidism, the importance of detecting minimal degrees of hypercalcemia is stressed; attention is also drawn to the new observation that the upper limit of normal for serum calcium is slightly lower in females than in males. The efficacy of various measures advocated for the prevention of renal calculi is also reviewed. In the author's experience the administration of thiazides has been particularly effective in the prevention of calcium stones. Thiazides cause a sustained reduction in urinary calcium excretion and increase in urinary magnesium excretion. These agents also appear to affect the skeleton by diminishing bone resorption and slowing down bone turnover. PMID:5438766

  6. Giant distal humeral geode.

    PubMed

    Maher, M M; Kennedy, J; Hynes, D; Murray, J G; O'Connell, D

    2000-03-01

    We describe the imaging features of a giant geode of the distal humerus in a patient with rheumatoid arthritis, which presented initially as a pathological fracture. The value of magnetic resonance imaging in establishing this diagnosis is emphasized. PMID:10794554

  7. Giant Subclavian Artery Aneurysm.

    PubMed

    Counts, Sarah; Zeeshan, Ahmad; Elefteriades, John

    2016-06-01

    We report the case of a 37-year-old construction executive presenting with chest pain, shortness of breath, and dizziness on exertion secondary to a giant left subclavian artery aneurysm and aortic valvular disease. PMID:27231430

  8. The Next Giant Step

    NASA Video Gallery

    Artist Robert McCall painted "The Next Giant Step" in 1979 to commemorate the heroism and courage of spaceflight pioneers. Located in the lobby of Johnson's building 2, the mural depicts America's ...

  9. The Giant Cell.

    ERIC Educational Resources Information Center

    Stockdale, Dennis

    1998-01-01

    Provides directions for the construction of giant plastic cells, including details for building and installing the organelles. Also contains instructions for preparing the ribosomes, nucleolus, nucleus, and mitochondria. (DDR)

  10. Tuberous Sclerosis Complex: One Woman's Search for Renal-Preserving Therapy.

    PubMed

    Coombs, Elizabeth Jo

    2015-01-01

    Everolimus was very effective in the treatment of Anne, a patient with TSC and renal angiomyolipomas. Anne's renal tumors continue to shrink in size, with a decrease of more than 50% achieved to date, and her GFR remains in the normal range. She no longer experiences chronic back pain due to kidney tumors and is not taking pain medications. She is active and able to exercise daily, and her blood pressure remains within normal limits. Usually diagnosed in childhood, TSC requires life-long management. Patients can have many manifestations of the disease, and nurses need to be made aware of them because they often play a critical role in educating patients and their families (Agricola et al., 2013). Currently, there is a great need for education and awareness in the medical field regarding TSC. The disease is often overlooked, misdiagnosed, or mismanaged. Patients can be given misleading information, which may lead to unnecessary procedures and distress. Moreover, with the correct management, patients with TSC have a normal life expectancy and preserved renal function. PMID:26591274

  11. Proximal renal tubular acidosis

    MedlinePlus

    Renal tubular acidosis - proximal; Type II RTA; RTA - proximal; Renal tubular acidosis type II ... by alkaline substances, mainly bicarbonate. Proximal renal tubular acidosis (Type II RTA) occurs when bicarbonate is not ...

  12. Acute Interstitial Nephritis Following Multiple Asian Giant Hornet Stings

    PubMed Central

    Li, Xiang-Dong; Liu, Zheng; Zhai, Ying; Zhao, Ming; Shen, Hai-Yan; Li, Yi; Zhang, Bo; Liu, Tao

    2015-01-01

    Patient: Male, 42 Final Diagnosis: Acute interstitial nephritis Symptoms: Difficulty breathing • headache • numbness • oliguria Medication: Methylprednisolone Clinical Procedure: Plasma exchange Specialty: Nephrology Objective: Rare disease Background: The Asian giant hornet is the largest wasp species in the world. Its stings can cause acute interstitial nephritis and acute renal failure. From July to October, 2013, Asian giant hornet attacks have killed 42 people and injured 1675 people with their powerful venomous stings in Hanzhong, Ankang, and Shangluo, three cities in the southern part of Shaanxi Province, China. Case Report: We report here a case of a 42-year-old man with acute interstitial nephritis following multiple Asian giant hornet stings. On admission, the patient had difficulty breathing, headache, and numbness in both limbs (arm and leg). He was treated in the Emergency Department and Department of Nephrology with plasma exchange and dialysis within 24 hours after being stung. A kidney biopsy revealed acute interstitial nephritis with interstitial infiltrations of eosinophils and lymphocytes. After intensive treatment, his liver function recovered within 10 days. Along with oral methylprednisolone, his renal function recovered 1 month later. Conclusions: This case shows that acute interstitial nephritis happens several days after being stung. Since the number of deaths in southern Shaanxi province is much higher than other places, our report draws the attention of fellow clinicians to the acute interstitial nephritis following multiple Asian giant hornet stings. PMID:26076055

  13. Renal alterations in feline immunodeficiency virus (FIV)-infected cats: a natural model of lentivirus-induced renal disease changes.

    PubMed

    Poli, Alessandro; Tozon, Natasa; Guidi, Grazia; Pistello, Mauro

    2012-09-01

    Human immunodeficiency virus (HIV) is associated with several renal syndromes including acute and chronic renal failures, but the underlying pathogenic mechanisms are unclear. HIV and feline immunodeficiency virus (FIV) share numerous biological and pathological features, including renal alterations. We investigated and compared the morphological changes of renal tissue of 51 experimentally and 21 naturally infected cats. Compared to the latter, the experimentally infected cats exhibited some mesangial widening and glomerulonephritis, milder proteinuria, and lower tubular and interstitial alterations. The numbers of giant protein tubular casts and tubular microcysts were also lower. In contrast, diffuse interstitial infiltrates and glomerular and interstitial amyloidosis were detected only in naturally infected cats. Similar alterations are found in HIV infected patients, thus supporting the idea of a causative role of FIV infection in renal disease, and underlining the relevance of the FIV and its natural host as an animal model for investigating lentivirus-associated nephropathy. PMID:23170163

  14. Renal Alterations in Feline Immunodeficiency Virus (FIV)-Infected Cats: A Natural Model of Lentivirus-Induced Renal Disease Changes

    PubMed Central

    Poli, Alessandro; Tozon, Natasa; Guidi, Grazia; Pistello, Mauro

    2012-01-01

    Human immunodeficiency virus (HIV) is associated with several renal syndromes including acute and chronic renal failures, but the underlying pathogenic mechanisms are unclear. HIV and feline immunodeficiency virus (FIV) share numerous biological and pathological features, including renal alterations. We investigated and compared the morphological changes of renal tissue of 51 experimentally and 21 naturally infected cats. Compared to the latter, the experimentally infected cats exhibited some mesangial widening and glomerulonephritis, milder proteinuria, and lower tubular and interstitial alterations. The numbers of giant protein tubular casts and tubular microcysts were also lower. In contrast, diffuse interstitial infiltrates and glomerular and interstitial amyloidosis were detected only in naturally infected cats. Similar alterations are found in HIV infected patients, thus supporting the idea of a causative role of FIV infection in renal disease, and underlining the relevance of the FIV and its natural host as an animal model for investigating lentivirus-associated nephropathy. PMID:23170163

  15. Renal Denervation

    PubMed Central

    Persu, Alexandre; Renkin, Jean; Thijs, Lutgarde; Staessen, Jan A.

    2013-01-01

    The term “ultima ratio” has multiple, though related, meanings. The motto “ultima ratio regum,” cast on the cannons of the French army of King Louis XIV, meant that war is the last argument of kings, that is, the one to be used after all diplomatic arguments have failed. Along similar lines, we propose that, given the current evidence, renal denervation should be used as a last resort, after state-of-the-art drug treatment optimized at expert centers failed to control blood pressure. PMID:22851728

  16. Giant perigenital seborrheic keratosis

    PubMed Central

    Bandyopadhyay, Debabrata; Saha, Abanti; Mishra, Vivek

    2015-01-01

    Seborrheic keratosis (SK) is a very common benign epidermal proliferation that is prevalent in all races. Most commonly occurring on the trunk, face, scalp, and the extremities, they can occur anywhere on the body except the palms and soles. The most common appearance is that of a very superficial verrucous plaque which appears to be stuck on the surface. Giant lesions are very rare, and their location on the genital area is rarer still. We report here a case of multiple giant SK lesions in a 59-year-old man. PMID:25657917

  17. An Innocent Giant

    PubMed Central

    Solanki, Lakhan Singh; Dhingra, Mandeep; Raghubanshi, Gunjan; Thami, Gurvinder Pal

    2014-01-01

    A cutaneous horn (cornu cutaneum) is a protrusion from the skin composed of a cornified material. It may be associated with a benign, premalignant, or malignant lesion at the base, masking numerous dermatoses. In a 24-year-old female, a giant cutaneous horn arising from a seborrheic keratosis located on the leg is presented. This case has been reported to emphasize that a giant cutaneous horn may also occur in young patients, even in photoprotected areas, and are not always associated with malignancy. PMID:25484426

  18. Giant perigenital seborrheic keratosis.

    PubMed

    Bandyopadhyay, Debabrata; Saha, Abanti; Mishra, Vivek

    2015-01-01

    Seborrheic keratosis (SK) is a very common benign epidermal proliferation that is prevalent in all races. Most commonly occurring on the trunk, face, scalp, and the extremities, they can occur anywhere on the body except the palms and soles. The most common appearance is that of a very superficial verrucous plaque which appears to be stuck on the surface. Giant lesions are very rare, and their location on the genital area is rarer still. We report here a case of multiple giant SK lesions in a 59-year-old man. PMID:25657917

  19. [Renal physiology].

    PubMed

    Gueutin, Victor; Deray, Gilbert; Isnard-Bagnis, Corinne

    2012-03-01

    The kidneys are responsible for the urinary excretion of uremic toxins and the regulation of several body systems such as intra and extracellular volume status, acid-base status, calcium and phosphate metabolism or erythropoiesis. They adapt quantitative and qualitative composition of the urine to keep these systems in balance. The flow of plasma is filtered in the range of 120 mL/min, and depends on the systemic and renal hemodynamics which is subject to self-regulation. The original urine will then be modified in successive segments of the nephron. The proximal nephron is to lead the massive reabsorption of water and essential elements such as sodium, bicarbonates, amino-acids and glucose. The distal nephron includes the distal convoluted tubule, the connector tube and the collecting duct. Its role is to adapt the quality composition of urine to the needs of the body. PMID:22157516

  20. Electroluminescence of Giant Stretchability.

    PubMed

    Yang, Can Hui; Chen, Baohong; Zhou, Jinxiong; Chen, Yong Mei; Suo, Zhigang

    2016-06-01

    A new type of electroluminescent device achieves giant stretchability by integrating electronic and ionic components. The device uses phosphor powders as electroluminescent materials, and hydrogels as stretchable and transparent ionic conductors. Subject to cyclic voltage, the phosphor powders luminesce, but the ionic conductors do not electrolyze. The device produces constant luminance when stretched up to an area strain of 1500%. PMID:26610277

  1. A giant ureteric calculus

    PubMed Central

    Rathod, Rajiv; Bansal, Prashant; Gutta, Srinivas

    2013-01-01

    Ureteric stones are usually small and symptomatic. We present a case of a 35-year old female who presented with minimally symptomatic right distal ureteric calculus with proximal hydroureteronephrosis. Laparoscopic right ureterolithotomy was performed and a giant ureteric calculus measuring 11 cm Χ 1.5 cm, weighing 40 g was retrieved. PMID:24082453

  2. Giant urethral calculus

    PubMed Central

    Kotkar, Kunal; Thakkar, Ravi; Songra, MC

    2011-01-01

    Primary urethral calculus is rarely seen and is usually encountered in men with urethral stricture or diverticulum. We present a case of giant urethral calculus secondary to a urethral stricture in a man. The patient was treated with calculus extraction with end to end urethroplasty. PMID:24950400

  3. Juvenile giant fibroadenoma

    PubMed Central

    Yagnik, Vipul D.

    2011-01-01

    Fibroadenomas are benign solid tumor associated with aberration of normal lobular development. Juvenile giant fibroadenoma is usually single and >5 cm in size /or >500 gms in weight. Important differential diagnoses are: phyllodes tumor and juvenile gigantomastia. Simple excision is the treatment of choice. PMID:24765310

  4. A giant ureteric calculus.

    PubMed

    Rathod, Rajiv; Bansal, Prashant; Gutta, Srinivas

    2013-07-01

    Ureteric stones are usually small and symptomatic. We present a case of a 35-year old female who presented with minimally symptomatic right distal ureteric calculus with proximal hydroureteronephrosis. Laparoscopic right ureterolithotomy was performed and a giant ureteric calculus measuring 11 cm Χ 1.5 cm, weighing 40 g was retrieved. PMID:24082453

  5. Hepatic epithelioid angiomyolipoma is a rare and potentially severe but treatable tumor: A report of three cases and review of the literature

    PubMed Central

    LIU, WENTAO; MENG, ZIHUI; LIU, HONGYU; LI, WEI; WU, QIONG; ZHANG, XUEWEN; E, CHANGYONG

    2016-01-01

    Hepatic epithelioid angiomyolipoma (EAML) is a rare type of hepatic tumor. Due to a lack of adequate understanding about this tumor, hepatic EAML is often misdiagnosed as other diseases with similar clinical characteristics such as hepatic cancer. In the present study, 3 cases of hepatic EAML are reported, and the main clinicopathological features of this disease are presented, based on a literature search that included articles published in English between February 2000 and September 2014. A total of 24 hepatic EAML cases were considered, of which, 17 were females and 4 presented multiple liver lesions. Among the patients with single lesions, 2 underwent surgery and relapsed after 5 months and 9 years, respectively. Immunohistochemical staining was positive for human melanoma black-45 in the present 3 cases. The aim of the present study was to focus the attention of clinicians on this type of hepatic tumor in order to improve its diagnosis and treatment. PMID:27313680

  6. Giant adrenal pseudocyst harbouring adrenocortical cancer

    PubMed Central

    Wilkinson, Michael; Fanning, Deirdre Mary; Moloney, James; Flood, Hugh

    2011-01-01

    The authors report a very rare case of adreno-cortical carcinoma arising in a giant adrenal pseudocyst. A 64-year-old woman presented to the emergency department with a 6 week history of progressively worsening severe left abdominal pain, anorexia, anergia and constipation. On examination, she was cachectic with tenderness over the left abdomen and flank. Medical history was significant for gastritis and anaemia. During her investigation, a well-defined para-renal 12×6 centimetre multi-loculated cyst, of uncertain origin was identified on CT. Ultrasound-guided biopsy was not diagnostic. MRI showed the cyst to be likely adrenal in origin. Serum and urinary catecholamines were unremarkable. At laparotomy an unresectable large, tense, fixed, cystic mass was seen to occupy the left side of the abdomen. The cyst was de-roofed. Pathology showed a high-grade poorly differentiated adreno-cortical carcinoma with a pseudo-capsule. She died 2 months postoperatively. PMID:22679267

  7. Inherited renal cystic diseases.

    PubMed

    Kim, Bohyun; King, Bernard F; Vrtiska, Terri J; Irazabal, Maria V; Torres, Vicente E; Harris, Peter C

    2016-06-01

    A number of inherited renal diseases present with renal cysts and often lead to end-stage renal disease. With recent advances in genetics, increasing number of genes and mutations have been associated with cystic renal diseases. Although genetic testing can provide a definite diagnosis, it is often reserved for equivocal cases or for ongoing investigational research. Therefore, imaging findings are essential in the routine diagnosis, follow-up, and detection of complications in patients with inherited cystic renal diseases. In this article, the most recent classification, genetic analysis, clinical presentations, and imaging findings of inherited cystic renal diseases will be discussed. PMID:27167233

  8. McKittrick-Wheelock syndrome: a rare case report of acute renal failure

    PubMed Central

    MOIS, EMIL IOAN; GRAUR, FLORIN; SECHEL, ROXANA; AL-HAJJAR, NADIM

    2016-01-01

    Giant tubular-villous adenoma of the rectum can determine secretory diarrhea, associated with a depleting syndrome of prerenal acute renal failure, hyponatremia, hypokalemia and hypoproteinemia. These symptoms are known as the McKittrick-Wheelock syndrome, and there are about 50 cases reported in literature. We present the case of a 59-year-old woman presented to our emergency department with abdominal pain, prerenal azotemia, and electrolyte disturbances with a background of chronic diarrhea, caused by a giant rectal tumor. Conservative therapy initially improved and normalized renal function, and made surgical resection of the tumor possible. PMID:27152085

  9. A giant vesical calculus.

    PubMed

    Rahman, M; Uddin, A; Das, G C; Akanda, N I

    2007-07-01

    Massive or giant vesical calculus is a rare entity in the recent urological practice. Males are affected more than the females. Vesical calculi are usually secondary to bladder outlet obstruction. These patients present with recurrent urinary tract infection, haematuria or with retention of urine. We report a young male patient who presented with defaecatory problems along with other urinary symptoms. The patient having an average built, non diabetic but hypertensive. The stone could be palpated by physical examination. His urea levels were within normal limits but urine examination shows infection. USG reveals bilateral hydronephrosis with multiple stones in both kidneys along with a giant vesical calculus. After controlling urinary infection and hypertention he underwent an open cystolithotomy. During operation digital rectal help was needed to remove the stone as it was adherent with bladder mucosa. Post operative period was uneventful. His urinary output was quite normal and had no defaecatory problems. Patient left the hospital 10 days after operation. PMID:17917633

  10. Preoperative Evaluation of Renal Cell Carcinoma by Using 18F-FDG PET/CT

    PubMed Central

    Takahashi, Miwako; Kume, Haruki; Koyama, Keitaro; Nakagawa, Tohru; Fujimura, Tetsuya; Morikawa, Teppei; Fukayama, Masashi; Homma, Yukio; Ohtomo, Kuni; Momose, Toshimitsu

    2015-01-01

    Purpose This study aimed to characterize the FDG uptake of renal cell carcinoma (RCC) by the pathological subtype and nuclear grade. Patients and Methods We retrospectively identified patients who underwent 18F-FDG PET and subsequent partial or radical nephrectomy for renal tumors. The relationships of the SUV of renal tumor with subtypes, nuclear grade, and clinicopathological variables were investigated. Results Ninety-two tumors were analyzed, including 52 low-grade (G1 and G2) and 18 high-grade (G3 and G4) clear cell RCC; 7 chromophobe, 5 papillary, and 1 unclassified RCC; and 9 benign tumors (7 angiomyolipoma and 2 oncocytoma). The SUVs of high-grade clear cell RCC (mean ± SD, 6.8 ± 5.1) and papillary RCC (6.6 ± 3.7) were significantly higher than that of the controls (2.2 ± 0.3). The SUV of high-grade clear cell RCC was higher than that of low-grade tumors (median, 4.0 vs. 2.2; P < 0.001). The optimal SUV cutoff value of 3.0 helped to differentiate high-grade from low-grade clear cell RCC, with 89% sensitivity and 87% specificity. On multiple regression analysis, a high grade was the most significant predictor of SUV for clear cell RCC. Conclusions FDG uptake higher than that observed in normal kidney tissues suggests a high-grade clear cell RCC or papillary RCC subtype. FDG-PET using SUV may have a role in prediction of pathological grade of renal tumor. PMID:26164183

  11. Ice Giant Exploration

    NASA Astrophysics Data System (ADS)

    Rymer, A. M.; Arridge, C. S.; Masters, A.; Turtle, E. P.; Simon, A. A.; Hofstadter, M. D.; Turrini, D.; Politi, R.

    2015-12-01

    The Ice Giants in our solar system, Uranus and Neptune, are fundamentally different from their Gas Giant siblings Jupiter and Saturn, from the different proportions of rock and ice to the configuration of their planetary magnetic fields. Kepler space telescope discoveries of exo-planets indicate that planets of this type are among the most ubiquitous universally and therefore a future mission to explore the nature of the Ice Giants in our own solar system will provide insights into the nature of extra-solar system objects in general. Uranus has the smallest self- luminosity of all the planets, potentially related to catastrophic events early in the planet's history, which also may explain Uranus' large obliquity. Uranus' atmosphere is subject to extreme seasonal forcing making it unique in the Solar System. Neptune is also unique in a number of ways, notably its large moon Triton which is likely a captured Kuiper Belt Object and one of only two moons in the solar system with a robustly collisional atmosphere. Similar to Uranus, the angle between the solar wind and the magnetic dipole axis is subject to large-amplitude variations on both diurnal and seasonal timescales, but peculiarly it has one of the quietest magnetospheres of the solar system, at least according to Voyager 2, the only spacecraft to encounter Neptune to date. A comprehensive mission, as advocated in the Decadal Survey, would provide enormous science return but is also challenging and expensive. In this presentation we will discuss mission scenarios and suggest how collaboration between disciplines and internationally can help us to pursue a mission that includes Ice Giant exploration.

  12. Giant thymic carcinoid.

    PubMed

    John, L C; Hornick, P; Lang, S; Wallis, J; Edmondson, S J

    1991-05-01

    Thymic carcinoid is a rare tumour. It may present with ectopic endocrine secretion or with symptoms of compression as a result of its size. A case is reported which presented with symptoms of compression where the size of the tumour was uniquely large such as to warrant the term giant thymic carcinoid. The typical histological features are described, together with its possible origin and its likely prognosis. PMID:1852667

  13. Giant dedifferentiated retroperitoneal liposarcoma.

    PubMed

    Dominguez, Elias; Lopez de Cenarruzabeitia, Iñigo; Martinez, Manuel; Rueda, J C; Lede, A; Barreiro, Erica; Diz, Susana

    2008-01-01

    Liposarcoma tumors only represent 0.1% of all cancers, but they are the more common of retroperitoneal sarcomas. It has a great tendency for local recurrence, mainly the dedifferentiated variety, but its complete resection can provide a 5-year survival of 70%. In this report, we present a case of a giant dedifferentiated retroperitoneal liposarcoma that did not affect any neighboring organ and that was successfully treated by means of complete surgical resection. PMID:19731863

  14. Giant rodlike reversed micelles

    SciTech Connect

    Yu, Z.J.; Neuman, R.D. )

    1994-05-04

    Herein we report that sodium bis(2-ethylhexyl)phosphate, which is similar in structure to the classical surfactant sodium bis(2-ethylhexyl)sulfosuccinate (AOT), forms very large rodlike reversed micelles and that their size can be even much larger if water is removed from the apolar solution. We further suggest that long-range electrostatic interactions are the primary driving force for the formation of giant reversed micelles. 19 refs., 3 figs.

  15. Giant cell arteritis

    PubMed Central

    Calvo-Romero, J

    2003-01-01

    Giant cell arteritis (GCA), temporal arteritis or Horton's arteritis, is a systemic vasculitis which involves large and medium sized vessels, especially the extracranial branches of the carotid arteries, in persons usually older than 50 years. Permanent visual loss, ischaemic strokes, and thoracic and abdominal aortic aneurysms are feared complications of GCA. The treatment consists of high dose steroids. Mortality, with a correct treatment, in patients with GCA seems to be similar that of controls. PMID:13679546

  16. Red giants seismology

    NASA Astrophysics Data System (ADS)

    Mosser, B.; Samadi, R.; Belkacem, K.

    2013-11-01

    The space-borne missions CoRoT and Kepler are indiscreet. With their asteroseismic programs, they tell us what is hidden deep inside the stars. Waves excited just below the stellar surface travel throughout the stellar interior and unveil many secrets: how old is the star, how big, how massive, how fast (or slow) its core is dancing. This paper intends to paparazze the red giants according to the seismic pictures we have from their interiors.

  17. Giant radio pulses

    NASA Astrophysics Data System (ADS)

    Kondratiev, Vladislav

    Rotation-powered radio pulsars exhibit a remarkably diverse spectrum of variability with characteristic time scales from days and even years (intermittent pulsars) to minutes-seconds (nulling) and (sub-)microseconds. The latter time scales are associated with the phenomenon of giant pulses (GPs) and micropulses. The story of GPs started in 1968, when Staelin and Reifenstein discovered the Crab pulsar through its spectacularly bright radio pulses. To date, only seven pulsars out of more than 2200 are known to show GP emission, namely the pulsars B0531+21, B1937+21, B0540-69, B1821-24, B1957+20, J0218+4232, and B1820-30A. Giant pulses are characterized by large energies (more than ten times of the energy of the average pulse), short durations, power-law energy distribution, specific rotational phase of occurrence, high degree of polarization, and accompanying high-energy radiation. Large energies of GPs and coincidence of their phase of occurrence with peaks of high-energy profiles hint at the same mechanism of radio GP and high-energy emission. The correlation of Crab pulsar GPs with optical, X-ray and gamma-ray photons was studied for the past 20 years, with only radio/optical link confirmed so far. In my talk I will present the summary of the observational evidence of radio GPs and give an overview of theoretical advances on giant-pulse emission mechanism.

  18. Renal vein thrombosis

    MedlinePlus

    ... the kidneys. Possible Complications Complications may include: Acute renal failure (especially if thrombosis occurs in a dehydrated child) ... Saunders; 2012:chap 34. Read More Acute kidney failure Arteriogram Blood ... embolus Renal Tumor Update Date 5/19/2015 Updated by: ...

  19. Kidney (Renal) Failure

    MedlinePlus

    ... renal function using ureteral stenting, nephrostomy, surgery or dialysis. What is kidney (renal) failure? How is kidney ... as a urinary stent or kidney stone removal. Dialysis , including hemodialysis and peritoneal dialysis: These procedures remove ...

  20. Renal papillary necrosis

    MedlinePlus

    ... renal papillary necrosis, especially after taking over-the-counter pain medicines ... diabetes or sickle cell anemia may reduce your risk. To prevent renal ... over-the-counter pain relievers. Do not take more than the ...

  1. Renal papillary necrosis

    MedlinePlus

    ... your provider. Alternative Names Necrosis - renal papillae; Renal medullary necrosis Images Kidney anatomy Kidney - blood and urine flow References Ruggenenti P, Cravedi P, Remuzzi G. Microvascular and macrovascular diseases of the kidney. In: Taal MW, Chertow GM, ...

  2. Unusual Giant Prostatic Urethral Calculus

    PubMed Central

    Bello, A.; Maitama, H. Y.; Mbibu, N. H.; Kalayi, G. D.; Ahmed, A.

    2010-01-01

    Giant vesico-prostatic urethral calculus is uncommon. Urethral stones rarely form primarily in the urethra, and they are usually associated with urethral strictures, posterior urethral valve or diverticula. We report a case of a 32-year-old man with giant vesico-prostatic (collar-stud) urethral stone presenting with sepsis and bladder outlet obstruction. The clinical presentation, management, and outcome of the giant prostatic urethral calculus are reviewed. PMID:22091328

  3. Cardio-renal syndrome

    PubMed Central

    Gnanaraj, Joseph; Radhakrishnan, Jai

    2016-01-01

    Cardio-renal syndrome is a commonly encountered problem in clinical practice. Its pathogenesis is not fully understood. The purpose of this article is to highlight the interaction between the cardiovascular system and the renal system and how their interaction results in the complex syndrome of cardio-renal dysfunction. Additionally, we outline the available therapeutic strategies to manage this complex syndrome.

  4. Renal Denervation

    PubMed Central

    Pan, Tao; Guo, Jin-he; Teng, Gao-jun

    2015-01-01

    Abstract Type 2 diabetes mellitus (T2DM) is a group of metabolic diseases of multiple etiologies. Although great progress has been made, researchers are still working on the pathogenesis of T2DM and how to best use the treatments available. Aside from several novel pharmacological approaches, catheter-based sympathetic renal denervation (RDN) has gained a significant role in resistant hypertension, as well as improvements in glycemic control in T2DM. In this article, we will summarize herein the role sympathetic activation plays in the progression of T2DM and review the recent clinical RDN experience in glucose metabolism. We performed systematic review in online databases, including PubMed, EmBase, and Web of Science, from inception until 2015. Studies were included if a statistical relationship was investigated between RDN and T2DM. The quality of each included study was assessed by Newcastle–Ottawa scale score. To synthesize these studies, a random-effects model or a fixed-effects model was applied as appropriate. Then, we calculated heterogeneity, performed sensitivity analysis, tested publication bias, and did meta-regression analysis. Finally, we identified 4 eligible articles. In most studies, RDN achieved via novel catheter-based approach using radiofrequency energy has gained a significant role in resistant hypertension, as well as improvements in glycemic control in T2DM. But the DREAMS-Study showed that RDN did not change median insulin sensitivity nor systemic sympathetic activity. Firstly, the current published studies lacked a proper control group, along with the sample capacity was small. Also, data obtained in the subgroups of diabetic patients were not separately analyzed and the follow-up period was very short. In addition, a reduction in blood pressure accounts for the improvements in glucose metabolism and insulin resistance cannot be excluded. If the favorable result of better glucose metabolism is confirmed in large-scale, randomized studies

  5. Giant Coulomb blockade magnetoresistance

    SciTech Connect

    Zhang, Xiaoguang; Wen, Z. C.; Wei, H. X.; Han, Prof. X. F.

    2010-01-01

    We show that the Coulomb blockade voltage can be made to depend strongly on the electron spin in a thin magnetic granular layer inserted in the middle of an insulating layer of a tunnel junction. This strong spin dependence is predicted from the spin-dependent inter-granular conductance through any of the following effects within the granular layer, giant magnetoresistance (GMR), tunneling magnetoresistance (TMR), colossal magnetoresistance (CMR), or GMR through a polymer spacer. The resulting Coulomb blockade magnetoresistance (CBMR) ratio can exceed the magnetoresistance ratio of the granular layer itself by orders of magnitude. Unlike other magenetoresistance effects, the CBMR effect does not require magnetic electrodes.

  6. Giant Cardiac Cavernous Hemangioma.

    PubMed

    Unger, Eric; Costic, Joseph; Laub, Glenn

    2015-07-01

    We report the case of an asymptomatic giant cardiac cavernous hemangioma in a 71-year-old man. The intracardiac mass was discovered incidentally during surveillance for his prostate cancer; however, the patient initially declined intervention. On presentation to our institution 7 years later, the lesion had enlarged significantly, and the patient consented to excision. At surgery, an 8 × 6.5 × 4.8 cm intracardiac mass located on the inferior heart border was excised with an intact capsule through a median sternotomy approach. The patient had an uneventful postoperative course. We discuss the diagnostic workup, treatment, and characteristics of this rare cardiac tumor. PMID:26140782

  7. Rheology of giant micelles

    NASA Astrophysics Data System (ADS)

    Cates, M. E.; Fielding, S. M.

    2006-12-01

    Giant micelles are elongated, polymer-like objects created by the self-assembly of amphiphilic molecules (such as detergents) in solution. Giant micelles are typically flexible, and can become highly entangled even at modest concentrations. The resulting viscoelastic solutions show fascinating flow behaviour (rheology) which we address theoretically in this article at two levels. First, we summarize advances in understanding linear viscoelastic spectra and steady-state nonlinear flows, based on microscopic constitutive models that combine the physics of polymer entanglement with the reversible kinetics of self-assembly. Such models were first introduced two decades ago, and since then have been shown to explain robustly several distinctive features of the rheology in the strongly entangled regime, including extreme shear thinning. We then turn to more complex rheological phenomena, particularly involving spatial heterogeneity, spontaneous oscillation, instability and chaos. Recent understanding of these complex flows is based largely on grossly simplified models which capture in outline just a few pertinent microscopic features, such as coupling between stresses and other order parameters such as concentration. The role of ‘structural memory’ (the dependence of structural parameters such as the micellar length distribution on the flow history) in explaining these highly nonlinear phenomena is addressed. Structural memory also plays an intriguing role in the little-understood shear thickening regime, which occurs in a concentration regime close to but below the onset of strong entanglement, and which is marked by a shear-induced transformation from an inviscid to a gelatinous state.

  8. Giant solitary trichoepithelioma

    PubMed Central

    Teli, Bhavuray; Thrishuli, P. B.; Santhosh, R.; Amar, D. N.; Rajpurohit, Shravan

    2015-01-01

    Adnexal tumors like giant solitary trichoepitheliomas are uncommon to most of us to permit a ready familiarity with them. Information regarding the genesis, clinical profile, behavior, and management options for this tumor is limited. There are 18 cases reported in the world literature till date. This review attempts to provide insight to this rare tumor. Our search included indexed literature from Pubmed, Directory of Open Access Journals, Health Inter Network Access to Research Initiative and Google databases in addition to standard dermatology texts. Giant solitary trichoepithelioma is a rare trichogenic tumor with potential for local recurrence. It has predilection for the older age, but may present at any age including at birth. It has close resemblance to basal cell carcinoma and other skin adnexal tumors - clinically, cytologically, and histologically. CD10, CD 34, PHLDA1 but not p75NTR are useful adjunct markers. Surgical excision is the standard treatment. Recurrence and possible transformation into BCC cautions follow up at regular intervals. PMID:25839021

  9. Giant solitary trichoepithelioma.

    PubMed

    Teli, Bhavuray; Thrishuli, P B; Santhosh, R; Amar, D N; Rajpurohit, Shravan

    2015-01-01

    Adnexal tumors like giant solitary trichoepitheliomas are uncommon to most of us to permit a ready familiarity with them. Information regarding the genesis, clinical profile, behavior, and management options for this tumor is limited. There are 18 cases reported in the world literature till date. This review attempts to provide insight to this rare tumor. Our search included indexed literature from Pubmed, Directory of Open Access Journals, Health Inter Network Access to Research Initiative and Google databases in addition to standard dermatology texts. Giant solitary trichoepithelioma is a rare trichogenic tumor with potential for local recurrence. It has predilection for the older age, but may present at any age including at birth. It has close resemblance to basal cell carcinoma and other skin adnexal tumors - clinically, cytologically, and histologically. CD10, CD 34, PHLDA1 but not p75NTR are useful adjunct markers. Surgical excision is the standard treatment. Recurrence and possible transformation into BCC cautions follow up at regular intervals. PMID:25839021

  10. Giant papillary conjunctivitis.

    PubMed Central

    Donshik, P C

    1994-01-01

    Giant papillary conjunctivitis is a syndrome found frequently as a complication of contact lenses. Many variables can affect the onset and severity of the presenting signs and symptoms. Rigid gas permeable contact lenses appear to result in less severe signs and symptoms, with a longer time before the development of giant papillary conjunctivitis. Nonionic, low-water-content soft contact lenses tend to produce less severe signs and symptoms than ionic, low-water-content soft contact lenses. Enzymatic treatment appears to lessen the severity of signs and symptoms. The association of an allergy appears to play a role in the onset of the severity of the signs and symptoms but does not appear to affect the final ability of the individual to wear contact lenses. Using multiple treatment options, such as changing the polymer to a glyceryl methyl methacrylate or a rigid lens, or utilizing a soft lens on a frequent-replacement basis, can result in a success rate of over 90%. In individuals who still have a return of symptoms, the use of topical mast cell stabilizers or a nonsteroidal anti-inflammatory drug as an adjunctive therapy offers the added possibility of keeping these patients in contact lenses. Images FIGURE 1 FIGURE 2 FIGURE 3 FIGURE 4 FIGURE 5 FIGURE 6 FIGURE 7 FIGURE 11 A FIGURE 11 B FIGURE 11 C FIGURE 11 D PMID:7886881

  11. Allometry indicates giant eyes of giant squid are not exceptional

    PubMed Central

    2013-01-01

    Background The eyes of giant and colossal squid are among the largest eyes in the history of life. It was recently proposed that sperm whale predation is the main driver of eye size evolution in giant squid, on the basis of an optical model that suggested optimal performance in detecting large luminous visual targets such as whales in the deep sea. However, it is poorly understood how the eye size of giant and colossal squid compares to that of other aquatic organisms when scaling effects are considered. Results We performed a large-scale comparative study that included 87 squid species and 237 species of acanthomorph fish. While squid have larger eyes than most acanthomorphs, a comparison of relative eye size among squid suggests that giant and colossal squid do not have unusually large eyes. After revising constants used in a previous model we found that large eyes perform equally well in detecting point targets and large luminous targets in the deep sea. Conclusions The eyes of giant and colossal squid do not appear exceptionally large when allometric effects are considered. It is probable that the giant eyes of giant squid result from a phylogenetically conserved developmental pattern manifested in very large animals. Whatever the cause of large eyes, they appear to have several advantages for vision in the reduced light of the deep mesopelagic zone. PMID:23418818

  12. Bilateral renal dysplasia, nephroblastomatosis, and bronchial stenosis. A new syndrome?

    PubMed

    Rodriguez, Maria Matilde; Correa-Medina, Mayrin; Whittington, Elizabeth E

    2015-06-01

    Bilateral nephroblastomatosis (NB) is an uncommon renal anomaly characterized by multiple confluent nephrogenic rests scattered through both kidneys, with only a limited number of cases reported in the medical literature. Some of these children may have associated either Perlman or Beckwith-Wiedemann syndrome and others do not demonstrate syndromic features. We report a full-term boy with anteverted nose, bilateral bronchial stenosis due to lack of cartilage, bilateral obstructive renal dysplasia and NB with glomeruloid features. The infant had visceromegaly, but neither gigantism nor hemihypertrophy. Immunohistochemistry for PAX2 (Paired box gene-2) and WT-1 (Wilms Tumor 1) were strongly positive in the areas of NB. GLEPP-1 (Glomerular Epithelial Protein) did not stain the areas of NB with a glomeruloid appearance, but was positive in the renal glomeruli as expected. We found neither associated bronchial stenosis nor the histology of NB resembling giant glomeruli in any of the reported cases of NB. PMID:25871299

  13. Bilateral Renal Dysplasia, Nephroblastomatosis, and Bronchial Stenosis. A New Syndrome?

    PubMed Central

    Rodriguez, Maria Matilde; Correa-Medina, Mayrin; Whittington, Elizabeth E.

    2015-01-01

    Bilateral nephroblastomatosis (NB) is an uncommon renal anomaly characterized by multiple confluent nephrogenic rests scattered through both kidneys, with only a limited number of cases reported in the medical literature. Some of these children may have associated either Perlman or Beckwith–Wiedemann syndrome and others do not demonstrate syndromic features. We report a full-term boy with anteverted nose, bilateral bronchial stenosis due to lack of cartilage, bilateral obstructive renal dysplasia and NB with glomeruloid features. The infant had visceromegaly, but neither gigantism nor hemihypertrophy. Immunohistochemistry for PAX2 (Paired box gene-2) and WT-1 (Wilms Tumor 1) were strongly positive in the areas of NB. GLEPP-1 (Glomerular Epithelial Protein) did not stain the areas of NB with a glomeruloid appearance, but was positive in the renal glomeruli as expected. We found neither associated bronchial stenosis nor the histology of NB resembling giant glomeruli in any of the reported cases of NB. PMID:25871299

  14. Malignant hepatic epithelioid angiomyolipoma with recurrence in the lung 7 years after hepatectomy: a case report and literature review.

    PubMed

    Fukuda, Yasunari; Omiya, Hideyasu; Takami, Koji; Mori, Kiyoshi; Kodama, Yoshinori; Mano, Masayuki; Nomura, Yoriko; Akiba, Jun; Yano, Hirohisa; Nakashima, Osamu; Ogawara, Mitsumasa; Mita, Eiji; Nakamori, Shoji; Sekimoto, Mitsugu

    2016-12-01

    Angiomyolipoma (AML) arising in the liver is rare and usually benign, but it occasionally has malignant potential. A 58-year-old man with a liver tumor identified by a previous doctor with features suggestive of hepatocellular carcinoma on computed tomography (CT) underwent anterior segmentectomy of the liver in 2006. Microscopically, the tumor was composed of exclusively epithelioid cells that were scatteredly positive for human melanoma black 45 on immunohistochemistry. Accordingly, primary hepatic epithelioid AML (eAML) was diagnosed. The patient was subsequently referred to our hospital for follow-up after hepatectomy. He had event-free survival for nearly 7 years. In 2013, two well-defined round nodules were detected in the right lung field by chest CT, and partial pneumonectomy was performed for diagnosis and treatment. Histological examination of the resected lung tissue showed that it was morphologically and immunohistochemically identical to his primary hepatic eAML, leading to the diagnosis of pulmonary metastasis. This paper demonstrates a rare case of malignant hepatic eAML with late recurrence in the lung after hepatectomy. PMID:27037804

  15. Giant magnetostrictive composites

    NASA Astrophysics Data System (ADS)

    Duenas, Terrisa Ann

    The limitation of magnetostrictive composites has been in their low magnetostrictive response when compared to their monolithic counterparts. In this dissertation research is presented describing the methods and analysis used to create a giant magnetostrictive composite (GMC) producing giant strains at low fields, exhibiting magnetization ``jumping'' and the ΔE effect. This composite combines the giant magnetostrictive material, Terfenol-D (Tb0.3Dy0.7Fe2) in particle form, with a nonmetallic binder and is capable of producing strains (at room temperature) exceeding 1000 ppm at a nominal field of 1.5 kOe mechanically unloaded and 1200 ppm at 8 MPa preload (2.5 kOe). Several studies leading to the high response of this composite are presented. A connectivity study shows that a [1-3] connected composite produces 50% more strain than a [0-3] composite. A resin study indicates that the lower the viscosity of the resin, the greater the magnetostrictive response; this is attributed to the removal of voids during degassing. A void study correlates the increase in voids to the decrease in strain response. A model is used to correlate analysis with experimental results within 10% accuracy and shows that an optimal volume fraction exists based on the properties of the binder. Using a Polyscience Spurr low- viscosity (60 cps) binder this volume fraction is nominally 20%; this optimum is attributed to the balance of epoxy contracting on the particle (built-in preload) and the actuation delivered by the magnetostrictive material. In addition to the connectivity, resin, void, and volume-fraction study, particle size and gradation studies are presented. Widely dispersed (<106, <212, <300 μm), narrowly dispersed (<45, (90-106), (275-300) μm), and an optimized bimodal (18.7% of (45-90) μm with 81.3% of (250-300) μm) particle distributions are studied. Results show that the larger the particle size, the higher the magnetostrictive response; this is attributed to the reduction of

  16. Renal cystic disease

    SciTech Connect

    Hartman, D.S.

    1988-01-01

    The book begins with an overview of renal cystic disease and a presentation of simple renal cysts. Subsequent chapters cover cystic disease in association with renal neoplasms and medullary sponge kidney. The chapters addressing autosomal-dominant and autosomal-recessive polycystic kidney disease discuss and differentiate the infantile and adult forms of the disease. There are also separate discussions of medullary cystic disease, multicystic dysplastic kidney, and cysts of the renarenal sinus.

  17. Calcified renal oncocytoma

    SciTech Connect

    Wasserman, N.F.; Ewing, S.L.

    1983-10-01

    Renal oncocytoma, a neoplasm thought to derive from cells of the proximal convoluted tubules, exhibits benign clinical features. Its preoperative distinction from typical renal cell carcinoma would enable the surgeon to perform a more limited procedure. In a patient who is a poor operative candidate, surgery might be deferred. However, preoperative diagnosis has been elusive. A rare case of bilateral renal oncocytoma is reported. One of these tumors represents the first reported oncocytoma showing radiologically demonstrable calcification.

  18. Giant magnetofossils and hyperthermal events

    NASA Astrophysics Data System (ADS)

    Chang, Liao; Roberts, Andrew P.; Williams, Wyn; Fitz Gerald, John D.; Larrasoaña, Juan C.; Jovane, Luigi; Muxworthy, Adrian R.

    2012-10-01

    Magnetotactic bacteria biomineralize magnetic minerals with precisely controlled size, morphology, and stoichiometry. These cosmopolitan bacteria are widely observed in aquatic environments. If preserved after burial, the inorganic remains of magnetotactic bacteria act as magnetofossils that record ancient geomagnetic field variations. They also have potential to provide paleoenvironmental information. In contrast to conventional magnetofossils, giant magnetofossils (most likely produced by eukaryotic organisms) have only been reported once before from Paleocene-Eocene Thermal Maximum (PETM; 55.8 Ma) sediments on the New Jersey coastal plain. Here, using transmission electron microscopic observations, we present evidence for abundant giant magnetofossils, including previously reported elongated prisms and spindles, and new giant bullet-shaped magnetite crystals, in the Southern Ocean near Antarctica, not only during the PETM, but also shortly before and after the PETM. Moreover, we have discovered giant bullet-shaped magnetite crystals from the equatorial Indian Ocean during the Mid-Eocene Climatic Optimum (˜40 Ma). Our results indicate a more widespread geographic, environmental, and temporal distribution of giant magnetofossils in the geological record with a link to "hyperthermal" events. Enhanced global weathering during hyperthermals, and expanded suboxic diagenetic environments, probably provided more bioavailable iron that enabled biomineralization of giant magnetofossils. Our micromagnetic modelling indicates the presence of magnetic multi-domain (i.e., not ideal for navigation) and single domain (i.e., ideal for navigation) structures in the giant magnetite particles depending on their size, morphology and spatial arrangement. Different giant magnetite crystal morphologies appear to have had different biological functions, including magnetotaxis and other non-navigational purposes. Our observations suggest that hyperthermals provided ideal conditions for

  19. Two giant stellar complexes

    NASA Astrophysics Data System (ADS)

    Efremov, Yu. N.; Efremov, E. Yu.

    Common star complexes are huge (0.3-1 kpc in diameter) groups of relatively young stars, associations and clusters. The complexes usually form regular chains along spiral arms of grand design galaxies, being evidently formed and supported by magneto- gravitational instability developing along an arm. Special attention is given to a few large complexes which have signatures of gravitational boundness, such as round shape and high central density. Concentrations of stars and clusters in such a complex in M51 galaxy were found in this paper; we concluded it is possible to suggest that the complex is gravitationally bound. It is also stressed that some properties of the giant complex in NGC 6946 (such as its semicircular and sharp Western edge) are still enigmatic.

  20. Giant facial lymphangioma.

    PubMed

    Sanger, Claire; Wong, Lindsey; Wood, Jeyhan; David, Lisa R; Argenta, Louis C

    2011-07-01

    Lymphatic malformation (LM) is a benign cystic entity resulting from aberrant lymphatic drainage. Often evident at birth, most LMs have declared themselves by 2 years of age. They can be concerning when they occur near vital structures such as the airway or orbit. The natural history varies considerable from spontaneous gradual regression to long-term growth and debilitation. Depending on the location, structures involved, and clinical course of the LM, therapeutic options include observation, intralesional sclerosis, laser therapy, and surgical excision. The literature provides guidelines for treatment options that must be carefully applied to the facial region. We present a newborn infant who presented to our institution with giant facial lymphangioma who underwent a combination of sclerosis, laser ablation, and surgery with reconstruction. PMID:21772195

  1. [Giant adrenal myelolipoma].

    PubMed

    El Mejjad, Amine; Fekak, Hamid; Dakir, Mohamed; Sarf, Ismail; Manni, Ahmed; Meziane, Fethi

    2004-02-01

    Adrenal myelolipoma is a rare, benign, non-secreting tumour composed of adipose and haematopoietic tissue. The authors report a rare case of giant adrenal myelolipoma in a 53-year-old patient presenting with low back pain and a palpable flank mass on examination. CT scan suggested the diagnosis and surgical resection was indicated in view of the size and symptomatic nature of this mass. Histological examination confirmed the diagnosis. The outcome was favourable without recurrence after a follow-up of one year. The diagnosis of adrenal myelolipoma is based on radiology. Conservative management is generally sufficient for small asymptomatic tumours, but resection is required for large (> 5 cm) and/or symptomatic tumours. PMID:15098761

  2. [Hereditary renal cell carcinomas].

    PubMed

    Hartmann, A; Stöhr, C G; Junker, K

    2010-10-01

    Renal cell carcinomas occur in several hereditary tumor syndromes. These renal tumors frequently have a specific histopathological appearance which can be a sign for a hereditary cause of the disease. The genetic alterations responsible for most of these tumor syndromes were identified in recent years. Interestingly, renal cell carcinomas show specific histopathological features in each of the hereditary renal cancer syndromes. Clear cell and often cystic renal cell carcinomas occur in von Hippel-Lindau syndrome (VHL), while oncocytomas and chromophobe renal cell carcinomas are found in the Birt-Hugg-Dube syndrome, often also as hybrid tumors. Well differentiated papillary carcinomas (Type 1 according to the WHO) are found in the hereditary papillary renal cell carcinoma (HPRC). In contrast, poorly diffentiated papillary renal cell carcinomas (Type 2 according to the WHO) occur in combination with leiomyomas and leiomyosarcomas of the skin and uterus in hereditary leiomyomatosis and renal cell carcinoma syndrome (HLRCC). The various genetic causes for these hereditary tumor syndromes open up new therapeutic possibilities, some of which are already being investigated in clinical studies. PMID:20960197

  3. The International Society of Urological Pathology (ISUP) Vancouver Classification of Renal Neoplasia.

    PubMed

    Srigley, John R; Delahunt, Brett; Eble, John N; Egevad, Lars; Epstein, Jonathan I; Grignon, David; Hes, Ondrej; Moch, Holger; Montironi, Rodolfo; Tickoo, Satish K; Zhou, Ming; Argani, Pedram

    2013-10-01

    were elucidated. Outside of the epithelial category, advances in our understanding of angiomyolipoma, including the epithelioid and epithelial cystic variants, were considered. In addition, the apparent relationship between cystic nephroma and mixed epithelial and stromal tumor was discussed, with the consensus that these tumors form a spectrum of neoplasia. Finally, it was thought that the synovial sarcoma should be removed from the mixed epithelial and mesenchymal category and placed within the sarcoma group. The new classification is to be referred to as the International Society of Urological Pathology Vancouver Classification of Renal Neoplasia. PMID:24025519

  4. Robot-assisted "Santosh-Post Graduate Institute tubularized flap pyelovesicostomy" in a solitary functioning kidney with giant hydronephrosis: A minimally invasive salvage procedure.

    PubMed

    Kumar, Santosh; Singh, Shivanshu; Kumar, Navneet

    2016-03-01

    We describe a case of a solitary functioning kidney with giant hydronephrosis secondary to ureteropelvic junction obstruction in a young girl who underwent successful robot-assisted tubularized flap pyelovesicostomy. The aim of this report was to highlight the feasibility and efficacy of this technique in salvaging such renal moieties and to present a brief review of the surgical options available for the management of giant hydronephrosis. PMID:26981597

  5. Robot-assisted "Santosh-Post Graduate Institute tubularized flap pyelovesicostomy" in a solitary functioning kidney with giant hydronephrosis: A minimally invasive salvage procedure

    PubMed Central

    Singh, Shivanshu; Kumar, Navneet

    2016-01-01

    We describe a case of a solitary functioning kidney with giant hydronephrosis secondary to ureteropelvic junction obstruction in a young girl who underwent successful robot-assisted tubularized flap pyelovesicostomy. The aim of this report was to highlight the feasibility and efficacy of this technique in salvaging such renal moieties and to present a brief review of the surgical options available for the management of giant hydronephrosis. PMID:26981597

  6. Tuberous Sclerosis Complex Renal Disease

    PubMed Central

    Dixon, Bradley P.; Hulbert, John C.; Bissler, John J.

    2010-01-01

    Although not as common as other genetic renal diseases such as autosomal dominant polycystic kidney disease, patients with tuberous sclerosis complex frequently have significant renal involvement. Recent revelations in the cell biology of these renal disease manifestations as well as effective therapies for tuberous sclerosis complex-related renal issues have heralded hope of improved renal survival and improved quality of life for the TSC patient. This review specifically addresses some of the major renal manifestations of this disease. PMID:21071977

  7. Atmospheres of Extrasolar Giant Planets

    NASA Technical Reports Server (NTRS)

    Marley, Mark

    2006-01-01

    The next decade will almost certainly see the direct imaging of extrasolar giant planets around nearby stars. Unlike purely radial velocity detections, direct imaging will open the door to characterizing the atmosphere and interiors of extrasola planets and ultimately provide clues on their formation and evolution through time. This process has already begun for the transiting planets, placing new constraints on their atmospheric structure, composition, and evolution. Indeed the key to understanding giant planet detectability, interpreting spectra, and constraining effective temperature and hence evolution-is the atmosphere. I will review the universe of extrasolar giant planet models, focusing on what we have already learned from modeling and what we will likely be able to learn from the first generation of direct detection data. In addition to these theoretical considerations, I will review the observations and interpretation of the - transiting hot Jupiters. These objects provide a test of our ability to model exotic atmospheres and challenge our current understanding of giant planet evolution.

  8. Landscape of the lost giants

    NASA Astrophysics Data System (ADS)

    2013-09-01

    The Pleistocene megafauna extinction erased a group of remarkable animals. Whether humans had a prominent role in the extinction remains controversial, but it is emerging that the disappearance of the giants has markedly affected the environment.

  9. Pharma giants swap research programs.

    PubMed

    2014-07-01

    Pharmaceutical giants Novartis and GlaxoSmithKline (GSK) agreed in late April to swap some assets, with Novartis handing off its vaccine business to GSK and getting most of the British company's cancer portfolio in return. PMID:25002632

  10. External compression as initial management of giant omphaloceles.

    PubMed

    DeLuca, F G; Gilchrist, B F; Paquette, E; Wesselhoeft, C W; Luks, F I

    1996-07-01

    The authors describe a noninvasive technique for the management of giant omphaloceles. Two patients with giant omphaloceles were managed with external compression. Dry sterile dressings were used, buttressed by an Ace bandage in the first case and by a handcrafted Velcro abdominal binder in the second. The binder was tightened every 2 or 3 days. Renal, cardiovascular, respiratory, and gastrointestinal parameters were measured regularly to determine whether the binder was too tight. The first patient had only occasional emesis, and the defect was repaired after 40 days of compression. The second patient experienced intermittent hypertension, occasional emesis, and mild oxygen desaturation, which resolved when the binder was loosened slightly. The fascia muscle and skin were closed after 30 days of external compression. Both patients are currently living at home and doing well. This form of external compression is an effective, inexpensive, and low-risk method for the gradual reduction of giant omphaloceles, and should be considered for patients born with this problem. PMID:8811569

  11. Kuiper Prize: Giant Planet Atmospheres

    NASA Astrophysics Data System (ADS)

    Ingersoll, Andrew P.

    2007-10-01

    The study of giant planet atmospheres is near and dear to me, for several reasons. First, the giant planets are photogenic; the colored clouds are great tracers, and one can make fantastic movies of the atmosphere in motion. Second, the giant planets challenge us with storms that last for hundreds of years and winds that blow faster the farther you go from the sun. Third, they remind us of Earth with their hurricanes, auroras, and lightning, but they also are the link to the 200 giant planets that have been discovered around other stars. This talk will cover the past, present, and future (one hopes) of giant planet research. I will review the surprises of the Voyager and Galileo eras, and will discuss what we are learning now from the Cassini orbiter. I will review the prospects for answering the outstanding questions like: Where's the water? What is providing the colors of the clouds? How deep do the features extend? Where do the winds get their energy? What is the role of the magnetic field? Finally, I will briefly discuss how extrasolar giant planets compare with objects in our own solar system.

  12. Giant retinal tears.

    PubMed

    Shunmugam, Manoharan; Ang, Ghee Soon; Lois, Noemi

    2014-01-01

    A giant retinal tear (GRT) is a full-thickness neurosensory retinal break that extends circumferentially around the retina for three or more clock hours in the presence of a posteriorly detached vitreous. Its incidence in large population-based studies has been estimated as 1.5% of rhegmatogenous retinal detachments, with a significant male preponderance, and bilaterality in 12.8%. Most GRTs are idiopathic, with trauma, hereditary vitreoretinopathies and high myopia each being causative in decreasing frequency. The vast majority of GRTs are currently managed with a pars plana vitrectomy; the use of adjunctive circumferential scleral buckling is debated, but no studies have shown a clear anatomical or visual advantage with its use. Similarly, silicone oil tamponade does not influence long-term outcomes when compared with gas. Primary and final retinal reattachment rates are achieved in 88% and 95% of patients, respectively. Even when the retina remains attached, however, visual recovery may be limited. Furthermore, fellow eyes of patients with a GRT are at higher risk of developing retinal tears and retinal detachment. Prophylactic treatment under these circumstances may be considered but there is no firm evidence of its efficacy at the present time. PMID:24138895

  13. A unique advantage for giant eyes in giant squid.

    PubMed

    Nilsson, Dan-Eric; Warrant, Eric J; Johnsen, Sönke; Hanlon, Roger; Shashar, Nadav

    2012-04-24

    Giant and colossal deep-sea squid (Architeuthis and Mesonychoteuthis) have the largest eyes in the animal kingdom [1, 2], but there is no explanation for why they would need eyes that are nearly three times the diameter of those of any other extant animal. Here we develop a theory for visual detection in pelagic habitats, which predicts that such giant eyes are unlikely to evolve for detecting mates or prey at long distance but are instead uniquely suited for detecting very large predators, such as sperm whales. We also provide photographic documentation of an eyeball of about 27 cm with a 9 cm pupil in a giant squid, and we predict that, below 600 m depth, it would allow detection of sperm whales at distances exceeding 120 m. With this long range of vision, giant squid get an early warning of approaching sperm whales. Because the sonar range of sperm whales exceeds 120 m [3-5], we hypothesize that a well-prepared and powerful evasive response to hunting sperm whales may have driven the evolution of huge dimensions in both eyes and bodies of giant and colossal squid. Our theory also provides insights into the vision of Mesozoic ichthyosaurs with unusually large eyes. PMID:22425154

  14. Diagnosis of Hepatic Angiomyolipoma by Combination of Baseline and Contrast-Enhanced Ultrasound—A Prospective Study in Non-Cirrhotic Patients

    PubMed Central

    Li, Rui; Tang, Chun-Lin; Zhang, Yi; Ma, Kuan-sheng; Zhang, Xiao-Hang; Guo, De-Yu; Yan, Xiao-Chu

    2015-01-01

    Objectives Hepatic angiomyolipoma (HAML) is a rare, benign mesenchymal tumor of the liver and its diagnosis has been considered challenging. The aim of this study was to investigate prospectively the diagnostic efficacy of the incorporation of both baseline ultrasound (US) and contrast-enhanced ultrasound (CEUS) features of HAML in patients without cirrhosis. Materials and Methods Consecutive 1748 non-cirrhotic patients with focal liver lesions (FLLs) were prospectively enrolled. Baseline US and CEUS were performed before resection or biopsy. Ultrasound imaging diagnosis of FLLs was compared with the pathological results. Results Final diagnoses were established in 41 patients with HAML (2.3%) with normal alpha fetal protein (AFP) level and in 1707 patients with FLL other than HAML. Diagnostic criteria for HAML was based on the combination of baseline US and CEUS appearance of the nodule: (1) Well-defined, marked hyper-echoic nodule without surrounding hypo-echoic halo on baseline US; (2) hyper-enhancement in the arterial phase (exclude initial peripheral nodular enhancement and spoke-wheel arteries) and remains hyper-enhancement or iso-enhancement in the late phase. The diagnostic criteria were fulfilled in 31 HAMLs, 1 hepatocellular adenoma and 1 hemangioma. Ten HAMLs were misdiagnosed as other liver tumors because they did not meet the diagnostic criteria mentioned above and consequently yielded a sensitivity, specificity, positive predictive values, negative predictive values and Youden index of 75.61%, 99.88%, 93.94%, 99.42%, and 0.75 respectively. Conclusion The combination of baseline US and CEUS may lead to the correct diagnosis noninvasively in the majority of HAMLs in non-cirrhotic patients with normal AFP level. PMID:26147859

  15. [Atherosclerotic renal artery stenosis].

    PubMed

    Sauguet, A; Honton, B

    2014-12-01

    Atherosclerotic renal artery stenosis can cause ischaemic nephropathy and arterial hypertension. Renal artery stenosis (RAS) continues to be a problem for clinicians, with no clear consensus on how to investigate and assess the clinical significance of stenotic lesions and manage the findings. RAS caused by fibromuscular dysplasia is probably commoner than previously appreciated, should be actively looked for in younger hypertensive patients and can be managed successfully with angioplasty. Atheromatous RAS is associated with increased incidence of cardiovascular events and increased cardiovascular mortality, and is likely to be seen with increasing frequency. Many patients with RAS may be managed effectively with medical therapy for several years without endovascular stenting, as demonstrated by randomized, prospective trials including the cardiovascular outcomes in Renal Atherosclerotic Lesions (CORAL) trial, the Angioplasty and Stenting for Renal Artery Lesions (ASTRAL) trial. These trials share the limitation of excluding subsets of patients with high-risk clinical presentations, including episodic pulmonary edema and rapidly progressing renal failure and hypertension. Blood pressure control and medication adjustment may become more difficult with declining renal function and may prevent the use of angiotensin receptor blocker and angiotensin-converting enzyme inhibitors. The objective of this review is to evaluate the current management of RAS for cardiologists in the context of recent randomized clinical trials. There is now interest in looking more closely at patient selection for intervention, with focus on intervening only in patients with the highest-risk presentations such as flash pulmonary edema, rapidly declining renal function and severe resistant hypertension. PMID:25450992

  16. Cadmium and renal cancer

    SciTech Connect

    Il'yasova, Dora; Schwartz, Gary G. . E-mail: gschwart@wfubmc.edu

    2005-09-01

    Background: Rates of renal cancer have increased steadily during the past two decades, and these increases are not explicable solely by advances in imaging modalities. Cadmium, a widespread environmental pollutant, is a carcinogen that accumulates in the kidney cortex and is a cause of end-stage renal disease. Several observations suggest that cadmium may be a cause of renal cancer. Methods: We performed a systematic review of the literature on cadmium and renal cancer using MEDLINE for the years 1966-2003. We reviewed seven epidemiological and eleven clinical studies. Results: Despite different methodologies, three large epidemiologic studies indicate that occupational exposure to cadmium is associated with increased risk renal cancer, with odds ratios varying from 1.2 to 5.0. Six of seven studies that compared the cadmium content of kidneys from patients with kidney cancer to that of patients without kidney cancer found lower concentrations of cadmium in renal cancer tissues. Conclusions: Exposure to cadmium appears to be associated with renal cancer, although this conclusion is tempered by the inability of studies to assess cumulative cadmium exposure from all sources including smoking and diet. The paradoxical findings of lower cadmium content in kidney tissues from patients with renal cancer may be caused by dilution of cadmium in rapidly dividing cells. This and other methodological problems limit the interpretation of studies of cadmium in clinical samples. Whether cadmium is a cause of renal cancer may be answered more definitively by future studies that employ biomarkers of cadmium exposure, such as cadmium levels in blood and urine.

  17. Multicystic renal dysplasia.

    PubMed

    Nagaraj, V P; Ratnakar, K S

    2001-07-01

    Multicystic renal dysplasia, the most common form of cystic renal disease in the newborn period, is a clinically important consequence of abnormal nephrogenesis. It usually presents as an abdominal mass. The dysplasias are usually unilateral, but it can be bilateral, segmental or focal. The clinical presentation usually depends on the extent of the dysplastic involvement and the degree of the associated urinary obstruction. Here, we present a case of histologically multicystic renal dysplasia, which is ?bilateral. The left kidney showed typical radiological, gross and histopathological features of multicystic dysplasia, but the right kidney showed only radiological features of dysplastic cystic kidney. PMID:11479648

  18. Renal Replacement Therapy.

    PubMed

    Villa, Gianluca; Ricci, Zaccaria; Ronco, Claudio

    2015-10-01

    Renal replacement therapy (RRT) is a cornerstone in the clinical management of patients with acute kidney injury. Results from different studies agree that early renal support therapy (aimed to support the residual kidney function during early phases of organ dysfunction) may reduce mortality with respect to late RRT (aimed to substitute the complete loss of function during the advanced kidney insufficiency). Although it seems plausible that a timely initiation of RRT may be associated with improved renal and nonrenal outcomes in these patients, there is scarce evidence in literature to exactly identify the most adequate onset timing for RRT. PMID:26410148

  19. Formation of giant planets

    NASA Astrophysics Data System (ADS)

    Magni, G.; Coradini, A.

    2003-04-01

    In this presentation we address the problem of the formation of giant planets and their regular satellites. We study in particular the problem of formation of the Jupiter System comparing the results of the model with the present characteristics of the system, in order to identify what are those better represented by our approach. In fact here, using a 3-D hydro-dynamical code, we study the modalities of gas accretion onto a solid core, believed to be the seed from which Jupiter started. To do that we have modelled three main regions: the central planet, a turbulent accretion disk surrounding it and an extended region from which the gas is collected. In the extended region we treat the gas as a frictionless fluid. Our main goal is to identify what are the characteristics of the planet during its growth and the physical parameters affecting its growth at the expenses of the nebular gas present in the feeding zone. Moreover we want to understand what are the thermodynamical parameters characterizing the gas captured by the planet and swirling around it. Finally, we check if a disk can be formed in prograde rotation around the planet and if this disk can survive the final phases of the planet formation. Due to the interaction between the accreting planet and the disk it has been necessary to develop a complete model of the Jupiter’s structure. In fact the radiation emitted by the growing planet heats up the surrounding gas. In turn the planet’s thermodynamic structure depend on the mass accretion rate onto it. When the accretion is rapid, shock waves in the gas are formed close to the planet. This region cannot be safely treated by a numerical code; for this reason we have developed a semi-analytically model of a a turbulent accretion disk to be considered as transition between the planet and the surrounding disk.

  20. Rotation of Giant Stars

    NASA Astrophysics Data System (ADS)

    Kissin, Yevgeni; Thompson, Christopher

    2015-07-01

    The internal rotation of post-main sequence stars is investigated, in response to the convective pumping of angular momentum toward the stellar core, combined with a tight magnetic coupling between core and envelope. The spin evolution is calculated using model stars of initial mass 1, 1.5, and 5 {M}⊙ , taking into account mass loss on the giant branches. We also include the deposition of orbital angular momentum from a sub-stellar companion, as influenced by tidal drag along with the excitation of orbital eccentricity by a fluctuating gravitational quadrupole moment. A range of angular velocity profiles {{Ω }}(r) is considered in the envelope, extending from solid rotation to constant specific angular momentum. We focus on the backreaction of the Coriolis force, and the threshold for dynamo action in the inner envelope. Quantitative agreement with measurements of core rotation in subgiants and post-He core flash stars by Kepler is obtained with a two-layer angular velocity profile: uniform specific angular momentum where the Coriolis parameter {Co}\\equiv {{Ω }}{τ }{con}≲ 1 (here {τ }{con} is the convective time), and {{Ω }}(r)\\propto {r}-1 where {Co}≳ 1. The inner profile is interpreted in terms of a balance between the Coriolis force and angular pressure gradients driven by radially extended convective plumes. Inward angular momentum pumping reduces the surface rotation of subgiants, and the need for a rejuvenated magnetic wind torque. The co-evolution of internal magnetic fields and rotation is considered in Kissin & Thompson, along with the breaking of the rotational coupling between core and envelope due to heavy mass loss.

  1. Successful management of a giant anterior sacral meningocele with an endoscopic cutting stapler: case report.

    PubMed

    Sunna, Tarek P; Westwick, Harrison J; Zairi, Fahed; Berania, Ilyes; Shedid, Daniel

    2016-05-01

    Anterior sacral meningoceles (ASMs) are rare defects in the sacrum with thecal sac herniations and symptoms that commonly include constipation, dysmenorrhea, and urinary disturbances. An ASM causing hydronephrosis and acute renal failure from compression of the lower portion of the urinary tract is a rare clinical entity. Only one other case has been reported. The authors present the case of a 37-year-old man admitted for obstructive renal failure and hydronephrosis due to a giant ASM that measured 25 × 12 × 18 cm and compressed the ureters and bladder. The ASM was successfully treated via an anterior transabdominal approach in which the authors used a novel technique for watertight closure of the meningocele pedicle with an endoscopic cutting stapler. The authors review the literature and discuss the surgical options for the treatment of ASMs, specifically the management of ASMs in the context of obstructive renal failure and hydronephrosis. PMID:26745349

  2. Renal Mitochondrial Cytopathies

    PubMed Central

    Emma, Francesco; Montini, Giovanni; Salviati, Leonardo; Dionisi-Vici, Carlo

    2011-01-01

    Renal diseases in mitochondrial cytopathies are a group of rare diseases that are characterized by frequent multisystemic involvement and extreme variability of phenotype. Most frequently patients present a tubular defect that is consistent with complete De Toni-Debré-Fanconi syndrome in most severe forms. More rarely, patients present with chronic tubulointerstitial nephritis, cystic renal diseases, or primary glomerular involvement. In recent years, two clearly defined entities, namely 3243 A > G tRNALEU mutations and coenzyme Q10 biosynthesis defects, have been described. The latter group is particularly important because it represents the only treatable renal mitochondrial defect. In this paper, the physiopathologic bases of mitochondrial cytopathies, the diagnostic approaches, and main characteristics of related renal diseases are summarized. PMID:21811680

  3. Giant lobelias exemplify convergent evolution

    PubMed Central

    2010-01-01

    Giant lobeliads on tropical mountains in East Africa and Hawaii have highly unusual, giant-rosette growth forms that appear to be convergent on each other and on those of several independently evolved groups of Asteraceae and other families. A recent phylogenetic analysis by Antonelli, based on sequencing the widest selection of lobeliads to date, raises doubts about this paradigmatic example of convergent evolution. Here I address the kinds of evidence needed to test for convergent evolution and argue that the analysis by Antonelli fails on four points. Antonelli's analysis makes several important contributions to our understanding of lobeliad evolution and geographic spread, but his claim regarding convergence appears to be invalid. Giant lobeliads in Hawaii and Africa represent paradigmatic examples of convergent evolution. PMID:20074322

  4. CMB lensing and giant rings

    NASA Astrophysics Data System (ADS)

    Rathaus, Ben; Itzhaki, Nissan

    2012-05-01

    We study the CMB lensing signature of a pre-inationary particle (PIP), assuming it is responsible for the giant rings anomaly that was found recently in the WMAP data. Simulating Planck-like data we find that generically the CMB lensing signal to noise ratio associated with such a PIP is quite small and it would be difficult to cross correlate the temperature giant rings with the CMB lensing signal. However, if the pre-inationary particle is also responsible for the bulk flow measured from the local large scale structure, which happens to point roughly at the same direction as the giant rings, then the CMB lensing signal to noise ratio is fairly significant.

  5. Giant myoma and erythrocytosis syndrome.

    PubMed

    Ozsaran, A A; Itil, I M; Terek, C; Kazandi, M; Dikmen, Y

    1999-08-01

    The objective of this study is to discuss the myomatous erythrocytosis syndrome in a patient with a giant subserous uterine myoma. She presented with plethora and an abdominal mass. After venesection of 4 units of blood, the preoperative haematocrit value of 53.3% and haemoglobin value of 17.5 g/dL had decreased to 48.6% and 16.8 g/dL levels, respectively. After the operative extraction of the giant subserous myoma with attached uterus weighing 14.2 kg, the haematocrit and the haemoglobin values had regressed to 40.3% and 14.3 g/dL levels, respectively. The findings indicated that the giant subserous myoma was the cause of the myomatous erythrocytosis syndrome in this patient. PMID:10554963

  6. Structure of giant muscle proteins

    PubMed Central

    Meyer, Logan C.; Wright, Nathan T.

    2013-01-01

    Giant muscle proteins (e.g., titin, nebulin, and obscurin) play a seminal role in muscle elasticity, stretch response, and sarcomeric organization. Each giant protein consists of multiple tandem structural domains, usually arranged in a modular fashion spanning 500 kDa to 4 MDa. Although many of the domains are similar in structure, subtle differences create a unique function of each domain. Recent high and low resolution structural and dynamic studies now suggest more nuanced overall protein structures than previously realized. These findings show that atomic structure, interactions between tandem domains, and intrasarcomeric environment all influence the shape, motion, and therefore function of giant proteins. In this article we will review the current understanding of titin, obscurin, and nebulin structure, from the atomic level through the molecular level. PMID:24376425

  7. 'Transcollateral' Renal Angioplasty for a Completely Occluded Renal Artery

    SciTech Connect

    Chandra, Subash; Chadha, Davinder S. Swamy, Ajay

    2011-02-15

    Percutaneous transluminal renal angioplasty with stenting has been effective in the control of hypertension, renal function, and pulmonary edema caused by atherosclerotic renal artery stenosis. However, the role of the procedure has not been fully established in the context of chronic total occlusion of renal artery. We report the successful use of this procedure in 57-year-old male patient who reported for evaluation of a recent episode of accelerated hypertension. A renal angiogram in this patient showed ostial stenosis of the right renal artery, which was filling by way of the collateral artery. Renal angioplasty for chronic total occlusion of right renal artery was successfully performed in a retrograde fashion through a collateral artery, thereby leading to improvement of renal function and blood pressure control.

  8. Disappearing renal calculus

    PubMed Central

    Cui, Helen; Thomas, Johanna; Kumar, Sunil

    2013-01-01

    We present a case of a renal calculus treated solely with antibiotics which has not been previously reported in the literature. A man with a 17 mm lower pole renal calculus and concurrent Escherichia coli urine infection was being worked up to undergo percutaneous nephrolithotomy. However, after a course of preoperative antibiotics the stone was no longer seen on retrograde pyelography or CT imaging. PMID:23580676

  9. Peripheral Giant Cell Granuloma in a Dog.

    PubMed

    Hiscox, Lorraine A; Dumais, Yvan

    2015-01-01

    Peripheral giant cell granuloma is considered rare in the dog with little known about the clinicopathologic features. There are few reports in the veterinary literature concerning this benign, reactive lesion, formerly known as giant cell epulis. In humans, the four most commonly described reactive epulides are focal fibrous hyperplasia (fibrous epulis), pyogenic granuloma, peripheral ossifying fibroma, and peripheral giant cell granuloma. This case report describes the diagnosis and surgical management of a peripheral giant cell granuloma in a dog. PMID:26415387

  10. Giant axonal neuropathy: MRS findings.

    PubMed

    Alkan, Alpay; Kutlu, Ramazan; Sigirci, Ahmet; Baysal, Tamer; Altinok, Tayfun; Yakinci, Cengiz

    2003-10-01

    Giant axonal neuropathy (GAN) is a rare genetic disease of childhood involving the central and peripheral nervous systems. Axonal loss with several giant axons filled with neurofilaments is the main histopathological feature of peripheral nerve biopsies in this disease. Routine neuroimaging studies reveal diffuse hyperintensities in cerebral and cerebellar white matter. In this case report, the authors present the brain magnetic resonance spectroscopic features (normal N-acetylaspartate/creatine and increased choline/creatine and myoinositol/creatine ratios), which might indicate the absence of neuroaxonal loss and the presence of significant demyelination and glial proliferation in white matter, of an 11-year-old boy diagnosed with GAN. PMID:14569833

  11. Chemical Abundances of Symbiotic Giants

    NASA Astrophysics Data System (ADS)

    Gałan, C.; Mikołajewska, J.; Hinkle, K. H.; Joyce, R. R.

    2015-12-01

    High resolution (R ˜ 50000), near-IR spectra were used to measure photospheric abundances of CNO and elements around the iron peak for 24 symbiotic giants. Spectrum synthesis was employed using local thermal equilibrium and hydrostatic model atmospheres. The metallicities are distributed in a wide range with maximum around [Fe/H] ˜-0.4 - - 0.3 dex. Enrichment in 14N indicates that all the sample giants have experienced the first dredge-up. The relative abundance of [Ti/Fe] is generally large in red symbiotic systems.

  12. Charting the Giants

    NASA Astrophysics Data System (ADS)

    2004-06-01

    zero expansion asymptotically after an infinite time and has a flat geometry). All three observational tests by means of supernovae (green), the cosmic microwave background (blue) and galaxy clusters converge at a Universe around Ωm ~ 0.3 and ΩΛ ~ 0.7. The dark red region for the galaxy cluster determination corresponds to 95% certainty (2-sigma statistical deviation) when assuming good knowledge of all other cosmological parameters, and the light red region assumes a minimum knowledge. For the supernovae and WMAP results, the inner and outer regions corespond to 68% (1-sigma) and 95% certainty, respectively. References: Schuecker et al. 2003, A&A, 398, 867 (REFLEX); Tonry et al. 2003, ApJ, 594, 1 (supernovae); Riess et al. 2004, ApJ, 607, 665 (supernovae) Galaxy clusters are far from being evenly distributed in the Universe. Instead, they tend to conglomerate into even larger structures, "super-clusters". Thus, from stars which gather in galaxies, galaxies which congregate in clusters and clusters tying together in super-clusters, the Universe shows structuring on all scales, from the smallest to the largest ones. This is a relict of the very early (formation) epoch of the Universe, the so-called "inflationary" period. At that time, only a minuscule fraction of one second after the Big Bang, the tiny density fluctuations were amplified and over the eons, they gave birth to the much larger structures. Because of the link between the first fluctuations and the giant structures now observed, the unique REFLEX catalogue - the largest of its kind - allows astronomers to put considerable constraints on the content of the Universe, and in particular on the amount of dark matter that is believed to pervade it. Rather interestingly, these constraints are totally independent from all other methods so far used to assert the existence of dark matter, such as the study of very distant supernovae (see e.g. ESO PR 21/98) or the analysis of the Cosmic Microwave background (e

  13. Pharmacokinetics in renal disease.

    PubMed

    Levy, G

    1977-04-01

    The physiologic perturbations associated with renal disease can have a pronounced effect on the kinetics of elimination of drugs and their metabolites from the body. Drugs are ordinarily cleared from the body by a number of routes, each of which can be characterized by a clearance value. The sum of these clearances (renal, hepatic, etc.) is the total or body clearance which is inversely proportional to the steady-state plasma concentration produced by a given drug dosage regimen. The quantitative contribution of each route of elimination to the metabolic fate of a drug is proportional to the clearance value of that route relative to the body clearance. As a first approximation, the reduction in the renal clearance of a drug caused by renal disease is proportional to the reduction in the renal clearance of creatinine. The metabolic (biotransformation) clearance of many extensively plasma protein bound drugs is proportional to their free fraction (ratio of concentrations of free to total drug) in plasma. Since severe renal disease causes a reduction in the plasma protein binding of many drugs, the metabolic clearance of such drugs will be increased. The contribution of hemodialysis to the total clearance of a drug depends on the magnitude of the clearance obtained by hemodialysis relative to the magnitude of the body clearance of the drug on a day between dialyses. To compensate for the increased elimination of a drug during hemodialysis, the dosing rate (i.e., the dose per unit of time) must be increased by the factor (hemodialysis clearance and body clearance):body clearance, where body clearance is that during a day between dialyses. Further dosage compensation may be needed if body clearance is increased during hemodialysis due to decreased plasma protein binding of the drug. Under certain conditions, an increased accumulation of pharmacologically active drug metabolites during renal failure becomes a matter of serious concern. PMID:851113

  14. The giant panda gut microbiome.

    PubMed

    Wei, Fuwen; Wang, Xiao; Wu, Qi

    2015-08-01

    Giant pandas (Ailuropoda melanoleuca) are bamboo specialists that evolved from carnivores. Their gut microbiota probably aids in the digestion of cellulose and this is considered an example of gut microbiota adaptation to a bamboo diet. However, this issue remains unresolved and further functional and compositional studies are needed. PMID:26143242

  15. Giant Serpentine Aneurysms: Multidisciplinary Management

    PubMed Central

    Anshun, W.; Feng, L.; Daming, W.

    2000-01-01

    Summary Sixty-five cases of intracranial giant serpentine aneurysms (GSΛs), including 61 cases reported in the literature and four additional cases presented in this study were reviewed. The clinical presentation, possible causes, natural history, and especially management of GSAs are discussed with emphasis on the need for aggressive intervention and multidisciplinary management. PMID:20667180

  16. Renal disease in Colombia.

    PubMed

    Gómez, Rafael Alberto

    2006-01-01

    Chronic renal disease represents a problem of public health in Colombia. Its prevalence has increased in last decade, with a prevalence of 44.7 patients per million (ppm) in 1993 to 294.6 ppm in 2004, considering that only 56.2% of the population has access to the health. This increase complies with the implementation of Law 100 of 1993, offering greater coverage of health services to the Colombian population. The cost of these pathologies is equivalent to the 2.49% of the budget for health of the nation. The three most common causes of renal failure are diabetes mellitus (DM; 30%), arterial hypertension (30%), and glomerulonephritis (7.85%). In incident patients, the DM accounts for 32.9%. The rate of global mortality is 15.8%, 17.4% in hemodialysis and 15.1% in peritoneal dialysis. In 2004, 467 renal transplants were made, 381 of deceased donor with an incidence of 10.3 ppm. The excessive cost of these pathologies can cause the nation's health care system to collapse if preventative steps are not taken. In December of 2004, the Colombian Association of Nephrology with the participation of the Latin American Society of Nephrology and Arterial Hypertension wrote the "Declaration of Bogotá," committing the state's scientific societies and promotional health companies to develop a model of attention for renal health that, in addition to implementing national registries, continues to manage renal disease. PMID:17162422

  17. Renal consequences of obesity.

    PubMed

    Naumnik, Beata; Myśliwiec, Michał

    2010-08-01

    The worldwide prevalence of obesity and its associated metabolic and cardiovascular disorders has risen dramatically within the past 2 decades. Our objective is to review the mechanisms that link obesity with altered kidney function. Current evidence suggests that excess weight gain may be responsible for 65-75% of the risk for arterial hypertension. Impaired renal pressure natriuresis, initially due to increased renal tubular sodium reabsorption, is a key factor linking obesity with hypertension. Obesity increases renal sodium reabsorption by activating the renin-angiotensin and sympathetic nervous systems, and by altering intrarenal physical forces. Adipose tissue functions as an endocrine organ, secreting hormones/cytokines (e.g., leptin) which may trigger sodium retention and hypertension. Additionally, excess visceral adipose tissue may physically compress the kidneys, increasing intrarenal pressures and tubular reabsorption. Eventually, sustained obesity via hyperinsulinemia, due to resistance to insulin, causes hyperfiltration, resulting in structural changes in the kidneys--glomerular hyperthrophy and occasionally focal segmental glomerulosclerosis. The consequences of kidney injury are continuous loss of glomerular filtration rate, further increase of arterial pressure and escalation of cardiovascular morbidity and mortality. There is a growing awareness of the renal consequences of obesity, and considerable progress is being made in understanding its pathophysiology. Weight reduction results in lowered proteinuria. Aside from low sodium diet and exercises, more widespread use of renoprotective therapy (e.g., ACE inhibitors and statins) in treatment of hypertension in obese subjects should be advocated. Renal protection should result in reducing the cardiovascular complications of obesity. PMID:20671624

  18. Renal Tumor Biopsy Technique

    PubMed Central

    Zhang, Lei; Li, Xue-Song; Zhou, Li-Qun

    2016-01-01

    Objective: To review hot issues and future direction of renal tumor biopsy (RTB) technique. Data Sources: The literature concerning or including RTB technique in English was collected from PubMed published from 1990 to 2015. Study Selection: We included all the relevant articles on RTB technique in English, with no limitation of study design. Results: Computed tomography and ultrasound were usually used for guiding RTB with respective advantages. Core biopsy is more preferred over fine needle aspiration because of superior accuracy. A minimum of two good-quality cores for a single renal tumor is generally accepted. The use of coaxial guide is recommended. For biopsy location, sampling different regions including central and peripheral biopsies are recommended. Conclusion: In spite of some limitations, RTB technique is relatively mature to help optimize the treatment of renal tumors. PMID:27174334

  19. Tofacitinab in Renal Transplantation

    PubMed Central

    Zand, Martin S.

    2013-01-01

    Tofacitinib (tositinib, CP-690,550) is a small molecule inhibitor of Janus associated kinases, primarily JAK3 and JAK2, which inhibits cytokine signaling through the IL-2Rγ chain. In this article, we review the mechanism of action of tofacitinib, and pre-clinical and clinical data regarding its use in solid organ transplantation thus far. It is hoped that tofacitinib may form the basis for calcineurin-free immunosuppression, improving renal function while eliminating calcineurin inhibitor renal toxicity. Current studies suggest that tofacitinib is an effective immunosuppressive agent for renal transplantation, but it's use in current protocols carries an increased risk of CMV, BK, and EBV viral infection, anemia and leukopenia, and post-transplant lymphoproliferative disorder. PMID:23849222

  20. Lung Metastasis of Renal Cell Carcinoma: ACase Report of Pulmonary Sarcomatoid Carcinoma.

    PubMed

    Fan, Tao; Song, Ying-Jie

    2016-06-01

    Pulmonary sarcomatoid carcinoma (PSC) is a rare malignant cancer composed of sarcoma and sarcoma-like elements with spindle or giant cell features. We report the case of a 60-year-old male with past medical history of right renal cell carcinoma 2 years earlier. Apulmonary nodule was detected in the left upper lobe, 23 months after nephrectomy. Systemic positron emission tomography-computerized tomography (PET-CT) revealed one high metabolic mass shadow in the left upper lobe. Chest CTscan with contrast revealed a left upper lobe mass (2.9 x 2.5 cm). The case was suspected to be a lung metastasis of renal cell carcinoma. After surgery, the pathology revealed PSC-giant cell carcinoma. The tumor's pathology and treatment methods are discussed. PMID:27376226

  1. Contemporary Management of Renal Trauma

    PubMed Central

    Shoobridge, Jennifer J; Corcoran, Niall M; Martin, Katherine A; Koukounaras, Jim; Royce, Peter L; Bultitude, Matthew F

    2011-01-01

    In the management of renal trauma, surgical exploration inevitably leads to nephrectomy in all but a few specialized centers. With current management options, the majority of hemodynamically stable patients with renal injuries can be successfully managed nonoperatively. Improved radiographic techniques and the development of a validated renal injury scoring system have led to improved staging of injury severity that is relatively easy to monitor. This article reviews a multidisciplinary approach to facilitate the care of patients with renal injury. PMID:21941463

  2. Renal denervation and hypertension.

    PubMed

    Schlaich, Markus P; Krum, Henry; Sobotka, Paul A; Esler, Murray D

    2011-06-01

    Essential hypertension remains one of the biggest challenges in medicine with an enormous impact on both individual and society levels. With the exception of relatively rare monogenetic forms of hypertension, there is now general agreement that the condition is multifactorial in nature and hence requires therapeutic approaches targeting several aspects of the underlying pathophysiology. Accordingly, all major guidelines promote a combination of lifestyle interventions and combination pharmacotherapy to reach target blood pressure (BP) levels in order to reduce overall cardiovascular risk in affected patients. Although this approach works for many, it fails in a considerable number of patients for various reasons including drug-intolerance, noncompliance, physician inertia, and others, leaving them at unacceptably high cardiovascular risk. The quest for additional therapeutic approaches to safely and effectively manage hypertension continues and expands to the reappraisal of older concepts such as renal denervation. Based on the robust preclinical and clinical data surrounding the role of renal sympathetic nerves in various aspects of BP control very recent efforts have led to the development of a novel catheter-based approach using radiofrequency (RF) energy to selectively target and disrupt the renal nerves. The available evidence from the limited number of uncontrolled hypertensive patients in whom renal denervation has been performed are auspicious and indicate that the procedure has a favorable safety profile and is associated with a substantial and presumably sustained BP reduction. Although promising, a myriad of questions are far from being conclusively answered and require our concerted research efforts to explore the full potential and possible risks of this approach. Here we briefly review the science surrounding renal denervation, summarize the current data on safety and efficacy of renal nerve ablation, and discuss some of the open questions that need

  3. Renal adaptation during hibernation

    PubMed Central

    Martin, Sandra L.; Jain, Swati; Keys, Daniel; Edelstein, Charles L.

    2013-01-01

    Hibernators periodically undergo profound physiological changes including dramatic reductions in metabolic, heart, and respiratory rates and core body temperature. This review discusses the effect of hypoperfusion and hypothermia observed during hibernation on glomerular filtration and renal plasma flow, as well as specific adaptations in renal architecture, vasculature, the renin-angiotensin system, and upregulation of possible protective mechanisms during the extreme conditions endured by hibernating mammals. Understanding the mechanisms of protection against organ injury during hibernation may provide insights into potential therapies for organ injury during cold storage and reimplantation during transplantation. PMID:24049148

  4. Autophagy in renal diseases.

    PubMed

    De Rechter, Stéphanie; Decuypere, Jean-Paul; Ivanova, Ekaterina; van den Heuvel, Lambertus P; De Smedt, Humbert; Levtchenko, Elena; Mekahli, Djalila

    2016-05-01

    Autophagy is the cell biology process in which cytoplasmic components are degraded in lysosomes to maintain cellular homeostasis and energy production. In the healthy kidney, autophagy plays an important role in the homeostasis and viability of renal cells such as podocytes and tubular epithelial cells and of immune cells. Recently, evidence is mounting that (dys)regulation of autophagy is implicated in the pathogenesis of various renal diseases, and might be an attractive target for new renoprotective therapies. In this review, we provide an overview of the role of autophagy in kidney physiology and kidney diseases. PMID:26141928

  5. Physiology of the Renal Interstitium

    PubMed Central

    2015-01-01

    Long overlooked as the virtual compartment and then strictly characterized through descriptive morphologic analysis, the renal interstitium has finally been associated with function. With identification of interstitial renin- and erythropoietin-producing cells, the most prominent endocrine functions of the kidney have now been attributed to the renal interstitium. This article reviews the functional role of renal interstitium. PMID:25813241

  6. Susceptibility of farmed juvenile giant grouper Epinephelus lanceolatus to a newly isolated grouper iridovirus (genus Ranavirus).

    PubMed

    Peng, Chao; Ma, Hongling; Su, Youlu; Wen, Weigeng; Feng, Juan; Guo, Zhixun; Qiu, Lihua

    2015-06-12

    A ranavirus was isolated from the diseased farmed groupers (Grouper iridovirus in genus Ranavirus, GIV-R), Epinephelus hybrids (blotchy rock cod, Epinephelus fuscoguttatus ♀×giant grouper, Epinephelus lanceolatus ♂), in Sanya, Hainan, in July 2013. In this study, susceptibility of farmed juvenile giant grouper E. lanceolatus to GIV-R was determined by intraperitoneally injection. The cumulative mortality reached to 81% at 5 day post infection. Histologically, severe degeneration with massive pycnotic nuclei in spleen and kidney tissues was observed, and some small-size inclusion body-bearing cells (IBCs) existed in spleen. Hemorrhage and infiltration of inflammatory cells were presented in gill, liver and heart along with tissue degeneration and necrosis of varying severity. The results of immunohistochemistry analysis showed that the strongest immunolabellings were obtained from the kidney and spleen tissues, while intermediate intensity signals were observed in the heart, stomach, gill and liver tissues, and the weakest signals were obtained from the intestine and brain, but no signal was obtained in eyes. Electron microscopy revealed that spleen of moribund fish contained many viral particles in cytoplasm. Interestingly, in surviving fish, abnormal hypertrophic cells were observed in both splenic corpuscle and renal corpuscle, while no hypertrophic cell was observed in the other parts of spleen and kidney tissues. Moreover, immunolabellings only stained the hypertrophic cells in splenic corpuscle and renal corpuscle. This indicated that splenic corpuscle and renal corpuscle play an important role in GIV-R infection and replication. PMID:25912024

  7. [Giant intradiploic infratentorial epidermoid cyst].

    PubMed

    Alberione, F; Caire, F; Fischer-Lokou, D; Gueye, M; Moreau, J J

    2007-10-01

    Epidermoid cysts are benign, uncommon lesions (1% of all intracranial tumors). Their localization is intradiploic in 25% of cases, and exceptionally subtentorial. We report here a rare case of giant intradiploic infratentorial epidermoid cyst. A 74-year old patient presented with recent diplopia and sindrome cerebellar. CT scan and MR imaging revealed a giant osteolytic extradural lesion of the posterior fossa (5.2 cm x 3.8 cm) with a small area of peripheral enhancement after contrast injection. Retrosigmoid suboccipital craniectomy allowed a satisfactory removal of the tumor, followed by an acrylic cranioplasty. The outcome was good. Neuropathological examination confirmed an epidermoid cyst. We review the literature and discuss our case. PMID:18008017

  8. Giant viruses come of age.

    PubMed

    Fischer, Matthias G

    2016-06-01

    Viruses with genomes up to a few megabases in length are a common occurrence in nature, even though they have escaped our notice until recently. These giant viruses infect mainly single-celled eukaryotes and isolation efforts concentrating on amoebal hosts alone have spawned hundreds of viral isolates, featuring viruses with previously unseen virion morphologies and the largest known viral genomes and particles. One of the challenges that lie ahead is to analyze and categorize the available data and to establish an approved classification system that reflects the evolutionary relationships and biological properties of these viruses. Extensive sampling of Acanthamoeba-infecting mimiviruses and initial characterization of their virophage parasites have provided a first blueprint of the genetic diversity and composition of a giant virus clade that will facilitate the taxonomic grouping of these fascinating microorganisms. PMID:26999382

  9. Proteorhodopsin genes in giant viruses

    PubMed Central

    2012-01-01

    Viruses with large genomes encode numerous proteins that do not directly participate in virus biogenesis but rather modify key functional systems of infected cells. We report that a distinct group of giant viruses infecting unicellular eukaryotes that includes Organic Lake Phycodnaviruses and Phaeocystis globosa virus encode predicted proteorhodopsins that have not been previously detected in viruses. Search of metagenomic sequence data shows that putative viral proteorhodopsins are extremely abundant in marine environments. Phylogenetic analysis suggests that giant viruses acquired proteorhodopsins via horizontal gene transfer from proteorhodopsin-encoding protists although the actual donor(s) could not be presently identified. The pattern of conservation of the predicted functionally important amino acid residues suggests that viral proteorhodopsin homologs function as sensory rhodopsins. We hypothesize that viral rhodopsins modulate light-dependent signaling, in particular phototaxis, in infected protists. This article was reviewed by Igor B. Zhulin and Laksminarayan M. Iyer. For the full reviews, see the Reviewers’ reports section. PMID:23036091

  10. Hairpin Furans and Giant Biaryls.

    PubMed

    Geng, Xin; Mague, Joel T; Donahue, James P; Pascal, Robert A

    2016-05-01

    The thermal reaction of two cyclopentadienones with 5,5'-binaphthoquinone or 6,6'-dimethoxy-5,5'-binaphthoquinone in refluxing nitrobenzene (210 °C) gives, in a single synthetic step that includes two Diels-Alder additions, two decarbonylations, and two dehydrogenations, giant biaryl bisquinones (compounds 13, 14, 15, 18, and 21). However, when two cyclopentadienones react with 6,6'-dimethoxy-5,5'-binaphthoquinone in nitrobenzene at higher temperatures (250-260 °C), the resulting products are molecular ribbons composed of two twisted aromatic systems fused to a heteropentahelicene (19, 20, and 22). These molecules are representatives of a new class of chiral polycyclic aromatic compounds, the "hairpin furans". Interestingly, reheating a dimethoxy-substituted giant biaryl (e.g., 21) in nitrobenzene at 260 °C does not yield the corresponding hairpin furan (22), and mechanistic studies indicate that some intermediate or byproduct of the synthesis of the giant biaryls is a reagent or catalyst necessary for the conversion of the dimethoxybiaryl to the furan. PMID:27040596

  11. Observed Properties of Giant Cells

    NASA Technical Reports Server (NTRS)

    Hathaway, David H.; Upton, Lisa; Colegrove, Owen

    2014-01-01

    The existence of Giant Cells has been suggested by both theory and observation for over 45 years. We have tracked the motions of supergranules in SDO/HMI Doppler velocity data and find larger (Giant Cell) flows that persist for months. The flows in these cells are clockwise around centers of divergence in the north and counter-clockwise in the south. Equatorward flows are correlated with prograde flows - giving the transport of angular momentum toward the equator that is needed to maintain the Sun's rapid equatorial rotation. The cells are most pronounced at mid- and high-latitudes where they exhibit the rotation rates representative of those latitudes. These are clearly large, long-lived, cellular features, with the dynamical characteristics expected from the effects of the Sun's rotation, but the shapes of the cells are not well represented in numerical models. While the Giant Cell flow velocities are small (<10 m/s), their long lifetimes should nonetheless substantially impact the transport of magnetic flux in the Sun's near surface layers.

  12. Renal imaging techniques.

    PubMed

    Hierholzer, K; Hierholzer, J

    1997-01-01

    The ancient approach to obtain an image of the kidneys (and other internal organs) was 'section-inspection-imaging' by drawing, painting, sculpturing, and modelling. The present study follows chronologically the development and use of sectioning techniques from ancient (often forbidden) methods to modern microdissection and maceration of silicone-rubber-injected tubules. Inspection evolved from the use of the naked eye to magnifying lenses, microscopes and finally electron microscopy. Pertinent examples such as the description of the kidneys as the site of urine formation, the visualization of loop structures in the renal medulla and the imaging of tight junction strands are discussed. Inspection or visualization of renal structure and function has been revolutionized by modern noninvasive techniques, such as X-ray imaging, imaging by radioisotopes, ultrasound, computer tomography and nuclear magnetic resonance. Pertinent examples are given demonstrating the potency of the various techniques. The contribution of computerized data evaluation is discussed. The development of micropuncture and microperfusion techniques has opened the field for direct imaging not only of renal (sub)structural details but also of functional parameters such as transtubular reabsorption rates, single glomerular capillary filtration and conductance of the paracellular pathway. We focus particularly on techniques specifically designed to visualize renal hemodynamic and transport parameters. PMID:9189257

  13. Malignancy after renal transplantation.

    PubMed

    Zeier, Martin; Hartschuh, Wolfgang; Wiesel, Manfred; Lehnert, Thomas; Ritz, Eberhard

    2002-01-01

    Malignancy following renal transplantation is an important medical problem during the long-term follow-up. The overall incidence of malignancy at this time is 3 to 5 times higher than in the general population. The most common malignancies are lymphoproliferative disorders (early after transplantation) and skin carcinomas (late after transplantation). The type of malignancy is different in various countries and dependent on genetic and environmental factors. Another important confounder for risk of malignancy after renal transplantation is the type of immunosuppression. Previous use of cytotoxic drugs (eg, cyclophosphamide) or a history of analgesic abuse are additional risk factors. Malignancy may even be transplanted by the graft. Previous cancer treatment in a uremic patient on the transplant waiting list is of great importance in relation to waiting time and postmalignancy screening. Finally, every dialysis patient on the waiting list should undergo a regular screening program before and after renal transplantation to detect a potentially malignant tumor in an early stage. In addition to specific oncological treatment, managing a malignancy after renal transplantation should include modification of immunosuppression. PMID:11774131

  14. Metabolomics and Renal Disease

    PubMed Central

    Rhee, Eugene P.

    2015-01-01

    Purpose of review This review summarizes recent metabolomics studies of renal disease, outlining some of the limitations of the literature to date. Recent findings The application of metabolomics in nephrology research has expanded from initial analyses of uremia to include both cross-sectional and longitudinal studies of earlier stages of kidney disease. Although these studies have nominated several potential markers of incident CKD and CKD progression, lack of overlap in metabolite coverage has limited the ability to synthesize results across groups. Further, direct examination of renal metabolite handling has underscored the substantial impact kidney function has on these potential markers (and many other circulating metabolites). In experimental studies, metabolomics has been used to identify a signature of decreased mitochondrial function in diabetic nephropathy and a preference for aerobic glucose metabolism in PKD; in each case, these studies have outlined novel therapeutic opportunities. Finally, as a complement to the longstanding interest in renal metabolite clearance, the microbiome has been increasingly recognized as the source of many plasma metabolites, including some with potential functional relevance to CKD and its complications. Summary The high-throughput, high-resolution phenotyping enabled by metabolomics technologies has begun to provide insight on renal disease in clinical, physiologic, and experimental contexts. PMID:26050125

  15. Ablative therapies for renal tumors

    PubMed Central

    Ramanathan, Rajan; Leveillee, Raymond J.

    2010-01-01

    Owing to an increased use of diagnostic imaging for evaluating patients with other abdominal conditions, incidentally discovered kidney masses now account for a majority of renal tumors. Renal ablative therapy is assuming a more important role in patients with borderline renal impairment. Renal ablation uses heat or cold to bring about cell death. Radiofrequency ablation and cryoablation are two such procedures, and 5-year results are now emerging from both modalities. Renal biopsy at the time of ablation is extremely important in order to establish tissue diagnosis. Real-time temperature monitoring at the time of radiofrequency ablation is very useful to ensure adequacy of ablation. PMID:21789083

  16. Guiding the Giant

    NASA Astrophysics Data System (ADS)

    1998-08-01

    New ESO Survey Provides Targets for the VLT Giant astronomical telescopes like the ESO Very Large Telescope (VLT) must be used efficiently. Observing time is expensive and there are long waiting lines of excellent research programmes. Thus the work at the telescope must be very well prepared and optimized as much as possible - mistakes should be avoided and no time lost! Astronomers working with the new 8-m class optical/infrared telescopes must base their observations on detailed lists of suitable target objects if they want to perform cutting-edge science. This is particularly true for research programmes that depend on observations of large samples of comparatively rare, distant objects. This type of work requires that extensive catalogues of such objects must be prepared in advance. One such major catalogue - that will serve as a very useful basis for future VLT observations - has just become available from the new ESO Imaging Survey (EIS). The Need for Sky Surveys Astronomers have since long recognized the need to carry out preparatory observations with other telescopes in order to "guide" large telescopes. To this end, surveys of smaller or larger parts of the sky have been performed by wide-field telescopes, paving the way for subsequent work at the limits of the largest available ground-based telescopes. For instance, a complete photographic survey of the sourthern sky (declination < -17.5°) was carried out in the 1970's with the ESO 1-metre Schmidt Telescope in support of the work at the 3.6-m telescope at the ESO La Silla observatory. However, while until recently most observational programmes could rely on samples of objects found on photographic plates, this is no longer possible. New image surveys must match the fainter limiting magnitudes reached by the new and larger telescopes. Modern digital, multi-colour, deep imaging surveys have thus become an indispensable complement to the 8-m telescopes. The new generation of imaging surveys will, without

  17. Cabergoline Treatment in Invasive Giant Prolactinoma

    PubMed Central

    Alsubaie, Sadeem; Almalki, Mussa H

    2014-01-01

    Patients with invasive giant prolactinoma suffer from a constellation of symptoms including headache, blurred vision, lethargy, and sexual dysfunction. Cabergoline, a potent dopamine agonist, is a known medication prescribed for the treatment of invasive giant prolactinoma. Here, we report a case of invasive giant prolactinoma in a 52-year-old Saudi male with dramatic response to cabergoline treatment clinically, biochemically, and radiologically. PMID:25002819

  18. RENAL INSUFFICIENCY FOLLOWING TRYPSIN INJECTION INTO THE RENAL ARTERIES.

    PubMed

    Friedman, M; Katz, L N

    1938-09-30

    1. The injection of trypsin into both renal arteries of the dog was found to cause an acute necrosis of large sections of the kidney, an immediate excretory insufficiency, and a transient hypertension. 2. Dogs surviving the acute phase of the trypsin injection, developed a chronic renal excretory insufficiency with no hypertension, despite the severity and duration of the renal excretory insufficiency. 3. The application of a Goldblatt clamp to the renal artery of one of the two kidneys, previously injected with trypsin, led to a rise in blood pressure which returned at once to normal when the ischemic kidney was removed, even though the pre-existing renal excretory insufficiency was augmented. This experience demonstrated unequivocally that chronic renal excretory insufficiency and hypertension are not directly related. 4. The application of a Goldblatt clamp to the renal artery of one kidney and the simultaneous injection of trypsin into the other led to a hypertension. The later removal of the ischemic kidney led to a severe renal excretory insufficiency, at the same time the pre-existing hypertension disappeared. This indicated again that renal excretory insufficiency and renal ischemia produced different phenomena and that the former had no direct relation to hypertension. PMID:19870800

  19. Speciation and phylogeography of giant petrels Macronectes.

    PubMed

    Techow, N M S M; O'Ryan, C; Phillips, R A; Gales, R; Marin, M; Patterson-Fraser, D; Quintana, F; Ritz, M S; Thompson, D R; Wanless, R M; Weimerskirch, H; Ryan, P G

    2010-02-01

    We examine global phylogeography of the two forms of giant petrel Macronectes spp. Although previously considered to be a single taxon, and despite debate over the status of some populations and the existence of minimal genetic data (one mitochondrial cytochrome b sequence per form), the current consensus based on morphology is that there are two species, Northern Giant Petrel M. halli and Southern Giant Petrel M. giganteus. This study examined genetic variation at cytochrome b as well as six microsatellite loci in giant petrels from 22 islands, representing most island groups at which the two species breed. Both markers support separate species status, although sequence divergence in cytochrome b was only 0.42% (corrected). Divergence was estimated to have occurred approximately 0.2mya, but with some colonies apparently separated for longer (up to 0.5 my). Three clades were found within giant petrels, which separated approximately 0.7mya, with the Southern Giant Petrel paraphyletic to a monophyletic Northern Giant Petrel. There was evidence of past fragmentation during the Pleistocene, with subsequent secondary contact within Southern Giant Petrels. The analysis also suggested a period of past population expansion that corresponded roughly to the timing of speciation and the separation of an ancestral giant petrel population from the fulmar Fulmarus clade. PMID:19755164

  20. Spontaneous thrombosis in giant intracranial aneurysms.

    PubMed Central

    Whittle, I R; Dorsch, N W; Besser, M

    1982-01-01

    Twelve patients in a series of 22 with giant intracranial aneurysms demonstrated neuroradiological features of partial or total spontaneous intra-aneurysmal thrombosis. The presence of this intra-aneurysmal clot significantly altered the computed tomographic appearance of the giant aneurysm. Massive intra-aneurysmal thrombosis did not protect against subarachnoid haemorrhage and the likelihood of rupture of a clot containing giant aneurysm was not significantly different from that of a non-thrombosed giant aneurysm. Although parent artery occlusion from a thrombosed giant aneurysm, and massive aneurysmal thrombosis leading to the formation of giant serpentine aneurysm were documented, these are rare epiphenomena. The risk of embolisation from a partially thrombosed giant aneurysm, which was documented in one case, would appear to be greater than that from a non-thrombosed giant aneurysm. The findings in this series, and a review of literature, suggest that the presence of intra-aneurysmal clot in giant intracranial aneurysms has little prognostic significance and does not alter the management or outcome after treatment. Images PMID:7175528

  1. Dental management of people with renal disease and renal transplants.

    PubMed

    Ferguson, C A; Whyman, R A

    1998-09-01

    Chronic renal failure is the result of progressive loss of functioning nephrons leading to loss of renal function and accumulation of excretory products. Loss of the regulatory and excretory functions of the kidneys causes oral manifestations and multiple complications which have implications for dental care. Dental management of patients with renal failure and renal transplants involves consideration of specific haematological and cardiovascular effects, and implications for the prescribing and use of pharmaceuticals. It also requires the dentist to appreciate the potential for involvement of multiple organ systems in the disease process and the implications this has for dental care. The orofacial manifestations of chronic renal failure are secondary to systemic manifestations and are not specific to the diagnosis of end-stage renal disease. PMID:9775650

  2. Warm Disks from Giant Impacts

    NASA Astrophysics Data System (ADS)

    Kohler, Susanna

    2015-10-01

    In the process of searching for exoplanetary systems, weve discovered tens of debris disks close around distant stars that are especially bright in infrared wavelengths. New research suggests that we might be looking at the late stages of terrestrial planet formation in these systems.Forming Terrestrial PlanetsAccording to the widely-accepted formation model for our solar-system, protoplanets the size of Mars formed within a protoplanetary disk around our Sun. Eventually, the depletion of the gas in the disk led the orbits of these protoplanets to become chaotically unstable. Finally, in the giant impact stage, many of the protoplanets collided with each other ultimately leading to the formation of the terrestrial planets and their moons as we know them today.If giant impact stages occur in exoplanetary systems, too leading to the formation of terrestrial exoplanets how would we detect this process? According to a study led by Hidenori Genda of the Tokyo Institute of Technology, we might be already be witnessing this stage in observations of warm debris disks around other stars. To test this, Genda and collaborators model giant impact stages and determine what we would expect to see from a system undergoing this violent evolution.Modeling CollisionsSnapshots of a giant impact in one of the authors simulations. The collision causes roughly 0.05 Earth masses of protoplanetary material to be ejected from the system. Click for a closer look! [Genda et al. 2015]The collaborators run a series of simulations evolving protoplanetary bodies in a solar system. The simulations begin 10 Myr into the lifetime of the solar system, i.e., after the gas from the protoplanetary disk has had time to be cleared and the protoplanetary orbits begin to destabilize. The simulations end when the protoplanets are done smashing into each other and have again settled into stable orbits, typically after ~100 Myr.The authors find that, over an average giant impact stage, the total amount of

  3. Improvement of renal function after opening occluded atherosclerotic renal arteries.

    PubMed

    Kanamori, Hiroshi; Toma, Masanao; Fukatsu, Atsushi

    2009-09-01

    Percutaneous transluminal renal angioplasty (PTRA) with stenting has been effective in the control of hypertension, renal function and pulmonary edema caused by atherosclerotic renal artery stenosis (ARAS). However, concerning the viability of renal function, this procedure has not been fully established, especially in the presence of renal atrophy or severe renal parenchymal disease. We report a dramatically improved case of acute renal failure caused by acute worsening ARAS treated by stenting. A 72-year-old female was admitted for accelerated renal dysfunction (serum ceatinine; 1.2-2.3 mg/dl) and hypertension (190/100 mmHg). At 10 days after admission, the patient's serum ceatinine increased to 6.7 mg/dl, her pulmonary edema was exaggerated and hemodialysis was required. Ultrasonography showed bilateral high-echoic kidneys, but no apparent finding of renal artery stenosis (RAS). At day 15, computed tomographic angiography indicated bilateral ostial RAS. Renal angiography demonstrated total occlusion of the right and severe (90%) disease in the left. ARAS was diagnosed by intravascular ultrasonography. The guidewire was inserted in both renal arteries, PTRA with stenting was performed in the right and a stent was directly implanted in the left. Immediately, each kidney enlarged to almost normal size, leading to satisfactory urination. She was released from hemodialysis the next day since her serum creatinine was normal and the pulmonary edema was improved. Although there is still no reliable prognostic factor including resistive index or kidney size, it is important that PTRA with stenting in ARAS should be considered in a case of accelerated renal dysfunction because of the possible improvement. PMID:19726830

  4. Bilateral renal calculi

    PubMed Central

    Sreenevasan, G

    1974-01-01

    Bilateral renal calculi were present in 114 (10.7%) of 1,070 cases of proved urinary calculus admitted to the Urological Department of the General Hospital, Kuala Lumpur, during the period November 1968—May 1973. The management of bilateral renal calculi is discussed with reference to the first 100 cases in this series. The introduction of renography has greatly facilitated the decision as to which kidney should be operated on first. The management of patients with and without uraemia is discussed and the use of the modified V and V—Y incisions for the removal of staghorn calculi is described. Complications and results are briefly reviewed. ImagesFig. 1Fig. 4Fig. 6Fig. 7 PMID:4845653

  5. Inherited renal carcinomas.

    PubMed

    Kawashima, Akira; Young, Scott W; Takahashi, Naoki; King, Bernard F; Atwell, Thomas D

    2016-06-01

    Hereditary forms of kidney carcinoma account for 5-8% of all malignant kidney neoplasms. The renal tumors are often multiple and bilateral and occur at an earlier age. Each of the hereditary kidney carcinoma syndromes is associated with specific gene mutations as well as a specific histologic type of kidney carcinoma. The presence of associated extrarenal manifestations may suggest a hereditary kidney cancer syndrome. Radiology is most commonly used to screen and manage patients with hereditary kidney cancer syndromes. This manuscript reviews the clinical and imaging findings of well-defined inherited kidney cancer syndromes including von Hippel-Lindau disease, Birt-Hogg-Dubé syndrome, hereditary papillary renal carcinoma syndrome, hereditary leiomyomatosis and RCC syndrome, tuberous sclerosis complex, and Lynch syndrome. PMID:27108134

  6. Renal Clearance of Nanoparticles

    PubMed Central

    Choi, Hak Soo; Liu, Wenhao; Misra, Preeti; Tanaka, Eiichi; Zimmer, John P.; Ipe, Binil Itty; Bawendi, Moungi G.; Frangioni, John V.

    2008-01-01

    SUMMARY The field of nanotechnology holds great promise for the diagnosis and treatment of human disease. However, the size and charge of most nanoparticles preclude their efficient clearance from the body as intact nanoparticles. Without such clearance or their biodegradation into biologically benign components, toxicity is potentially amplified and radiological imaging is hindered. Using quantum dots (QDs) as a model system, we have precisely defined the requirements for renal filtration and urinary excretion of inorganic, metal-containing nanoparticles. Zwitterionic or neutral organic coatings prevented adsorption of serum proteins, which otherwise increased hydrodynamic diameter (HD) by over 15 nm and prevented renal excretion. A final HD smaller than 5.5 nm resulted in rapid and efficient urinary excretion, and elimination of QDs from the body. This study provides a foundation for the design and development of biologically targeted nanoparticles for biomedical applications. PMID:17891134

  7. Renal injury in sport.

    PubMed

    Holmes, F Clarke; Hunt, Jeremy J; Sevier, Thomas L

    2003-04-01

    Hematuria is the most common presenting sign of renal injury. Its presence in athletes may indicate a benign entity such as exercise-induced hematuria or a more serious injury in the presence of trauma. Exercise-induced hematuria can originate in the kidney, bladder, urethra, or prostate. The type of activity, as well as activity duration and intensity, contributes to its development. A wide differential diagnosis must be considered if hematuria persists longer than 24 to 72 hours. Trauma to the kidney can occur from a direct blow or deceleration; contact and collision sports are most commonly involved. Fortunately, most sports-related renal trauma is mild, and can be managed expectantly. A sporting injury rarely results in nephrectomy. Determining return to play for the athlete with a single kidney remains a controversial issue that requires patient education and an individualized approach. PMID:12831667

  8. Renal stones in pregnancy

    PubMed Central

    Gibbons, Norma; DasGupta, Ranan

    2014-01-01

    Diagnosis and treatment of renal stones during pregnancy is a complex problem. Risks to the fetus from ionising radiation and interventional procedures need to be balanced with optimising clinical care for the mother. Management of such patients requires a clear understanding of available options, with a multidisciplinary team approach. In this review, we discuss the role of different diagnostic tests including ultrasound, magnetic resonance urography, and computerized tomography. We also provide an update on recent developments in the treatment of renal stones during pregnancy. Expectant management remains first-line treatment. Where definitive treatment of the stone is required, new evidence suggests that ureteroscopic stone removal may be equally safe, and possibly better than traditional temporising procedures.

  9. Renal Medullary Interstitial Cells

    NASA Astrophysics Data System (ADS)

    Rao, Reena; Hao, Chuan-Ming; Breyer, Matthew D.

    2007-04-01

    Renal medullary interstitial cells (RMICs) are specialized fibroblast-like cells that reside in the renal medulla among the vasa recta, the thin limbs of Henle's loop, and medullary collecting ducts. These cells are characterized by abundant lipid droplets in the cytoplasm. The lipid droplets are composed of triglycerides, cholesterol esters and free long-chain fatty acids, including arachidonic acid. RMICs are also a major site of cyclooxygenase2 (COX-2) expression, and thus a major site of COX-2 derived prostanoid biosynthesis. RMICs are also a potential target of hormones such as angiotensin II and endothelin. The RMIC COX-2 expression and the abundance of lipid droplets change with salt and water intake. These properties of RMICs are consistent with an important role of these cells in modulating physiologic and pathologic processes of the kidney.

  10. Giant rockslides from the inside

    NASA Astrophysics Data System (ADS)

    Weidinger, Johannes T.; Korup, Oliver; Munack, Henry; Altenberger, Uwe; Dunning, Stuart A.; Tippelt, Gerold; Lottermoser, Werner

    2014-03-01

    The growing body of research on large-scale mass wasting events so far has only scarcely investigated the sedimentology of chaotic deposits from non-volcanic terrestrial landslides such that any overarching and systematic terminological framework remains elusive. Yet recent work has emphasized the need for better understanding the internal structure and composition of rockslide deposits as a means to characterise the mechanics during the final stages of runout and emplacement. We offer a comprehensive overview on the occurrence of rock fragmentation and frictional melt both at different geographic locations, and different sections within large (>106 m) rockslide masses. We argue that exposures of pervasively fragmented and interlocked jigsaw-cracked rock masses; basal mélange containing rip-up clasts and phantom blocks; micro-breccia; and thin bands of basal frictionite are indispensable clues for identifying deposits from giant rockslides that may remain morphologically inconspicuous otherwise. These sedimentary assemblages are diagnostic tools for distinguishing large rockslide debris from macro- and microscopically similar glacial deposits, tectonic fault-zone breccias, and impact breccias, and thus help avoid palaeoclimatic and tectonic misinterpretations, let alone misestimates of the hazard from giant rockslides. Moreover, experimental results from Mössbauer spectroscopy of frictionite samples support visual interpretations of thin sections, and demonstrate that short-lived (<10 s) friction-induced partial melting at temperatures >1500 °C in the absence of water occurred at the base of several giant moving rockslides. This finding supports previous theories of dry excess runout accompanied by comminution of rock masses down to μm-scale, and indicates that catastrophic motion of large fragmenting rock masses does not require water as a potential lubricant.

  11. Renal Infarction Caused by Isolated Spontaneous Renal Artery Intramural Hematoma

    PubMed Central

    Park, Sihyung; Lee, Ga Hee; Jin, Kyubok; Park, Kang Min; Kim, Yang Wook; Park, Bong Soo

    2015-01-01

    Patient: Male, 46 Final Diagnosis: Renal infarction Symptoms: Flank pain Medication: — Clinical Procedure: CT Specialty: Nephrology Objective: Rare disease Background: Acute renal infarction is an uncommon condition resulting from an obstruction or a decrease in renal arterial blood flow. Isolated spontaneous renal artery intramural hematoma is a rare cause of renal infarction. Case Report: A 46-year-old healthy man presented to our emergency room because of sudden onset of severe right flank pain. An enhanced abdominal computed tomography scan showed a low-attenuated lesion in the lateral portion of the right kidney but no visible thromboembolisms in the main vessels. Computed tomography angiography revealed acute infarction resulting from intramural hematoma of the anterior segmental artery of the right kidney, with distal occlusion. Conclusions: The rarity and non-specific clinical presentation of renal infarction often lead to a delayed diagnosis that may result in impaired renal function. Clinical suspicion is important in the early diagnosis, and intramural hematoma of the renal artery should be considered the cause of renal infarction even in healthy patients without pre-disposing factors. PMID:26596500

  12. Giant Piloleiomyoma of the Forehead

    PubMed Central

    Kim, Gun-Wook; Park, Hyun-Je; Kim, Hoon-Soo; Kim, Su-Han; Ko, Hyun-Chang; Kim, Byung-Soo

    2011-01-01

    Cutaneous piloleiomyomas are benign smooth muscle tumors arising from the arrector pili muscles. Piloleiomyomas appear as firm dermal papules of skin color or with a reddish to brown surface, and are commonly located on the extremities. Histologically, these lesions are composed of interlacing bundles of smooth muscle cells in the reticular dermis. Our case presented with an unusually large nodule on the forehead that was accompanied by intermittent pain. Histological analysis was compatible with piloleiomyoma and the lesion showed haphazardly arranged bundles of smooth muscle in the dermis. We describe herein an interesting case of a giant piloleiomyoma occurring on the forehead. PMID:22148036

  13. [Aortitis in giant cell arteritis].

    PubMed

    Schmidt, J; Duhaut, P

    2016-04-01

    Aortitis is a frequent complication of giant cell arteritis. Imaging techniques can reveal the inflammation of the aortic wall. CT-scan can show circumferential aortic wall thickening, or TEP-scan can show aortic FDG-uptake. Aortic aneurysm and dissection is a feared but probably rare complication of the inflammation of the aortic wall during GCA. Screening for aortitis could be proposed for patients with symptoms of aortic involvement, for patients with signs of large vessels involvement (limb claudication, bruit) or for patients with incomplete response to treatment. The best follow-up and treatment are to be determined for the patients with aortitis related to GCA. PMID:26781692

  14. Renal Replacement Therapy.

    PubMed

    Ricci, Zaccaria; Romagnoli, Stefano; Ronco, Claudio

    2016-01-01

    During the last few years, due to medical and surgical evolution, patients with increasingly severe diseases causing multiorgan dysfunction are frequently admitted to intensive care units. Therapeutic options, when organ failure occurs, are frequently nonspecific and mostly directed towards supporting vital function. In these scenarios, the kidneys are almost always involved and, therefore, renal replacement therapies have become a common routine practice in critically ill patients with acute kidney injury. Recent technological improvement has led to the production of safe, versatile and efficient dialysis machines. In addition, emerging evidence may allow better individualization of treatment with tailored prescription depending on the patients' clinical picture (e.g. sepsis, fluid overload, pediatric). The aim of the present review is to give a general overview of current practice in renal replacement therapies for critically ill patients. The main clinical aspects, including dose prescription, modality of dialysis delivery, anticoagulation strategies and timing will be addressed. In addition, some technical issues on physical principles governing blood purification, filters characteristics, and vascular access, will be covered. Finally, a section on current standard nomenclature of renal replacement therapy is devoted to clarify the "Tower of Babel" of critical care nephrology. PMID:26918174

  15. Renal Replacement Therapy

    PubMed Central

    Ricci, Zaccaria; Romagnoli, Stefano; Ronco, Claudio

    2016-01-01

    During the last few years, due to medical and surgical evolution, patients with increasingly severe diseases causing multiorgan dysfunction are frequently admitted to intensive care units. Therapeutic options, when organ failure occurs, are frequently nonspecific and mostly directed towards supporting vital function. In these scenarios, the kidneys are almost always involved and, therefore, renal replacement therapies have become a common routine practice in critically ill patients with acute kidney injury. Recent technological improvement has led to the production of safe, versatile and efficient dialysis machines. In addition, emerging evidence may allow better individualization of treatment with tailored prescription depending on the patients’ clinical picture (e.g. sepsis, fluid overload, pediatric). The aim of the present review is to give a general overview of current practice in renal replacement therapies for critically ill patients. The main clinical aspects, including dose prescription, modality of dialysis delivery, anticoagulation strategies and timing will be addressed. In addition, some technical issues on physical principles governing blood purification, filters characteristics, and vascular access, will be covered. Finally, a section on current standard nomenclature of renal replacement therapy is devoted to clarify the “Tower of Babel” of critical care nephrology. PMID:26918174

  16. Percutaneous renal cryoablation: current status.

    PubMed

    Mazaris, Evangelos M; Varkarakis, Ioannis M; Solomon, Stephen B

    2008-04-01

    Over the last 13 years, renal cryoablation has emerged as a promising technique for the treatment of solid renal tumors. The improvement in imaging modalities such as ultrasound, computed tomography and MRI, as well as the introduction of thinner probes, has led to the spread of the minimally invasive percutaneous approach. We review the historical background of percutaneous renal cryoablation (PRC), present its basic principles, mention the contemporary clinical data and outcomes of this technique and suggest future directions for its wider application in renal tumors. Early results have demonstrated that it may offer an alternative for the treatment of small renal masses with the advantages of minimal complications, spared renal function, decreased overall costs and equivalent oncologic efficacy. Long-term results are required in order to apply this minimally invasive technique to a broader spectrum of patients. PMID:18407738

  17. Drug-induced renal disorders.

    PubMed

    Ghane Shahrbaf, Fatemeh; Assadi, Farahnak

    2015-01-01

    Drug-induced nephrotoxicity are more common among infants and young children and in certain clinical situations such as underlying renal dysfunction and cardiovascular disease. Drugs can cause acute renal injury, intrarenal obstruction, interstitial nephritis, nephrotic syndrome, and acid-base and fluid electrolytes disorders. Certain drugs can cause alteration in intraglomerular hemodynamics, inflammatory changes in renal tubular cells, leading to acute kidney injury (AKI), tubulointerstitial disease and renal scarring. Drug-induced nephrotoxicity tends to occur more frequently in patients with intravascular volume depletion, diabetes, congestive heart failure, chronic kidney disease, and sepsis. Therefore, early detection of drugs adverse effects is important to prevent progression to end-stage renal disease. Preventive measures requires knowledge of mechanisms of drug-induced nephrotoxicity, understanding patients and drug-related risk factors coupled with therapeutic intervention by correcting risk factors, assessing baseline renal function before initiation of therapy, adjusting the drug dosage and avoiding use of nephrotoxic drug combinations. PMID:26468475

  18. Bilateral giant cyst of the shoulder.

    PubMed

    Agarwal, A; Ferrante, J; Schmidt, R; Eisenbeis, C H

    1987-01-01

    The case of a 61 year old white female with a rapidly progressive rheumatoid arthritis who developed bilateral giant cyst of the shoulder is described here. Arthrographic investigation indicated that these giant cysts were true synovial cysts rather than "pseudocysts". PMID:3427842

  19. Multiple oncocytomas and renal carcinoma

    SciTech Connect

    Velasquez, G.; Glass, T.A.; D'Souza, V.J.; Formanek, A.G.

    1984-01-01

    Renal oncocytoma, although rare, is being diagnosed more frequently, and criteria to differentiate it from other tumors have been described. Multiple oncocytomas have been reported, but an association between multiple oncocytomas and renal carcinoma in the same kidney has not been described. The authors report a case with two oncocytomas and a renal carcinoma in the right kidney as well as a right adrenal adenoma.

  20. Sodium in weak G-band giants

    NASA Technical Reports Server (NTRS)

    Drake, Jeremy J.; Lambert, David L.

    1994-01-01

    Sodium abundances have been determined for eight weak G-band giants whose atmospheres are greatly enriched with products of the CN-cycling H-burning reactions. Systematic errors are minimized by comparing the weak G-band giants to a sample of similar but normal giants. If, further, Ca is selected as a reference element, model atmosphere-related errors should largely be removed. For the weak-G-band stars (Na/Ca) = 0.16 +/- 0.01, which is just possibly greater than the result (Na/Ca) = 0.10 /- 0.03 from the normal giants. This result demonstrates that the atmospheres of the weak G-band giants are not seriously contaminated with products of ON cycling.

  1. Deep Imaging of Giant Planets

    NASA Astrophysics Data System (ADS)

    Chauvin, G.

    2010-10-01

    With the development of high contrast imaging instruments and techniques, vast efforts have been devoted during the past decade to detect and characterize lighter, cooler and closer companions to nearby stars, and ultimately image new planetary systems. Complementary to other observing techniques (radial velocity, transit, micro-lensing, pulsar-timing and astrometry), this approach has opened a new astrophysical window to study the physical properties and the formation and evolution mechanisms of giant planets at orbits larger than a few AUs. In this review, I will briefly present the main motivations to use deep imaging to search for exoplanets and review the constant progress achieved thanks to improved performances of advanced instrumentation and data analysis techniques. I will describe the main classes of stars identified and observed so far to increase the chances of detection. I will also detail the classical strategy adopted to identify false alarms and characterize true companions. I will review the current status of the different deep imaging surveys as well as the main results that recently led to the discovery of giant planets probably formed like the ones of our solar system. Finally, I will rise the questions and uncertainties related to the formation mechanisms, the physical properties and the frequency of these planetary mass companions to conclude with the exciting and attractive perspectives offered with the future generation of deep imaging instruments.

  2. Giant Planets in Open Clusters

    NASA Astrophysics Data System (ADS)

    Quinn, S. N.; White, R. J.; Latham, D. W.

    2015-10-01

    Two decades after the discovery of 51 Peg b, more than 200 hot Jupiters have now been confirmed, but the details of their inward migration remain uncertain. While it is widely accepted that short period giant planets could not have formed in situ, several different mechanisms (e.g., Type II migration, planet-planet scattering, Kozai-Lidov cycles) may contribute to shrinking planetary orbits, and the relative importance of each is not well-constrained. Migration through the gas disk is expected to preserve circular, coplanar orbits and must occur quickly (within ˜ 10 Myr), whereas multi-body processes should initially excite eccentricities and inclinations and may take hundreds of millions of years. Subsequent evolution of the system (e.g., orbital circularization and inclination damping via tidal interaction with the host star) may obscure these differences, so observing hot Jupiters soon after migration occurs can constrain the importance of each mechanism. Fortunately, the well-characterized stars in young and adolescent open clusters (with known ages and compositions) provide natural laboratories for such studies, and recent surveys have begun to take advantage of this opportunity. We present a review of the discoveries in this emerging realm of exoplanet science, discuss the constraints they provide for giant planet formation and migration, and reflect on the future direction of the field.

  3. The renal scan in pregnant renal transplant patients

    SciTech Connect

    Goldstein, H.A.; Ziessman, H.A.; Fahey, F.H.; Collea, J.V.; Alijani, M.R.; Helfrich, G.B.

    1985-05-01

    With the greater frequency of renal transplant surgery, more female pts are becoming pregnant and carrying to term. In the renal allograft blood vessels and ureter may be compressed resulting in impaired renal function and/or, hypertension. Toxemia of pregnancy is seen more frequently than normal. Radionuclide renal scan monitoring may be of significant value in this high risk obstetrical pt. After being maintained during the pregnancy, renal function may also deteriorate in the post partum period. 5 pregnant renal transplant pts who delivered live babies had renal studies with Tc-99m DTPA to assess allograft perfusion and function. No transplanted kidney was lost during or after pregnancy as a result of pregnancy. No congenital anomalies were associated with transplant management. 7 studies were performed on these 5 pts. The 7 scans all showed the uterus/placenta. The bladder was always distorted. The transplanted kidney was rotated to a more vertical position in 3 pts. The radiation dose to the fetus is calculated at 0.024 rad/mCi administered. This study demonstrates the anatomic and physiologic alterations expected in the transplanted kidney during pregnancy when evaluated by renal scan and that the radiation burden may be acceptable in management of these pts.

  4. Two Giant Planets Orbiting the K Giant Star η Cet

    NASA Astrophysics Data System (ADS)

    Trifonov, T.; Reffert, S.; Tan, X.; Lee, M. H.; Quirrenbach, A.

    2014-01-01

    We present evidence of a new planetary system around the K giant η Cet (HIP 5364, HD 6805, HR 334), based on 124 high-precision optical and infrared radial velocity data, taken at Lick Observatory (Hamilton) and at VLT (CRIRES). The best dynamical fit to the data is consistent with two massive planets (m 1sini~2.6M Jup , m 2sini~3.3MJup ) and with periods of P 1~407 days, P 2~740 days. To test the η Cet system's stability we perform ~ 10,000 dynamical investigations with maximum time spans of 108 years. We find that in case of moderate eccentricities, the planets can be effectively trapped in an anti-aligned stable 2:1 mean motion resonance (MMR), very close to the separatrix. A larger non-resonant stable region exists in low-eccentricity parameter space, although less probable than the 2:1 MMR region.

  5. Early diagnosis of renal disease and renal failure.

    PubMed

    Lees, George E

    2004-07-01

    The main goal of early diagnosis of renal disease and renal failure in dogs and cats is to enable timely application of therapeutic interventions that may slow or halt disease progression. Strategies for early diagnosis of renal disease use urine tests that detect proteinuria that is a manifestation of altered glomerular permselectivity or impaired urine-concentrating ability as well blood tests to evaluate plasma creatinine concentration. Animals with progressive renal disease should be carefully investigated and treated appropriately. Animals with mild, possibly nonprogressive, renal disease should be monitored adequately to detect any worsening trends,which should lead to further investigation and treatment even if the increments of change are small. PMID:15223206

  6. Contemporary Renal Cell Cancer Epidemiology

    PubMed Central

    Chow, Wong-Ho; Devesa, Susan S.

    2010-01-01

    We analyzed renal cell cancer incidence patterns in the United States and reviewed recent epidemiologic evidence with regard to environmental and host genetic determinants of renal cell cancer risk. Renal cell cancer incidence rates continued to rise among all racial/ethnic groups in the United States, across all age groups, and for all tumor sizes, with the most rapid increases for localized stage disease and small tumors. Recent cohort studies confirmed the association of smoking, excess body weight, and hypertension with an elevated risk of renal cell cancer, and suggested that these factors can be modified to reduce the risk. There is increasing evidence for an inverse association between renal cell cancer risk and physical activity and moderate intake of alcohol. Occupational exposure to TCE has been positively associated with renal cell cancer risk in several recent studies, but its link with somatic mutations of the VHL gene has not been confirmed. Studies of genetic polymorphisms in relation to renal cell cancer risk have produced mixed results, but genome-wide association studies with larger sample size and a more comprehensive approach are underway. Few epidemiologic studies have evaluated risk factors by subtypes of renal cell cancer defined by somatic mutations and other tumor markers. PMID:18836333

  7. UNITED STATES RENAL DATA SYSTEM

    EPA Science Inventory

    The United States Renal Data System (USRDS) is a national data system that collects, analyzes, and distributes information about end-stage renal disease (ESRD) in the United States. The USRDS is funded directly by the National Institute of Diabetes and Digestive and Kidney Diseas...

  8. Giant tunneling magnetoresistance in silicene

    SciTech Connect

    Wang, Yu; Lou, Yiyi

    2013-11-14

    We have theoretically studied ballistic electron transport in silicene under the manipulation of a pair of ferromagnetic gate. Transport properties like transmission and conductance have been calculated by the standard transfer matrix method for parallel and antiparallel magnetization configurations. It is demonstrated here that, due to the stray field-induced wave-vector filtering effect, remarkable difference in configuration-dependent transport gives rise to a giant tunneling magnetoresistance. In combination with the peculiar buckled structure of silicene and its electric tunable energy gap, the receiving magnetoresistance can be efficiently modulated by the externally-tunable stray field, electrostatic potential, and staggered sublattice potential, providing some flexible strategies to construct silicene-based nanoelectronic device.

  9. Giant magnetoresistance in nanogranular magnets.

    SciTech Connect

    Glatz, A.; Beloborodov, I. S.; Vinokur, V. M.; Materials Science Division; Univ. of Chicago

    2008-05-01

    We study the giant magnetoresistance of nanogranular magnets in the presence of an external magnetic field and finite temperature. We show that the magnetization of arrays of nanogranular magnets has hysteretic behavior at low temperatures leading to a double peak in the magnetoresistance which coalesces at high temperatures into a single peak. We numerically calculate the magnetization of magnetic domains and the motion of domain walls in this system using a combined mean-field approach and a model for an elastic membrane moving in a random medium, respectively. From the obtained results, we calculate the electric resistivity as a function of magnetic field and temperature. Our findings show excellent agreement with various experimental data.

  10. The Giant Metrewave Radio Telescope

    NASA Astrophysics Data System (ADS)

    Nityananda, R.

    2003-05-01

    The Giant Metrewave Radio Telescope (GMRT) of the National Centre of Radio Astrophysics (NCRA) of the Tata Institute of Fundamental Research (TIFR) at Khodad, India, has been operational in the band 0.2 to 2 metres for the last two and a half years. The system characteristics and performance and recent results from the group will be presented. Details of use over the last six months by scientists from other observatories under the GMRT Time Allocation Committee (GTAC) and future plans will be also be reviewed in this paper. Areas which have been studied include observations made in the GMRT band of neutral hydrogen, nearby galaxies, supernova remnants, the Galactic Centre, pulsars, the Sun and others.

  11. The Chinese Giant Solar Telescope

    NASA Astrophysics Data System (ADS)

    Liu, Zhong; Deng, Yuanyong; Ji, Haisheng

    2014-01-01

    Chinese Giant Solar Telescope is the next generation ground-based solar telescope. The main science task of this telescope is to observe the ultra fine structures of the solar magnetic field and dynamic field. Due to the advantages in polarization detection and thermal controlling with a symmetrical circular system, the current design of CGST is a 6~8 meter circular symmetrical telescope. The results of simulations and analysis showed that the current design could meet the demands of most science cases not only in infrared bands but also in near infrared bands and even in visible bands. The prominences and the filaments are very important science cases of CGST. The special technologies for prominence observation will be developed, including the day time laser guide star and MCAO. CGST is proposed by all solar observatories and several institutes and universities in China. It is supported by CAS and NSFC (National Natural Science Foundation of China) as a long term astronomical project.

  12. Core formation by giant impacts

    NASA Technical Reports Server (NTRS)

    Tonks, W. B.; Melosh, H. J.

    1991-01-01

    Ideas about the accretion and early evolution of the Earth and the other terrestrial planets have recently undergone a number of revolutionary changes. It has become clear that giant impacts were far from rare events. In the later stages of accretion any given planetary embryo is liable to be struck several times by other bodies of up to half its own diameter. Such an impact may have the ability to trigger core formation. Traditional accretion models have had great difficulty explaining the formation of the core. If one admits the importance of infrequent large events that may melt an entire hemisphere, the core formation difficulty vanishes. Millimeter-size iron blebs in the melted region will rain out due to their density difference with the silicate melt. Core formation may not require the melting of the entire hemisphere of the planet. The conditions are explored under which impact induced core formation may occur.

  13. Renal Heme Oxygenase-1 Induction with Hemin Augments Renal Hemodynamics, Renal Autoregulation, and Excretory Function

    PubMed Central

    Botros, Fady T.; Dobrowolski, Leszek; Navar, L. Gabriel

    2012-01-01

    Heme oxygenases (HO-1; HO-2) catalyze conversion of heme to free iron, carbon monoxide, and biliverdin/bilirubin. To determine the effects of renal HO-1 induction on blood pressure and renal function, normal control rats (n = 7) and hemin-treated rats (n = 6) were studied. Renal clearance studies were performed on anesthetized rats to assess renal function; renal blood flow (RBF) was measured using a transonic flow probe placed around the left renal artery. Hemin treatment significantly induced renal HO-1. Mean arterial pressure and heart rate were not different (115 ± 5 mmHg versus 112 ± 4 mmHg and 331 ± 16 versus 346 ± 10 bpm). However, RBF was significantly higher (9.1 ± 0.8 versus 7.0 ± 0.5 mL/min/g, P < 0.05), and renal vascular resistance was significantly lower (13.0 ± 0.9 versus 16.6 ± 1.4 [mmHg/(mL/min/g)], P < 0.05). Likewise, glomerular filtration rate was significantly elevated (1.4 ± 0.2 versus 1.0 ± 0.1 mL/min/g, P < 0.05), and urine flow and sodium excretion were also higher (18.9 ± 3.9 versus 8.2 ± 1.0 μL/min/g, P < 0.05 and 1.9 ± 0.6 versus 0.2 ± 0.1 μmol/min/g, P < 0.05, resp.). The plateau of the autoregulation relationship was elevated, and renal vascular responses to acute angiotensin II infusion were attenuated in hemin-treated rats reflecting the vasodilatory effect of HO-1 induction. We conclude that renal HO-1 induction augments renal function which may contribute to the antihypertensive effects of HO-1 induction observed in hypertension models. PMID:22518281

  14. Renal failure after ruptured aneurysm.

    PubMed

    Abbott, W M; Abel, R M; Beck, C H; Fischer, J E

    1975-09-01

    The effectiveness of an intravenous nutritional program plus aggressive dialysis was studied in 32 patients with renal failure following ruptured abdominal aortic aneurysm. Each patient was managed postoperatively with a renal failure fluid regimen, consisting of the eight essential amino acids plus dextrose in conjunction with peritoneal dialysis and hemodialysis. This regimen induced salutary metabolic effects temporarily improving the patient's condition in most instances. No technical or septic complications associated with the intravenous dietary therapy occurred. However, the incidence of recovery of renal function was low, and the overall patient survival was only 12.5%. The experience indicates that although this program has been shown to be efficacious in some patients with acute renal failure, it seems of little benefit in those whose renal failure follows ruptured aortic aneurysm. PMID:808197

  15. Renal biopsy: methods and interpretation.

    PubMed

    Vaden, Shelly L

    2004-07-01

    Renal biopsy most often is indicated in the management of dogs and cats with glomerular disease or acute renal failure. Renal biopsy can readily be performed in dogs and cats via either percutaneous or surgical methods. Care should be taken to ensure that proper technique is used. When proper technique is employed and patient factors are properly addressed, renal biopsy is a relatively safe procedure that minimally affects renal function. Patients should be monitored during the post biopsy period for severe hemorrhage, the most common complication. Accurate diagnosis of glomerular disease, and therefore, accurate treatment planning,requires that the biopsy specimens not only be evaluated by light microscopy using special stains but by electron and immunofluorescent microscopy. PMID:15223207

  16. Renal Denervation: Where to Now?

    PubMed

    Wimmer, Neil J; Mauri, Laura

    2015-12-01

    Resistant hypertension remains a growing problem worldwide. Renal sympathetic denervation was thought to be a new method for the treatment for resistant hypertension. Early studies demonstrated a marked benefit in patients who underwent renal denervation procedures, but the pivotal SYMPLICITY 3-HTN trial, the only sham-controlled randomized trial performed, did not show a benefit for patients treated with the procedure compared to sham. There is still much to learn about the physiology and anatomy of renal sympathetic pathways as well as careful attention to medication adherence in order to understand the role of renal sympathetic denervation in treating hypertensive patients. While renal denervation technology remains available in clinical practice outside of the USA, we expect further development of this technology in the upcoming years and the continued evaluation of this technology in patients with hypertension as well as other disease states to fully understand its role. PMID:26482759

  17. SYNOVIAL GIANT CELL TUMOR OF THE KNEE

    PubMed Central

    Abdalla, Rene Jorge; Cohen, Moisés; Nóbrega, Jezimar; Forgas, Andrea

    2015-01-01

    Synovial giant cell tumor is a benign neoplasm, rarely reported in the form of malignant metastasis. Synovial giant cell tumor most frequently occurs on the hand, and, most uncommon, on the ankle and knee. In the present study, the authors describe a rare case of synovial giant cell tumor on the knee as well as the treatment approach. Arthroscopy has been shown, in this case, to be the optimal method for treating this kind of lesion, once it allowed a less aggressive approach, while providing good visualization of all compartments of knee joint and full tumor resection. PMID:27004193

  18. Rotation and macroturbulence in bright giants

    SciTech Connect

    Gray, D.F.; Toner, C.G.

    1986-11-01

    Spectral line profiles of 35 F, G, and K bright giants were analyzed to obtain rotation rates, v sin i, and macroturbulence dispersion. This sample indicates that rotation rates of cool class II giants is less than 11 km/s, in contrast with some recent periodicity measurements. Macroturbulence dispersion generally increases with effective temperature, but the range of values at a given effective temperature is much larger than seen for lower luminosity classes; this is interpreted in terms of red-giant and blue-loop evolution. No evidence is found for angular momentum dissipation on the first crossing of the H-R diagram. 57 references.

  19. The Metallicity of Giant Planets

    NASA Astrophysics Data System (ADS)

    Thorngren, Daniel P.; Fortney, Jonathan

    2015-12-01

    Unique clues about the formation processes of giant planets can be found in their bulk compositions. Transiting planets provide us with bulk density determinations that can then be compared to models of planetary structure and evolution, to deduce planet bulk metallicities. At a given mass, denser planets have a higher mass fraction of metals. However, the unknown hot Jupiter "radius inflation" mechanism leads to under-dense planets that severely biases this work. Here we look at cooler transiting gas giants (Teff < 1000 K), which do not exhibit the radius inflation effect seen in their warmer cousins. We identified 40 such planets between 20 M_Earth and 20 M_Jup from the literature and used evolution models to determine their bulk heavy-element ("metal") mass. Several important trends are apparent. We see that all planets have at least ~10 M_Earth of metals, and that the mass of metal correlates strongly with the total mass of the planet. The heavy-element mass goes as the square root of the total mass. Both findings are consistent with the core accretion model. We also examined the effect of the parent star metallicity [Fe/H], finding that planets around high-metallicity stars are more likely to have large amounts of metal, but the relation appears weaker than previous studies with smaller sample sizes had suggested. We also looked for connections between bulk composition and planetary orbital parameters and stellar parameters, but saw no pattern, which is also an important result. This work can be directly compared to current and future outputs from planet formation models, including population synthesis.

  20. Hydrodynamic Simulations of Giant Impacts

    NASA Astrophysics Data System (ADS)

    Reinhardt, Christian; Stadel, Joachim

    2013-07-01

    We studied the basic numerical aspects of giant impacts using Smoothed Particles Hydrodynamics (SPH), which has been used in most of the prior studies conducted in this area (e.g., Benz, Canup). Our main goal was to modify the massive parallel, multi-stepping code GASOLINE widely used in cosmological simulations so that it can properly simulate the behavior of condensed materials such as granite or iron using the Tillotson equation of state. GASOLINE has been used to simulate hundreds of millions of particles for ideal gas physics so that using several millions of particles in condensed material simulations seems possible. In order to focus our attention of the numerical aspects of the problem we neglected the internal structure of the protoplanets and modelled them as homogenous (isothermal) granite spheres. For the energy balance we only considered PdV work and shock heating of the material during the impact (neglected cooling of the material). Starting at a low resolution of 2048 particles for the target and the impactor we run several simulations for different impact parameters and impact velocities and successfully reproduced the main features of the pioneering work of Benz from 1986. The impact sends a shock wave through both bodies heating the target and disrupting the remaining impactor. As in prior simulations material is ejected from the collision. How much, and whether it leaves the system or survives in an orbit for a longer time, depends on the initial conditions but also on resolution. Increasing the resolution (to 1.2x10⁶ particles) results in both a much clearer shock wave and deformation of the bodies during the impact and a more compact and detailed "arm" like structure of the ejected material. Currently we are investigating some numerical issues we encountered and are implementing differentiated models, making one step closer to more realistic protoplanets in such giant impact simulations.

  1. Renal transplantation in infants.

    PubMed

    Jalanko, Hannu; Mattila, Ilkka; Holmberg, Christer

    2016-05-01

    Renal transplantation (RTx) has become an accepted mode of therapy in infants with severe renal failure. The major indications are structural abnormalities of the urinary tract, congenital nephrotic syndrome, polycystic diseases, and neonatal kidney injury. Assessment of these infants needs expertise and time as well as active treatment before RTx to ensure optimal growth and development, and to avoid complications that could lead to permanent neurological defects. RTx can be performed already in infants weighing around 5 kg, but most operations occur in infants with a weight of 10 kg or more. Perioperative management focuses on adequate perfusion of the allograft and avoidance of thrombotic and other surgical complications. Important long-term issues include rejections, infections, graft function, growth, bone health, metabolic problems, neurocognitive development, adherence to medication, pubertal maturation, and quality of life. The overall outcome of infant RTx has dramatically improved, with long-term patient and graft survivals of over 90 and 80 %, respectively. PMID:26115617

  2. Studies on the ingestion characteristics of giant freshwater prawn, Chinese prawn and giant tiger prawn

    NASA Astrophysics Data System (ADS)

    Zang, Wei-Ling; Wang, Wei-Dong; Dai, Xi-Lin; Jiang, Min; Zhu, Zheng-Guo; Yang, Ming-Hui; Liu, Xian-Zhong; Xu, Gui-Rong; Ding, Fu-Jiang

    2000-12-01

    The ingestion of giant freshwater prawn, Chinese prawn and giant tiger prawn had continuity and the ingestion high peak occurred at night. Light and temperature had significant effects on the daily ingestion rate (DIR) of giant freshwater prawn Macrobrachium rosenbergii. Red light and blue light favorably induced favorable ingestion. In the adaptive range of temperature, the DIR increased with rising temperature and feeding frequency, but decreased with rising body weight.

  3. Calcium oxalate nephrolithiasis: effect of renal crystal deposition on the cellular composition of the renal interstitium.

    PubMed

    de Water, R; Noordermeer, C; van der Kwast, T H; Nizze, H; Boevé, E R; Kok, D J; Schröder, F H

    1999-04-01

    Urinary calcium oxalate (CaOx) crystals and crystal agglomerates are normally harmlessly excreted, but in nephrolithiasis they are retained by tubular epithelial cells and shifted into the renal interstitium. This crystalline material induces an inflammatory response consisting of an increase in the number of interstitial cells and an expansion of the extracellular matrix. The newly arrived cells either derive from the blood or the connective tissue or they are formed by local proliferation. Identification of the cells that surround the interstitial crystals is a first step in investigating the question of whether the interstitial cells could remove the crystalline material. Therefore, we performed an immunohistochemical study on the kidneys of rats made hyperoxaluric by ethylene glycol (EG) and ammonium chloride (AC). Attention was paid to expression of the leukocyte common antigen (LCA), which identifies all types of leukocytes, the ED1 antigen, which is specific for monocytes and macrophages, and the major histocompatibility class II antigen (MHC II), which is present on dendritic cells, B lymphocytes, and activated macrophages. The results obtained were compared with those seen in two human kidney specimens with acute and chronic oxalosis. In both rat and humans, macrophages and multinucleated giant cells are the major cells that encapsulate the interstitial crystals. This similarity in response underlines the relevance of the rat nephrolithiasis model. The rat experiments showed, furthermore, that the number of interstitial crystals and the amount of biochemically measured kidney-associated oxalate both decrease with time, if the nephrolithiatic agents EG and AC are omitted from the drinking water. Further studies must clarify whether macrophages and multinucleated giant cells are able to remove the interstitial crystals and how these cells are recruited at the inflammatory site. PMID:10196021

  4. Juno and Cassini Proximal: Giant Steps Towards Understanding Giant Planets

    NASA Astrophysics Data System (ADS)

    Stevenson, D. J.

    2014-12-01

    In 2016-17, Juno and Cassini Proximal will provide comparable large advances in our understanding of the interiors of Jupiter and Saturn. Both will provide high accuracy gravity and magnetic field data, while Juno will in addition determine the water abundance deep in the Jovian atmosphere, essential for understanding of giant planet formation and the density of the outer envelope (needed to construct interior models). Although Jupiter and Saturn are both gas giants, they differ in important ways (magnetic field, strength of zonal flows, enrichment in heavy elements, and probably the distribution of helium within). The opportunity to contrast and compare will be invaluable. Juno and Cassini are expected to determine the gravity field to about a part in 109 though with different spatial coverage and with less accurate determination near the poles. The determination of Jupiter's likely central concentration of heavy elements is particularly challenging because it is only a few percent at most of the total mass and yet important for understanding Jupiter's formation, which in turn likely determined the architecture of our solar system. This determination will be done from gravity, water determination and magnetic field and also aided by advances in our understanding of material properties. The corresponding determination for Saturn may prove easier (because the heavy element enrichment is a larger fraction of the mass) though complicated by lack of knowledge of water abundance and the need to identify a more precise value for the deep rotation of the planet (difficult for Saturn because of the lack of a measurable magnetic dipole tilt thus far). For both planets, the higher harmonics of gravity will likely be controlled by differential rotation (the zonal flows) and this will tell us their depth, an issue of major interest in the dynamics of these bodies. The magnetic field structure for Jupiter will be determined to higher accuracy than the Earth's core field (since

  5. Renal disease and chronic renal failure in dental practice.

    PubMed

    Fitzpatrick, J J; Wilson, M H; McArdle, N S; Stassen, L F A

    2008-01-01

    Patients with renal diseases are increasingly common in dental practice. This is due to advances in medicine, and the increasing life expectancy of western populations. Chronic renal failure is a serious condition that general dental practitioners may see in their practice. This article discusses the functions of the kidney, and the causes and medical management of chronic renal failure, as well as considerations in the dental management of these patients. Common complications such as infection and bleeding are discussed. General recommendations are made, based on current evidence with respect to prescribing of medications. PMID:18986093

  6. Innate predator recognition in giant pandas.

    PubMed

    Du, Yiping; Huang, Yan; Zhang, Hemin; Li, Desheng; Yang, Bo; Wei, Ming; Zhou, Yingmin; Liu, Yang

    2012-02-01

    Innate predator recognition confers a survival advantage to prey animals. We investigate whether giant pandas exhibit innate predator recognition. We analyzed behavioral responses of 56 naive adult captive giant pandas (Ailuropoda melanoleuca), to urine from predators and non-predators and water control. Giant pandas performed more chemosensory investigation and displayed flehmen behaviors more frequently in response to predator urine compared to both non-predator urine and water control. Subjects also displayed certain defensive behaviors, as indicated by vigilance, and in certain cases, fleeing behaviors. Our results suggest that there is an innate component to predator recognition in captive giant pandas, although such recognition was only slight to moderate. These results have implications that may be applicable to the conservation and reintroduction of this endangered species. PMID:22303845

  7. Mass loss in red giants and supergiants

    NASA Technical Reports Server (NTRS)

    Sanner, F.

    1975-01-01

    The circumstellar envelopes surrounding late-type giants and supergiants were studied using high resolution, photoelectric scans of strong optical resonance lines. A method for extracting the circumstellar from the stellar components of the lines allowed a quantitative determination of the physical conditions in the envelopes and the rates of mass loss at various positions in the red giant region of the HR diagram. The observed strengthening of the circumstellar spectrum with increasing luminosity and later spectral type is probably caused by an increase in the mass of the envelopes. The mass loss rate for individual stars is proportional to the visual luminosity; high rates for the supergiants suggest that mass loss is important in their evolution. The bulk of the mass return to the interstellar medium in the red giant region comes from the normal giants, at a rate comparable to that of planetary nebulae.

  8. Tests of the Giant Impact Hypothesis

    NASA Technical Reports Server (NTRS)

    Jones, J. H.

    1998-01-01

    The giant impact hypothesis has gained popularity as a means of explaining a volatile-depleted Moon that still has a chemical affinity to the Earth. As Taylor's Axiom decrees, the best models of lunar origin are testable, but this is difficult with the giant impact model. The energy associated with the impact would be sufficient to totally melt and partially vaporize the Earth. And this means that there should he no geological vestige of Barber times. Accordingly, it is important to devise tests that may be used to evaluate the giant impact hypothesis. Three such tests are discussed here. None of these is supportive of the giant impact model, but neither do they disprove it.

  9. "GIANT" Steps to Create Online Orientations

    ERIC Educational Resources Information Center

    Bacon, Pamela

    2005-01-01

    Online orientation is provided due to the flexibility of online learning. The online orientation consists of the GIANT steps which stands for Get support, Identify your curriculum, Assemble your program, Navigate students through the pilot project and Test students.

  10. Selecting M-giants with WISE photometry

    NASA Astrophysics Data System (ADS)

    Li, Jing

    2015-08-01

    We use M-giants, M-dwarfs and QSOs identified by LAMOST to assess how well WISE & 2MASS colour-cuts can separate these populations through photometry. We find that the WISE bands are very efficient to separate M-giants from M-dwarfs, especially for the early-type stars. We derive a new photometric relation to estimate [Fe/H] for M-giants. We show that previous photometric distance relations may be biased and devise a new empirical distance relation. We detect M-giants in the Sagittarius stream from the ALLWISE Source Archive. Our detection shows good agreement with the bright stream, although the leading tail appears to be misaligned by a couple of degrees. We have measured the metallicity distribution at four locations along the stream, finding a clear metallicity offset between the leading and trailing tails.

  11. EUVE Observations of the Hyades Giants

    NASA Technical Reports Server (NTRS)

    Stern, Robert A.; Oliversen, Ronald J. (Technical Monitor)

    1998-01-01

    We describe EUVE and ROSAT observations of the Hyades K0 III giants theta(sup 1) (vB 71 = HR1411) and gamma (vB 28 = HR1346) Tau. We also discuss ASCA observations of theta(sup 1)Tau. The coronal activity of these "clump" giants is intermediate between that of the Sun and of high activity stars such as RS CVn systems. There is no evidence for significant short or long term variability up to several years. Modeling of the individual and combined spectra suggest that these two X-ray and EUV-bright Hyades giants resemble in their activity levels another clump giant, beta Cet, with a peak in the emission measure distribution near log T approx. 6.8, reminiscent of the Capella emission measure "bump."

  12. Chromospheric activity of cool giant stars

    NASA Technical Reports Server (NTRS)

    Steiman-Cameron, T. Y.

    1986-01-01

    During the seventh year of IUE twenty-six spectra of seventeen cool giant stars ranging in spectral type from K3 thru M6 were obtained. Together with spectra of fifteen stars observed during the sixth year of IUE, these low-resolution spectra have been used to: (1) examine chromospheric activity in the program stars and late type giants in general, and (2) evaluate the extent to which nonradiative heating affects the upper levels of cool giant photospheres. The stars observed in this study all have well determined TiO band strengths, angular diameters (determined from lunar occulations), bolometric fluxes, and effective temperatures. Chromospheric activity can therefore be related to effective temperatures providing a clearer picture of activity among cool giant stars than previously available. The stars observed are listed.

  13. EUVE Observations of the Hyades Giants

    NASA Technical Reports Server (NTRS)

    Stern, Robert A.

    1998-01-01

    The contractor describes EUVE and ROSAT observations of the Hyades K0 III giants theta(sup 1(vB 71 = HR 1411) and gamma$ (vB 28 = HR 1346) Tau, and ASCA observations of theta(sup 1) Tau. The coronal activity of these "clump" giants is intermediate between that of the Sun and of high-activity stars such as RS CVn systems. There is no evidence for significant short or long term variability up to several years. Modeling of the individual and combined spectra suggest that these two X-ray and EUV- bright Hyades giants resemble in their activity levels another clump giant, beta Cet, with a peak in the emission measure distribution near log T approx. 6.8, reminiscent of the Capella emission measure "bump."

  14. Giant cell arteritis presenting as scalp necrosis.

    PubMed

    Maidana, Daniel E; Muñoz, Silvia; Acebes, Xènia; Llatjós, Roger; Jucglà, Anna; Alvarez, Alba

    2011-01-01

    The differential of scalp ulceration in older patients should include several causes, such as herpes zoster, irritant contact dermatitis, ulcerated skin tumors, postirradiation ulcers, microbial infections, pyoderma gangrenosum, and giant cell arteritis. Scalp necrosis associated with giant cell arteritis was first described in the 1940s. The presence of this dermatological sign within giant cell arteritis represents a severity marker of this disease, with a higher mean age at diagnosis, an elevated risk of vision loss and tongue gangrene, as well as overall higher mortality rates, in comparison to patients not presenting this manifestation. Even though scalp necrosis due to giant cell arteritis is exceptional, a high level of suspicion must be held for this clinical finding, in order to initiate prompt and proper treatment and avoid blindness. PMID:21789466

  15. Renal Glucose Handling

    PubMed Central

    Ferrannini, Ele; Veltkamp, Stephan A.; Smulders, Ronald A.; Kadokura, Takeshi

    2013-01-01

    OBJECTIVE Ipragliflozin, a sodium-glucose cotransporter 2 inhibitor, stimulates glycosuria and lowers glycemia in patients with type 2 diabetes (T2DM). The objective of this study was to assess the pharmacodynamics of ipragliflozin in T2DM patients with impaired renal function. RESEARCH DESIGN AND METHODS Glycosuria was measured before and after a single ipragliflozin dose in 8 nondiabetic subjects and 57 T2DM patients (age 62 ± 9 years, fasting glucose 133 ± 39 mg/dL, mean ± SD) with normal renal function (assessed as the estimated glomerular filtration rate [eGFR]) (eGFR1 ≥90 mL · min–1 · 1.73 m−2), mild (eGFR2 ≥60 to <90), moderate (eGFR3 ≥30 to <60), or severe reduction in eGFR (eGFR4 ≤15 to <30). RESULTS Ipragliflozin significantly increased urinary glucose excretion in each eGFR class (P < 0.0001). However, ipragliflozin-induced glycosuria declined (median [IQR]) across eGFR class (from 46 mg/min [33] in eGFR1 to 8 mg/min [7] in eGFR4, P < 0.001). Ipragliflozin-induced fractional glucose excretion (excretion/filtration) was 39% [27] in the T2DM patients (pooled data), similar to that of the nondiabetic subjects (37% [17], P = ns). In bivariate analysis of the pooled data, ipragliflozin-induced glycosuria was directly related to eGFR and fasting glucose (P < 0.0001 for both, r2 = 0.55), predicting a decrement in 24-h glycosuria of 15 g for each 20 mL/min decline in eGFR and an increase of 7 g for each 10 mg/dL increase in glucose above fasting normoglycemia. CONCLUSIONS In T2DM patients, ipragliflozin increases glycosuria in direct, linear proportion to GFR and degree of hyperglycemia, such that its amount can be reliably predicted in the individual patient. Although absolute glycosuria decreases with declining GFR, the efficiency of ipragliflozin action (fractional glucose excretion) is maintained in patients with severe renal impairment. PMID:23359360

  16. Central giant cell granuloma of the maxilla

    PubMed Central

    Gupta, Manish; Gupta, Monica; Singh, Sunder; Kaur, Rupinder

    2013-01-01

    Central giant cell granuloma (CGCG), formerly called giant cell reparative granuloma, is a non-neoplastic proliferative lesion of an unknown aetiology. It occurs most commonly in the mandible. The case reported here resembled a wide variety of conditions that led to a misdiagnosis both on clinical and radiographic examinations but was histopathologically diagnosed as CGCG. We managed this case by endoscopic excision and curettage via nasal route without producing external scar and avoiding damage to the un-erupted tooth. PMID:23475995

  17. Arterial Embolization of Giant Hepatic Hemangiomas

    SciTech Connect

    Giavroglou, Constantinos; Economou, Hippolete; Ioannidis, Ioannis

    2003-02-15

    Hepatic cavernous hemangiomas are usually small and asymptomatic. They are usually discovered incidentally and only a few require treatment. However, giant hemangiomas may cause symptoms,which are indications for treatment. We describe four cases of symptomatic giant hepatic hemangiomas successfully treated with transcatheter arterial embolization, performed with polyvinyl alcohol particles. There were no complications. Follow-up with clinical and imaging examinations showed disappearance of symptoms and decrease in size of lesions.

  18. Diagnostic Utility of Diffusion-weighted Magnetic Resonance Imaging in Differentiating Small Solid Renal Tumors (≤4 cm) at 3.0T Magnetic Resonance Imaging

    PubMed Central

    Zhang, Han-Mei; Wu, Ying-Hua; Gan, Qi; Lyu, Xiao; Zhu, Xiang-Lan; Kuang, Min; Liu, Rong-Bo; Huang, Zi-Xing; Yuan, Fang; Liu, Xi-Jiao; Song, Bin

    2015-01-01

    Background: The aim of this study was to assess the performance of apparent diffusion coefficient (ADC) measurement obtained with diffusion-weighted magnetic resonance imaging (DW-MRI) to distinguish renal cell carcinomas (RCCs) from small benign solid renal tumors (≤4 cm). Methods: In this cross-sectional study, 49 consecutive patients with histopathologically confirmed small solid renal tumors, and seven healthy volunteers were imaged using nonenhanced MRI and DW-MRI. The ADC map was calculated using the b values of 0, 50, 400, and 600 s/mm2 and values compared via the Kruskal–Wallis and Mann–Whitney tests. The utility of ADC for differentiating RCCs and benign lesions was assessed using a receiver operating characteristic curve. Multiple nonenhanced MRI features were analyzed by Logistic regression. Results: The tumors consisted of 33 cases of clear-cell RCCs (ccRCCs) and 16 cases of benign tumors, including 14 cases of minimal fat angiomyolipomas and 2 cases of oncocytomas. The ADCs showed significant differences among benign tumors ([0.90 ± 0.52] × 10−3 mm2/s), ccRCCs ([1.53 ± 0.31] × 10−3 mm2/s) and the normal renal parenchyma ([2.22 ± 0.12] × 10−3 mm2/s) (P < 0.001). Moreover, there was statistically significant difference between high and low-grade ccRCCs (P = 0.004). Using a cut-off ADC of 1.36 × 10−3 mm2/s, DW-MRI resulted in an area under the curve (AUC), sensitivity, and specificity equal to 0.839, 75.8%, and 87.5%, respectively. Nonenhanced MRI alone and the combination of imaging methods led to an AUC, sensitivity and specificity equal to 0.919, 93.9%, and 81.2%, 0.998, 97%, and 100%, respectively. The Logistic regression showed that the location of the center of the tumor (inside the contour of the kidney) and appearance of stiff blood vessel were significantly helpful for diagnosing ccRCCs. Conclusions: DW-MRI has potential in distinguishing ccRCCs from benign lesions in human small solid renal tumors (≤4 cm), and in

  19. Patterning the Renal Vascular Bed

    PubMed Central

    Herzlinger, Doris; Hurtado, Romulo

    2015-01-01

    The renal vascular bed has a stereotypic architecture that is essential for the kidney’s role in excreting metabolic waste and regulating the volume and composition of body fluids. The kidney’s excretory functions are dependent on the delivery of the majority of renal blood flow to the glomerular capillaries, which filter plasma removing from it metabolic waste, as well as vast quantities of solutes and fluids. The renal tubules reabsorb from the glomerular filtrate solutes and fluids required for homeostasis, while the post-glomerular capillary beds return these essential substances back into the systemic circulation. Thus, the kidney’s regulatory functions are dependent on the close proximity or alignment of the post-glomerular capillary beds with the renal tubules. This review will focus on our current knowledge of the mechanisms controlling the embryonic development of the renal vasculature. An understanding of this process is critical for developing novel therapies to prevent vessel rarefaction and will be essential for engineering renal tissues suitable for restoring kidney function to the ever-increasing population of patients with end stage renal disease. PMID:25128732

  20. Management of giant liver hemangiomas: an update.

    PubMed

    Hoekstra, Lisette T; Bieze, Matthanja; Erdogan, Deha; Roelofs, Joris J T H; Beuers, Ulrich H W; van Gulik, Thomas M

    2013-03-01

    Liver hemangiomas are the most common benign liver tumors and are usually incidental findings. Liver hemangiomas are readily demonstrated by abdominal ultrasonography, computed tomography or magnetic resonance imaging. Giant liver hemangiomas are defined by a diameter larger than 5 cm. In patients with a giant liver hemangioma, observation is justified in the absence of symptoms. Surgical resection is indicated in patients with abdominal (mechanical) complaints or complications, or when diagnosis remains inconclusive. Enucleation is the preferred surgical method, according to existing literature and our own experience. Spontaneous or traumatic rupture of a giant hepatic hemangioma is rare, however, the mortality rate is high (36-39%). An uncommon complication of a giant hemangioma is disseminated intravascular coagulation (Kasabach-Merritt syndrome); intervention is then required. Herein, the authors provide a literature update of the current evidence concerning the management of giant hepatic hemangiomas. In addition, the authors assessed treatment strategies and outcomes in a series of patients with giant liver hemangiomas managed in our department. PMID:23445235

  1. Renal Ablation Update

    PubMed Central

    Khiatani, Vishal; Dixon, Robert G.

    2014-01-01

    Thermal ablative technologies have evolved considerably in the recent past and are now an important component of current clinical guidelines for the treatment of small renal masses. Both radiofrequency ablation and cryoablation have intermediate-term oncologic control that rivals surgical options, with favorable complication profiles. Studies comparing cryoablation and radiofrequency ablation show no significant difference in oncologic control or complication profile between the two modalities. Early data from small series with microwave ablation have shown similar promising results. Newer technologies including irreversible electroporation and high-intensity–focused ultrasound have theoretical advantages, but will require further research before becoming a routine part of the ablation armamentarium. The purpose of this review article is to discuss the current ablative technologies available, briefly review their mechanisms of action, discuss technical aspects of each, and provide current data supporting their use. PMID:25049445

  2. [Cystic renal pathology].

    PubMed

    Rosi, P; Cesaroni, M; Bracarda, S; Rociola, W; Virgili, G

    1993-08-01

    Ultrasonography has a great interest in diagnosis of cystic kidney disorders for typical eco-pattern of this pathology. In this work we show the eco-pattern of the most common cystic kidney disorders. Particularly we examine simple cysts (typical, atypical, complicated), multicystic kidney dysplasia, autosomal recessive polycystic kidney disease (infantile) autosomal dominant polycystic kidney disease (adult age). The so-called neoplastic cysts (multiloculated cysts, multiloculated cysts nephroma, cystic nephroblastoma), medullar cysts (medullary sponge kidney, medullary cystic disease), parapyelic cysts, acquired cystic kidney disease in renal failure patients, parasitic cysts, epidermoid cysts. About this disorders we present the more typical and expressive ultrasonographic appearance and we define the role and the opportunity of diagnostic setting by echography, moreover ultrasonography allows us to make a differential diagnosis between cystic kidney disorders and other kidney disease. PMID:8353538

  3. Renal ablation update.

    PubMed

    Khiatani, Vishal; Dixon, Robert G

    2014-06-01

    Thermal ablative technologies have evolved considerably in the recent past and are now an important component of current clinical guidelines for the treatment of small renal masses. Both radiofrequency ablation and cryoablation have intermediate-term oncologic control that rivals surgical options, with favorable complication profiles. Studies comparing cryoablation and radiofrequency ablation show no significant difference in oncologic control or complication profile between the two modalities. Early data from small series with microwave ablation have shown similar promising results. Newer technologies including irreversible electroporation and high-intensity-focused ultrasound have theoretical advantages, but will require further research before becoming a routine part of the ablation armamentarium. The purpose of this review article is to discuss the current ablative technologies available, briefly review their mechanisms of action, discuss technical aspects of each, and provide current data supporting their use. PMID:25049445

  4. [Cilia and renal cysts].

    PubMed

    Paces-Fessy, Mélanie

    2014-11-01

    Advances in genomics, bioinformatics and the creation of model organisms have identified many genes associated with polycystic kidney diseases. Historically, these genes were not necessarily associated with ciliopathies, but it appeared that many connections can be made between the cystic kidney disease and function of the primary cilium. Indeed, the proteins encoded by these genes are localized to the cilium itself, to the basal body or are known to regulate the expression and localization of ciliary proteins. The goal of this article is to describe the multiple cellular processes that may lead to the development of renal cysts if they are deregulated. These include changes in proliferation rate, cell polarity or signaling pathways involved in embryonic kidney development. To highlight the role of the primary cilium in cystogenesis, I will discuss several studies investigating the function of ciliary genes and cilia in the kidneys of different model organisms. PMID:25388585

  5. Hyperparathyroidism of Renal Disease

    PubMed Central

    Yuen, Noah K; Ananthakrishnan, Shubha; Campbell, Michael J

    2016-01-01

    Renal hyperparathyroidism (rHPT) is a common complication of chronic kidney disease characterized by elevated parathyroid hormone levels secondary to derangements in the homeostasis of calcium, phosphate, and vitamin D. Patients with rHPT experience increased rates of cardiovascular problems and bone disease. The Kidney Disease: Improving Global Outcomes guidelines recommend that screening and management of rHPT be initiated for all patients with chronic kidney disease stage 3 (estimated glomerular filtration rate, < 60 mL/min/1.73 m2). Since the 1990s, improving medical management with vitamin D analogs, phosphate binders, and calcimimetic drugs has expanded the treatment options for patients with rHPT, but some patients still require a parathyroidectomy to mitigate the sequelae of this challenging disease. PMID:27479950

  6. Renal Cancer in the Elderly.

    PubMed

    González León, Tania; Morera Pérez, Maricela

    2016-01-01

    The increase of the aging population corresponds with the rise of renal cancer in elderly patients. The distinction between functional and chronological age, quality of life, and survival estimate are important issues, among others, that should be considered in the management of renal cancer in elderly patients. We made this review with the purpose of synthesizing the most updated criteria regarding indications and outcomes of the different therapeutic options in the management of elderly patients with renal cancer, beginning from the physiologic considerations that characterize them, their capacity to tolerate different therapeutic possibilities, and the prognosis of the patients' risks and comorbidity assessment. PMID:26715222

  7. Unusual renal tumour: multilocular cystic renal cell carcinoma.

    PubMed

    Palmeiro, Marta Morna; Niza, João Luz; Loureiro, Ana Luisa; Conceição e Silva, João Paulo

    2016-01-01

    Multilocular cystic renal cell carcinoma (MCRCC) is a rare presentation of renal cell carcinoma. Most patients are asymptomatic and frequently MCRCCs are detected incidentally. MCRCCs have good prognosis because of their low malignant potential. We report a case of a 39-year-old woman who presented with mild right flank pain and normal laboratory data. On imaging examinations, a Bosniak III cystic lesion was detected in the lower third of the right kidney. She underwent right partial nephrectomy and histopathology showed a multilocular cystic renal cell carcinoma Fuhrman grade 1. In this article, we also present a review of the literature on MCRCC, highlight the correlation of the pathological and imaging characteristics of these low aggressive renal lesions, and underscore the importance of their recognition to prevent unnecessary radical surgery. PMID:26957035

  8. Orthotopic liver transplantation for giant liver haemangioma: A case report

    PubMed Central

    Lange, Undine G; Bucher, Julian N; Schoenberg, Markus B; Benzing, Christian; Schmelzle, Moritz; Gradistanac, Tanja; Strocka, Steffen; Hau, Hans-Michael; Bartels, Michael

    2015-01-01

    In liver haemangiomas, the risk of complication rises with increasing size, and treatment can be obligatory. Here we present a case of a 46-year-old female who suffered from a giant haemangioma causing severe portal hypertension and vena cava compression, leading to therapy refractory ascites, hyponatremia and venostasis-associated thrombosis with pulmonary embolism. The patients did not experience tumour rupture or consumptive coagulopathy. Surgical resection was impossible because of steatosis of the non-affected liver. Orthotopic liver transplantation was identified as the only treatment option. The patient’s renal function remained stable even though progressive morbidity and organ allocation were improbable according to the patient’s lab model for end-stage liver disease (labMELD) score. Therefore, non-standard exception status was approved by the European organ allocation network “Eurotransplant”. The patient underwent successful orthotopic liver transplantation 16 mo after admission to our centre. Our case report indicates the underrepresentation of morbidity associated with refractory ascites in the labMELD-based transplant allocation system, and it indicates the necessity of promptly applying for non-standard exception status to enable transplantation in patients with a severe clinical condition but low labMELD score. Our case highlights the fact that liver transplantation should be considered early in patients with non-resectable, symptomatic benign liver tumours. PMID:26722664

  9. Orthotopic liver transplantation for giant liver haemangioma: A case report.

    PubMed

    Lange, Undine G; Bucher, Julian N; Schoenberg, Markus B; Benzing, Christian; Schmelzle, Moritz; Gradistanac, Tanja; Strocka, Steffen; Hau, Hans-Michael; Bartels, Michael

    2015-12-24

    In liver haemangiomas, the risk of complication rises with increasing size, and treatment can be obligatory. Here we present a case of a 46-year-old female who suffered from a giant haemangioma causing severe portal hypertension and vena cava compression, leading to therapy refractory ascites, hyponatremia and venostasis-associated thrombosis with pulmonary embolism. The patients did not experience tumour rupture or consumptive coagulopathy. Surgical resection was impossible because of steatosis of the non-affected liver. Orthotopic liver transplantation was identified as the only treatment option. The patient's renal function remained stable even though progressive morbidity and organ allocation were improbable according to the patient's lab model for end-stage liver disease (labMELD) score. Therefore, non-standard exception status was approved by the European organ allocation network "Eurotransplant". The patient underwent successful orthotopic liver transplantation 16 mo after admission to our centre. Our case report indicates the underrepresentation of morbidity associated with refractory ascites in the labMELD-based transplant allocation system, and it indicates the necessity of promptly applying for non-standard exception status to enable transplantation in patients with a severe clinical condition but low labMELD score. Our case highlights the fact that liver transplantation should be considered early in patients with non-resectable, symptomatic benign liver tumours. PMID:26722664

  10. Hypohyperparathyroidism: a model for renal osteodystrophy?

    PubMed

    Junor, B J; Edward, N

    1981-06-01

    A child who presented with features of renal osteodystrophy but with normal renal function is described. Improvement occurred both on large doses of vitamin D and small doses of 1, alpha-hydroxy-vitamin D3 (1, alpha-OHD3). Investigations suggested that the primary defect was an impaired renal response to parathyroid hormone. The relationship between renal osteodystrophy, abnormalities of vitamin D metabolism and hypohyperparathyroidism is discussed and an alternative hypothesis for the development of renal bone disease suggested. PMID:7301683

  11. Familial renal glycosuria and modifications of glucose renal excretion.

    PubMed

    Prié, D

    2014-12-01

    Under physiological conditions, the kidneys contribute to glucose homoeostasis by producing glucose by gluconeogenesis and preventing glucose loss in urine. The glucose filtered by the glomeruli is completely reabsorbed in the renal proximal tubule. Renal gluconeogenesis produces 25% of the circulating glucose in the postabsorptive state, while the amount of glucose reabsorbed by the kidneys largely exceeds the quantity synthesized by kidney gluconeogenesis. Sodium-glucose cotransporter type 2 (SGLT-2) and glucose transporter 2 (GLUT2) carry out more than 90% of renal glucose uptake. In diabetes, both gluconeogenesis and renal glucose reabsorption are increased. The augmentation of glucose uptake in diabetes is due to the overexpression of renal glucose transporters SGLT-2 and GLUT2 in response to the increase in expression of transcription activator hepatic nuclear factor 1-alpha (HNF1α). The rise in glucose uptake contributes to hyperglycaemia and induces glomerular hyperfiltration by increasing sodium and water reabsorption in the proximal tubule that, in turn, modifies urine flux at the macula densa. SGLT-2 inhibitors improve glycaemic control and prevent renal hyperfiltration in diabetes. Loss of SGLT-2 transporter function is a benign state characterized by glycosuria. In contrast, mutations of other glucose transporters expressed in the kidney are responsible for severe disorders. PMID:25554066

  12. The Effects of Renal Denervation on Renal Hemodynamics and Renal Vasculature in a Porcine Model

    PubMed Central

    Verloop, Willemien L.; Hubens, Lisette E. G.; Spiering, Wilko; Doevendans, Pieter A.; Goldschmeding, Roel; Bleys, Ronald L. A. W.; Voskuil, Michiel

    2015-01-01

    Rationale Recently, the efficacy of renal denervation (RDN) has been debated. It is discussed whether RDN is able to adequately target the renal nerves. Objective We aimed to investigate how effective RDN was by means of functional hemodynamic measurements and nerve damage on histology. Methods and Results We performed hemodynamic measurements in both renal arteries of healthy pigs using a Doppler flow and pressure wire. Subsequently unilateral denervation was performed, followed by repeated bilateral hemodynamic measurements. Pigs were terminated directly after RDN or were followed for 3 weeks or 3 months after the procedure. After termination, both treated and control arteries were prepared for histology to evaluate vascular damage and nerve damage. Directly after RDN, resting renal blood flow tended to increase by 29±67% (P = 0.01). In contrast, renal resistance reserve increased from 1.74 (1.28) to 1.88 (1.17) (P = 0.02) during follow-up. Vascular histopathology showed that most nerves around the treated arteries were located outside the lesion areas (8±7 out of 55±25 (14%) nerves per pig were observed within a lesion area). Subsequently, a correlation was noted between a more impaired adventitia and a reduction in renal resistance reserve (β: -0.33; P = 0.05) at three weeks of follow-up. Conclusion Only a small minority of renal nerves was targeted after RDN. Furthermore, more severe adventitial damage was related to a reduction in renal resistance in the treated arteries at follow-up. These hemodynamic and histological observations may indicate that RDN did not sufficiently target the renal nerves. Potentially, this may explain the significant spread in the response after RDN. PMID:26587981

  13. Biomass yield comparisons of giant miscanthus, giant reed, and miscane grown under irrigated and rainfed conditions

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The U.S. Department of Energy has initiated efforts to decrease the nation’s dependence on imported oil by developing domestic renewable sources of cellulosic-derived bioenergy. In this study, giant miscanthus (Miscanthus x giganteus), sugarcane (complex hybrid of Saccharum spp.), and giant reed (Ar...

  14. The Giant Planet Satellite Exospheres

    NASA Technical Reports Server (NTRS)

    McGrath, Melissa A.

    2014-01-01

    Exospheres are relatively common in the outer solar system among the moons of the gas giant planets. They span the range from very tenuous, surface-bounded exospheres (e.g., Rhea, Dione) to quite robust exospheres with exobase above the surface (e.g., lo, Triton), and include many intermediate cases (e.g., Europa, Ganymede, Enceladus). The exospheres of these moons exhibit an interesting variety of sources, from surface sputtering, to frost sublimation, to active plumes, and also well illustrate another common characteristic of the outer planet satellite exospheres, namely, that the primary species often exists both as a gas in atmosphere, and a condensate (frost or ice) on the surface. As described by Yelle et al. (1995) for Triton, "The interchange of matter between gas and solid phases on these bodies has profound effects on the physical state of the surface and the structure of the atmosphere." A brief overview of the exospheres of the outer planet satellites will be presented, including an inter-comparison of these satellites exospheres with each other, and with the exospheres of the Moon and Mercury.

  15. Red Giant Plunging Through Space

    NASA Technical Reports Server (NTRS)

    2006-01-01

    [figure removed for brevity, see original site] Poster Version

    This image from NASA's Spitzer Space Telescope (left panel) shows the 'bow shock' of a dying star named R Hydrae, or R Hya, in the constellation Hydra.

    Bow shocks are formed where the stellar wind from a star are pushed into a bow shape (illustration, right panel) as the star plunges through the gas and dust between stars. Our own Sun has a bow shock, but prior to this image one had never been observed around this particular class of red giant star.

    R Hya moves through space at approximately 50 kilometers per second. As it does so, it discharges dust and gas into space. Because the star is relatively cool, that ejecta quickly assumes a solid state and collides with the interstellar medium. The resulting dusty nebula is invisible to the naked eye but can be detected using an infrared telescope. This bow shock is 16,295 astronomical units from the star to the apex and 6,188 astronomical units thick (an astronomical unit is the distance between the sun and Earth). The mass of the bow shock is about 400 times the mass of the Earth.

    The false-color Spitzer image shows infrared emissions at 70 microns. Brighter colors represent greater intensities of infrared light at that wavelength. The location of the star itself is drawn onto the picture in the black 'unobserved' region in the center.

  16. Origins of Giant Molecular Clouds

    NASA Astrophysics Data System (ADS)

    Ostriker, E. C.; Kim, W.-T.

    2004-12-01

    The material in giant molecular clouds (GMCs) constitutes a large proportion of the Milky Way's ISM, and determining how cloud-formation processes affect the properties and spatial distribution of GMCs is important to understanding the structure of the Milky Way. Understanding the formation of GMCs is also key to theories of galactic evolution because it represents the first stage in the overall process of star formation. Several lines of evidence point to a need for relatively rapid GMC formation via coherent dynamical instabilities, and both Parker- and Jeans- type modes have been proposed as potential cloud-forming mechanisms. Recent numerical simulations have investigated these instabilities directly, using spatially-localized models of the interstellar medium that self-consistently incorporate rotational shear, self-gravity, and magnetic fields, as well as the effects of stellar spiral arms. These models have demonstrated that condensation via gravitational instability, aided by magnetic torques, is the most likely candidate for explaining the formation of GMCs. The models have also shown that spiral arm ``spurs'' -- clearly seen as regular projections from dust lanes in at least one external galaxy -- may originate as magneto-gravitational instabilities of the ISM within the dense portions of stellar spiral arms. This raises the interesting possibility that spur structures with similar dynamical origins could potentially be present in the Milky Way as well.

  17. Nebulin--a giant chameleon.

    PubMed

    Pelin, Katarina; Wallgren-Pettersson, Carina

    2008-01-01

    Nebulin is an enormous protein of the muscle sarcomere. It is a determinant of thin filament length, Z-disk structure and fiber contractility. The nebulin gene contains four regions of alternative splicing, providing a wealth of different isoforms of the protein. The precise function of these numerous isoforms in various types of muscle tissue remains to be elucidated, as does their role in the maintenance of normal muscle strength and activity. Understanding these basic mechanisms is a prerequisite for the development of specific therapies for the disorders caused by mutations in the nebulin gene. Such mutations are the main cause of autosomal recessive nemaline (rod) myopathy, especially of the typical form of this congenital myopathy. Further known disorders caused by nebulin mutations are several other subcategories of recessively inherited nemaline myopathy and a novel distal myopathy caused byhomozygous missense mutations in the nebulin gene. Because of the giant size of the gene, molecular genetic testing methods are difficult to design for routine diagnostic use. PMID:19181091

  18. A giant thunderstorm on Saturn.

    PubMed

    Fischer, G; Kurth, W S; Gurnett, D A; Zarka, P; Dyudina, U A; Ingersoll, A P; Ewald, S P; Porco, C C; Wesley, A; Go, C; Delcroix, M

    2011-07-01

    Lightning discharges in Saturn's atmosphere emit radio waves with intensities about 10,000 times stronger than those of their terrestrial counterparts. These radio waves are the characteristic features of lightning from thunderstorms on Saturn, which last for days to months. Convective storms about 2,000 kilometres in size have been observed in recent years at planetocentric latitude 35° south (corresponding to a planetographic latitude of 41° south). Here we report observations of a giant thunderstorm at planetocentric latitude 35° north that reached a latitudinal extension of 10,000 kilometres-comparable in size to a 'Great White Spot'-about three weeks after it started in early December 2010. The visible plume consists of high-altitude clouds that overshoot the outermost ammonia cloud layer owing to strong vertical convection, as is typical for thunderstorms. The flash rates of this storm are about an order of magnitude higher than previous ones, and peak rates larger than ten per second were recorded. This main storm developed an elongated eastward tail with additional but weaker storm cells that wrapped around the whole planet by February 2011. Unlike storms on Earth, the total power of this storm is comparable to Saturn's total emitted power. The appearance of such storms in the northern hemisphere could be related to the change of seasons, given that Saturn experienced vernal equinox in August 2009. PMID:21734705

  19. Urea distribution in renal failure

    PubMed Central

    Blackmore, D. J.; Elder, W. J.; Bowden, C. H.

    1963-01-01

    An assessment of intracellular urea removed during haemodialysis has been made from urea extraction and plasma urea estimations. An apparent wide variation in the movement of intracellular urea in patients with acute renal failure from obstetric and traumatic causes and with chronic renal failure is reported. A method for the estimation of red cell water urea is presented. In two patients with chronic renal failure the red cell urea level was much higher than would have been expected from the plasma urea level before dialysis. In two obstetric patients there was no such discrepancy. The conclusion is drawn that research should be directed to variations of intracellular metabolism in renal failure before a more rational approach can be made to its management. PMID:16811009

  20. The renal mononuclear phagocytic system.

    PubMed

    Nelson, Peter J; Rees, Andrew J; Griffin, Matthew D; Hughes, Jeremy; Kurts, Christian; Duffield, Jeremy

    2012-02-01

    The renal mononuclear phagocytic system, conventionally composed of macrophages (Mø) and dendritic cells (DCs), plays a central role in health and disease of the kidney. Overlapping definitions of renal DCs and Mø, stemming from historically separate research tracks and the lack of experimental tools to specifically study the roles of these cells in vivo, have generated confusion and controversy, however, regarding their immunologic function in the kidney. This brief review provides an appraisal of the current state of knowledge of the renal mononuclear phagocytic system interpreted from the perspective of immunologic function. Physical characteristics, ontogeny, and known functions of the main subsets of renal mononuclear phagocytes as they relate to homeostasis, surveillance against injury and infection, and immune-mediated inflammatory injury and repair within the kidney are described. Gaps and inconsistencies in current knowledge are used to create a roadmap of key questions to be answered in future research. PMID:22135312

  1. Taurine and the renal system

    PubMed Central

    2010-01-01

    Taurine participates in a number of different physiologic and biologic processes in the kidney, often reflected by urinary excretion patterns. The kidney is key to aspects of taurine body pool size and homeostasis. This review will examine the renal-taurine interactions relative to ion reabsorption; renal blood flow and renal vascular endothelial function; antioxidant properties, especially in the glomerulus; and the role of taurine in ischemia and reperfusion injury. In addition, taurine plays a role in the renal cell cycle and apoptosis, and functions as an osmolyte during the stress response. The role of the kidney in adaptation to variations in dietary taurine intake and the regulation of taurine body pool size are described. Finally, the protective function of taurine against several kidney diseases is reviewed. PMID:20804616

  2. Renal Disease and Adult Vaccination

    MedlinePlus

    ... Resources for Healthcare Professionals Renal Disease and Adult Vaccination Recommend on Facebook Tweet Share Compartir Vaccines are ... have immunity to this disease Learn about adult vaccination and other health conditions Asplenia Diabetes Type 1 ...

  3. Renal protection in cardiovascular surgery

    PubMed Central

    Di Tomasso, Nora; Monaco, Fabrizio; Landoni, Giovanni

    2016-01-01

    Acute kidney injury (AKI) is one of the most relevant complications after major surgery and is a predictor of mortality. In Western countries, patients at risk of developing AKI are mainly those undergoing cardiovascular surgical procedures. In this category of patients, AKI depends on a multifactorial etiology, including low ejection fraction, use of contrast media, hemodynamic instability, cardiopulmonary bypass, and bleeding. Despite a growing body of literature, the treatment of renal failure remains mainly supportive (e.g. hemodynamic stability, fluid management, and avoidance of further damage); therefore, the management of patients at risk of AKI should aim at prevention of renal damage. Thus, the present narrative review analyzes the pathophysiology underlying AKI (specifically in high-risk patients), the preoperative risk factors that predispose to renal damage, early biomarkers related to AKI, and the strategies employed for perioperative renal protection. The most recent scientific evidence has been considered, and whenever conflicting data were encountered possible suggestions are provided. PMID:26998249

  4. Primary carcinoma of renal calyx.

    PubMed

    Williams, Phillip A; Mai, Kien T

    2013-10-01

    Renal calyx carcinoma (RCXC) may mimic collecting duct carcinoma (CDC) or urothelial carcinoma (UC) of the renal pelvis. RCXC is distinguished from CDC and UC of the renal pelvis as having the tumor epicenter in the renal calyx, with limited involvement of the surrounding renal pelvis surface urothelium. In this study, we summarize our experience with this entity. Ten cases of RCXC, including 9 cases with urothelial differentiation (RCXC-UC) and 1 case with salivary gland-type differentiation (RCXC-SC), were identified. Ten consecutive cases of UC were selected for comparison, with extensive renal pelvis involvement and with secondary renal parenchymal invasion. Two cases of collecting duct carcinoma (CDC) were also examined. Immunohistochemistry (IHC) was performed on representative tissue blocks for PAX8, PAX2, CK5, CK7, CK20, p63, GATA3, AMACR, RCC, CD10, vimentin, S100, and MSA. The 10 cases of RCXC (M:F=4:6, ages: 62-91 years, mean: 76) presented with renal masses of 3-6cm. Ureteroscopic studies and renal pelvic washings showed atypical/malignant cells in three cases. Seven patients were treated with nephrectomy followed by radiation±chemotherapy, and all cases developed metastases to lymph nodes or liver/lung/bone. In all 7 cases with nephrectomy, there was extensive renal parenchymal involvement with infiltrating borders and diffuse spread along collecting ducts. Six RCXC-UC contained focal squamous differentiation. The RCXC-SC displayed features of adenoid cystic and basaloid features. In situ UC, with or without papillary components, was identified in the calyces in all 7 nephrectomy cases with remaining renal pelvis harboring small tumor burden in 5 cases, and no tumor in another 2 cases. Of the three cases without nephrectomy, no tumor in the renal pelvis could be visualized with endoscopy, however one case was associated with UC of the urinary bladder. Of 10 control UC cases, tumor was limited to the tip of renal papilla in 7 cases, extensive in 3

  5. Treatment of Autonomous Hyperparathyroidism in Post Renal Transplant Recipients

    ClinicalTrials.gov

    2015-12-23

    Chronic Allograft Nephropathy; Chronic Kidney Disease; Chronic Renal Failure; Disordered Mineral Metabolism; End Stage Renal Disease; Hyperparathyroidism; Hypophosphatemia; Kidney Disease; Kidney Transplantation; Post Renal Transplantation

  6. Cystic renal neoplasms and renal neoplasms associated with cystic renal diseases in adults: cross-sectional imaging findings.

    PubMed

    Katabathina, Venkata S; Garg, Deepak; Prasad, Srinivasa R; Vikram, Raghu

    2012-01-01

    Cystic renal neoplasms in adults are a heterogeneous group of tumors with characteristic histogenesis, pathological findings, and variable biological profiles. They include disparate entities that are either biologically benign (lymphangioma, cystic nephroma, and mixed epithelial and stromal tumor) or malignant (cystic renal cell carcinoma, multilocular cystic renal cell carcinoma, and primary renal synovial sarcoma). Renal cystic diseases are characterized by cystic changes of the kidneys due to hereditary, developmental, or acquired etiology. Cystic renal diseases such as acquired cystic kidney disease, von Hippel-Lindau disease, and tuberous sclerosis are associated with the development of a wide spectrum of benign and malignant renal neoplasms. Most cystic renal tumors and cystic disease-associated renal neoplasms show characteristic cross-sectional imaging findings that permit accurate diagnosis. In addition, cross-sectional imaging is pivotal in the follow-up and surveillance of adult cystic tumors of the kidney. PMID:23192202

  7. Giant elves: Lightning-generated electromagnetic pulses in giant planets.

    NASA Astrophysics Data System (ADS)

    Luque Estepa, Alejandro; Dubrovin, Daria; José Gordillo-Vázquez, Francisco; Ebert, Ute; Parra-Rojas, Francisco Carlos; Yair, Yoav; Price, Colin

    2015-04-01

    We currently have direct optical observations of atmospheric electricity in the two giant gaseous planets of our Solar System [1-5] as well as radio signatures that are possibly generated by lightning from the two icy planets Uranus and Neptune [6,7]. On Earth, the electrical activity of the troposphere is associated with secondary electrical phenomena called Transient Luminous Events (TLEs) that occur in the mesosphere and lower ionosphere. This led some researchers to ask if similar processes may also exist in other planets, focusing first on the quasi-static coupling mechanism [8], which on Earth is responsible for halos and sprites and then including also the induction field, which is negligible in our planet but dominant in Saturn [9]. However, one can show that, according to the best available estimation for lightning parameters, in giant planets such as Saturn and Jupiter the effect of the electromagnetic pulse (EMP) dominates the effect that a lightning discharge has on the lower ionosphere above it. Using a Finite-Differences, Time-Domain (FDTD) solver for the EMP we found [10] that electrically active storms may create a localized but long-lasting layer of enhanced ionization of up to 103 cm-3 free electrons below the ionosphere, thus extending the ionosphere downward. We also estimate that the electromagnetic pulse transports 107 J to 1010 J toward the ionosphere. There emissions of light of up to 108 J would create a transient luminous event analogous to a terrestrial elve. Although these emissions are about 10 times fainter than the emissions coming from the lightning itself, it may be possible to target them for detection by filtering the appropiate wavelengths. [1] Cook, A. F., II, T. C. Duxbury, and G. E. Hunt (1979), First results on Jovian lightning, Nature, 280, 794, doi:10.1038/280794a0. [2] Little, B., C. D. Anger, A. P. Ingersoll, A. R. Vasavada, D. A. Senske, H. H. Breneman, W. J. Borucki, and The Galileo SSI Team (1999), Galileo images of

  8. Metoclopramide and renal vascular resistance.

    PubMed

    Manara, A R; Bolsin, S; Monk, C R; Hartnell, G; Harris, R A

    1991-01-01

    We have studied the effect of i.v. metoclopramide on renal vascular resistance in nine healthy volunteers. Peak systolic and end-diastolic frequencies were measured using duplex Doppler ultrasound of a renal interlobar artery, before and after the administration of i.v. metoclopramide 10 mg, and the resistance index derived. There was no significant change in mean arterial pressure or resistance index following metoclopramide. PMID:1997046

  9. Management of acute renal failure

    PubMed Central

    Fry, A C; Farrington, K

    2006-01-01

    Acute renal failure is a common condition, frequently encountered in both community practice and hospital inpatients. While it remains a heterologous condition, following basic principles makes investigation straightforward, and initial management follows a standard pathway in most patients. This article shows this, advises on therapeutic strategies, including those in special situations, and should help the clinician in deciding when to refer to a nephrologist, and when to consider renal replacement therapy. PMID:16461473

  10. Oxygen radicals and renal diseases.

    PubMed

    Klahr, S

    1997-01-01

    Reactive oxygen metabolites (superoxide, hydrogen peroxide, hydroxyl radical, and hypochlorous acid) are important mediators of renal damage in acute renal failure and glomerular and tubulointerstitial diseases. The role of these oxygen metabolites in the above entities is discussed, and the effects of antioxidants and scavengers of O2 radicals are considered. The role of oxygen radicals in the regulation of gene transcription is also considered. PMID:9387104

  11. [Renal injury in Takayasu's arteritis].

    PubMed

    Boubaker, Karima; Kaaroud, Hayet; Goucha, Rim; Kheder, Adel

    2014-11-01

    Renal involvement in Takayasu's arteritis is frequent and worsens the progression of the disease. This is primarily a renal artery stenosis causing renovascular hypertension. The glomerular disease is exceptional. This study was undertaken to determine the clinical, radiological, biological features and therapeutic response in patients with kidney disease associated with Takayasu arteritis. A retrospective chart review was conducted on 11 patients (five men and six females), with a mean age of 31.1 years (19-40 years). The discovery of kidney disease preceded the diagnosis of Takayasu's arteritis in eight cases. Ten patients developed hypertension. Laboratory finding showed proteinuria in five cases of which one case was due to nephrotic syndrome. Renal failure was found in six cases including four cases in stage of terminal chronic renal failure. Impairment of the renal artery was present in nine patients, proximal in seven cases and distal in two cases, bilateral in five cases and unilateral in four cases. Narrowing renal artery was found in seven cases. The renal biopsy revealed membranoproliferative glomerulonephritis in one case and nephrosclerosis in another case. Eleven patients were followed for an average period of 155 months (3-335 months). Remission of nephrotic syndrome was concomitant with the remission of the disease. Seven patients developed outbreaks of Takayasu's arteritis of which six were in care. Relapse of nephrotic syndrome was concomitant with the outbreak of the disease followed by spontaneous remission of both diseases. Improved pressure was obtained in 5 cases and worsening renal function in seven cases. Death was observed in two cases. PMID:25440941

  12. Renal Ammonia Metabolism and Transport

    PubMed Central

    Weiner, I. David; Verlander, Jill W.

    2015-01-01

    Renal ammonia metabolism and transport mediates a central role in acid-base homeostasis. In contrast to most renal solutes, the majority of renal ammonia excretion derives from intrarenal production, not from glomerular filtration. Renal ammoniagenesis predominantly results from glutamine metabolism, which produces 2 NH4+ and 2 HCO3− for each glutamine metabolized. The proximal tubule is the primary site for ammoniagenesis, but there is evidence for ammoniagenesis by most renal epithelial cells. Ammonia produced in the kidney is either excreted into the urine or returned to the systemic circulation through the renal veins. Ammonia excreted in the urine promotes acid excretion; ammonia returned to the systemic circulation is metabolized in the liver in a HCO3−-consuming process, resulting in no net benefit to acid-base homeostasis. Highly regulated ammonia transport by renal epithelial cells determines the proportion of ammonia excreted in the urine versus returned to the systemic circulation. The traditional paradigm of ammonia transport involving passive NH3 diffusion, protonation in the lumen and NH4+ trapping due to an inability to cross plasma membranes is being replaced by the recognition of limited plasma membrane NH3 permeability in combination with the presence of specific NH3-transporting and NH4+-transporting proteins in specific renal epithelial cells. Ammonia production and transport are regulated by a variety of factors, including extracellular pH and K+, and by several hormones, such as mineralocorticoids, glucocorticoids and angiotensin II. This coordinated process of regulated ammonia production and transport is critical for the effective maintenance of acid-base homeostasis. PMID:23720285

  13. Osteoclastic giant cell tumor of the pancreas☆

    PubMed Central

    Temesgen, Wudneh M.; Wachtel, Mitchell; Dissanaike, Sharmila

    2014-01-01

    INTRODUCTION Pancreatic giant cell tumors are rare, with an incidence of less than 1% of all pancreatic tumors. Osteoclastic giant cell tumor (OGCT) of the pancreas is one of the three types of PGCT, which are now classified as undifferentiated carcinoma with osteoclast-like giant cells. PRESENTATION OF CASE The patient is a 57 year old woman who presented with a 3 week history of epigastric pain and a palpable abdominal mass. Imaging studies revealed an 18 cm × 15 cm soft tissue mass with cystic components which involved the pancreas, stomach and spleen. Exploratory laparotomy with distal pancreatectomy, partial gastrectomy and splenectomy was performed. Histology revealed undifferentiated pancreatic carcinoma with osteoclast-like giant cells with production of osteoid and glandular elements. DISCUSSION OGCT of the pancreas resembles benign-appearing giant cell tumors of bone, and contain osteoclastic-like multinucleated cells and mononuclear cells. OGCTs display a less aggressive course with slow metastasis and lymph node spread compared to pancreatic adenocarcinoma. Due to the rarity of the cancer, there is a lack of prospective studies on treatment options. Surgical en-bloc resection is currently considered first line treatment. The role of adjuvant therapy with radiotherapy or chemotherapy has not been established. CONCLUSION Pancreatic giant cell tumors are rare pancreatic neoplasms with unique clinical and pathological characteristics. Osteoclastic giant cell tumors are the most favorable sub-type. Surgical en bloc resection is the first line treatment. Long-term follow-up of patients with these tumors is essential to compile a body of literature to help guide treatment. PMID:24631915

  14. YOUNG SOLAR SYSTEM's FIFTH GIANT PLANET?

    SciTech Connect

    Nesvorny, David

    2011-12-15

    Studies of solar system formation suggest that the solar system's giant planets formed and migrated in the protoplanetary disk to reach the resonant orbits with all planets inside {approx}15 AU from the Sun. After the gas disk's dispersal, Uranus and Neptune were likely scattered by the gas giants, and approached their current orbits while dispersing the transplanetary disk of planetesimals, whose remains survived to this time in the region known as the Kuiper Belt. Here we performed N-body integrations of the scattering phase between giant planets in an attempt to determine which initial states are plausible. We found that the dynamical simulations starting with a resonant system of four giant planets have a low success rate in matching the present orbits of giant planets and various other constraints (e.g., survival of the terrestrial planets). The dynamical evolution is typically too violent, if Jupiter and Saturn start in the 3:2 resonance, and leads to final systems with fewer than four planets. Several initial states stand out in that they show a relatively large likelihood of success in matching the constraints. Some of the statistically best results were obtained when assuming that the solar system initially had five giant planets and one ice giant, with the mass comparable to that of Uranus and Neptune, and which was ejected to interstellar space by Jupiter. This possibility appears to be conceivable in view of the recent discovery of a large number of free-floating planets in interstellar space, which indicates that planet ejection should be common.

  15. Renal artery injury during robot-assisted renal surgery.

    PubMed

    Lee, Jae Won; Yoon, Young Eun; Kim, Dae Keun; Park, Sung Yul; Moon, Hong Sang; Lee, Tchun Yong

    2010-07-01

    Laparoscopic partial nephrectomy (LPN) is becoming the standard of care for incidentally diagnosed, small renal tumors. With its seven degrees of freedom and three-dimensional vision, the DaVinci robotic surgical system has been used to assist in LPNs. The main disadvantage of robot-assisted surgery, however, is the lack of tactile feedback. We present a case of renal artery injury during robot-assisted renal surgery. Robot-assisted partial nephrectomy (RPN) was planned for 47-year-old man with a 3.5-cm right renal mass. After standard bowel mobilization, renal hilar dissection was performed. In the attempt to complete the dissection posteriorly, however, there was sudden profuse bleeding. The intraperitoneal pressure immediately increased to 20 mm Hg, and an additional suction device was inserted through the 5-mm liver retractor port. On inspection, there was an injury at the takeoff of the posterior segmental artery. A decision was made to convert to robot-assisted laparoscopic radical nephrectomy. The main renal artery and renal vein were controlled with Hem-o-Lok clips. The estimated blood loss was 2,000 mL. Four units of packed red blood cells were transfused intraoperatively. The post-transfusion hemoglobin level was 12.6 g/dL. There were no other perioperative complications. The surgeon should keep in mind that the robotic arms are very powerful and can easily injure major vessels because of lack of tactile feedback. A competent and experienced tableside surgeon is very important in robot-assisted surgery because the unsterile console surgeon cannot immediately react to intraoperative complications. PMID:20590468

  16. Sunspots and Giant-Cell Convection

    NASA Technical Reports Server (NTRS)

    Moore, Ron L.; Hathaway, David H.; Reichmann, Ed J.

    2000-01-01

    From analysis of Doppler velocity images from SOHO/MDI, Hathaway et al (2000, Solar Phys., in press) have found clear evidence for giant convection cells that fill the solar surface, have diameters 3 - 10 times that typical of supergranules, and have lifetimes approx. greater than 10 days. Analogous to the superposition of the granular convection on the supergranular convection, the approx. 30,000 km diameter supergranules are superposed on these still larger giant cells. Because the giant cells make up the large-scale end of a continuous power spectrum that peaks at the size scale of supergranules, it appears that the giant cells are made by the same mode of convection as the supergranules. This suggests that the giant cells are similar to supergranules, just longer-lived, larger in diameter, and deeper. Here we point out that the range of lengths of large bipolar sunspot groups is similar to the size range of giant cells. This, along with the long lives (weeks) of large sunspots, suggests that large sunspots sit in long-lived, deep downflows at the corners of giant cells, and that the distance from leader to follower sunspots in large bipolar groups is the distance from one giant-cell corner to the next. By this line of reasoning, an unusually large and strong downdraft might pull in both legs of a rising spot-group magnetic flux loop, resulting in the formation of a delta sunspot. This leads us to suggest that a large, strong giant-cell corner downdraft should be present at the birthplaces of large delta sunspots for some time (days to weeks) before the birth. Thus, early detection of such downdrafts by local helioscismology might provide an early warning for the formation of those active regions (large delta sunspot groups) that produce the Sun's most violent flares and coronal mass ejections. This work is supported by NASA's Office of Space Science through the Solar Physics Branch of its Sun-Earth Connection Program.

  17. Pathophysiology and management of progressive renal disease.

    PubMed

    Brown, S A; Crowell, W A; Brown, C A; Barsanti, J A; Finco, D R

    1997-09-01

    Recently, the hypothesis that all renal diseases are inherently progressive and self-perpetuating has focused attention on adaptive changes in renal structure and function that occur whenever renal function is reduced. These glomerular adaptations to renal disease include increases in filtration rate, capillary pressure and size, and are referred to as glomerular hyperfiltration, glomerular hypertension and glomerular hypertrophy, respectively. Extrarenal changes, such as dietary phosphate excess, systemic hypertension, hyperlipidaemia, acidosis and hyperparathyroidism occur in animals with renal disease and may be contributors to progression of renal disease. Emphasis in the management of companion animals with renal disease has shifted to identifying, understanding and controlling those processes that play a role in the progression from early to end-stage renal failure. Advances made by veterinary nephrologists in the past 15 years permit resolution of old controversies, formulation of new hypotheses and discussion of unresolved issues about the nature of progressive renal disease in dogs and cats. PMID:9308397

  18. An MHD model for magnetar giant flares

    SciTech Connect

    Meng, Y.; Lin, J.; Zhang, Q. S.; Zhang, L.; Reeves, K. K.; Yuan, F. E-mail: jlin@ynao.ac.cn

    2014-04-10

    Giant flares on soft gamma-ray repeaters that are thought to take place on magnetars release enormous energy in a short time interval. Their power can be explained by catastrophic instabilities occurring in the magnetic field configuration and the subsequent magnetic reconnection. By analogy with the coronal mass ejection events on the Sun, we develop a theoretical model via an analytic approach for magnetar giant flares. In this model, the rotation and/or displacement of the crust causes the field to twist and deform, leading to flux rope formation in the magnetosphere and energy accumulation in the related configuration. When the energy and helicity stored in the configuration reach a threshold, the system loses its equilibrium, the flux rope is ejected outward in a catastrophic way, and magnetic reconnection helps the catastrophe develop to a plausible eruption. By taking SGR 1806–20 as an example, we calculate the free magnetic energy released in such an eruptive process and find that it is more than 10{sup 47} erg, which is enough to power a giant flare. The released free magnetic energy is converted into radiative energy, kinetic energy, and gravitational energy of the flux rope. We calculated the light curves of the eruptive processes for the giant flares of SGR 1806–20, SGR 0526–66, and SGR 1900+14, and compared them with the observational data. The calculated light curves are in good agreement with the observed light curves of giant flares.

  19. Giant components in directed multiplex networks.

    PubMed

    Azimi-Tafreshi, N; Dorogovtsev, S N; Mendes, J F F

    2014-11-01

    We describe the complex global structure of giant components in directed multiplex networks that generalizes the well-known bow-tie structure, generic for ordinary directed networks. By definition, a directed multiplex network contains vertices of one type and directed edges of m different types. In directed multiplex networks, we distinguish a set of different giant components based on the existence of directed paths of different types between their vertices such that for each type of edges, the paths run entirely through only edges of that type. If, in particular, m=2, we define a strongly viable component as a set of vertices in which for each type of edges each two vertices are interconnected by at least two directed paths in both directions, running through the edges of only this type. We show that in this case, a directed multiplex network contains in total nine different giant components including the strongly viable component. In general, the total number of giant components is 3^{m}. For uncorrelated directed multiplex networks, we obtain exactly the size and the emergence point of the strongly viable component and estimate the sizes of other giant components. PMID:25493836

  20. Giant components in directed multiplex networks

    NASA Astrophysics Data System (ADS)

    Azimi-Tafreshi, N.; Dorogovtsev, S. N.; Mendes, J. F. F.

    2014-11-01

    We describe the complex global structure of giant components in directed multiplex networks that generalizes the well-known bow-tie structure, generic for ordinary directed networks. By definition, a directed multiplex network contains vertices of one type and directed edges of m different types. In directed multiplex networks, we distinguish a set of different giant components based on the existence of directed paths of different types between their vertices such that for each type of edges, the paths run entirely through only edges of that type. If, in particular, m =2 , we define a strongly viable component as a set of vertices in which for each type of edges each two vertices are interconnected by at least two directed paths in both directions, running through the edges of only this type. We show that in this case, a directed multiplex network contains in total nine different giant components including the strongly viable component. In general, the total number of giant components is 3m. For uncorrelated directed multiplex networks, we obtain exactly the size and the emergence point of the strongly viable component and estimate the sizes of other giant components.

  1. An MHD Model for Magnetar Giant Flares

    NASA Astrophysics Data System (ADS)

    Meng, Y.; Lin, J.; Zhang, L.; Reeves, K. K.; Zhang, Q. S.; Yuan, F.

    2014-04-01

    Giant flares on soft gamma-ray repeaters that are thought to take place on magnetars release enormous energy in a short time interval. Their power can be explained by catastrophic instabilities occurring in the magnetic field configuration and the subsequent magnetic reconnection. By analogy with the coronal mass ejection events on the Sun, we develop a theoretical model via an analytic approach for magnetar giant flares. In this model, the rotation and/or displacement of the crust causes the field to twist and deform, leading to flux rope formation in the magnetosphere and energy accumulation in the related configuration. When the energy and helicity stored in the configuration reach a threshold, the system loses its equilibrium, the flux rope is ejected outward in a catastrophic way, and magnetic reconnection helps the catastrophe develop to a plausible eruption. By taking SGR 1806-20 as an example, we calculate the free magnetic energy released in such an eruptive process and find that it is more than 1047 erg, which is enough to power a giant flare. The released free magnetic energy is converted into radiative energy, kinetic energy, and gravitational energy of the flux rope. We calculated the light curves of the eruptive processes for the giant flares of SGR 1806-20, SGR 0526-66, and SGR 1900+14, and compared them with the observational data. The calculated light curves are in good agreement with the observed light curves of giant flares.

  2. Anaplastic giant cell thyroid carcinoma.

    PubMed

    Wallin, G; Lundell, G; Tennvall, J

    2004-01-01

    Anaplastic (giant cell) thyroid carcinoma (ATC), is one of the most aggressive malignancies in humans with a median survival time after diagnosis of 3-6 months. Death from ATC was earlier seen because of local growth and suffocation. ATC is uncommon, accounting for less than 5 % of all thyroid carcinomas. The diagnosis can be established by means of multiple fine needle aspiration biopsies, which are neither harmful nor troublesome for the patient. The cytological diagnosis of this high-grade malignant tumour is usually not difficult for a well trained cytologist. The intention to treat patients with ATC is cure, although only few of them survive. The majority of the patients are older than 60 years and treatment must be influenced by their high age. We have by using a combined modality regimen succeeded in achieving local control in most patients. Every effort should be made to control the primary tumour and thereby improve the quality of remaining life and it is important for patients, relatives and the personnel to know that cure is not impossible. Different treatment combinations have been used since 30 years including radiotherapy, cytostatic drugs and surgery, when feasible. In our latest combined regimen, 22 patients were treated with hyper fractionated radiotherapy 1.6Gy x 2 to a total target dose of 46 Gy given preoperatively, 20 mg doxorubicin was administered intravenously once weekly and surgery was carried out 2-3 weeks after the radiotherapy. 17 of these 22 patients were operated upon and none of these 17 patients got a local recurrence. In the future we are awaiting the development of new therapeutic approaches to this aggressive type of carcinoma. Inhibitors of angiogenesis might be useful. Combretastatin has displayed cytotoxicity against ATC cell lines and has had a positive effect on ATC in a patient. Sodium iodide symporter (NIS) genetherapy is also being currently considered for dedifferentiated thyroid carcinomas with the ultimate aim of

  3. Electrodynamics on extrasolar giant planets

    SciTech Connect

    Koskinen, T. T.; Yelle, R. V.; Lavvas, P.; Cho, J. Y-K.

    2014-11-20

    Strong ionization on close-in extrasolar giant planets (EGPs) suggests that their atmospheres may be affected by ion drag and resistive heating arising from wind-driven electrodynamics. Recent models of ion drag on these planets, however, are based on thermal ionization only and do not include the upper atmosphere above the 1 mbar level. These models are also based on simplified equations of resistive magnetohydrodynamics that are not always valid in extrasolar planet atmospheres. We show that photoionization dominates over thermal ionization over much of the dayside atmosphere above the 100 mbar level, creating an upper ionosphere dominated by ionization of H and He and a lower ionosphere dominated by ionization of metals such as Na, K, and Mg. The resulting dayside electron densities on close-in exoplanets are higher than those encountered in any planetary ionosphere of the solar system, and the conductivities are comparable to the chromosphere of the Sun. Based on these results and assumed magnetic fields, we constrain the conductivity regimes on close-in EGPs and use a generalized Ohm's law to study the basic effects of electrodynamics in their atmospheres. We find that ion drag is important above the 10 mbar level where it can also significantly alter the energy balance through resistive heating. Due to frequent collisions of the electrons and ions with the neutral atmosphere, however, ion drag is largely negligible in the lower atmosphere below the 10 mbar level for a reasonable range of planetary magnetic moments. We find that the atmospheric conductivity decreases by several orders of magnitude in the night side of tidally locked planets, leading to a potentially interesting large-scale dichotomy in electrodynamics between the day and night sides. A combined approach that relies on UV observations of the upper atmosphere, phase curve and Doppler measurements of global dynamics, and visual transit observations to probe the alkali metals can potentially be

  4. [Renal transplantation: ethical issues].

    PubMed

    Mamzer-Bruneel, Marie-France; Laforêt, Emmanuelle Grand; Kreis, Henri; Thervet, Éric; Martinez, Frank; Snanoudj, Renaud; Hervé, Christian; Legendre, Christophe

    2012-12-01

    One of the most significant advances in medicine during the last 50 years is the development of organ transplantation. In the context of chronic kidney diseases, renal transplantation offers patients a better clinical outcome than other treatment options. However, the benefits of organ transplantation have not been maximized due to an inadequate supply of organs for transplantation. Despite the establishment of elaborate legal rules for organs procurement, both on deceased and living donors in numerous countries, ethical concerns remain. Most of them are consequences of the strategies implemented or proposed to address the so-called organ shortage. The involvement of society in these complex problems is crucial as numerous questions emerge: could actual state of organ procurement change? Is it possible and/or realistic to increase the number of organs, with respects to living donors or deceased persons? Is the shortage an indicator to limit the use of kidney transplantation? How do we maintain efficiency and justice, in this context. PMID:23168353

  5. Renal cell carcinoma

    PubMed Central

    Gao, Jianjun; Rathmell, W Kimryn

    2014-01-01

    The treatment of renal cell carcinoma (RCC) has changed greatly over the past 15 years. Progress in the surgical management of the primary tumor and increased understanding of the molecular biology and genomics of the disease have led to the development of new therapeutic agents. The management of the primary tumor has changed owing to the realization that clean margins around the primary lesion are sufficient to prevent local recurrence, as well as the development of more sophisticated tools and techniques that increase the safety of partial nephrectomy. The management of advanced disease has altered even more dramatically as a result of new agents that target the tumor vasculature or that attenuate the activation of intracellular oncogenic pathways. This review summarizes data from prospective randomized phase III studies on the surgical management and systemic treatment of RCC, and provides an up to date summary of the histology, genomics, staging, and prognosis of RCC. It describes the management of the primary tumor and offers an overview of systemic agents that form the mainstay of treatment for advanced disease. The review concludes with an introduction to the exciting new class of immunomodulatory agents that are currently in clinical trials and may form the basis of a new therapeutic approach for patients with advanced RCC. PMID:25385470

  6. A GIANT SAMPLE OF GIANT PULSES FROM THE CRAB PULSAR

    SciTech Connect

    Mickaliger, M. B.; McLaughlin, M. A.; Lorimer, D. R.; Palliyaguru, N.; Langston, G. I.; Bilous, A. V.; Kondratiev, V. I.; Lyutikov, M.; Ransom, S. M.

    2012-11-20

    We observed the Crab pulsar with the 43 m telescope in Green Bank, WV over a timespan of 15 months. In total we obtained 100 hr of data at 1.2 GHz and seven hours at 330 MHz, resulting in a sample of about 95,000 giant pulses (GPs). This is the largest sample, to date, of GPs from the Crab pulsar taken with the same telescope and backend and analyzed as one data set. We calculated power-law fits to amplitude distributions for main pulse (MP) and interpulse (IP) GPs, resulting in indices in the range of 2.1-3.1 for MP GPs at 1.2 GHz and in the range of 2.5-3.0 and 2.4-3.1 for MP and IP GPs at 330 MHz. We also correlated the GPs at 1.2 GHz with GPs from the Robert C. Byrd Green Bank Telescope (GBT), which were obtained simultaneously at a higher frequency (8.9 GHz) over a span of 26 hr. In total, 7933 GPs from the 43 m telescope at 1.2 GHz and 39,900 GPs from the GBT were recorded during these contemporaneous observations. At 1.2 GHz, 236 (3%) MP GPs and 23 (5%) IP GPs were detected at 8.9 GHz, both with zero chance probability. Another 15 (4%) low-frequency IP GPs were detected within one spin period of high-frequency IP GPs, with a chance probability of 9%. This indicates that the emission processes at high and low radio frequencies are related, despite significant pulse profile shape differences. The 43 m GPs were also correlated with Fermi {gamma}-ray photons to see if increased pair production in the magnetosphere is the mechanism responsible for GP emission. A total of 92,022 GPs and 393 {gamma}-ray photons were used in this correlation analysis. No significant correlations were found between GPs and {gamma}-ray photons. This indicates that increased pair production in the magnetosphere is likely not the dominant cause of GPs. Possible methods of GP production may be increased coherence of synchrotron emission or changes in beaming direction.

  7. Giant hydronephrosis due to ureteropelvic junction obstruction: A rare case report, and a review of the literature

    PubMed Central

    WANG, QI-FEI; ZENG, GUANG; ZHONG, LIN; LI, QUAN-LIN; CHE, XIANG-YU; JIANG, TAO; ZHANG, ZHI-WEI; ZHENG, WEI; TANG, QI-ZHEN; CHEN, FENG; WANG, KE-NAN

    2016-01-01

    The hydronephrotic kidney, resulting from a ureteropelvic junction obstruction (UPJO), presents commonly as a clinical condition, with the presence of usually no more than 1–2 liters in the collecting system, but a very small number of cases of giant hydronephroses (GHs) has been reported in adults. A GH is defined as the adult renal pelvis containing >1 liter of urine, or at least 1.5% of the body weight. In the majority of cases, the range of the hydronephrotic kidney remains restricted to the renal area. However, the patient described in the present case report had a range for the hydronephrotic kidney which occupied almost the entire abdominal cavity (~24 l), and cases such as these are rarely presented; therefore the aim of the present case study was to document a clear case of GH resulting from UPJO, also accompanied by a review of the current literature. PMID:27330757

  8. What Are Polymyalgia Rheumatica and Giant Cell Arteritis?

    MedlinePlus

    ... Cell Arteritis Find a Clinical Trial Journal Articles What Are Polymyalgia Rheumatica and Giant Cell Arteritis? PDF Version Size: 58 KB November 2014 What Are Polymyalgia Rheumatica and Giant Cell Arteritis? Fast ...

  9. Asymptomatic post-rheumatic giant left atrium.

    PubMed

    Özkartal, Tardu; Tanner, Felix C; Niemann, Markus

    2016-06-26

    A 78-year-old asymptomatic woman was referred to our clinic for a second opinion regarding indication for mitral valve surgery. An echocardiogram showed a moderate mitral stenosis with a concomitant severe regurgitation. The most striking feature, however, was a giant left atrium with a parasternal anteroposterior diameter of 79 mm and a left atrial volume index of 364 mL/m². There are various echocardiographic definitions of a giant left atrium, which are mainly based on measurements of the anteroposterior diameter of the left atrium using M-mode in the parasternal long axis view. Since the commonly accepted method for echocardiographic evaluation of left atrial size is left atrial volume index, we propose a cut-off value of 140 mL/m(2) for the definition of a "giant left atrium". PMID:27354895

  10. Giant axonal neuropathy: visual and oculomotor deficits.

    PubMed

    Kirkham, T H; Guitton, D; Coupland, S G

    1980-08-01

    Giant axonal neuropathy, a generalised disorder or neurofilaments, presents as a chronic, progressive peripheral neuropathy in childhood. Evidence for central nervous system involvement is demonstrated in this study of four male patients with giant axonal neuropathy who had defective visual function and abnormal ocular motility. The visual system was studied by electroretinography, which showed normal retinal function, and by visual evoked potentials, which showed disease of both optic nerves and retrochiasmal visual pathways. The ocular motility disorder, studied by electrooculography, comprised defective pursuit, inability to maintain eccentric gaze with gaze paretic and rebound nystagmus, abnormal optokinetic responses and failure of suppression of the vestibulo-ocular reflex by fixation. These findings suggested involvement by giant axonal neuropathy of the cerebellar and brain stem pathways important in the control of ocular motility. PMID:7192592

  11. Asymptomatic post-rheumatic giant left atrium

    PubMed Central

    Özkartal, Tardu; Tanner, Felix C; Niemann, Markus

    2016-01-01

    A 78-year-old asymptomatic woman was referred to our clinic for a second opinion regarding indication for mitral valve surgery. An echocardiogram showed a moderate mitral stenosis with a concomitant severe regurgitation. The most striking feature, however, was a giant left atrium with a parasternal anteroposterior diameter of 79 mm and a left atrial volume index of 364 mL/m². There are various echocardiographic definitions of a giant left atrium, which are mainly based on measurements of the anteroposterior diameter of the left atrium using M-mode in the parasternal long axis view. Since the commonly accepted method for echocardiographic evaluation of left atrial size is left atrial volume index, we propose a cut-off value of 140 mL/m2 for the definition of a “giant left atrium”. PMID:27354895

  12. Electrically controlled giant piezoresistance in silicon nanowires.

    PubMed

    Neuzil, Pavel; Wong, Chee Chung; Reboud, Julien

    2010-04-14

    Herein we demonstrate giant piezoresistance in silicon nanowires (NWs) by the modulation of an electric field-induced with an external electrical bias. Positive bias for a p-type device (negative for an n-type) partially depleted the NWs forming a pinch-off region, which resembled a funnel through which the electrical current squeezed. This region determined the total current flowing through the NWs. In this report, we combined the electrical biasing with the application of mechanical stress, which impacts the charge carriers' concentration, to achieve an electrically controlled giant piezoresistance in nanowires. This phenomenon was used to create a stress-gated field-effect transistor, exhibiting a maximum gauge factor of 5000, 2 orders of magnitude increase over bulk value. Giant piezoresistance can be tailored to create highly sensitive mechanical sensors operating in a discrete mode such as nanoelectromechanical switches. PMID:20192246

  13. Case report of solitary giant hepatic lymphangioma

    PubMed Central

    Lee, Hwan Hyo

    2016-01-01

    A hepatic lymphangioma is a rare benign neoplasm that is usually associated with systemic lymphangiomatosis. A solitary hepatic lymphangioma is extremely rare. Therefore, we present a rare case of a female patient who underwent right hepatectomy for solitary giant hepatic lymphangioma. A 42-year-old female presented to the emergency department with complaint of severe abdominal pain of the right upper quadrant. Abdominal computed tomography showed an approximately 23×30-cm sized, giant, relatively well-defined, homogenous cystic mass with few septa in the right liver (segments VII and VIII). The preoperative diagnosis was a giant hepatic cystadenoma or cystadenocarcinoma. We performed right hepatectomy. The permanent histopathological report revealed cystic lymphangioma of the liver. Although the prognosis of solitary hepatic lymphangioma after surgical resection is favorable, recurrence has been reported in literature. PMID:27212994

  14. Genetics Home Reference: action myoclonus-renal failure syndrome

    MedlinePlus

    ... Action Myoclonus - Renal Failure Syndrome Genetic Testing Registry: Epilepsy, progressive myoclonic 4, with or without renal failure ... failure syndrome action myoclonus–renal failure syndrome AMRF epilepsy, progressive myoclonic 4, with or without renal failure ...

  15. Lithium-rich Giants in Globular Clusters

    NASA Astrophysics Data System (ADS)

    Kirby, Evan N.; Guhathakurta, Puragra; Zhang, Andrew J.; Hong, Jerry; Guo, Michelle; Guo, Rachel; Cohen, Judith G.; Cunha, Katia

    2016-03-01

    Although red giants deplete lithium on their surfaces, some giants are Li-rich. Intermediate-mass asymptotic giant branch (AGB) stars can generate Li through the Cameron-Fowler conveyor, but the existence of Li-rich, low-mass red giant branch (RGB) stars is puzzling. Globular clusters are the best sites to examine this phenomenon because it is straightforward to determine membership in the cluster and to identify the evolutionary state of each star. In 72 hours of Keck/DEIMOS exposures in 25 clusters, we found four Li-rich RGB and two Li-rich AGB stars. There were 1696 RGB and 125 AGB stars with measurements or upper limits consistent with normal abundances of Li. Hence, the frequency of Li-richness in globular clusters is (0.2 ± 0.1)% for the RGB, (1.6 ± 1.1)% for the AGB, and (0.3 ± 0.1)% for all giants. Because the Li-rich RGB stars are on the lower RGB, Li self-generation mechanisms proposed to occur at the luminosity function bump or He core flash cannot explain these four lower RGB stars. We propose the following origin for Li enrichment: (1) All luminous giants experience a brief phase of Li enrichment at the He core flash. (2) All post-RGB stars with binary companions on the lower RGB will engage in mass transfer. This scenario predicts that 0.1% of lower RGB stars will appear Li-rich due to mass transfer from a recently Li-enhanced companion. This frequency is at the lower end of our confidence interval. The data presented herein were obtained at the W. M. Keck Observatory, which is operated as a scientific partnership among the California Institute of Technology, the University of California and the National Aeronautics and Space Administration. The Observatory was made possible by the generous financial support of the W. M. Keck Foundation.

  16. Hyperdense renal masses: a CT manifestation of hemorrhagic renal cysts

    SciTech Connect

    Sussman, S.; Cochran, S.T.; Pagani, J.J.; McArdle, C.; Wong, W.; Austin, R.; Curry, N.; Kelly, K.M.

    1984-01-01

    Eleven patients with sharply circumscribed round to ovoid renal cysts measuring 70-90 H on CT are reported. The cysts were hyperdense on unenhanced scans, measuring 30-60 H greater than the adjacent parenchyma, and either hypodense, isodense, or hyperdense on enhanced scans. Four patients had polycystic kidney disease; of the other 7 patients, the cysts were cortical in 6 and parapelvic in 1. Eight patients had a solitary cyst and 3 had multiple cysts. Sonography demonstrated internal echoes and/or lack of increased through-transmission in 6 patients. Pathological analysis was available in 6 cases and indicated a benign, hemorrhagic renal cyst. This hyperdense CT appearance is characteristic of some hemorrhagic renal cysts, though differentiation between benign and malignant cysts requires cyst puncture and/or surgery.

  17. The role of renal biopsy in small renal masses

    PubMed Central

    Burruni, Rodolfo; Lhermitte, Benoit; Cerantola, Yannick; Tawadros, Thomas; Meuwly, Jean-Yves; Berthold, Dominik; Jichlinski, Patrice; Valerio, Massimo

    2016-01-01

    Renal biopsy is being increasingly proposed as a diagnostic tool to characterize small renal masses (SRM). Indeed, the wide adoption of imaging in the diagnostic workup of many diseases had led to a substantial increased incidence of SRM (diameter ≤4 cm). While modern ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) techniques have high sensitivity for detecting SRM, none is able to accurately and reliably characterize them in terms of histological features. This is currently of key importance in guiding clinical decision-making in some situations, and in these cases renal biopsy should be considered. In this review, we aim to summarize the technique, diagnostic performance, and predicting factors of nondiagnostic biopsy, as well as the future perspectives. PMID:26858784

  18. Surgical Resection of a Giant Coronary Aneurysm.

    PubMed

    Mehall, John R; Verlare, Jordan L

    2015-06-01

    Coronary aneurysms are quite uncommon, and those qualifying as giant aneurysms are even more so. Currently, no standardized treatment protocol exists. We report the case of a 46-year-old man presenting with clinical signs and symptoms of acute myocardial infarction who was found to have a giant coronary aneurysm. The patient was initially evaluated with a computed tomography angiogram, which revealed a 9-cm aneurysm of the left circumflex coronary artery. Surgical resection of the aneurysm, ligation of the proximal circumflex artery, and bypass using the left internal mammary artery to vascularize the proximal circumflex artery was performed. PMID:26046882

  19. Giant eruptions of very massive stars

    NASA Astrophysics Data System (ADS)

    Davidson, Kris

    2016-07-01

    Giant eruptions or supernova-impostor events are far more mysterious than true supernovae. An extreme example can release as much radiative energy as a SN, ejecting several Mʘ of material. These events involve continuous radiation-driven outflows rather than blast waves. They constitute one of the main unsolved problems in stellar astrophysics, but have received little theoretical attention. The most notorious giant-eruption survivor, ƞ Carinae, is amazingly close to us for such a rare event. It offers a wealth of observational clues, many of them quite unexpected in terms of simple theory.

  20. MAPPING DIRECTLY IMAGED GIANT EXOPLANETS

    SciTech Connect

    Kostov, Veselin; Apai, Daniel

    2013-01-01

    With the increasing number of directly imaged giant exoplanets, the current atmosphere models are often not capable of fully explaining the spectra and luminosity of the sources. A particularly challenging component of the atmosphere models is the formation and properties of condensate cloud layers, which fundamentally impact the energetics, opacity, and evolution of the planets. Here we present a suite of techniques that can be used to estimate the level of rotational modulations these planets may show. We propose that the time-resolved observations of such periodic photometric and spectroscopic variations of extrasolar planets due to their rotation can be used as a powerful tool to probe the heterogeneity of their optical surfaces. In this paper, we develop simulations to explore the capabilities of current and next-generation ground- and space-based instruments for this technique. We address and discuss the following questions: (1) what planet properties can be deduced from the light curve and/or spectra, and in particular can we determine rotation periods, spot coverage, spot colors, and spot spectra?; (2) what is the optimal configuration of instrument/wavelength/temporal sampling required for these measurements?; and (3) can principal component analysis be used to invert the light curve and deduce the surface map of the planet? Our simulations describe the expected spectral differences between homogeneous (clear or cloudy) and patchy atmospheres, outline the significance of the dominant absorption features of H{sub 2}O, CH{sub 4}, and CO, and provide a method to distinguish these two types of atmospheres. Assuming surfaces with and without clouds for most currently imaged planets the current models predict the largest variations in the J band. Simulated photometry from current and future instruments is used to estimate the level of detectable photometric variations. We conclude that future instruments will be able to recover not only the rotation periods

  1. Circadian regulation of renal function.

    PubMed

    Firsov, Dmitri; Bonny, Olivier

    2010-10-01

    Urinary excretion of water and all major electrolytes exhibit robust circadian oscillations. The 24-h periodicity has been well documented for several important determinants of urine formation, including renal blood flow, glomerular filtration, tubular reabsorption, and tubular secretion. Disturbance of the renal circadian rhythms is increasingly recognized as a risk factor for hypertension, polyuria, and other diseases and may contribute to renal fibrosis. The origin of these rhythms has been attributed to the reactive response of the kidney to circadian changes in volume and/or in the composition of extracellular fluids that are entrained by rest/activity and feeding/fasting cycles. However, numerous studies have shown that most of the renal excretory rhythms persist for long periods of time, even in the absence of periodic environmental cues. These observations led to the hypothesis of the existence of a self-sustained mechanism, enabling the kidney to anticipate various predictable circadian challenges to homeostasis. The molecular basis of this mechanism remained unknown until the recent discovery of the mammalian circadian clock made of a system of autoregulatory transcriptional/translational feedback loops, which have been found in all tissues studied, including the kidney. Here, we present a review of the growing evidence showing the involvement of the molecular clock in the generation of renal excretory rhythms. PMID:20664559

  2. Spin-dependent deprotonation induced giant magnetocurrent in electrochemical cells.

    PubMed

    Pan, Haiping; Shen, Yan; Duan, Jiashun; Lu, Kai; Hu, Bin

    2016-04-21

    A giant magnetocurrent (>100%) is observed in the electrochemical system based on tertiary amines at room temperature. This giant magnetocurrent is ascribed to spin-dependent deprotonation during the oxidation of tertiary amines. This presents a new approach of using spin-dependent deprotonation to generate giant magnetocurrent in electrochemical reactions. PMID:27009519

  3. Evaluation of Glyphosate for Managing Giant Reed (Arundo donax)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Giant reed is an invasive plant of riparian habitats throughout California and the United States. Two herbicides approved for controlling giant reed in California are glyphosate and imazapyr. Sources indicate that 1.5% to 5% glyphosate solutions are effective at controlling giant reed. Imazapyr has ...

  4. GIANT PITUITARY ADENOMA WITH NORMAL VISION AND MISLEADING RADIOLOGICAL FINDINGS.

    PubMed

    Khalid, Muhammad; Raina, Umer Farooq; uz Zaman, Khaleeq; Tahir, Muhammad

    2015-01-01

    Giant pituitary adenomas are rare and present with visual loss. Giant pituitary adenoma has rarely been reported presenting with normal vision. We report Giant pituitary adenoma with Normal vision in a 35 years old patient presenting with adult onset epilepsy and headache. PMID:26721053

  5. Drugs Approved for Kidney (Renal Cell) Cancer

    MedlinePlus

    ... Ask about Your Treatment Research Drugs Approved for Kidney (Renal Cell) Cancer This page lists cancer drugs ... that are not listed here. Drugs Approved for Kidney (Renal Cell) Cancer Afinitor (Everolimus) Aldesleukin Avastin (Bevacizumab) ...

  6. Radiographic Kinetics of Sarcomatoid Renal Cell Carcinoma.

    PubMed

    Syed, Ali; Raval, Amar; Pridjian, Andrew; Birbe, Ruth; Trabulsi, Edouard J

    2016-07-01

    Renal cell carcinoma is a common entity often managed surgically with excellent survival benefits. We report a rare case of sarcomatoid renal cell carcinoma with aggressive growth kinetics after palliative resection captured radiographically. PMID:27041470

  7. General Information about Renal Cell Cancer

    MedlinePlus

    ... Renal Cell Cancer Treatment (PDQ®)–Patient Version General Information About Renal Cell Cancer Go to Health Professional ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  8. Paraneoplastic Cough and Renal Cell Carcinoma

    PubMed Central

    Sullivan, Stephen

    2016-01-01

    A case of patient with intractable cough due to renal cell carcinoma is reported. The discussion reviews the literature regarding this unusual paraneoplastic manifestation of renal malignancy. PMID:27445553

  9. Genetics Home Reference: renal coloboma syndrome

    MedlinePlus

    ... 1 link) The Kidney and Urology Foundation of America GeneReviews (1 link) Renal Coloboma Syndrome Genetic Testing Registry (1 link) Renal coloboma syndrome Scientific articles on PubMed (1 link) PubMed OMIM (1 ...

  10. Primary renal primitive neuroectodermal tumor

    PubMed Central

    Goel, V; Talwar, V; Dodagoudar, C; Singh, S; Sharma, A; Patnaik, N

    2015-01-01

    Primitive Neuroectodermal Tumor of the kidney is a rare entity. Very few cases of primary renal PNET have been reported to date. Most literature about rPNET is isolated case reports. We report a case of rPNET in a 39-year-old male with a pre-operative diagnosis of renal cell carcinoma with renal vein thrombosis. The patient underwent radical nephrectomy with thrombolectomy, and histopathological examination revealed a highly aggressive tumor composed of monotonous sheets of round cells. Tumor cells were positive for CD 99 and FLI-1, hence confirming the diagnosis of Primitive Neuroectodermal Tumor. Post-surgery, patient was given VAC/IE-based adjuvant chemotherapy. In view of highly aggressive nature of this tumor, prompt diagnosis and imparting effective chemotherapy regimen to the patient is required, and it is important to differentiate PNET from other small round-cell tumors because of different therapeutic approach. PMID:25766349

  11. Future challenges in renal transplantation.

    PubMed

    Whalen, H; Clancy, M; Jardine, A

    2012-02-01

    There is a worldwide increase in the incidence of end-stage renal disease. Renal transplantation has been shown to be cost effective, prolong survival and provide a better quality of life in comparison to dialysis. Consequently, there has been a steady increase in demand for organs leading to a shortage of available kidneys, and an increase in transplant waiting lists. Renal transplantation is therefore an expanding field with a number of unique future challenges to address. This article outlines strategies that may be employed to expand organ supply in order to meet increased demand. The ethical issues surrounding this are also summarized. Furthermore, we highlight techniques with the potential to minimize peri-transplant injury to the kidney on its journey from donor to recipient. Current and potential future management strategies to optimize graft and patient survival are also discussed. PMID:22361673

  12. Management of diabetic renal disease

    PubMed Central

    Eboh, Cecil

    2015-01-01

    Diabetic nephropathy is the leading cause of end stage renal failure (ESRF) worldwide, representing over 50% of patients on renal replacement therapy in some parts of the world. The condition is common in people with type 1 and type 2 diabetes, although the incidence appears to be declining, especially in type 1 diabetes. More than 1 in 3 people with type 2 diabetes have impaired kidney function. Advances in our understanding of the pathogenesis and natural history of the condition have enabled us to consider earlier therapy aimed at renal preservation and reduction in cardiovascular morbidity. Microalbuminuria is now established as the earliest risk marker for nephropathy in type 1 diabetes and cardiovascular disease in type 2 diabetes. This review examines the current concepts in the pathogenesis and management of diabetic nephropathy. PMID:26244141

  13. Parasites and chronic renal failure

    PubMed Central

    Mohammadi Manesh, Reza; Hosseini Safa, Ahmad; Sharafi, Seyedeh Maryam; Jafari, Rasool; Bahadoran, Mehran; Yousefi, Morteza; Nasri, Hamid; Yousofi Darani, Hossein

    2014-01-01

    Suppression of the human immune system results in an increase in susceptibility to infection by various infectious agents. Conditions such as AIDS, organ transplantation and chronic renal insufficiency (CRI) are the most important cause of insufficient immune response against infections. Long term renal disorders result in uremia, which can suppress human immune system. Parasitic infections are one of the most important factors indicating the public health problems of the societies. These infections can be more hostile and life threatening in susceptible individuals than in the normal people. In these patients some parasitic infections such as blastocystiosis, cryptosporidiosis and toxoplasmosis have been reported to be more prevalent. This review aimed to give an overview about parasitic infections in patients with renal disorders. PMID:25610885

  14. Expression of CD34 and CD68 in peripheral giant cell granuloma and central giant cell granuloma: An immunohistochemical analysis

    PubMed Central

    VK, Varsha; Hallikeri, Kaveri; Girish, HC; Murgod, Sanjay

    2014-01-01

    Background: Central and Peripheral giant cell granulomas of jaws are uncommon, benign, reactive disorders that are characterized by the presence of numerous multinucleated giant cells and mononuclear cells within a stroma. The origin of the multinucleated giant cells is controversial; probably originating from fusion of histiocytes, endothelial cells and fibroblasts. Objective: To assess the expression of CD34 and CD68 in central and peripheral giant cell granulomas to understand the origin of these multinucleated giant cells. Materials and Methods: Twenty cases of Central and Peripheral giant cell granulomas were evaluated immunohistochemically for CD34 and CD68 proteins expression. Results: Immunopositivity for CD34 was seen only in cytoplasm of endothelial cells of blood vessels; whereas, consistent cytoplasmic immunopositivity for CD68 was seen in few stromal cells. Statistical significance was seen in mean number of multinucleated giant cells, mean number of nuclei in multinucleated giant cells, CD68 expression and ratio of macrophages to multinucleated giant cells among two lesions. Conclusion: Although the central giant cell granulomas share some clinical and histopathological similarities with peripheral giant cell granulomas, differences in mean number of nuclei in multinucleated giant cells and CD68 immunoreactivity may underlie the distinct clinical behavior. PMID:25948986

  15. Renal calculus complicated with squamous cell carcinoma of renal pelvis: Report of two cases.

    PubMed

    Xiao, Jiantao; Lei, Jun; He, Leye; Yin, Guangming

    2015-01-01

    Longstanding renal calculus is a risk factor of squamous cell carcinoma (SCC) of the renal pelvis. It is highly aggressive and usually diagnosed at advanced stages with a poor prognosis. We present two cases of kidney stone complications with renal pelvic SCC. These two patients had a radical nephrectomy and the dissected tissues were renal pelvic SCC. Our cases further emphasize that renal pelvic SCC should be considered in patients with longstanding renal calculus. These cases contribute greatly to an early diagnosis and early treatment, both of which will significantly minimize the damage of, and markedly improve the prognosis of, renal pelvic SCC. PMID:26029303

  16. Renal calculus complicated with squamous cell carcinoma of renal pelvis: Report of two cases

    PubMed Central

    Xiao, Jiantao; Lei, Jun; He, Leye; Yin, Guangming

    2015-01-01

    Longstanding renal calculus is a risk factor of squamous cell carcinoma (SCC) of the renal pelvis. It is highly aggressive and usually diagnosed at advanced stages with a poor prognosis. We present two cases of kidney stone complications with renal pelvic SCC. These two patients had a radical nephrectomy and the dissected tissues were renal pelvic SCC. Our cases further emphasize that renal pelvic SCC should be considered in patients with longstanding renal calculus. These cases contribute greatly to an early diagnosis and early treatment, both of which will significantly minimize the damage of, and markedly improve the prognosis of, renal pelvic SCC. PMID:26029303

  17. Renal tubular secretion of pramipexole.

    PubMed

    Knop, Jana; Hoier, Eva; Ebner, Thomas; Fromm, Martin F; Müller, Fabian

    2015-11-15

    The dopamine agonist pramipexole is cleared predominantly by the kidney with a major contribution of active renal secretion. Previously the organic cation transporter 2 (OCT2) was shown to be involved in the uptake of pramipexole by renal tubular cells, while the mechanism underlying efflux into tubular lumen remains unclear. Cimetidine, a potent inhibitor of multidrug and toxin extrusion proteins 1 (MATE1) and 2-K (MATE2-K), decreases renal pramipexole clearance in humans. We hypothesized that, in addition to OCT2, pramipexole may be a substrate of MATE-mediated transport. Pramipexole uptake was investigated using MDCK or HEK cells overexpressing OCT2, MATE1 or MATE2-K and the respective vector controls (Co). Transcellular pramipexole transport was investigated in MDCK cells single- or double-transfected with OCT2 and/or MATE1 and in Co cells, separating a basal from an apical compartment in a model for renal tubular secretion. Pramipexole uptake was 1.6-, 1.1-, or 1.6-folds in cells overexpressing OCT2, MATE1 or MATE2-K, respectively as compared to Co cells (p<0.05). In transcellular transport experiments, intracellular pramipexole accumulation was 1.7-folds in MDCK-OCT2 (p<0.001), and transcellular pramipexole transport was 2.2- and 4.0-folds in MDCK-MATE1 and MDCK-OCT2-MATE1 cells as compared to Co cells (p<0.001). Transcellular pramipexole transport was pH dependent and inhibited by cimetidine with IC50 values of 12μM and 5.5μM in MATE1 and OCT2-MATE1 cells, respectively. Taken together, coordinate activity of OCT2-mediated uptake and MATE-mediated efflux determines pramipexole renal secretion. Reduced OCT2 or MATE transport activity due to genetic variation or drug-drug interactions may affect pramipexole renal secretion. PMID:26360835

  18. Renal pelvis urothelial carcinoma of the upper moiety in complete right renal duplex: a case report

    PubMed Central

    Zhang, Yiran; Yu, Quanfeng; Zhang, Zhihong; Liu, Ranlu; Xu, Yong

    2015-01-01

    Urothelial carcinoma (UC) originated from renal pelvis is the common tumor of the urinary system, however, neoplasia of the renal pelvis in duplex kidneys is extremely rare, especially in the complete renal and ureteral duplex cases. We present the first case of renal pelvis UC of the upper moiety in a complete right renal duplex. This male patient has bilateral complete renal and ureteral duplex. To the best of our knowledge, this is the first reported case of renal pelvis UC in a complete renal duplex system. After this experience we feel that the diagnosis of renal pelvis UC in duplex kidneys is not so easy, and once the diagnosis is determined, the whole renal duplex units and bladder cuff or ectopic orifice should be excised radically. PMID:26823906

  19. Papillary adenocarcinoma of the renal pelvis with renal calculus: A rare case report

    PubMed Central

    LI, JIANLONG; LI, QING; YU, YI

    2016-01-01

    Papillary adenocarcinoma of the renal pelvis is a rare clinicopathology of a kidney tumor with renal calculus. In the present case report, percutaneous renal biopsy, nephroscope lithotripsy and radical nephroureterectomy within a papillary adenocarcinoma of the renal pelvis accompanied with renal calculus was performed on a 65-year-old patient, also including a report on the patient's data and a literature review. The histopathological features confirmed the diagnosis of papillary adenocarcinoma of the renal pelvis. Tumors of the renal pelvis are uncommon features of urothelial carcinoma, and papillary adenocarcinoma of the renal pelvis is a very unusual entity. The present case report describes papillary adenocarcinoma of the renal pelvis with renal calculus, which has rarely been previously reported. PMID:27123287

  20. Emerging Entities in Renal Neoplasia.

    PubMed

    Mehra, Rohit; Smith, Steven C; Divatia, Mukul; Amin, Mahul B

    2015-12-01

    This article reviews emerging entities in renal epithelial neoplasia, including tubulocystic carcinoma, clear-cell-papillary renal cell carcinoma (RCC), thyroid-like follicular RCC, ALK-related RCC, translocation RCC, acquired cystic disease-related RCC, succinate dehydrogenase-deficient RCC, and hereditary leiomyomatosis-RCC syndrome-associated RCC. Many of these rarer subtypes of RCC were recently studied in more depth and are included in the upcoming version of the World Health Organization classification of tumors. Emphasis is placed on common gross and morphologic features, differential diagnoses, use of ancillary studies for making accurate diagnoses, molecular alterations, and predicted biologic behavior based on previous studies. PMID:26612218

  1. Isolation of renal brush borders.

    PubMed

    Morré, D James; Hammond, Timothy

    2007-03-01

    Methods are described to isolate intact brush borders and brush border membranes from renal cell homogenates. A rapid method yields sealed vesicles that reconstitute renal brush border transport. In one variation of this protocol, 10 to 20 mM CaCl2 or MgCl2 is added to aggregate non-brush border structures for subsequent removal by centrifugation. For analytical studies, guidance is provided for subsequent purification steps including preparative free-flow and aqueous two-phase partition. Marker enzymes and morphological parameters are included for assessment of yield and fraction purity. PMID:18228514

  2. Mass spectrometry and renal calculi

    PubMed Central

    Purcarea, VL; Sisu, I; Sisu, E

    2010-01-01

    The present review represents a concise and complete survey of the literature covering 2004–2009, concerning the mass spectrometric techniques involved in the structural investigation of renal calculi. After a short presentation of the fundamental mass spectrometric techniques (MALDI–TOF, QTOF, MS–MS) as well as hyphenated methods (GC–MS, LC–MS, CE–MS), an extensive study of the urinary proteome analysis as well as the detection and quantification by mass spectrometry of toxins, drugs and metabolites from renal calculi is presented. PMID:20968197

  3. Imaging patients with renal impairment.

    PubMed

    Mathur, Mahan; Weinreb, Jeffrey C

    2016-06-01

    Imaging with intravascular contrast media is generally considered safe, particularly in patients without renal failure. However, as renal function deteriorates, the potential risk of nonallergic-type adverse events increases. This presents a unique challenge, particularly when the use of intravenous contrast media is deemed essential for diagnostic purposes. Following a discussion regarding the definition and epidemiology of kidney injury, this review focuses on the evolving understanding of both contrast-induced nephropathy and nephrogenic systemic fibrosis and discusses preventative strategies aimed at minimizing the risk of developing these entities. Alternative non-contrast imaging techniques are also discussed. PMID:27015867

  4. THE REDSHIFT DISTRIBUTION OF GIANT ARCS IN THE SLOAN GIANT ARCS SURVEY

    SciTech Connect

    Bayliss, Matthew B.; Gladders, Michael D.; Koester, Benjamin P.; Oguri, Masamune; Hennawi, Joseph F.; Sharon, Keren; Dahle, Haakon

    2011-01-20

    We measure the redshift distribution of a sample of 28 giant arcs discovered as a part of the Sloan Giant Arcs Survey. Gemini/GMOS-North spectroscopy provides precise redshifts for 24 arcs, and 'redshift desert' constrains for the remaining 4 arcs. This is a direct measurement of the redshift distribution of a uniformly selected sample of bright giant arcs, which is an observable that can be used to inform efforts to predict giant arc statistics. Our primary giant arc sample has a median redshift z = 1.821 and nearly two-thirds of the arcs, 64%, are sources at z {approx}> 1.4, indicating that the population of background sources that are strongly lensed into bright giant arcs resides primarily at high redshift. We also analyze the distribution of redshifts for 19 secondary strongly lensed background sources that are not visually apparent in Sloan Digital Sky Survey imaging, but were identified in deeper follow-up imaging of the lensing cluster fields. Our redshift sample for the secondary sources is not spectroscopically complete, but combining it with our primary giant arc sample suggests that a large fraction of all background galaxies that are strongly lensed by foreground clusters reside at z {approx}> 1.4. Kolmogorov-Smirnov tests indicate that our well-selected, spectroscopically complete primary giant arc redshift sample can be reproduced with a model distribution that is constructed from a combination of results from studies of strong-lensing clusters in numerical simulations and observational constraints on the galaxy luminosity function.

  5. Laser treatment of giant xanthelasma palpebrarum.

    PubMed

    Corradino, Bartolo; Di Lorenzo, Sara; Triolo, Antonio; Moschella, Francesco

    2015-11-01

    Xanthelasma palpebrarum is the most common cutaneous xanthoma. It typically presents in middle-aged and older adults, most often around the eyelids. The diagnosis is made clinically. Giant xanthelasmas palpebrarum are xanthelasmas that extensively affect the superior and inferior bilateral eyelids. Many techniques have been put forward for treating these lesions (surgical, laser, and chemical techniques), but we describe our experience in the treatment of giant xanthelasmas by ultrapulsed CO2 laser. Between 2009 and 2012, in the Division of Plastic and Reconstructive Surgery at the University of Palermo, 12 patients with giant xanthelasmas were treated using a CO2 laser. The laser parameters are as follows: frequency 20 Hz, energy 75 mJ, and power 1.5 W. Each laser session lasts 15 min; the treatment consists of three or four sessions that are carried out at intervals of 15 days. Patients were followed up after 2, 6, and 12 months. This technique is rapid and it is accepted very well by patients. The only disadvantage is a long healing time (10-15 days). The ultrapulsed CO2 laser, in experienced hands, is an excellent device that enables the complete removal of giant xanthelasmas with a minimally invasive but very effective technique. PMID:25252796

  6. Polymyalgia rheumatica and giant cell arteritis.

    PubMed

    Subrahmanyan, Peddasomayajula; Dasgupta, Bhaskar

    2006-05-01

    Polymyalgia rheumatica and giant cell arteritis are the commonest inflammatory rheumatic conditions seen in the elderly. This review focuses on the diagnostic processes and complications of disease and treatment; and the safe management of these conditions with careful consideration of balance between benefits and long-term risks of glucocorticosteroid therapy. PMID:16729627

  7. The local density of halo giants

    NASA Technical Reports Server (NTRS)

    Morrison, Heather L.

    1993-01-01

    A new estimate of the local density of halo giants - 36 +/- 7 with M(V) less than 0.5 per cu kpc - is presented. This number is derived from an objective-prism survey for nearby metal-weak stars, and so is free from many of the assumptions needed to derive the local halo density in the traditional way, from high proper motion surveys. This number agrees well with estimates of the local density of halo horizontal-branch stars, but is approximately a factor of 2 smaller than the density derived by Bahcall and Casertano (1986). This may be due to the inclusion of some thick disk stars in their proper-motion selected sample. The halo density derived from giants can be expressed as a disk-to-halo ratio of 850:1 (+/- 35 percent). Using these results, a simple model is built to predict numbers of halo giants in specified directions in the Galaxy. It is shown that it performs much better than the Bahcall-Soniera model, in the specific case of halo giants. The surface brightness due to the halo at the solar radius is calculated to be 27.7 V magnitudes per sq arcsec, if the Galaxy was viewed from the outside, edge-on, thus raising the possibility of detecting light from halo field stars in other galaxies similar to our own.

  8. Giant light enhancement in atomic clusters

    SciTech Connect

    Gadomsky, O. N. Gadomskaya, I. V.; Altunin, K. K.

    2009-07-15

    We show that the polarizing effect of the atoms in an atomic cluster can lead to full compensation of the radiative damping of excited atomic states, a change in the sign of the dispersion of the atomic polarizability, and giant light enhancement by the atomic cluster.

  9. Giant diverticulum of the sigmoid colon.

    PubMed

    García Flórez, L J; Otero Diez, J; López Muñiz, C; Santamaría Girón, L; Pérez Suárez, A

    2002-12-01

    The giant colonic diverticulum is a very rare clinical entity usually located in the sigmoid colon of elderly patients. A case of an 87-year-old woman recently treated in our hospital is reported hereinafter. The patient was non-surgically treated due to her advanced age and high surgical risk. PMID:12733335

  10. Giant Cavernous Haemangioma of the Anterior Mediastinum

    PubMed Central

    Kaya, Seyda Ors; Samancılar, Ozgur; Usluer, Ozan; Acar, Tuba; Yener, Ali Galip

    2015-01-01

    Cavernous hemangiomas of the anterior mediastinum is rare. We present a case of a 56-year-old male patient with a giant cavernous hemangioma of the anterior mediastinum, 18 cm in diameters, approached by left posterolateral thoracotomy. To the best of our knowledge, such a unique case has not been previously presented in the literature. PMID:26644773

  11. Recovery From Giant Eruptions in Massive Stars

    NASA Astrophysics Data System (ADS)

    Kashi, A.; Davidson, K.; Humphreys, R. M.

    2015-12-01

    We perform radiation hydrodynamic simulations to study how very massive stars recover from giant eruptions. The post eruption star experience strong mass loss due to strong winds, driven by radial pulsations in the star*s interior, that operate by the κ-mechanism. The mass loss history obtained in our simulations resembles η Car*s history.

  12. Reading on the Shoulders of Giants

    ERIC Educational Resources Information Center

    Ben-Chaim, Michael; Riendeau, Michael

    2012-01-01

    Reflecting on his successful scientific career, Isaac Newton highlighted his intellectual debt to his predecessors. "If I have seen further," he wrote, "it was "only" by standing on the shoulders of giants." The authors have chosen the title of their article as a token of recognition of their debt to the teachings of Newton and other intellectuals…

  13. Giant Cell Arteritis and Polymyalgia Rheumatica

    MedlinePlus

    ... symptoms of both GCA and PMR. Other Organizations Arthritis Foundation Questions to Ask Your Doctor What is the likely cause of my symptoms? Do I need any blood tests or biopsies? I have giant cell arteritis. Am I more likely to have polymyalgia rheumatica? I have polymyalgia ...

  14. Giant Viruses of Amoebas: An Update.

    PubMed

    Aherfi, Sarah; Colson, Philippe; La Scola, Bernard; Raoult, Didier

    2016-01-01

    During the 12 past years, five new or putative virus families encompassing several members, namely Mimiviridae, Marseilleviridae, pandoraviruses, faustoviruses, and virophages were described. In addition, Pithovirus sibericum and Mollivirus sibericum represent type strains of putative new giant virus families. All these viruses were isolated using amoebal coculture methods. These giant viruses were linked by phylogenomic analyses to other large DNA viruses. They were then proposed to be classified in a new viral order, the Megavirales, on the basis of their common origin, as shown by a set of ancestral genes encoding key viral functions, a common virion architecture, and shared major biological features including replication inside cytoplasmic factories. Megavirales is increasingly demonstrated to stand in the tree of life aside Bacteria, Archaea, and Eukarya, and the megavirus ancestor is suspected to be as ancient as cellular ancestors. In addition, giant amoebal viruses are visible under a light microscope and display many phenotypic and genomic features not found in other viruses, while they share other characteristics with parasitic microbes. Moreover, these organisms appear to be common inhabitants of our biosphere, and mimiviruses and marseilleviruses were isolated from human samples and associated to diseases. In the present review, we describe the main features and recent findings on these giant amoebal viruses and virophages. PMID:27047465

  15. Tuberculosis Detection by Giant African Pouched Rats

    ERIC Educational Resources Information Center

    Poling, Alan; Weetjens, Bart; Cox, Christophe; Beyene, Negussie; Durgin, Amy; Mahoney, Amanda

    2011-01-01

    In recent years, operant discrimination training procedures have been used to teach giant African pouched rats to detect tuberculosis (TB) in human sputum samples. This article summarizes how the rats are trained and used operationally, as well as their performance in studies published to date. Available data suggest that pouched rats, which can…

  16. Vocal repertoire of the social giant otter.

    PubMed

    Leuchtenberger, Caroline; Sousa-Lima, Renata; Duplaix, Nicole; Magnusson, William E; Mourão, Guilherme

    2014-11-01

    According to the "social intelligence hypothesis," species with complex social interactions have more sophisticated communication systems. Giant otters (Pteronura brasiliensis) live in groups with complex social interactions. It is likely that the vocal communication of giant otters is more sophisticated than previous studies suggest. The objectives of the current study were to describe the airborne vocal repertoire of giant otters in the Pantanal area of Brazil, to analyze call types within different behavioral contexts, and to correlate vocal complexity with level of sociability of mustelids to verify whether or not the result supports the social intelligence hypothesis. The behavior of nine giant otters groups was observed. Vocalizations recorded were acoustically and statistically analyzed to describe the species' repertoire. The repertoire was comprised by 15 sound types emitted in different behavioral contexts. The main behavioral contexts of each sound type were significantly associated with the acoustic variable ordination of different sound types. A strong correlation between vocal complexity and sociability was found for different species, suggesting that the communication systems observed in the family mustelidae support the social intelligence hypothesis. PMID:25373985

  17. Generation of a Chiral Giant Micelle.

    PubMed

    Ito, Thiago H; Salles, Airton G; Priebe, Jacks P; Miranda, Paulo C M L; Morgon, Nelson H; Danino, Dganit; Mancini, Giovanna; Sabadini, Edvaldo

    2016-08-23

    Over the past few years, chiral supramolecular assemblies have been successfully used for recognition, sensing and enantioselective transformations. Several approaches are available to control chirality of discrete assemblies (e.g., cages and capsules), but few are efficient in assuring chirality for micellar aggregates. Optically active amino acid-derived surfactants are commonly used to generate chiral spherical micelles. To circumvent this limitation, we benefited from the uniaxial growth of spherical micelles into long cylindrical micelles usually called wormlike or giant micelles, upon the addition of cosolutes. This paper describes the unprecedented formation of chiral giant micelles in aqueous solutions of cetyltrimethylammonium bromide (CTAB) upon increasing addition of enantiopure sodium salt of 1,1'-bi-2-naphthol (Na-binaphtholate) as a cosolute. Depending on the concentrations of CTAB and Na-binaphtholate, chiral gel-like systems are obtained. The transition from spherical to giant micellar structures was probed using rheology, cryo-transmission electron microscopy, polarimetry, and electronic circular dichroism (CD). CD can be effectively used to monitor the incorporation of Na-binaphtholate into the micelle palisade as well as to determine its transition to giant micellar structures. Our approach expands the scope for chirality induction in micellar aggregates bringing the possibility to generate "smart" chiral systems and an alternative asymmetric chiral environment to perform enantioselective transformations. PMID:27499127

  18. Insights on a Giant Aneurysm Treated Endovascularly.

    PubMed

    Graziano, Francesca; Iacopino, Domenico Gerardo; Ulm, Arthur John

    2016-07-01

    Background Endovascular treatment with stent-assisted Guglielmi detachable coils is an accepted method for treating intracranial giant aneurysms that otherwise would require more invasive or destructive treatment or could not be treated at all. Nevertheless, there is a paucity of information concerning inner postcoiling aneurysmal changes in human subjects over the long term. We report a postmortem analysis of a patient with a giant aneurysm at the vertebrobasilar junction (VBJ) who was treated endovascularly and studied pathologically 24 months after treatment. Materials and Method The head was removed at autopsy and prefixed in a 10% neutral buffered formalin solution. The brain was gently removed from the skull base after cutting the intracranial nerves and vascular structures. The giant VBJ aneurysm and its relationship with the brainstem, cranial nerves, and vessels were captured photographically and analyzed. Afterward, under operating microscope guidance, the vertebrobasilar system with the aneurysm was gently and carefully detached from the brainstem and carefully analyzed. Results No complete fibrous obliteration of the aneurysm lumen could be detected in our case, and no endothelialization had taken place 24 months after treatment. Conclusions Our findings agree with those of previous similar reports. Coiling, in particular in large or giant aneurysms, may be burdened by the risk of coil compaction and recanalization, but it has the advantage of not affecting the flow in the perforating arteries. PMID:26296255

  19. Giant-cell granuloma of the sinuses

    SciTech Connect

    Rhea, J.T.; Weber, A.L.

    1983-04-01

    Three cases are presented which illustrate giant-cell granulomas in the maxillary, ethmoid, and sphenoid sinuses. The radiographic features are nonspecific, and the lesion can mimic carcinoma. Ossification can be demonstrated, especially with computed tomography, and may indicate a benign lesion.

  20. Giant Viruses of Amoebas: An Update

    PubMed Central

    Aherfi, Sarah; Colson, Philippe; La Scola, Bernard; Raoult, Didier

    2016-01-01

    During the 12 past years, five new or putative virus families encompassing several members, namely Mimiviridae, Marseilleviridae, pandoraviruses, faustoviruses, and virophages were described. In addition, Pithovirus sibericum and Mollivirus sibericum represent type strains of putative new giant virus families. All these viruses were isolated using amoebal coculture methods. These giant viruses were linked by phylogenomic analyses to other large DNA viruses. They were then proposed to be classified in a new viral order, the Megavirales, on the basis of their common origin, as shown by a set of ancestral genes encoding key viral functions, a common virion architecture, and shared major biological features including replication inside cytoplasmic factories. Megavirales is increasingly demonstrated to stand in the tree of life aside Bacteria, Archaea, and Eukarya, and the megavirus ancestor is suspected to be as ancient as cellular ancestors. In addition, giant amoebal viruses are visible under a light microscope and display many phenotypic and genomic features not found in other viruses, while they share other characteristics with parasitic microbes. Moreover, these organisms appear to be common inhabitants of our biosphere, and mimiviruses and marseilleviruses were isolated from human samples and associated to diseases. In the present review, we describe the main features and recent findings on these giant amoebal viruses and virophages. PMID:27047465

  1. A rare case of giant vaginal fibromyoma

    PubMed Central

    Asnani, Mona; Srivastava, Kumkum; Gupta, Hem Prabha; Kunwar, Shipra; Srivastava, A N

    2016-01-01

    Summary Vaginal fibroids rarely exist as a primary vaginal tumor. Approximately 300 cases have been reported in the literature. Here we are reporting a rare case of giant vaginal fibromyoma. It was diagnosed as cervical fibroid polyp preoperatively but found to be vaginal fibromyoma peroperatively. PMID:26989649

  2. Chirp-driven giant phase space vortices

    NASA Astrophysics Data System (ADS)

    Trivedi, Pallavi; Ganesh, Rajaraman

    2016-06-01

    In a collisionless, unbounded, one-dimensional plasma, modelled using periodic boundary conditions, formation of steady state phase space coherent structures or phase space vortices (PSV) is investigated. Using a high resolution one-dimensional Vlasov-Poisson solver based on piecewise-parabolic advection scheme, the formation of giant PSV is addressed numerically. For an infinitesimal external drive amplitude and wavenumber k, we demonstrate the existence of a window of chirped external drive frequency that leads to the formation of giant PSV. The linear, small amplitude, external drive, when chirped, is shown to couple effectively to the plasma and increase both streaming of "untrapped" and "trapped" particle fraction. The steady state attained after the external drive is turned off and is shown to lead to a giant PSV with multiple extrema and phase velocities, with excess density fraction, defined as the deviation from the Maxwellian background, Δ n / n 0 ≃ 20 % - 25 % . It is shown that the process depends on the chirp time duration Δt. The excess density fraction Δn/n0, which contains both trapped and untrapped particle contribution, is also seen to scale with Δt, only inhibited by the gradient of the distribution in velocity space. Both single step drive and multistep chirp processes are shown to lead to steady state giant PSV, with multiple extrema due to embedded holes and clumps, long after the external drive is turned off.

  3. Acute Renal Failure after Uterine Artery Embolization

    SciTech Connect

    Rastogi, Sachin; Wu, Yu-Hsin; Shlansky-Goldberg, Richard D.; Stavropoulos, S. William

    2004-09-15

    Renal failure is a potential complication of any endovascular procedure using iodinated contrast, including uterine artery embolization (UAE). In this report we present a case of acute renal failure (ARF) following UAE performed as a treatment for uterine fibroids. The likely causes of ARF in this patient are explored and the possible etiologies of renal failure in patients undergoing UAE are reviewed.

  4. Renal rescue of dopamine D2 receptor function reverses renal injury and high blood pressure

    PubMed Central

    Konkalmatt, Prasad R.; Asico, Laureano D.; Zhang, Yanrong; Yang, Yu; Drachenberg, Cinthia; Zheng, Xiaoxu; Han, Fei; Jose, Pedro A.; Armando, Ines

    2016-01-01

    Dopamine D2 receptor (DRD2) deficiency increases renal inflammation and blood pressure in mice. We show here that long-term renal-selective silencing of Drd2 using siRNA increases renal expression of proinflammatory and profibrotic factors and blood pressure in mice. To determine the effects of renal-selective rescue of Drd2 expression in mice, the renal expression of DRD2 was first silenced using siRNA and 14 days later rescued by retrograde renal infusion of adeno-associated virus (AAV) vector with DRD2. Renal Drd2 siRNA treatment decreased the renal expression of DRD2 protein by 55%, and DRD2 AAV treatment increased the renal expression of DRD2 protein by 7.5- to 10-fold. Renal-selective DRD2 rescue reduced the expression of proinflammatory factors and kidney injury, preserved renal function, and normalized systolic and diastolic blood pressure. These results demonstrate that the deleterious effects of renal-selective Drd2 silencing on renal function and blood pressure were rescued by renal-selective overexpression of DRD2. Moreover, the deleterious effects of 45-minute bilateral ischemia/reperfusion on renal function and blood pressure in mice were ameliorated by a renal-selective increase in DRD2 expression by the retrograde ureteral infusion of DRD2 AAV immediately after the induction of ischemia/reperfusion injury. Thus, 14 days after ischemia/reperfusion injury, the renal expression of profibrotic factors, serum creatinine, and blood pressure were lower in mice infused with DRD2 AAV than in those infused with control AAV. These results indicate an important role of renal DRD2 in limiting renal injury and preserving normal renal function and blood pressure. PMID:27358912

  5. Renal functional reserve and renal recovery after acute kidney injury.

    PubMed

    Sharma, Aashish; Mucino, Marìa Jimena; Ronco, Claudio

    2014-01-01

    Renal functional reserve (RFR) represents the capacity of the kidney to increase glomerular filtration rate (GFR) in response to certain physiological or pathological stimuli or conditions. Once baseline GFR is determined, RFR can be assessed clinically after an oral protein load or intravenous amino acid infusion. In clinical practice, baseline GFR displays variable levels due to diet or other factors. RFR is the difference between peak 'stress' GFR induced by the test (p.o. or i.v.) and the baseline GFR. In clinical scenarios where hyperfiltration is present (high baseline GFR due to pregnancy, hypertension or diabetic nephropathy, in solitary kidney or kidney donors), RFR may be fully or partially used to achieve normal or supranormal renal function. Since commonly used renal function markers, such as GFR, may remain within normal ranges until 50% of nephrons are lost or in patients with a single remnant kidney, the RFR test may represent a sensitive and early way to assess the functional decline in the kidney. RFR assessment may become an important tool to evaluate the ability of the kidney to recover completely or partially after a kidney attack. In case of healing with a defect and progressive fibrosis, recovery may appear complete clinically, but a reduced RFR may be a sign of a maladaptive repair or subclinical loss of renal mass. Thus, a reduction in RFR may represent the equivalent of renal frailty or susceptibility to insults. The main aim of this article is to review the concept of RFR, its utility in different clinical scenarios, and future perspective for its use. PMID:25343829

  6. On the standing wave mode of giant pulsations

    NASA Technical Reports Server (NTRS)

    Takahashi, K.; Sato, N.; Warnecke, J.; Luehr, H.; Spence, H. E.; Tonegawa, Y.

    1992-01-01

    In order to determine the standing wave mode of giant pulsations, a systematic survey of magnetic field data from the AMPTE CCE spacecraft and from ground stations located near the geomagnetic foot point of CCE was made. One giant pulsation was associated with a compressional wave, while no giant pulsation was observed in association with transverse wave events. The CCE magnetic field record for the giant pulsation exhibited a remarkable similarity to a giant pulsation observed from the ATS 6 geostationary satellite near the magnetic equator. It is concluded that the compressional nature of the giant pulsation is due to an odd-mode standing wave structure, which places a strong constraint on the generation mechanism of giant pulsations.

  7. Chemical Renal Denervation in the Rat

    SciTech Connect

    Consigny, Paul M. Davalian, Dariush; Donn, Rosy Hu, Jie; Rieser, Matthew Stolarik, DeAnne

    2013-12-03

    Introduction: The recent success of renal denervation in lowering blood pressure in drug-resistant hypertensive patients has stimulated interest in developing novel approaches to renal denervation including local drug/chemical delivery. The purpose of this study was to develop a rat model in which depletion of renal norepinephrine (NE) could be used to determine the efficacy of renal denervation after the delivery of a chemical to the periadventitial space of the renal artery. Methods: Renal denervation was performed on a single renal artery of 90 rats (n = 6 rats/group). The first study determined the time course of renal denervation after surgical stripping of a renal artery plus the topical application of phenol in alcohol. The second study determined the efficacy of periadventitial delivery of hypertonic saline, guanethidine, and salicylic acid. The final study determined the dose–response relationship for paclitaxel. In all studies, renal NE content was determined by liquid chromatography–mass spectrometry. Results: Renal NE was depleted 3 and 7 days after surgical denervation. Renal NE was also depleted by periadventitial delivery of all agents tested (hypertonic saline, salicylic acid, guanethidine, and paclitaxel). A dose response was observed after the application of 150 μL of 10{sup −5} M through 10{sup −2} M paclitaxel. Conclusion: We developed a rat model in which depletion of renal NE was used to determine the efficacy of renal denervation after perivascular renal artery drug/chemical delivery. We validated this model by demonstrating the efficacy of the neurotoxic agents hypertonic saline, salicylic acid, and guanethidine and increasing doses of paclitaxel.

  8. Renal function in diabetic nephropathy.

    PubMed

    Dabla, Pradeep Kumar

    2010-05-15

    Diabetic nephropathy is the kidney disease that occurs as a result of diabetes. Cardiovascular and renal complications share common risk factors such as blood pressure, blood lipids, and glycemic control. Thus, chronic kidney disease may predict cardiovascular disease in the general population. The impact of diabetes on renal impairment changes with increasing age. Serum markers of glomerular filtration rate and microalbuminuria identify renal impairment in different segments of the diabetic population, indicating that serum markers as well as microalbuminuria tests should be used in screening for nephropathy in diabetic older people. The American Diabetes Association and the National Institutes of Health recommend Estimated glomerular filtration rate (eGFR) calculated from serum creatinine at least once a year in all people with diabetes for detection of kidney dysfunction. eGFR remains an independent and significant predictor after adjustment for conventional risk factors including age, sex, duration of diabetes, smoking, obesity, blood pressure, and glycemic and lipid control, as well as presence of diabetic retinopathy. Cystatin-C (Cys C) may in future be the preferred marker of diabetic nephropathy due differences in measurements of serum creatinine by various methods. The appropriate reference limit for Cys C in geriatric clinical practice must be defined by further research. Various studies have shown the importance of measurement of albuminuria, eGFR, serum creatinine and hemoglobin level to further enhance the prediction of end stage renal disease. PMID:21537427

  9. [Great moments in renal transplantation].

    PubMed

    Ghossain, Antoine

    2015-01-01

    A selective review of some great moments in renal transplantation experienced or witnessed with some of the great architects of this epic. The path was strewn with hazards, sometimes halts or changes of attitude that harmed or helped some patients. PMID:26591188

  10. Emphysema in the renal allograft

    SciTech Connect

    Potter, J.L.; Sullivan, B.M.; Fluornoy, J.G.; Gerza, C.

    1985-04-01

    Two diabetic patients in whom emphysematous pyelonephritis developed after renal transplantation are described. Clinical recognition of this unusual and serious infection is masked by the effects of immunosuppression. Abdominal radiographic, ultrasound, and computed tomography findings are discussed. The clinical presentation includes urinary tract infection, sepsis, and acute tubular malfunction of the allograft in insulin-dependent diabetics.

  11. Renal leiomyosarcoma in a cat.

    PubMed

    Evans, Dawn; Fowlkes, Natalie

    2016-05-01

    Renal leiomyosarcoma was diagnosed in a 10-year-old Domestic Shorthair cat with a 3-year history of clinically managed, chronic renal disease. Sudden death was preceded by a brief episode of mental dullness and confusion. At postmortem examination, the gross appearance of the left kidney was suggestive of hydronephrosis, and a nephrolith was present in the contralateral kidney. However, histology revealed an infiltrative, poorly differentiated, spindle cell sarcoma bordering the grossly cavitated area. Neoplastic cells were immunoreactive for vimentin and smooth muscle actin, which led to a diagnosis of renal leiomyosarcoma; neoplastic cells were not immunoreactive for desmin. Leiomyosarcoma arising in the kidney is a rare occurrence in humans and an even rarer occurrence in veterinary medicine with no prior cases being reported in cats in the English literature. The macroscopic appearance of the tumor at postmortem examination was misleadingly suggestive of hydronephrosis as a result of the large cavitation and may be similar to particularly unusual cases of renal leiomyosarcomas in humans that have a cystic or cavitated appearance. PMID:26975352

  12. Renal effects of percutaneous stone removal

    SciTech Connect

    Eshghi, M.; Schiff, R.G.; Smith, A.D.

    1989-02-01

    Preoperative and postoperative renography with 99mTechnetium-diethylene-triamine pentaacetic acid was performed on 33 patients who were free of renal scarring, infection, and obstruction and who underwent percutaneous renal stone removal. Although there was a transient decrease in renal function postoperatively in some patients, statistically significant reductions in renal function occurred only in 1 patient with an arteriovenous malformation that was embolized and in 1 patient who had a postoperative ureteropelvic junction stricture. The creation of more than one nephrostomy tract did not affect the results. In the absence of serious complications, percutaneous nephrostomy does not have a significant effect on renal function.

  13. Propranolol disposition in renal failure.

    PubMed Central

    Wood, A J; Vestal, R E; Spannuth, C L; Stone, W J; Wilkinson, G R; Shand, D G

    1980-01-01

    1 Previous studies of propranolol disposition in renal failure have been conflicting. 2 Using simultaneous administration of [3H]-propranolol intravenously and unlabelled propranolol orally the principal determinants of drug distribution were calculated in normals, patients with severe renal impairment (creatinine clearance 14.5 +/- 2.8 ml/min) but not on haemodialysis and patients on haemodialysis (creatinine clearance less than 5 ml/min). 3 The effect of haemodialysis on propranolol binding and free fraction was also examined. The percentage of propranolol unbound rose from 7.1% to 9.9%. (P less than 0.001) 20 min following heparinization and beginning haemodialysis. This was accompanied by a large rise in free fatty acids from 0.567 +/- 0.059 to 3.326 +/- 0.691 mumol/ml (P less than 0.005). 4 The blood to plasma concentration ratios of propranolol were significantly higher in patients with renal failure (P less than 0.02) and on haemodialysis (P less than 0.001) and were significantly negatively correlated (P less than 0.001) with the haematocrit. 5 Although the half-life propranolol was significantly shortened in the patients with renal failure (P less than 0.02), there was no change in the apparent liver blood flow, extraction ratio or the principal determinants of steady-state drug concentrations in blood namely oral and intravenous clearance from blood. 6 There is, therefore, no pharmacokinetic basis to adjust the dosage of propranolol in patients with renal failure. PMID:7470370

  14. Renal lesions of nondomestic felids.

    PubMed

    Newkirk, K M; Newman, S J; White, L A; Rohrbach, B W; Ramsay, E C

    2011-05-01

    To comprehensively evaluate the occurrence of renal lesions in a variety of nondomestic felids, necropsy cases from 1978 to 2008 were reviewed from a municipal zoo and a large cat sanctuary for those in which the kidneys were examined histologically. Seventy exotic felids were identified (25 tigers, 18 lions, 6 cougars, 5 leopards, 3 snow leopards, 3 clouded leopards, 3 Canadian lynx, 2 ocelots, 2 bobcats, 2 cheetahs, 1 jaguar), and their histologic renal lesions were evaluated and compared. The most common lesion was tubulointerstitial nephritis (TIN); 36 of 70 (51%) cats were affected to some degree. Lymphocytic interstitial nephritis was the most common lesion in the tigers (9 of 25, 36%) and was rarely seen in other species. Although the renal pelvis was not available for all cats, 28 of 47 (60%) had some degree of lymphocytic pyelitis. There was no significant association between the presence of pyelitis and that of TIN. Only 1 cat had pyelonephritis. Renal papillary necrosis was present in 13 of 70 (19%) cats and was significantly associated with historical nonsteroidal anti-inflammatory drug treatment (odds ratio, 7.1; 95% confidence interval, 1.9 to 26.8). Only 1 cat (lion) had amyloid accumulation, and it was restricted to the corticomedullary junction. Primary glomerular lesions were absent in all cats. Intraepithelial pigment was identified in many of the cats but was not correlated with severity of TIN. Despite several previous reports describing primary glomerular disease or renal amyloidosis in exotic felids, these lesions were rare to absent in this population. PMID:20876911

  15. Renal interventions during endovascular aneurysm repair.

    PubMed

    Davies, Mark G

    2013-12-01

    Renal insufficiency is a risk factor for mortality and morbidity during endovascular aneurysm repair. Multiple changes in practice have occurred to mitigate renal injury and renal dysfunction. Transrenal fixation does carry an increased risk of a decline in renal function in the medium term. Renal stenting for athero-occlusive disease during endovascular aneurysm repair needs careful consideration, as indications have changed and there are unexpected consequences with early vessel occlusion. The growing number of renal interventions during complex endovascular aneurysm repair with the advent of chimney snorkel/periscope techniques and the introduction of fenestrated grafts has shown the resilience of the intervention with relatively low renal issues (approximately 10%), but has also illustrated the need for additional device development. PMID:25220325

  16. Imaging of haemodialysis: renal and extrarenal findings.

    PubMed

    Degrassi, Ferruccio; Quaia, Emilio; Martingano, Paola; Cavallaro, Marco; Cova, Maria Assunta

    2015-06-01

    Electrolyte alterations and extra-renal disorders are quite frequent in patients undergoing haemodialysis or peritoneal dialysis. The native kidneys may be the site of important pathologies in patients undergoing dialysis, especially in the form of acquired renal cystic disease with frequent malignant transformation. Renal neoplasms represents an important complication of haemodialysis-associated acquired cystic kidney disease and imaging surveillance is suggested. Extra-renal complications include renal osteodistrophy, brown tumours, and thoracic and cardiovascular complications. Other important fields in which imaging techniques may provide important informations are arteriovenous fistula and graft complications. Teaching points • Renal neoplasms represent a dreaded complication of haemodialysis.• In renal osteodystrophy bone resorption typically manifests along the middle phalanges.• Brown tumours are well-defined lytic lesions radiographically, possibly causing bone expansion.• Vascular calcifications are very common in patients undergoing haemodialysis.• Principal complications of the AV fistula consist of thrombosis, aneurysms and pseudoaneurysms. PMID:25680325

  17. The Rise of a Giant

    NASA Astrophysics Data System (ADS)

    2006-12-01

    European astronomy has received a tremendous boost with the decision from ESO's governing body to proceed with detailed studies for the European Extremely Large Telescope. This study, with a budget of 57 million euro, will make it possible to start, in three years time, the construction of an optical/infrared telescope with a diameter around 40m that will revolutionise ground-based astronomy. The chosen design is based on a revolutionary concept specially developed for a telescope of this size. "The decision by the ESO Council to go ahead with the design study for an European Extremely Large Telescope is a very exciting one for European astronomy,", said Richard Wade, President of the ESO Council. "Today is a great day because the ESO Council has authorised us to go forward with the final design of the next flagship telescope of ESO,", says Catherine Cesarsky, ESO's Director General. ESO PR Photo 46/06 ESO PR Photo 46/06 The European Extremely Large Telescope (Artist's Impression) Since the end of last year, ESO has been working together with its user community of European astronomers and astrophysicists to define the new giant telescope needed by the middle of the next decade [1]. More than one hundred astronomers from all European countries have been involved throughout 2006, helping the ESO Project Offices to produce a novel concept, in which performance, cost, schedule and risk were carefully evaluated. This fast pace has also been possible thanks to early conceptual studies in Europe (such as the ESO OWL and the EURO-50 studies) and research and development done in collaboration with a large number of European institutes and high-tech industries to develop critical enabling technologies within the framework of the EU FP6 programme and with significant contributions from all partners. Provisionally dubbed E-ELT for the European Extremely Large Telescope, ESO's innovative concept was presented in detail two weeks ago to more than 250 European astronomers at a

  18. Giant oil fields of the Gulf Coast area

    SciTech Connect

    Haeberle, F.R.

    1993-09-01

    The 134 giant fields in the Gulf Coastal area contain 29% of the total giant-field reserves. Cumulative production is 32% of the giant-field cumulative total and 20% of the United States cumulative production. Eighty-nine of the giant fields are offshore with 22% of the reserves, 11 fields are in east Texas with 24% of the reserves, and 1 field is in Florida with 1% of the reserves. In 106 of the giant fields the primary producing interval is Cenozoic with 65% of the reserves, and in 28 giant fields the producing interval is Mesozoic with 35% of the reserves. The primary producing interval is Mesozoic with 35% of the reserves. The primary producing interval in 124 giant fields consists of clastics with 91% of the reserves, in 7 fields the primary lithology is carbonates with 6% of the reserves, and in 3 giant fields the lithology is mixed clastics and carbonates. A total of 127 fields are in structural traps with all of the reserves, 4 fields are stratigraphic traps (3%) with 18% of the reserves, and 3 fields are combination traps with 1% of the reserves. Over 50 of the giant oil fields in structural traps are salt domes. The most prevalent types of giant fields in the Gulf Coastal area are onshore structural traps with Cenozoic clastics as the primary producing intervals.

  19. Renal relevant radiology: renal functional magnetic resonance imaging.

    PubMed

    Ebrahimi, Behzad; Textor, Stephen C; Lerman, Lilach O

    2014-02-01

    Because of its noninvasive nature and provision of quantitative measures of a wide variety of physiologic parameters, functional magnetic resonance imaging (MRI) shows great potential for research and clinical applications. Over the past decade, application of functional MRI extended beyond detection of cerebral activity, and techniques for abdominal functional MRI evolved. Assessment of renal perfusion, glomerular filtration, interstitial diffusion, and parenchymal oxygenation turned this modality into an essential research and potentially diagnostic tool. Variations in many renal physiologic markers can be detected using functional MRI before morphologic changes become evident in anatomic magnetic resonance images. Moreover, the framework of functional MRI opened a window of opportunity to develop novel pathophysiologic markers. This article reviews applications of some well validated functional MRI techniques, including perfusion, diffusion-weighted imaging, and blood oxygen level-dependent MRI, as well as some emerging new techniques such as magnetic resonance elastography, which might evolve into clinically useful tools. PMID:24370767

  20. Diagnostic value of routine bone scintigraphy renal imaging in renal cell carcinoma

    SciTech Connect

    Chancellor, M.B.; Konnak, J.W.; Grossman, H.B.

    1989-05-01

    Technetium-99m-phosphate compounds used in bone scanning are excreted by the kidney, and excellent renal images can be obtained on routine bone scintigrams. The preoperative bone scans of 49 patients who underwent radical nephrectomy for renal cell carcinoma between 1981 and 1985 were reviewed for renal imaging. Ninety-four percent of the patients had abnormal bone scan renal images (82% had focal decreased uptake, and 12% had focal increased uptake). Six percent of the renal images were symmetrical bilaterally. When bone scans are employed in the postoperative follow-up of patients with renal cancer, they can be used to assess the status of the remaining kidney.

  1. Renal Cell Carcinoma Arising From Renal Allograft Detected by 18F-FDG PET-CT.

    PubMed

    Guo, Yuehong; Wang, Tie

    2016-05-01

    Renal cell carcinoma arising from renal allograft is a rare condition. A 56-year-old man with a history of 3 renal transplantation due to renal failure presented poor appetite and weight loss for 3 months. Possibility of tumor of unknown origin was suspected. For this reason, an FDG PET/CT was performed, and the images showed a hypermetabolic focus in the lower pole of the left renal transplant, suggestive of a malignant lesion. Subsequent pathological examination following allograft nephrectomy confirmed grade 4 renal cell carcinoma. PMID:26825198

  2. Does Renal Artery Supply Indicate Treatment Success of Renal Denervation?

    SciTech Connect

    Schmid, Axel; Ditting, Tilmann; Sobotka, Paul A.; Veelken, Roland Schmieder, Roland E.; Uder, Michael; Ott, Christian

    2013-08-01

    PurposeRenal denervation (RDN) emerged as an innovative interventional antihypertensive therapy. With the exception of pretreatment blood pressure (BP) level, no other clear predictor for treatment efficacy is yet known. We analyzed whether the presence of multiple renal arteries has an impact on BP reduction after RDN.MethodsFifty-three patients with treatment-resistant hypertension (office BP {>=} 140/90 mmHg and 24-h ambulatory BP monitoring ({>=}130/80 mmHg) underwent bilateral catheter-based RDN. Patients were stratified into one-vessel (OV) (both sides) and at least multivessel (MV) supply at one side. Both groups were treated on one vessel at each side; in case of multiple arteries, only the dominant artery was treated on each side.ResultsBaseline clinical characteristics (including BP, age, and estimated glomerular filtration rate) did not differ between patients with OV (n = 32) and MV (n = 21). Office BP was significantly reduced in both groups at 3 months (systolic: OV -15 {+-} 23 vs. MV -16 {+-} 20 mmHg; diastolic: OV -10 {+-} 12 vs. MV -8 {+-} 11 mmHg, both p = NS) as well as 6 months (systolic: OV -18 {+-} 18 vs. MV -17 {+-} 22 mmHg; diastolic: OV -10 {+-} 10 vs. -10 {+-} 12 mmHg, both p = NS) after RDN. There was no difference in responder rate (rate of patients with office systolic BP reduction of at least 10 mmHg after 6 months) between the groups.ConclusionIn patients with multiple renal arteries, RDN of one renal artery-namely, the dominant one-is sufficient to induce BP reduction in treatment-resistant hypertension.

  3. Renal outcome of children with unilateral renal agenesis.

    PubMed

    Doğan, Çağla Serpil; Torun Bayram, Meral

    2013-01-01

    The aim of this study was to evaluate associated urological anomalies and renal outcome in children with unilateral renal agenesis (URA). Medical records of 51 cases of URA followed at Şanlıurfa Children 's Hospital between January 2009 and December 2012 were reviewed retrospectively. In all patients, diagnosis was made by abdominal ultrasound (US) and confirmed by a radionuclide scan. The children were between 3 months and 17 years of age (median age: 5 years). There were 31 males (60.8%) and 20 females (39.2%). In 33 patients (67.3%), the left kidney was absent. Urological anomalies were found in 12/51 patients (23.5%), including ureterovesical junction obstruction in 4 (7.8%), bladder dysfunction in 2 (3.9%), and vesicoureteral reflux (VUR), ureteropelvic junction obstruction, ureterovesical and ureteropelvic junction obstruction, duplicated collecting system plus grade IV VUR, ectopic kidney plus grade V VUR, and ectopic kidney in 1 patient (2%) each. Chronic renal insufficiency (CRI) developed in 5/51 patients (9.8%) (stage III in 3 patients and stage IV in 2), 4 of whom had additional urological anomaly; in the remaining 1 patient, a 17-year-old female, imaging studies were normal except for a small and hyperechogenic solitary kidney determined on US. A total of 3 patients (5.8%) developed hypertension, and all except one had an associated urological anomaly. Proteinuria was seen in 2 patients (3.8%) with stage IV CRI, one of whom was also hypertensive. In conclusion, urological anomalies usually accompany URA and should be followed closely to decrease the risk of renal failure. PMID:24577979

  4. Viral metagenomics: are we missing the giants?

    PubMed

    Halary, S; Temmam, S; Raoult, D; Desnues, C

    2016-06-01

    Amoeba-infecting giant viruses are recently discovered viruses that have been isolated from diverse environments all around the world. In parallel to isolation efforts, metagenomics confirmed their worldwide distribution from a broad range of environmental and host-associated samples, including humans, depicting them as a major component of eukaryotic viruses in nature and a possible resident of the human/animal virome whose role is still unclear. Nevertheless, metagenomics data about amoeba-infecting giant viruses still remain scarce, mainly because of methodological limitations. Efforts should be pursued both at the metagenomic sample preparation level and on in silico analyses to better understand their roles in the environment and in human/animal health and disease. PMID:26851442

  5. Identification of a giant cell fibroma.

    PubMed

    Lukes, Sherri M; Kuhnert, Joleen; Mangels, Mark A

    2005-01-01

    Fibrous hyperplastic connective tissue lesions are common in the oral cavity and may be similar both clinically and histologically. A giant cell fibroma, a type of fibrous hyperplasia, was discovered during a preventive patient visit in the dental hygiene clinic at a Midwestern university. The patient, a 19-year-old female, presented with a dome-shaped lesion of normal mucosal color on the attached gingiva apical to tooth number 11. She was referred to the dental school for biopsy, which revealed fibrocollagenous connective tissue exhibiting large stellate fibroblasts. She returned after 10 months and was referred to the graduate periodontal department, where the lesion was removed. Several fibrous hyperplastic lesions can be considered in the differential diagnosis of giant cell fibroma. Dental hygienists should be familiar with the different fibrous hyperplasias, noting lesions during the intra- and extra-oral examinations for further evaluation by the dentist. PMID:16197774

  6. Giant viruses of the Kutch Desert.

    PubMed

    Kerepesi, Csaba; Grolmusz, Vince

    2016-03-01

    The Kutch Desert (Great Rann of Kutch, Gujarat, India) is a unique ecosystem: in the larger part of the year it is a hot, salty desert that is flooded regularly in the Indian monsoon season. In the dry season, the crystallized salt deposits form the "white desert" in large regions. The first metagenomic analysis of the soil samples of Kutch was published in 2013, and the data were deposited in the NCBI Sequence Read Archive. At the same time, the sequences were analyzed phylogenetically for prokaryotes, especially for bacteria. In the present work, we identified DNA sequences of recently discovered giant viruses in the soil samples from the Kutch Desert. Since most giant viruses have been discovered in biofilms in industrial cooling towers, ocean water, and freshwater ponds, we were surprised to find their DNA sequences in soil samples from a seasonally very hot and arid, salty environment. PMID:26666442

  7. Disk-fed Giant Planet Formation

    NASA Astrophysics Data System (ADS)

    Owen, James E.; Menou, Kristen

    2016-03-01

    Massive giant planets, such as the ones being discovered by direct imaging surveys, likely experience the majority of their growth through a circumplanetary disk. We argue that the entropy of accreted material is determined by boundary layer processes, unlike the “cold-” or “hot-start” hypotheses usually invoked in the core-accretion and direct-collapse scenarios. A simple planetary evolution model illustrates how a wide range of radius and luminosity tracks become possible, depending on details of the accretion process. Specifically, the protoplanet evolves toward “hot-start” tracks if the scale height of the boundary layer is ≳0.24, a value not much larger than the scale height of the circumplanetary disk. Understanding the luminosity and radii of young giant planets will thus require detailed models of circumplanetary accretion.

  8. Thermal escape from extrasolar giant planets.

    PubMed

    Koskinen, Tommi T; Lavvas, Panayotis; Harris, Matthew J; Yelle, Roger V

    2014-04-28

    The detection of hot atomic hydrogen and heavy atoms and ions at high altitudes around close-in extrasolar giant planets (EGPs) such as HD209458b implies that these planets have hot and rapidly escaping atmospheres that extend to several planetary radii. These characteristics, however, cannot be generalized to all close-in EGPs. The thermal escape mechanism and mass loss rate from EGPs depend on a complex interplay between photochemistry and radiative transfer driven by the stellar UV radiation. In this study, we explore how these processes change under different levels of irradiation on giant planets with different characteristics. We confirm that there are two distinct regimes of thermal escape from EGPs, and that the transition between these regimes is relatively sharp. Our results have implications for thermal mass loss rates from different EGPs that we discuss in the context of currently known planets and the detectability of their upper atmospheres. PMID:24664923

  9. Magma ocean formation due to giant impacts

    NASA Technical Reports Server (NTRS)

    Tonks, W. B.; Melosh, H. J.

    1992-01-01

    The effect of giant impacts on the initial chemical and thermal states of the terrestrial planets is just now being explored. A large high speed impact creates an approximately hemispherical melt region with a radius that depends on the projectile's radius and impact speed. It is shown that giant impacts on large planets can create large, intact melt regions containing melt volumes up to a few times the volume of the projectile. These large melt regions are not created on asteroid sized bodies. If extruded to the surface, these regions contain enough melt to create a magma ocean of considerable depth, depending on the impact speed, projectile radius, and gravity of the target planet.

  10. Giant vortex state in mesoscopic superconductors

    NASA Astrophysics Data System (ADS)

    Cobacy García, Luis; Giraldo, Jairo

    2005-08-01

    Using the self-consistent solution of the nonlinear Ginzburg-Landau equations, the superconducting state of a type II mesoscopic cylinder and of an infinite thin sheet with a circular hole (antidot), in the presence of an homogeneous magnetic field is studied. Close to the third critical field, the magnetic field penetrates the sample in the form of a vortex around the axis of the cylinder or of the antidot. This result has been found previously by other authors. The vortex, called a giant vortex, can carry several flux quanta. The giant vortex is persistent when the state is metastable and evolves to the so called paramagnetic Meissner effect (PME) within the cylinder. The behaviour of this effect as a function of the Ginzburg-Landau (GL) parameter is studied and the results are discussed. Gibbs free energy, order parameter and magnetic induccion as a function of the applied field and of the GL parameter are also studied.

  11. Effects of a giant impact on Uranus

    NASA Technical Reports Server (NTRS)

    Slattery, W. L.; Benz, W.; Cameron, A. G. W.

    1991-01-01

    The effects of a giant impact on Uranus with respect to the axis tilt of Uranus and its satellites are discussed. The simulations of possible giant impacts were carried out using Cray supercomputers. The technique used is called smooth particle hydrodynamics (SPH). In this technique, the material in the proto-Uranus planet and in the impactor is divided into a large number of particles which can overlap one another so that local averages over these particles determine density and pressure in the problem, and the particles themselves have their own temperatures and internal energies. During the course of the simulation, these particles move around under the influence of the forces acting on them: gravity and pressure gradients. The results of model simulations are presented.

  12. Giant pleomorphic adenoma of the parotid gland.

    PubMed

    Takahama, Ademar; da Cruz Perez, Danyel Elias; Magrin, José; de Almeida, Oslei Paes; Kowalski, Luiz Paulo

    2008-01-01

    Pleomorphic adenoma is the most common type of all benign and malignant salivary gland tumors, involving more frequently the parotid gland. It is a benign tumor with a slow and continuous growth that without treatment can reach an enormous size. We present a case of a giant pleomorphic adenoma in a 78-year-old man with a history of more than 30 years of a growing lesion in the parotid gland. Clinical examination revealed a giant mass on the right side of the face, however without any sign of facial nerve damage. The tumor was completely resected by total parotidectomy and preservation of the facial nerve. Macroscopically, the tumor measured 28 cm and weighed 4.0 Kg. On the histological examination there was a predominance of epithelial and myoepithelial cells in a hyaline and myxoid stroma. It was not found any area of malignant transformation. In the post-operatory the aesthetic and functional results were excellent. PMID:18167483

  13. Giant Congenital Melanocytic Nevi and Neurocutaneous Melanosis

    PubMed Central

    Araújo, Catarina; Pardal, Francisco; Brito, Celeste

    2015-01-01

    Introduction. The major medical concern with giant congenital melanocytic nevi CMN is high risk of developing cutaneous melanoma, leptomeningeal melanoma, and neurocutaneous melanocytosis. Case Report. A 30-year-old woman with a giant congenital melanocytic nevus covering nearly the entire right thoracodorsal region and multiple disseminated melanocytic nevi presented with neurological symptoms. Cerebral magnetic resonance imaging revealed a large expansive lesion in the left frontal region. Postsurgically pathological diagnosis revealed characteristics of melanoma. Immunohistochemical examination showed S100(+), HMB45(+), MelanA(+), and MiTF(+). She received radiotherapy with temozolomide followed by two more chemotherapy cycles with temozolomide. She followed a rapidly progressive course, reflecting widespread leptomeningeal infiltration, and she died of multiorgan failure seven months after diagnosis of cerebral melanoma. Discussion. This patient was diagnosed as having a neurocutaneous melanosis with malignant widespread leptomeningeal infiltration. Diffuse spinal involvement is unusual and is described in only another patient. PMID:25722729

  14. The treatment of giant rhinophyma - Case Report.

    PubMed

    Popa, D; Osman, Georgeta; Parvanescu, H; Ciurea, Raluca; Ciurea, M

    2012-01-01

    The aim of the article is to present an update on the pathophysiology, clinical features and treatment of rhinophyma. A 56 years old patient, living in urban area, presented with a giant rhinophyma which caused him not only upper airways obstruction and difficulty in eating, but also aesthetic and psycho-social disadvantages.The treatment of the patient was a surgical intervention consisting in removal of the nasal tumor and split-thickness skin grafting of the defect. The aesthetic result after surgical intervention was very good, there were no postoperative complications or recurrences.Rhinophyma represents the most advanced form of acne rosacea. The diagnosis is easy to establish based on the clinical features of the disease. In advanced forms of rhinophyma, when the tumor is giant, the main method of treatment is surgery. PMID:24778841

  15. On the interior properties of red giants

    NASA Astrophysics Data System (ADS)

    Iben, I., Jr.

    The interior evolution of red giants is focused on, the major emphasis being on the evolution of stars during the double shell-burning stage. The evolutionary course during the first and second ascent up the red giant branch of the H-R diagram are discussed for stars that vary with respect to certain critical masses, and the thermal pulse phase is also treated. Core, envelope, and surface phenomena are explained along with the process of development into white dwarfs or supernovas. The interplay of internal forces caused by various fuel-burning processes, electron-degeneracy pressure, and gravity are detailed, and phenomena such as core dredge-up, relaxed oscillations, and AGB stars are explained. Numbers are given for the properties of H-burning and convective shells, and detailed comparisons with observations are made.

  16. The giant calculus within the prostatic urethra.

    PubMed

    Demir, Omer; Kefi, Aykut; Cahangirov, Asif; Cihan, Ahmet; Obuz, Funda; Esen, Adil Ahmet; Celebi, Ilhan

    2011-08-01

    The giant calculus within the prostatic urethra is a rare clinical entity in the young population. Most of the calculi within the urethra migrate from the urinary bladder and obliterate the urethra. These stones are often composed of calcium phosphate or calcium oxalate. The decision of treatment strategy is affected by the size, shape and position of the calculus and by the status of the urethra. If the stone is large and immovable, it may be extracted via the perineal or the suprapubic approach. In most cases, the giant calculi were extracted via the transvesical approach and external urethrotomy. Our case is the biggest prostatic calculus, known in the literature so far, which was treated endoscopically by the combination of laser and the pneumatic lithotriptor. PMID:21188583

  17. Mass loss from warm giants: Magnetic effects

    NASA Technical Reports Server (NTRS)

    Mullan, D. J.

    1980-01-01

    Among warm giant stars, rapid mass loss sets in along a well defined velocity dividing line (VDL). Hot corona also disappear close to the VDL and thermal pressure cannot drive the observed rapid mass loss in these stars. The VDL may be associated with magnetic fields changing from closed to open. Such a change is consistent with the lack of X-rays from late-type giants. A magnetic transition locus based on Pneuman's work on helmet streamer stability agrees well with the empirical VDL. The change from closed to open fields not only makes rapid mass loss possible, but also contributes to energizing the mass loss in the form of discrete bubbles.

  18. Clouds in brown dwarfs and giant planets

    NASA Astrophysics Data System (ADS)

    Metchev, S.; Apai, D.; Radigan, J.; Artigau, É.; Heinze, A.; Helling, C.; Homeier, D.; Littlefair, S.; Morley, C.; Skemer, A.; Stark, C.

    2013-02-01

    A growing body of observational and theoretical evidence points toward the importance of clouds in the atmospheres of ultra-cool brown dwarfs and giant planets. Empirically, the presence of clouds is inferred from the red, likely dusty atmospheres of young substellar objects, and from detections of periodic variability in a fraction of brown dwarfs - as expected from rotation and a patchy cloud cover. Theoretical models have progressed alongside by including ever more comprehensive atomic and molecular opacity tables, incorporating the treatment of non-equilibrium chemistry and clouds through vertical mixing and grain size/sedimentation parameters, and employing 3-D hydrodynamical simulations. In this proceeding we summarize the key issues raised during the first gathering of observers and theorists to discuss clouds and atmospheric circulation in non-irradiated ultra-cool dwarfs and giant planets.

  19. Thermal escape from extrasolar giant planets

    PubMed Central

    Koskinen, Tommi T.; Lavvas, Panayotis; Harris, Matthew J.; Yelle, Roger V.

    2014-01-01

    The detection of hot atomic hydrogen and heavy atoms and ions at high altitudes around close-in extrasolar giant planets (EGPs) such as HD209458b implies that these planets have hot and rapidly escaping atmospheres that extend to several planetary radii. These characteristics, however, cannot be generalized to all close-in EGPs. The thermal escape mechanism and mass loss rate from EGPs depend on a complex interplay between photochemistry and radiative transfer driven by the stellar UV radiation. In this study, we explore how these processes change under different levels of irradiation on giant planets with different characteristics. We confirm that there are two distinct regimes of thermal escape from EGPs, and that the transition between these regimes is relatively sharp. Our results have implications for thermal mass loss rates from different EGPs that we discuss in the context of currently known planets and the detectability of their upper atmospheres. PMID:24664923

  20. The vanishing giant abdominal aortic aneurysm.

    PubMed

    Krivoshei, Lian; Halak, Moshe; Schneiderman, Jacob; Silverberg, Daniel

    2011-05-01

    Spontaneous sac size regression of a giant abdominal aortic aneurysm (AAA) is a rare event that has not been previously described. We report a case of an 89-year-old woman with a known 9-cm AAA, which was diagnosed in 2003. The patient had refused any kind of treatment at that time. Recent imaging studies obtained 7 years later revealed an AAA of 4 cm diameter. This is the first recorded case of significant spontaneous AAA sac shrinkage. PMID:21444348

  1. Giant Right Intrathoracic Myxoid Fusocellular Lipoma

    PubMed Central

    Botianu, Petre V. H.; Cerghizan, Anda Mihaela; Botianu, Alexandru M.

    2015-01-01

    Intrathoracic lipomas are rare benign tumors; their behavior is not completely clear and their surgical removal may be challenging. We report a case of a giant right intrathoracic myxoid fusocellular lipoma compressing the lung, tracheobronchial tree, and esophagus which was removed through a posterolateral thoracotomy. Complete removal resulted in resolution of the chest pain and improvement of the dyspnea, with no recurrence at 4-year follow-up. PMID:26509096

  2. Macroscopic synthesis and characterization of giant fullerenes

    NASA Astrophysics Data System (ADS)

    Selvan, R.; Unnikrishnan, R.; Ganapathy, S.; Pradeep, T.

    2000-01-01

    Thermal treatment of carbon soot produced by arc evaporation of nickel-filled graphite rods in 500 Torr of helium gives giant fullerenes showing characteristic IR, Raman, NMR and powder XRD signatures. Transmission electron micrographs show faceted structures with pentagonal, hexagonal and spherical shapes. The simplicity and similarity of the IR spectrum with those of smaller fullerenes suggest that the material is a form of large fullerenes. Chemical treatment of the material gives carbon onions.

  3. Giant Myoepithelioma of the Soft Palate

    PubMed Central

    Oktay, Murat; Yaman, Huseyin; Belada, Abdullah; Besir, Fahri Halit; Guclu, Ender

    2014-01-01

    Myoepitheliomas are benign salivary gland tumors and account for less than 1% of all salivary gland tumors. They are usually located in the parotid gland. The soft palate is very rare affected site. The differential diagnosis of myoepitheliomas should include reactive and neoplastic lesions. The treatment of myoepitheliomas is complete removal of the tumor. Herein, we report a case with giant myoepithelioma of the soft palate, reviewing the related literature. PMID:24711949

  4. The Age Parameter in Giant EAS

    NASA Astrophysics Data System (ADS)

    Capdevielle, J. N.; Cohen, F.; Sanosyan, K.

    The age parameter from the longitudinal development can be used to describe the lateral distribution in giant EAS up to 5 km from the axis, even if the scaling properties of Approximation B in cascade theory fail after 3.5 Moliere radii. A set of analytic descriptions is proposed under the gaussian hypergeometric formalism replacing the Eulerian formalism of the classical NKG distribution, valid for electrons, muons and vertical equivalent muons (v.e.m.).

  5. Giant optical nonlinearity of plasmonic nanostructures

    SciTech Connect

    Melentiev, P N; Afanasev, A E; Balykin, V I

    2014-06-30

    The experimental studies of giant optical nonlinearity of single metal nanostructures are briefly reviewed. A new hybrid nanostructure – split-hole resonator (SHR) – is investigated. This structure is characterised by a record-high efficiency of third-harmonic generation and multiphoton luminescence (its nonlinearity exceeds that of a single nanohole by five orders of magnitude) and an unprecedently high sensitivity to light polarisation (extinction coefficient 4 × 10{sup 4}). (extreme light fields and their applications)

  6. Giant Leiomyosarcoma of the Urinary Bladder

    PubMed Central

    Ribeiro, José G.A.; Klojda, Carlos A.B.; Araújo, Claudio P. De; Pires, Lucas A.S.

    2016-01-01

    The bladder leiomyosarcoma is a rare and agressive mesenchymal tumour, and adult women of reproductive age have a higher incidence of developing the bladder leiomyosarcoma. The pathophysiology of the disease is not certain, and its main symptoms are hematuria, dysuria and abdominal pain. There are not a considerable amount of cases described in the literature. We report a case of a giant leiomyosarcoma of the urinary bladder in a 31-year-old woman. PMID:27437302

  7. Giant Condyloma Acuminata of the Inguinal Region.

    PubMed

    Nain, Prabhdeep Singh; Sidhu, Sudeep; Garg, Bhavna

    2015-12-01

    A 70-year-old male presented with a progressively increasing polypoidal lesion in the right inguinal region since last 10 years. He had no anal or penile lesion. Excision biopsy was done under spinal anaesthesia. Histopathology showed it to be a giant condyloma acuminata. We report this case due to its large size and its location in inguinal region without pre-existing anal or rectal lesion. PMID:26730100

  8. Focus on renal congestion in heart failure

    PubMed Central

    Afsar, Baris; Ortiz, Alberto; Covic, Adrian; Solak, Yalcin; Goldsmith, David; Kanbay, Mehmet

    2016-01-01

    Hospitalizations due to heart failure are increasing steadily despite advances in medicine. Patients hospitalized for worsening heart failure have high mortality in hospital and within the months following discharge. Kidney dysfunction is associated with adverse outcomes in heart failure patients. Recent evidence suggests that both deterioration in kidney function and renal congestion are important prognostic factors in heart failure. Kidney congestion in heart failure results from low cardiac output (forward failure), tubuloglomerular feedback, increased intra-abdominal pressure or increased venous pressure. Regardless of the cause, renal congestion is associated with increased morbidity and mortality in heart failure. The impact on outcomes of renal decongestion strategies that do not compromise renal function should be explored in heart failure. These studies require novel diagnostic markers that identify early renal damage and renal congestion and allow monitoring of treatment responses in order to avoid severe worsening of renal function. In addition, there is an unmet need regarding evidence-based therapeutic management of renal congestion and worsening renal function. In the present review, we summarize the mechanisms, diagnosis, outcomes, prognostic markers and treatment options of renal congestion in heart failure. PMID:26798459

  9. Renal Clearance of Mineral Metabolism Biomarkers.

    PubMed

    van Ballegooijen, Adriana J; Rhee, Eugene P; Elmariah, Sammy; de Boer, Ian H; Kestenbaum, Bryan

    2016-02-01

    CKD leads to disturbances in multiple interrelated hormones that regulate bone and mineral metabolism. The renal handling of mineral metabolism hormones in humans is incompletely understood. We determined the single-pass renal clearance of parathyroid hormone, fibroblast growth factor 23, vitamin D metabolites, and phosphate from paired blood samples collected from the abdominal aorta and renal vein in 17 participants undergoing simultaneous right and left heart catheterization and estimated associations of eGFR with the renal elimination of metabolites. The mean age ±SD of the study population was 71.4±10.0 years and 11 participants (65%) were male. We found a relatively large mean±SD single-pass renal extraction of parathyroid hormone (44.2%±10.3%) that exceeded the extraction of creatinine (22.1%±7.9%). The proportionate renal extraction of parathyroid hormone correlated with eGFR. The renal extraction of fibroblast growth factor 23 was, on average, lower than that of parathyroid hormone with greater variability across individuals (17.1%±19.5%). There were no differences in the mean concentrations of vitamin D metabolites across the renal vein and artery. In summary, we demonstrate substantial single-pass renal extraction of parathyroid hormone at a rate that exceeds glomerular filtration. Impaired renal clearance of parathyroid hormone may contribute to secondary hyperparathyroidism in CKD. PMID:26047790

  10. Giant Cell Tumor of Bone - An Overview

    PubMed Central

    Sobti, Anshul; Agrawal, Pranshu; Agarwala, Sanjay; Agarwal, Manish

    2016-01-01

    Giant Cell tumors (GCT) are benign tumors with potential for aggressive behavior and capacity to metastasize. Although rarely lethal, benign bone tumors may be associated with a substantial disturbance of the local bony architecture that can be particularly troublesome in peri-articular locations. Its histogenesis remains unclear. It is characterized by a proliferation of mononuclear stromal cells and the presence of many multi- nucleated giant cells with homogenous distribution. There is no widely held consensus regarding the ideal treatment method selection. There are advocates of varying surgical techniques ranging from intra-lesional curettage to wide resection. As most giant cell tumors are benign and are located near a joint in young adults, several authors favor an intralesional approach that preserves anatomy of bone in lieu of resection. Although GCT is classified as a benign lesion, few patients develop progressive lung metastases with poor outcomes. Treatment is mainly surgical. Options of chemotherapy and radiotherapy are reserved for selected cases. Recent advances in the understanding of pathogenesis are essential to develop new treatments for this locally destructive primary bone tumor. PMID:26894211

  11. Silicon abundances in population I giants

    NASA Technical Reports Server (NTRS)

    Boehm-Vitense, Erika

    1992-01-01

    Silicon to carbon abundance ratios for population I giants were determined from emission lines originating in the transition layers between stellar chromospheres and coronae. For effective temperatures larger than 6200 K we find a group of stars with increased silicon to carbon but normal nitrogen to carbon abundance ratios. These stars are presumably descendents from Ap stars with increased surface silicon to carbon abundance ratios. For G stars this anomaly disappears as is to be expected due to the increased depth of the convection zone and therefore deeper mixing which dilutes the surface overabundances. The disappearance of the abundance anomalies proves that the anomalous abundances observed for the F giants are indeed only a surface phenomenon. It also proves that the same holds for their progenitors, the Ap and Am stars, as has been generally believed. Unexplained is the increased silicon to carbon abundance ratio observed for several stars cooler than 5100 L. RS CVn and related stars do not show this increased abundance ratio. There are also some giants which appear to be enriched in carbon, perhaps due to a helium flash with some mixing if the star is a clump star.

  12. Rare cause of odynophagia: Giant esophageal ulcer

    PubMed Central

    Veroux, Massimiliano; Aprile, Giuseppe; Amore, Francesca F; Corona, Daniela; Giaquinta, Alessia; Veroux, Pierfrancesco

    2016-01-01

    Gastrointestinal complications are a frequent cause of morbidity after transplantation and may affect up to 40% of kidney transplant recipients. Here we report a rare case of idiopathic giant esophageal ulcer in a kidney transplant recipient. A 37-year-old female presented with a one-week history of odynophagia and weight loss. Upon admission, the patient presented cold sores, and a quantitative cytomegalovirus polymerase chain reaction was positive (105 copies/mL). An upper endoscopy demonstrated the presence of a giant ulcer. Serological test and tissue biopsies were unable to demonstrate an infectious origin of the ulcer. Immunosuppression was reduced and everolimus was introduced. An empirical i.v. therapy with acyclovir was started, resulting in a dramatic improvement in symptoms and complete healing of the ulcer. Only two cases of idiopathic giant esophageal ulcer in kidney transplant recipients have been reported in the literature; in both cases, steroid therapy was successful without recurrence of symptoms or endoscopic findings. However, this report suggests that correction of immune imbalance is mandatory to treat such a rare complication. PMID:27076774

  13. Two cases of giant serpentine aneurysm.

    PubMed

    Kumabe, T; Kaneko, U; Ishibashi, T; Kaneko, K; Uchigasaki, S

    1990-06-01

    Giant serpentine aneurysm (GSA) is an entity defined on radiological and pathological grounds as a giant, partially thrombosed aneurysm containing tortuous vascular channels. We have had the opportunity to study two patients with GSAs, which has allowed for a complete comparative anatomical and radiological study. This report emphasizes the etiology of the GSAs. Twenty-two patients with GSAs have been reported in the literature, of which pathological studies were done in 10. In most of these, the aneurysm was found to be filled with an organized thrombus, but in our patients the aneurysm was filled with relatively new clot. The aneurysm enlarged and a change in the tortuous vascular channel was observed over a period of 1 year in the first patient, whereas a globoid aneurysm developed into a GSA in the brief period of just 2 weeks in the second patient. This rapid transformation of a globoid aneurysm into a GSA is of particular interest when the etiology of GSAs is considered. Our patients therefore shed some interesting light on the possible pathophysiology of GSAs. That is, the bloodstream may change dynamically in a giant aneurysm and may become a serpentine channel under conditions that lead to a "Coanda effect." PMID:2362659

  14. The kinematics of halo red giants

    NASA Astrophysics Data System (ADS)

    Carney, B. W.; Latham, D. W.

    1986-07-01

    The authors have obtained 337 radial velocities with typical accuracies of ± 0.7 km s-1 for 85 metal-poor field red giants, selected from the kinematically unbiased samples of Bond (1980) and Bidelman and MacConnell (1973). The multiply observed stars suggest the field halo giant binary fraction exceeds 10%. Using their own velocities and those published by others, the authors have a sample of 174 red giants with [Fe/H] ≤ -1.5. Their mean motion with respect to the local standard of rest is >V< = -206±23 km s-1, and the velocity dispersions are σR = 154±18 km s-1, σθ = 102±27 km s-1, and σφ = 107±15 km s-1. Using photometrically derived absolute magnitudes and published proper motions, the authors compute orbital eccentricities for 72 stars not already considered in a similar study of southern stars by Norris, Bessell, and Pickles (1985). They find a few (5% - 8%) stars with e < 0.4.

  15. Observations of Radio Giant Pulses with GAVRT

    NASA Astrophysics Data System (ADS)

    Jones, Glenn

    2011-08-01

    Radio giant pulses provide a unique opportunity to study the pulsar radio emission mechanism in exquisite detail. Previous studies have revealed a wide range of properties and phenomena, including extraordinarily high brightness temperatures, sub-nanosecond emission features, and banded dynamic spectra. New measurements of giant pulse characteristics can help guide and test theoretical emission models. To this end, an extensive observation campaign has begun which will provide more than 500 hours on the Crab with a 34-meter antenna located in California, USA. The observations are being done as part of an educational outreach program called the Goldstone-Apple Valley Radio Telescope (GAVRT). This antenna has a novel wide bandwidth receiver which provides up to 8 GHz of instantaneous bandwidth in the range of 2.5 to 14 GHz. These observations will provide detailed information about the variability, amplitude distribution, and detailed frequency structure of radio giant pulses. In addition, a database of pulses from these observations and others of the Crab pulsar is being created which will simplify multiwavelength correlation analysis.

  16. Management of giant pseudomeningoceles after spinal surgery

    PubMed Central

    2010-01-01

    Background Pseudomeningoceles are a rare complication after spinal surgery, and studies on these complex formations are few. Methods Between October 2000 and March 2008, 11 patients who developed symptomatic pseudomeningoceles after spinal surgery were recruited. In this retrospective study, we reported our experiences in the management of these complex, symptomatic pseudomeningoceles after spinal surgery. A giant pseudomeningocele was defined as a pseudomeningocele >8 cm in length. We also evaluated the risk factors for the formation of giant pseudomeningoceles. Results All patients were treated successfully with a combined treatment protocol of open revision surgery for extirpation of the pseudomeningoceles, repair of dural tears, and implantation of a subarachnoid catheter for drainage. Surgery-related complications were not observed. Recurrence of pseudomeningocele was not observed for any patient at a mean follow-up of 16.5 months. This result was confirmed by magnetic resonance imaging. Conclusions We conclude that a combined treatment protocol involving open revision surgery for extirpation of pseudomeningoceles, repair of dural tears, and implantation of a subarachnoid catheter for drainage is safe and effective to treat giant pseudomeningoceles. PMID:20302667

  17. Leiomyosarcoma of the renal vein.

    PubMed

    Imao, Tetsuya; Amano, Toshiyasu; Takemae, Katsurou

    2011-02-01

    A 43-year-old woman was referred to our clinic for evaluation of a left retroperitoneal mass. She presented to our internal medicine department complaining of back pain. Computed tomography (CT) scan revealed a left retroperitoneal mass 55 mm in size in the hilum of the left kidney. Enhanced CT scan and magnetic resonance imaging (MRI) disclosed a poorly staining mass. Metaiodobenzylguanidine scintigraphy demonstrated no accumulation in the mass; moreover, endocrinologic examination was normal. Laparoscopic resection of the left retroperitoneal tumor was attempted; however, strong adhesion between the tumor and the left renal vein was encountered. Thus, left nephrectomy after open conversion was performed. Histological findings indicated leiomyosarcoma originating from the left renal vein. The postoperative course has been uneventful; neither recurrence nor metastasis is evident 2 years postsurgery. PMID:20694494

  18. Mesalazine-induced renal calculi

    PubMed Central

    Jacobsson, Henrik; Eriksen, Jaran; Karlén, Per

    2013-01-01

    Patient: Female, 32 Final Diagnosis: Renal colic Symptoms: Acute colic pain • macrohematuria Medication: Mesalazine Clinical Procedure: CT scan of urinary tract • cystoscopy • gynecological consultation • stone analysis Specialty: Gastroenterology and Hepatology • Clinical Pharmacology Objective: Unexpected drug reaction Background: Mesalazine, a 5-aminosalicylic acid compound, is one of the cornerstones in modern treatment regimens of ulcerative colitis. It is generally well tolerated, although adverse reactions such as nephrotoxicity, perimyocarditis, and pancreatitis have been reported. Case Report: We report the case of a 32-year-old woman with colitis who developed recurrent episodes of renal colic after introduction of mesalazine to her treatment. Biochemical analysis of the stones showed that they were composed of crystalized drug material. Conclusions: To our knowledge this is the first report of mesalazine precipitation in the urinary tract. We believe that it is vital for physicians to recognize this potentially severe adverse effect in the use of this treatment. PMID:24478817

  19. Radiocontrast-induced renal failure

    SciTech Connect

    Misson, R.T.; Cutler, R.E.

    1985-05-01

    Review of the literature concerning contrast-induced renal dysfunction shows that the currently used agents are remarkably safe with careful patient selection. Clinically apparent kidney failure after their use is essentially nonexistent in those without preexistent renal insufficiency. The incidence rises rapidly in those with azotemia from any cause, however, and diabetic persons with nephropathy are perhaps at special risk. Vigorous volume expansion is possibly effective as a preventive measure and may attenuate adverse effects in those in whom postcontrast dysfunction occurs. New agents are becoming available. It is not yet known if these will prove safer or cost-effective. They have some experimentally demonstrated and theoretical advantages over the presently used agents. 58 references, 1 figure, 2 tables.

  20. Renal calculi and their management.

    PubMed

    Melick, R A

    1976-03-01

    Any patient presenting with renal colic requires the taking of a detailed history-- with inquiries about diet and drugs, an examination of the urine, intravenous pyelography and measurement of the calcium concentration in serum and urine. Any stone passed should be analysed. Recurrent stone formation warrants more comprehensive metabolic investigation. The cause of renal calculi in most patients is still not known. When a cause is found, specific treatment can prevent or control stone formation. For the majority in whom no abnormality is detected, various methods of reducing stone formation have been tried but results are disappointing. The most important points in management are the early detection and effective treatment of urinary tract infection or obstruction and the maintenance of a high fluid intake. PMID:1272102

  1. Asymptomatic hyperuricemia following renal transplantation

    PubMed Central

    Bellomo, Gianni

    2015-01-01

    Evidence is accumulating indicating a role for uric acid in the genesis and progression of kidney disease, and a few studies are beginning to show a possible beneficial effect of urate-lowering therapy. Whether this holds true for renal allograft recipients is not clear. In this short review evidence from epidemiological as well as intervention studies is summarized and discussed, with some practical considerations presented at the end. PMID:26167455

  2. Asymptomatic hyperuricemia following renal transplantation.

    PubMed

    Bellomo, Gianni

    2015-07-01

    Evidence is accumulating indicating a role for uric acid in the genesis and progression of kidney disease, and a few studies are beginning to show a possible beneficial effect of urate-lowering therapy. Whether this holds true for renal allograft recipients is not clear. In this short review evidence from epidemiological as well as intervention studies is summarized and discussed, with some practical considerations presented at the end. PMID:26167455

  3. Leiomyoma in a Renal Allograft.

    PubMed

    Li, Yan Jun; Siriwardana, Amila Rohan; Symons, James Lawrence Penn; O'Neill, Gordon Francis; Qiu, Min Ru; Furlong, Timothy John

    2016-01-01

    Leiomyomas are smooth muscle tumours that are rarely found in the kidney. There is one report of a leiomyoma in a kidney transplant in a paediatric recipient. Here, we report an adult renal transplant recipient who developed an Epstein-Barr virus-positive leiomyoma in his allograft 15 years after transplantation. The patient was converted to everolimus for posttransplant immunosuppression management and there was no sign of progression over a year. PMID:27195169

  4. Leiomyoma in a Renal Allograft

    PubMed Central

    Li, Yan Jun; Siriwardana, Amila Rohan; Symons, James Lawrence Penn; O'Neill, Gordon Francis; Qiu, Min Ru; Furlong, Timothy John

    2016-01-01

    Leiomyomas are smooth muscle tumours that are rarely found in the kidney. There is one report of a leiomyoma in a kidney transplant in a paediatric recipient. Here, we report an adult renal transplant recipient who developed an Epstein-Barr virus-positive leiomyoma in his allograft 15 years after transplantation. The patient was converted to everolimus for posttransplant immunosuppression management and there was no sign of progression over a year. PMID:27195169

  5. Liquid Water Oceans in Ice Giants

    NASA Technical Reports Server (NTRS)

    Wiktorowicz, Sloane J.; Ingersoll, Andrew P.

    2007-01-01

    Aptly named, ice giants such as Uranus and Neptune contain significant amounts of water. While this water cannot be present near the cloud tops, it must be abundant in the deep interior. We investigate the likelihood of a liquid water ocean existing in the hydrogen-rich region between the cloud tops and deep interior. Starting from an assumed temperature at a given upper tropospheric pressure (the photosphere), we follow a moist adiabat downward. The mixing ratio of water to hydrogen in the gas phase is small in the photosphere and increases with depth. The mixing ratio in the condensed phase is near unity in the photosphere and decreases with depth; this gives two possible outcomes. If at some pressure level the mixing ratio of water in the gas phase is equal to that in the deep interior, then that level is the cloud base. The gas below the cloud base has constant mixing ratio. Alternately, if the mixing ratio of water in the condensed phase reaches that in the deep interior, then the surface of a liquid ocean will occur. Below this ocean surface, the mixing ratio of water will be constant. A cloud base occurs when the photospheric temperature is high. For a family of ice giants with different photospheric temperatures, the cooler ice giants will have warmer cloud bases. For an ice giant with a cool enough photospheric temperature, the cloud base will exist at the critical temperature. For still cooler ice giants, ocean surfaces will result. A high mixing ratio of water in the deep interior favors a liquid ocean. We find that Neptune is both too warm (photospheric temperature too high) and too dry (mixing ratio of water in the deep interior too low) for liquid oceans to exist at present. To have a liquid ocean, Neptune s deep interior water to gas ratio would have to be higher than current models allow, and the density at 19 kbar would have to be approx. equal to 0.8 g/cu cm. Such a high density is inconsistent with gravitational data obtained during the Voyager

  6. Cultured Human Renal Cortical Cells

    NASA Technical Reports Server (NTRS)

    1998-01-01

    During the STS-90 shuttle flight in April 1998, cultured renal cortical cells revealed new information about genes. Timothy Hammond, an investigator in NASA's microgravity biotechnology program was interested in culturing kidney tissue to study the expression of proteins useful in the treatment of kidney diseases. Protein expression is linked to the level of differentiation of the kidney cells, and Hammond had difficulty maintaining differentiated cells in vitro. Intrigued by the improvement in cell differentiation that he observed in rat renal cells cultured in NASA's rotating wall vessel (a bioreactor that simulates some aspects of microgravity) and during an experiment performed on the Russian Space Station Mir, Hammond decided to sleuth out which genes were responsible for controlling differentiation of kidney cells. To do this, he compared the gene activity of human renal cells in a variety of gravitational environments, including the microgravity of the space shuttle and the high-gravity environment of a centrifuge. Hammond found that 1,632 genes out of 10,000 analyzed changed their activity level in microgravity, more than in any of the other environments. These results have important implications for kidney research as well as for understanding the basic mechanism for controlling cell differentiation.

  7. Immunotherapy in renal cell carcinoma.

    PubMed

    Bukowski, R M

    1999-06-01

    Patients with metastatic renal cell carcinoma continue to present a therapeutic challenge. Current therapeutic approaches involve surgery and various types of immunotherapy. The rationale for this latter form of therapy include the observations of spontaneous tumor regression, the presence of a T-cell-mediated immune response, and the tumor responses observed in patients receiving cytokine therapy. Analysis of prognostic factors in these patients demonstrates that clinical responses occur most frequently in individuals with good performance status. The cytokines interleukin-2 (IL-2, aldesleukin [Proleukin], interferon-alfa (Intron A, Roferon-A), or the combination produce responses in 15% to 20% of patients. Randomized trials suggest that administration of interferon-alfa may result in a modest improvement in median survival. Investigation of the molecular genetics of renal cell carcinoma and the presence of T-lymphocyte immune dysregulation have suggested new therapeutic strategies. Further preclinical and clinical studies investigating inhibitors of angiogenesis or pharmacologic methods to reverse immune dysregulation are ongoing. Therapeutic results in patients with renal cell carcinoma remain limited, and investigational approaches are warranted. PMID:10378218

  8. Mechanisms of compensatory renal growth.

    PubMed

    Cleper, Roxana

    2012-11-01

    Congenitally reduced renal mass- as with agenesis of one kidney, unilateral multicystic dysplastic kidney or with premature birth with early arrest of nephrogenesis- as well as acquired loss of a significant part of kidney tissue- as with kidney donation, after surgery for tumor etc- set in motion compensatory processes with main target to meet metabolic body needs. The sensors for reduced renal mass have not yet been identified. The effectors of the compensatory process include a wide range of growth factors- IGF1, TGF-b1, HGF- and signaling molecules-mTOR- which has intricate reciprocal interactions. As nephrogenesis stops at 34-36 weeks of gestation and can't be restarted thereafter, the main result of this compensatory process is increase in glomerular size (glomerulomegaly) and tubular hypertrophy. Renal volume evaluation by ultrasound is a practical noninvasive tool for assessment of compensatory kidney growth. The increased nephron and kidney size induced by the compensatory process have potential detrimental long-term effect through stretch-induced glomerular cell activation of profibrogenic and vasoconstrictor pathways as well as tubular cell nephrotoxicity caused by abnormal activation of reabsorptive mechanisms including GLUT1 and megalin. Deep understanding of these potentially damage process might help in timely implementation of protective strategies. PMID:23469392

  9. [Immune tolerance after renal transplantation].

    PubMed

    Krajewska, Magdalena; Weyde, Wacław; Klinger, Marian

    2006-01-01

    Progress in immunosuppressive therapy has improved short-term survival of renal allografts by decreasing the frequency of acute rejections. However, the long-term survival of renal grafts has not improved. Transplanted kidneys are lost in the late period after transplantation as a result of vasculopathy and chronic rejection. Immunological tolerance means the lack of immunological activity towards certain antigens while the response towards others remains correct. The induction of immunological tolerance of donor antigens (transplant tolerance) is examined intensively to work out treatment methods which will allow prevention of chronic allograft rejection. The paper includes an overview of current knowledge on allograft tolerance. Immune response to alloantigens is described and the mechanisms of immunological tolerance induction (including clonal deletion, anergy connected with the microchimerism phenomenon, and active suppression caused by regulatory lymphocytes) are characterized. The role of dendritic cells in the process of inducing and maintaining tolerance is highlighted. Tolerance-inducing strategies in renal transplant recipients and clinically applied evaluation methods are presented. At present, optimizing recipient matching is used to decrease the risk of graft rejection. Hopefully, gene therapy will be possible in the near future. However, before introducing such a procedure into clinical studies, optimal therapy conditions and risk evaluation must be defined in tests on animals. PMID:16552396

  10. Mammalian Target of Rapamycin Inhibitors and Life-Threatening Conditions in Tuberous Sclerosis Complex.

    PubMed

    Moavero, Romina; Romagnoli, Gloria; Graziola, Federica; Curatolo, Paolo

    2015-12-01

    Tuberous sclerosis complex (TSC) is a multisystem disease associated with an overall reduction in life expectancy due to the possible occurrence of different life-threatening conditions. Subjects affected by TSC are, in fact, at risk of hydrocephalus secondary to the growth of subependymal giant cell astrocytomas, or of sudden unexpected death in epilepsy. Other nonneurological life-threatening conditions include abdominal bleeding owing to renal angiomyolipomas rupture, renal insufficiency due to progressive parenchymal destruction by multiple cysts, pulmonary complications due to lymphangioleiomyomatosis, and cardiac failure or arrhythmias secondary to rhabdomyomas. In the last decades, there has been a great progress in understanding the pathophysiology of TSC-related manifestations, which are mainly linked to the hyperactivation of the so-called mammalian target of rapamycin (mTOR) pathway, as a consequence of the mutation in 1 of the 2 genes TSC1 or TSC2. This led to the development of new treatment strategies for this disease. In fact, it is now available as a biologically targeted therapy with everolimus, a selective mTOR inhibitor, which has been licensed in Europe and USA for the treatment of subependymal giant cell astrocytomas and angiomyolipomas in subjects with TSC. This drug also proved to benefit other TSC-related manifestations, including pulmonary lymphangioleiomyomatosis, cardiac rhabdomyomas, and presumably epileptic seizures. mTOR inhibitors are thus proving to be a systemic therapy able to simultaneously address different and potentially life-threatening complications, giving the hope of improving life expectation in individuals with TSC. PMID:26706015

  11. Hamartomas from patients with tuberous sclerosis show loss of heterozygosity for chromosome 9q34

    SciTech Connect

    Green, A.J.; Sepp, T.; Yates, J.R.W. |

    1994-09-01

    We have previously shown allele loss in hamartomas from cases of tuberous sclerosis (TSC) for markers in the region of the recently characterized TSC2 gene on chromosome 16p13.3. Germline deletions in the TSC2 gene have been shown in 5% of patients with TSC. These data strongly suggest that the TSC2 gene acts as a tumor suppressor gene. We hypothesised that hamartomas from patients with TSC can also show allele loss for markers on chromosome 9q34 in the region of the TSC1 gene. We studied 7 hamartomas (3 renal angiomyolipomas, 3 giant cell astrocytomas, and a cardiac rhabdomyoma) from 7 cases of TSC, none of which showed allele loss for markers on chromosome 16p13.3. Eight microsatellite markers were analyzed, comprising from centromeric to telomeric, ASS - D9S64 - D9S149 -D9S150 - DBH - D9S66 - D9S114 - D9S67. Two hamartomas (one renal angiomyolipoma and one giant cell astrocytoma) showed allele loss for at least two markers. The region of allele loss involved the TSC1 locus, but did not include D9S149 or D9S67. We have shown allele loss in two of seven TSC hamartomas in the region of the TSC1 gene on 9q34. Based on this deletion mapping, we suggest that the TSC1 gene on 9a34, like the TSC2 gene, acts as a tumor suppressor gene.

  12. Giant Impacts on Earth-Like Worlds

    NASA Astrophysics Data System (ADS)

    Kohler, Susanna

    2016-05-01

    Earth has experienced a large number of impacts, from the cratering events that may have caused mass extinctions to the enormous impact believed to have formed the Moon. A new study examines whether our planets impact history is typical for Earth-like worlds.N-Body ChallengesTimeline placing the authors simulations in context of the history of our solar system (click for a closer look). [Quintana et al. 2016]The final stages of terrestrial planet formation are thought to be dominated by giant impacts of bodies in the protoplanetary disk. During this stage, protoplanets smash into one another and accrete, greatly influencing the growth, composition, and habitability of the final planets.There are two major challenges when simulating this N-body planet formation. The first is fragmentation: since computational time scales as N^2, simulating lots of bodies that split into many more bodies is very computationally intensive. For this reason, fragmentation is usually ignored; simulations instead assume perfect accretion during collisions.Total number of bodies remaining within the authors simulations over time, with fragmentation included (grey) and ignored (red). Both simulations result in the same final number of bodies, but the ones that include fragmentation take more time to reach that final number. [Quintana et al. 2016]The second challengeis that many-body systems are chaotic, which means its necessary to do a large number of simulations to make statistical statements about outcomes.Adding FragmentationA team of scientists led by Elisa Quintana (NASA NPP Senior Fellow at the Ames Research Center) has recently pushed at these challenges by modeling inner-planet formation using a code that does include fragmentation. The team ran 140 simulations with and 140 without the effects of fragmentation using similar initial conditions to understand how including fragmentation affects the outcome.Quintana and collaborators then used the fragmentation-inclusive simulations to

  13. Imaging in acute renal infection in children

    SciTech Connect

    Sty, J.R.; Wells, R.G.; Starshak, R.J.; Schroeder, B.A.

    1987-03-01

    Infection is the most common disease of the urinary tract in children, and various imaging techniques have been used to verify its presence and location. On retrospective analysis, 50 consecutive children with documented upper urinary tract infection had abnormal findings on renal cortical scintigraphy with 99mTc-glucoheptonate. The infection involved the renal poles only in 38 and the poles plus other renal cortical areas in eight. Four had abnormalities that spared the poles. Renal sonograms were abnormal in 32 of 50 children. Excretory urograms were abnormal in six of 23 children in whom they were obtained. Vesicoureteral reflux was found in 34 of 40 children in whom voiding cystourethrography was performed. These data show the high sensitivity of renal cortical scintigraphy with 99mTc-glucoheptonate in documenting upper urinary tract infection. The location of the abnormalities detected suggests that renal infections spread via an ascending mode and implies that intrarenal reflux is a major contributing factor.

  14. Renal dysplasia in boxers and Finnish harriers.

    PubMed

    Hoppe, A; Karlstam, E

    2000-09-01

    Puppies from two litters of dogs were found to have severe polyuria and polydipsia. Four of the dogs were investigated by means of clinical examination, haematological and biochemical analysis, and urinalysis. A modified water deprivation response test was also performed in two of the dogs. Renal changes on postmortem examination in three of the dogs were found to be consistent with renal dysplasia. A possible explanation for the finding of hyposthenuria and the extreme polyuria and polydipsia in association with renal dysplasia may be lack of response to antidiuretic hormone owing to anomalous maturation of the renal tubules. Six other puppies from the two litters of dogs did not show any clinical signs of polyuria and polydipsia, although postmortem examination in one of them also revealed renal dysplasia. The clinical features of renal dysplasia may therefore vary greatly between individuals. PMID:11023130

  15. Renal Anomalies Associated with Ectopic Neurohypophysis

    PubMed Central

    Özen, Samim; Şişmek, Damla Gökşen; Önder, Asan; Darcan, Şükran

    2011-01-01

    Objective: Although the etiology of ectopic neurohypophysis that leads to pituitary hormone deficiencies is not yet clearly understood, birth trauma or genetic factors have been considered responsible. Concurrent cranial and extracranial congenital anomalies have been reported in such cases. The aim of the present study was to investigate the frequency of renal anomalies in nonsyndromic cases with ectopic neurohypophysis. Methods: We retrospectively evaluated the medical records of 20 patients with ectopic neurohypophysis who were followed up between January 1990 and December 2007 in a tertiary University Hospital. Results: Renal anomalies were identified in three (15%) cases including unilateral renal agenesis in one case, renal hypoplasia in one case, and double collecting system and unilateral renal agenesis in one case. Conclusions: In the present study, the increased frequency of renal anomalies in cases of ectopic neurohypophysis was highlighted, and it was emphasized that there might be common genetic factors that lead to such associations. Conflict of interest:None declared. PMID:21750632

  16. [Relationship of renal cell carcinoma and hypertension].

    PubMed

    Masanauskiene, Edita; Naudziūnas, Albinas; Jankauskiene, Laima; Unikauskas, Alvydas

    2009-01-01

    The morbidity and mortality due to renal cell carcinoma has increased worldwide over the last 30 years. Renal cell carcinoma accounts for about 90-95% of all renal tumors. The mean age of patients with this type of tumor ranges between 50 and 70 years. It is important to note that primary arterial hypertension as well as obesity and smoking are considered as independent risk factors for renal cell carcinoma. The increase in both systolic and diastolic blood pressure as well as the severity of arterial hypertension may have an impact on development of renal cell carcinoma. We describe the case of a 45-year-old male patient with hypertensive crisis. Computed tomography scan revealed renal cell carcinoma, which was confirmed histologically after surgical treatment. PMID:20173406

  17. [Current management of renal artery stenosis].

    PubMed

    Lenz, T

    2013-12-01

    Severe renal artery stenosis may cause renovascular hypertension; in case of bilateral narrowing or in a stenotic solitary kidney, renal insufficiency (ischemic kidney disease) or rarely pulmonary flush edema may occur. Renal artery stenosis may be treated by revascularization, using either percutaneous (balloon angioplasty, stenting) or less common open surgical procedures, both with excellent primary patency rates. However, randomized trials of renal artery angioplasty or stenting have failed to demonstrate a longer-term benefit with regard to blood pressure control and renal function over medical management alone (except for fibromuscular disease). Furthermore, endovascular procedures are associated with substantial risks. It has not yet been demonstrated that renal revascularization leads to a prolongation of event-free survival. Careful patient selection is essential to maximize the potential benefit. PMID:24217529

  18. Acute renal failure due to falciparum malaria.

    PubMed

    Habte, B

    1990-01-01

    Seventy-two patients with severe falciparum malaria are described. Twenty-four (33.3%) were complicated by acute renal failure. Comparing patients with renal failure and those without, statistically significant differences occurred regarding presence of cerebral malaria (83% vs 46%), jaundice (92% vs 33%), and death (54% vs 17%). A significantly higher number of patients with renal failure were nonimmune visitors to malaria endemic regions. Renal failure was oliguric in 45% of cases. Dialysis was indicated in 38%, 29% died in early renal failure, and 33% recovered spontaneously. It is concluded that falciparum malaria is frequently complicated by cerebral malaria and renal failure. As nonimmune individuals are prone to develop serious complications, malaria prophylaxis and vigorous treatment of cases is mandatory. PMID:2236718

  19. M-giant star candidates identified in LAMOST DR 1

    NASA Astrophysics Data System (ADS)

    Zhong, Jing; Lépine, Sébastien; Li, Jing; Chen, Li; Hou, Jin-Liang; Yang, Ming; Li, Guang-Wei; Zhang, Yong; Hou, Yong-Hui

    2015-08-01

    We perform a discrimination procedure with the spectral index diagram of TiO5 and CaH2+CaH3 to separate M giants from M dwarfs. Using the M giant spectra identified from LAMOST DR1 with high signal-to-noise ratio, we have successfully assembled a set of M giant templates, which show more reliable spectral features. Combining with the M dwarf/subdwarf templates in Zhong et al., we present an extended library of M-type templates which includes not only M dwarfs with a well-defined temperature and metallicity grid but also M giants with subtypes from M0 to M6. Then, the template-fitting algorithm is used to automatically identify and classify M giant stars from LAMOST DR1. The resulting catalog of M giant stars is cross-matched with 2MASS JHKs and WISE W1/W2 infrared photometry. In addition, we calculated the heliocentric radial velocity of all M giant stars by using the cross-correlation method with the template spectrum in a zero-velocity rest frame. Using the relationship between the absolute infrared magnitude MJ and our classified spectroscopic subtype, we derived the spectroscopic distance of M giants with uncertainties of about 40%. A catalog of 8639 M giants is provided. As an additional result of this analysis, we also present a catalog of 101 690 M dwarfs/subdwarfs which are processed by our classification pipeline.

  20. Giant Serpentine Aneurysm of the Middle Cerebral Artery

    PubMed Central

    Lee, Seung Joo; Kwun, Byung Duk; Kim, Chang Jin

    2010-01-01

    Giant serpentine aneurysms are rare and have distinct angiographic findings. The rarity, large size, complex anatomy and hemodynamic characteristics of giant serpentine aneurysms make treatment difficult. We report a case of a giant serpentine aneurysm of the right middle cerebral artery (MCA) that presented as headache. Treatment involved a superficial temporal artery (STA)-MCA bypass followed by aneurysm resection. The patient was discharged without neurological deficits, and early and late follow-up angiography disclosed successful removal of the aneurysm and a patent bypass graft. We conclude that STA-MCA bypass and aneurysm excision is a successful treatment method for a giant serpentine aneurysm. PMID:20856671

  1. Two cases of giant pyogenic granuloma of scalp

    PubMed Central

    Chandra, B. Satish; Rao, P. Narasimha

    2013-01-01

    Pyogenic granuloma is a benign vascular tumor of unknown etiology, though multiple factors play a role in its onset, e.g., trauma, chronic irritation, drugs etc., It is commonly seen in children and adolescents. Giant pyogenic granuloma is its atypical variant. We are presenting two cases of giant pyogenic granuloma, one, in a 28-year-old adult, presenting as a giant fluffy swelling of scalp and the other in a 11-year-old child, presenting as a giant ulcerated globular swelling of the scalp. PMID:24350008

  2. Exotic Earths: forming habitable worlds with giant planet migration.

    PubMed

    Raymond, Sean N; Mandell, Avi M; Sigurdsson, Steinn

    2006-09-01

    Close-in giant planets (e.g., "hot Jupiters") are thought to form far from their host stars and migrate inward, through the terrestrial planet zone, via torques with a massive gaseous disk. Here we simulate terrestrial planet growth during and after giant planet migration. Several-Earth-mass planets also form interior to the migrating jovian planet, analogous to recently discovered "hot Earths." Very-water-rich, Earth-mass planets form from surviving material outside the giant planet's orbit, often in the habitable zone and with low orbital eccentricities. More than a third of the known systems of giant planets may harbor Earth-like planets. PMID:16960000

  3. Renal proximal tubular dysgenesis associated with severe neonatal hemosiderotic liver disease.

    PubMed

    Bale, P M; Kan, A E; Dorney, S F

    1994-01-01

    We report the necropsy findings for three infants with the unusual combination of proximal renal tubular dysgenesis and severe congenital liver disease with excessive iron in several organs resembling neonatal hemochromatosis. Two of the infants were caucasian siblings and one was an Australian aborigine. One died in utero at 35 weeks of gestation and two died at 7 days. The liveborn infants presented with anuria and liver failure. The livers all showed marked loss of hepatocytes and replacement by pseudotubules in the collapsed lobules. The liveborn infants also showed giant cell transformation of hepatocytes, small regenerative nodules, cholestasis, and normal bile ducts. Absence of proximal renal convolutions was confirmed by epithelial membrane antigen positivity in nearly all tubules. In each family there was another sibling with congenital liver disease, fatal in one case, but no renal tubular dysgenesis. No infection or metabolic disease was uncovered in any of our patients, and the cause of the hepatocyte destruction was not determined. The combination in three infants of two rare congenital diseases could be genetic or acquired in utero from the same etiological agent. Alternatively, the absence of proximal convolutions could be secondary to hypoperfusion, perhaps because of shock due to extensive necrosis of hepatocytes. PMID:8066004

  4. Discovery of Renal Tuberculosis in a Partial Nephrectomy Specimen Done for Renal Tumor

    PubMed Central

    Saadi, Ahmed; Ayed, Haroun; Bouzouita, Abderrazak; Kerkeni, Walid; Cherif, Mohamed; Ben Slama, Riadh M.; Derouiche, Amine; Chebil, Mohamed

    2015-01-01

    The association of renal cancer and renal tuberculosis is uncommon. While the incidental discovery of renal cell carcinoma in a tuberculous kidney is a classical finding, the discovery of tuberculous lesions after nephrectomy for cancer is exceptional. We report the case of a female patient aged 60 who had a partial nephrectomy for a 5 cm exophytic kidney tumor. Pathological examination concluded that renal clear cell carcinoma associated with follicular caseo tuberculosis. PMID:26793504

  5. Renal Infarction Caused by Spontaneous Renal Artery Dissection: Treatment with Catheter-Directed Thrombolysis and Stenting

    SciTech Connect

    Jeon, Yong Sun Cho, Soon Gu; Hong, Ki Cheon

    2009-03-15

    Spontaneous renal artery dissection (SRAD) is rare and presents a diagnostic and therapeutic challenge. We report a case of a 36-year-old man who had an SRAD-complicated renal infarction. The patient experienced severe unilateral flank pain. Enhanced abdominal computed axial tomography scan showed renal infarction, and urinalysis showed no hematuria. Selective renal angiography was essential to evaluate the extent of dissection and suitability for repair. The patient was treated with catheter-directed thrombolysis and frenal artery stenting.

  6. Favourable outcome of scleroderma renal crisis.

    PubMed Central

    Collins, D A; Patel, S; Eastwood, J B; Bourke, B E

    1996-01-01

    Severe hypertension and rapidly progressive acute renal failure is a well recognized complication of scleroderma, often referred to as the renal crisis, and widely thought to cause irreversible deterioration in renal function. With the advent of angiotensin-converting-enzyme inhibitors (ACE-I) the outlook for patients with this condition has dramatically improved. We report here one such patient. Images Figure 1 PMID:8709086

  7. Endovascular Exclusion of Renal Artery Aneurysm

    SciTech Connect

    Andersen, Poul Erik Rohr, Nils

    2005-06-15

    A patient who was operated for an abdominal aortic aneurysm 7 years earlier presented with recently discovered iliac and renal artery aneurysms. The renal artery had an angulation of 90{sup o}, but the aneurysm was successfully excluded using a covered vascular stent graft placed over an extrastiff guidewire. Even in cases of complex anatomy of a renal aneurysm, endovascular treatment should be considered. With development of more flexible and low-profile endoprosthesis with accurate deployment, these have become more usable.

  8. Myocardial Calcinosis in Chronic Renal Failure

    PubMed Central

    Kempf, Ashley E.; Momeni, Maryam Golshan; Saremi, Farhood

    2009-01-01

    The authors are presenting an 18 year old male with history of end stage renal disease and rejected renal transplant. In his workup echocardiogram and non contract CT of chest revealed diffuse endocardial and myocardial calcifications. Extensive cardiac calcification is a rare but important entity in relation to end stage renal disease as it may cause complications such as valvular dysfunction and fatal arrhythmia. PMID:22470643

  9. [Renal colic: new care in emergency centers].

    PubMed

    Morandi, Eléonore; Kherad, Omar; Chollet, Yves; Dussoix, Philippe

    2016-02-01

    The prevalence of renal colic is increasing in industrialized countries, representing a frequent reason for consultation in emergencies. Most patients have simple renal colic that will require analgesia and ambulatory monitoring. Doctors working in emergency centers play a key role in the diagnosis, care and guidance of these patients. They must identify factors of gravity and request urological advice if necessary. This article summarizes the recent diagnostic and therapeutic innovations in the management and guidance of renal colic in emergency centers. PMID:26999995

  10. Renal dysfunction associated with liver transplantation.

    PubMed Central

    Jindal, R. M.; Popescu, I.

    1995-01-01

    It has been known for some time that a variety of liver diseases affect kidney function, but renal dysfunction associated with orthotopic liver transplantation has received scant attention. Although the mechanisms mediating these abnormalities are incompletely defined, advances in the understanding of renal pathophysiology after liver transplantation have made it possible to develop new treatment strategies. Aggressive and early intervention to diagnose and treat renal complications associated with liver transplantation should be the goal for transplant centres. PMID:7479462

  11. Purinergic signaling in inflammatory renal disease

    PubMed Central

    Arulkumaran, Nishkantha; Turner, Clare M.; Sixma, Marije L.; Singer, Mervyn; Unwin, Robert; Tam, Frederick W. K.

    2013-01-01

    Extracellular purines have a role in renal physiology and adaption to inflammation. However, inflammatory renal disease may be mediated by extracellular purines, resulting in renal injury. The role of purinergic signaling is dependent on the concentrations of extracellular purines. Low basal levels of purines are important in normal homeostasis and growth. Concentrations of extracellular purines are significantly elevated during inflammation and mediate either an adaptive role or propagate local inflammation. Adenosine signaling mediates alterations in regional renal blood flow by regulation of the renal microcirculation, tubulo-glomerular feedback, and tubular transport of sodium and water. Increased extracellular ATP and renal P2 receptor-mediated inflammation are associated with various renal diseases, including hypertension, diabetic nephropathy, and glomerulonephritis. Experimental data suggests P2 receptor deficiency or receptor antagonism is associated with amelioration of antibody-mediated nephritis, suggesting a pathogenic (rather than adaptive) role of purinergic signaling. We discuss the role of extracellular nucleotides in adaptation to ischemic renal injury and in the pathogenesis of inflammatory renal disease. PMID:23908631

  12. Tubulocystic Renal Cell Carcinoma: A Great Imitator

    PubMed Central

    Banerjee, Indraneel; Yadav, Sher Singh; Tomar, Vinay; Yadav, Suresh; Talreja, Shyam

    2016-01-01

    Tubulocystic renal cell carcinoma (TCRC) is a rare renal tumor. Patients are usually asymptomatic; it is usually detected incidentally, during imaging studies for Bosniak type III and type IV renal cysts. These tumors rarely metastasize. The role of targeted therapy in such rare tumors is still controversial. We report a case of TCRC initially presented as a Bosniak type II renal cyst and was discovered ultimately to be a metastatic disease. This type of presentation might broaden our understanding of this rare disease. PMID:27601972

  13. Sickle cell disease: renal manifestations and mechanisms

    PubMed Central

    Nath, Karl A.; Hebbel, Robert P.

    2015-01-01

    Sickle cell disease (SCD) substantially alters renal structure and function, and causes various renal syndromes and diseases. Such diverse renal outcomes reflect the uniquely complex vascular pathobiology of SCD and the propensity of red blood cells to sickle in the renal medulla because of its hypoxic, acidotic, and hyperosmolar conditions. Renal complications and involvement in sickle cell nephropathy (SCN) include altered haemodynamics, hypertrophy, assorted glomerulopathies, chronic kidney disease, acute kidney injury, impaired urinary concentrating ability, distal nephron dysfunction, haematuria, and increased risks of urinary tract infections and renal medullary carcinoma. SCN largely reflects an underlying vasculopathy characterized by cortical hyperperfusion, medullary hypoperfusion, and an increased, stress-induced vasoconstrictive response. Renal involvement is usually more severe in homozygous disease (sickle cell anaemia, HbSS) than in compound heterozygous types of SCD (for example HbSC and HbSβ+-thalassaemia), and is typically mild, albeit prevalent, in the heterozygous state (sickle cell trait, HbAS). Renal involvement contributes substantially to the diminished life expectancy of patients with SCD, accounting for 16–18% of mortality. As improved clinical care promotes survival into adulthood, SCN imposes a growing burden on both individual health and health system costs. This Review addresses the renal manifestations of SCD and focuses on their underlying mechanisms. PMID:25668001

  14. Abnormal patterns of the renal veins

    PubMed Central

    Azari, Hassan; Abedinzadeh, Mehdi

    2012-01-01

    Knowledge of the renal vascular anatomy may greatly contribute to the success of surgical, invasive and radiological procedures of the retroperitoneal region. Here, morphometric and histological studies of a human cadaveric specimen presented a complex, anomalous pattern of renal veins. The left renal vein had an oblique retro-aortic course and received two lumbar veins. It bifurcated near its drainage point into the inferior vena cava. The right renal vein received the right testicular vein. In addition, the left kidney was located at a low position. The spleen was enlarged. The present case is unique and provides information that may help surgeons or angiologists to apply safer interventions. PMID:22536553

  15. Cognitive and emotional effects of renal transplantation

    PubMed Central

    Pawar, A.A.; Rathod, J.; Chaudhury, S.; Saxena, S.K.; Saldanha, D.; Ryali, V.S.S.R.; Srivastava, K.

    2006-01-01

    Background: Recent studies have shown a high prevalence of depression and cognitive changes in patients with end-stage renal disease (ERSD) and renal transplant recipients. There are few data available on the cognitive and emotional changes in patients undergoing renal transplantation in India. Aim: To evaluate the changes in cognitive profile and depression in renal transplant recipients. Methods: Thirty consecutive patients undergoing renal transplantation were evaluated 1 month before and 3 months after successful renal transplant with Beck Depression Inventory (BDI), Weschler Adult Performance Intelligence Scale (WAPIS), Luria Nebraska Neuropsychological battery (LNNB) and Life satisfaction scale. Results: Our study revealed an 86.7% prevalence of depression in ESRD patients as compared to 56.7% in post renal transplant patients. Analysis of neurocognitive functions on LNNB did not reveal any significant impairment. Furthermore, analysis of the Life satisfaction scale revealed most of the patients scored high satisfaction levels despite the stress of their disease. Results on WAPIS brought out significant improvement in intelligence quotient (IQ) after renal transplantation. Conclusion: Successful renal transplant is associated with improvement in depression, IQ and life satisfaction. PMID:20703410

  16. Early origin of adult renal disease.

    PubMed

    Maringhini, Silvio; Corrado, Ciro; Maringhini, Guido; Cusumano, Rosa; Azzolina, Vitalba; Leone, Francesco

    2010-10-01

    Observational studies in humans and experimental studies in animals have clearly shown that renal failure may start early in life. 'Fetal programming' is regulated by adaptations occurring in uterus including maternal nutrition, placental blood supply, and epigenetic changes. Low birth weight predisposes to hypertension and renal insufficiency. Congenital abnormalities of the kidney and urinary tract, adverse postnatal events, wrong nutritional habits may produce renal damage that will become clinically relevant in adulthood. Prevention should start early in children at risk of renal disease. PMID:20822331

  17. Effects of renal lymphatic occlusion and venous constriction on renal function.

    PubMed Central

    Stolarczyk, J.; Carone, F. A.

    1975-01-01

    The effects of renal lymphatic occlusion or increased lymph flow due to renal vein constriction on renal function were investigated in rats. In each experiment, the renal lymphatics or vein of the left kidney were occluded or constricted and the right kidney served as a control. Occlusion of renal lymphatics caused renal enlargement, no change in glomerular filtration rate, a marked increase in urine flow and solute excretion without any change in urine osmolality, and enhanced urinary loss of urea, potassium, sodium and ammonium. Urea concentrations in medullary and papillary tissues were significantly elevated. Renal vein constriction caused renal enlargement and a marked drop in glomerular filtration rate, urine volume, urine osmolality and solute excretion. tissue concentrations of urea and potassium were decreased in the medulla and papilla and total tissue solute was significantly decreased in the papilla. The data indicate that in the rat, renal lymphatic occlusion traps urea in the medulla and induces a urea diuresis resulting in a large flow of normally concentrated urine. On the other hand, increased lymph flow secondary to renal vein constriction decreases medullary urea and potassium concentrations and papillary osmolality. These changes and the reduced glomerular filtration rate result in a small flow if dilute urine. Thus both renal lymphatic occlusion and enhanced lymph flow have a significant effect on renal function. Images Fig 1 PMID:1122006

  18. Transcatheter Embolization of a Renal Arteriovenous Fistula Complicated by an Aneurysm of the Feeding Renal Artery

    SciTech Connect

    Kensella, Denise; Kakani, Nirmal Pocock, Richard; Thompson, John; Cowan, Andrew; Watkinson, A.

    2008-03-15

    Renal arteriovenous fistula (AVF) is rare. Renal AVF complicated by aneurysm of the feeding artery presents a technical challenge for endovascular treatment. We report a case managed by covered stenting of the renal artery aneurysm, coil embolization of the fistula, and bare stenting of the aorta.

  19. MORPHOMETRIC, BIOCHEMICAL, AND PHYSIOLOGICAL ASSESSMENT OF PERINATALLY INDUCED RENAL DYSFUNCTION

    EPA Science Inventory

    Three chemicals, known either to alter renal development when administered during fetal development or to affect renal function when administered to adult rats, were administered to Sprague-Dawley rats at critical periods of renal development. Chlorambucil (CHL) was administered ...

  20. The M giant candidates identified in the LAMOST DR1

    NASA Astrophysics Data System (ADS)

    Zhong, Jing

    2015-08-01

    M giants are red-giant-branch (RGB) stars with low surface temperature and high luminosity in the late-phase of stellar evolution. Its luminous nature allows us to use these stars as good tracers to study the outer Galactic halo and distant substructures. A well classified M-giant stars sample has important scientific values for the statistic research. In order to fully utilize the spectral data of LAMOST spectroscopic survey, we perform a discrimination procedure with the spectral index diagram of TiO5 and CaH2+CaH3 to separate M giants from M dwarfs. Using the M giant spectra identified from the LAMOST DR1 with high signal-to-noise ratio, we have successfully assembled a set of M giant templates from M0 to M6. Then, the template-fit algorithm were used to automatically identify and classify M giants from the LAMOST DR1. In addition, we calculated the heliocentric radial velocity of all M giants by using the cross-correlation method with the template spectrum in a zero-velocity rest frame. Using the relationship between the absolute infrared magnitude MJ and our classified spectroscopic subtype, we derived the spectroscopic distance of M giants, with uncertainties of about 40%. Finally, we present a spectroscopic catalog of 8639 M giants including stellar parameters like photometry, proper motion, radial velocity, distance, spectral type and so on. In particular, the large sample of M giants is carried out for the first time. We will further use this sample to study the sub-structures and tidal stream in the Galactic Anti-Center.

  1. Small renal tumor with lymph nodal enlargement: A histopathological surprise

    PubMed Central

    Thottathil, Mujeeburahiman; Verma, Ashish; D’souza, Nischith; Khan, Altaf

    2016-01-01

    Renal cancer with lymph nodal mass on the investigation is clinically suggestive of an advanced tumor. Small renal cancers are not commonly associated with lymph nodal metastasis. Association of renal cell carcinoma with renal tuberculosis (TB) in the same kidney is also rare. We report here a case of small renal cancer with multiple hilar and paraaortic lymph nodes who underwent radical nephrectomy, and histopathology report showed renal and lymph nodal TB too. PMID:27453671

  2. Ultrastructural changes in renal proximal tubules after tetraethyllead intoxication

    SciTech Connect

    Chang, L.W.; Wade, P.R.; Reuhl, K.R.; Olson, M.J.

    1980-10-01

    Tetraethyllead (TEL) has been shown to be both an occupational and an environmental hazard to human health. The present study investigates pathological changes in the kidney as a result of TEL poisoning. Rabbits were injected (ip) with 100 to 200 mg TEL, and controls were injected with an equal volume of normal saline solution. Animals were sacrificed upon onset of toxic symptoms (hyperirritation, tremor, and convulsion). Animals were perfused with 2.5% glutaraldehyde. Tissue samples from the renal cortex were obtained for electron microscopy. Pathological changes were not remarkable at the light microscopic level; however, electron microscopic examination revealed marked cytological changes in the epithelial cells of the proximal tubules (PT) of animals treated with TEL. Enlargement of apical vacuoles and accumulation of lysosomes and microbodies were prominent findings in many PT epithelial cells. Many lysosomes appeared to be atypical in nature, displaying a high degree of pleomorphism in size, shape, and density. Giant lysosomes measuring 8 to 10 ..mu..m in diameter and crystalloid bodies within lysosomes were also observed. Configurational changes (increased convolution, branching, vesiculation, and degranulation) of the rough endoplasmic reticulum leading to the formation of honeycomb-like bodies were also found in many PT epithelial cells. The formation of the honeycomb-like bodies may represent a hyperplastic, hypoactive form of the rough endoplasmic reticulum and denotes a disruption of protein synthesis in these cells by TEL.

  3. The Retroperitoneal Laparoscopic Renal Capsulectomy for Spontaneous Renal Subcapsular Fluid Collection

    PubMed Central

    Zhu, Guodong; Wu, Dapeng; Wu, Kaijie; Song, Wenbin; Yang, Zhishang; Zhang, Yue; Zhang, Linlin; He, Dalin

    2016-01-01

    Abstract Spontaneous renal subcapsular fluid collection may occur as a rare presentation of nephritic syndrome, and distension of the renal capsula and Gerota fascia due to massive fluid accumulation may cause pain. In addition, hypertension secondary to renal ischemia and activation of renin–angiotensin–aldosterone system may also occur. The objective of this study is to evaluate the surgical outcome of retroperitoneal laparoscopic renal capsulectomy for patients with this disease. We retrospectively analyzed the clinical data of 10 female patients with spontaneous renal subcapsular fluid collection, diagnosed with B ultrasound and enhanced computed tomography (CT) scan. Eight patients first underwent percutaneous renal subcapsular drainage, which seemed to be less effective, and then all patients underwent retroperitoneal laparoscopic renal capsulectomy. The volume of renal subcapsular fluid was documented, the fluid was examined by routine biochemical tests, and the excised renal capsules underwent pathological examination individually. The postoperative drainage time for each patient was documented, and follow-up was conducted 1, 3, 6, 12 months, and 2 years postoperatively. Retroperitoneal laparoscopic renal capsulectomy was successfully performed in all patients with no major complications. The average volume of renal subcapsular fluid was 436 milliliter (mL, 180–880 mL) in light yellow color, and the concentration of creatinine and urea nitrogen was quite similar to that of serum. The pathological findings revealed fibrous dysplasia of the renal capsule with chronic infiltration of inflammatory cells. The average drainage time was 11.5 days (5–30 days) postoperatively. All patients recovered 1 month after the operation and there were no recurrences with a mean follow-up period of 12 months (6–24 months). The reason for spontaneous renal subcapsular fluid collection is unknown, and the aim of treatment is mainly to alleviate symptoms. In our

  4. Renal opiate receptor mediation of renin secretion to renal nerve stimulation in the dog.

    PubMed

    Koyama, S; Hosomi, H

    1986-06-01

    The present study was designed to evaluate renal opiate receptor mediation of the renin secretion response to electrical stimulation of the renal nerves in the pentobarbital sodium-anesthetized dog by use of the opiate agonist leucine-enkephalin (Leu-enk) and the opiate antagonist naloxone. In all animals studied, left kidneys were pump perfused at a constant renal blood flow. Renal perfusion pressure (RPP) and glomerular filtration rate (GFR) were unaltered at a stimulation frequency of 1.0 Hz; however, renin secretion rate (RSR) increased significantly in the nontreated group. High-frequency renal nerve stimulation (10 Hz) increased RPP and decreased GFR. RSR at the high-frequency stimulation was significantly augmented in the nontreated group. Renal arterial infusion of either Leu-enk (25 micrograms X kg-1 X min-1) or naloxone (7 micrograms X kg-1 X min-1) did not alter base-line levels of renal hemodynamics and RSR and did not produce significant changes in these variables even when renal nerves were stimulated at the low frequency; however, Leu-enk inhibited RPP and RSR responses to the high-frequency stimulation, and naloxone augmented these responses. Phentolamine (13 micrograms X kg-1 X min-1) prevented renal hemodynamic responses to the renal nerve stimulation, whereas RSR responses to the stimulation were unaffected. Propranolol (8 micrograms X kg-1 X min-1) resulted in decreases in RSR at the renal nerve stimulation despite the presence of changes in renal hemodynamics similar to the other groups. The results indicate that intrarenal opiate receptors may participate in inhibiting renal secretion of renin mediated by the renal nerves when renal vasoconstriction and reduction of GFR occurred at the high-frequency stimulation. PMID:3013030

  5. DO GIANT PLANETS SURVIVE TYPE II MIGRATION?

    SciTech Connect

    Hasegawa, Yasuhiro; Ida, Shigeru E-mail: ida@geo.titech.ac.jp

    2013-09-10

    Planetary migration is one of the most serious problems to systematically understand the observations of exoplanets. We clarify that the theoretically predicted type II, migration (like type I migration) is too fast, by developing detailed analytical arguments in which the timescale of type II migration is compared with the disk lifetime. In the disk-dominated regime, the type II migration timescale is characterized by a local viscous diffusion timescale, while the disk lifetime is characterized by a global diffusion timescale that is much longer than the local one. Even in the planet-dominated regime where the inertia of the planet mass reduces the migration speed, the timescale is still shorter than the disk lifetime except in the final disk evolution stage where the total disk mass decays below the planet mass. This suggests that most giant planets plunge into the central stars within the disk lifetime, and it contradicts the exoplanet observations that gas giants are piled up at r {approx}> 1 AU. We examine additional processes that may arise in protoplanetary disks: dead zones, photoevaporation of gas, and gas flow across a gap formed by a type II migrator. Although they make the type II migration timescale closer to the disk lifetime, we show that none of them can act as an effective barrier for rapid type II migration with the current knowledge of these processes. We point out that gas flow across a gap and the fraction of the flow accreted onto the planets are uncertain and they may have the potential to solve the problem. Much more detailed investigation for each process may be needed to explain the observed distribution of gas giants in extrasolar planetary systems.

  6. MERGING CRITERIA FOR GIANT IMPACTS OF PROTOPLANETS

    SciTech Connect

    Genda, H.; Kokubo, E.; Ida, S.

    2012-01-10

    At the final stage of terrestrial planet formation, known as the giant impact stage, a few tens of Mars-sized protoplanets collide with one another to form terrestrial planets. Almost all previous studies on the orbital and accretional evolution of protoplanets in this stage have been based on the assumption of perfect accretion, where two colliding protoplanets always merge. However, recent impact simulations have shown that collisions among protoplanets are not always merging events, that is, two colliding protoplanets sometimes move apart after the collision (hit-and-run collision). As a first step toward studying the effects of such imperfect accretion of protoplanets on terrestrial planet formation, we investigated the merging criteria for collisions of rocky protoplanets. Using the smoothed particle hydrodynamic method, we performed more than 1000 simulations of giant impacts with various parameter sets, such as the mass ratio of protoplanets, {gamma}, the total mass of two protoplanets, M{sub T}, the impact angle, {theta}, and the impact velocity, v{sub imp}. We investigated the critical impact velocity, v{sub cr}, at the transition between merging and hit-and-run collisions. We found that the normalized critical impact velocity, v{sub cr}/v{sub esc}, depends on {gamma} and {theta}, but does not depend on M{sub T}, where v{sub esc} is the two-body escape velocity. We derived a simple formula for v{sub cr}/v{sub esc} as a function of {gamma} and {theta} (Equation (16)), and applied it to the giant impact events obtained by N-body calculations in the previous studies. We found that 40% of these events should not be merging events.

  7. Analysis of Renal Anomalies in VACTERL Association

    PubMed Central

    Cunningham, Bridget K.; Khromykh, Alina; Martinez, Ariel F.; Carney, Tyler; Hadley, Donald W.; Solomon, Benjamin D.

    2014-01-01

    VACTERL association refers to a combination of congenital anomalies that can include: Vertebral anomalies, Anal atresia, Cardiac malformations, Tracheo-Esophageal fistula with esophageal atresia, Renal anomalies (typically structural renal anomalies), and Limb anomalies. We conducted a description of a case series to characterize renal findings in a cohort of patients with VACTERL association. Out of the overall cohort, 48 patients (with at least 3 component features of VACTERL and who had abdominal ultrasound performed) met criteria for analysis. Four other patients were additionally analyzed separately, with the hypothesis that subtle renal system anomalies may occur in patients who would not otherwise meet criteria for VACTERL association. Thirty-three (69%) of the 48 patients had a clinical manifestation affecting the renal system. The most common renal manifestation (RM) was vesicoureteral reflux (VUR) in addition to a structural defect (present in 27%), followed by unilateral renal agenesis (24%), and then dysplastic/multicystic kidneys or duplicated collected system (18% for each). Twenty-two (88%) of the 25 patients with a structural RM had an associated anorectal malformation. Individuals with either isolated lower anatomic anomalies, or both upper and lower anatomic anomalies were not statistically more likely to have a structural renal defect than those with isolated upper anatomic anomalies (p=0.22, p=0.284 respectively). Given the high prevalence of isolated VUR in our cohort, we recommend a screening VCUG or other imaging modality be obtained to evaluate for VUR if initial renal US shows evidence of obstruction or renal scarring, as well as ongoing evaluation of renal health. PMID:25196458

  8. Tissue engineering of a bioartificial renal tubule.

    PubMed

    MacKay, S M; Funke, A J; Buffington, D A; Humes, H D

    1998-01-01

    Development of a bioartificial renal tubule with a confluent monolayer of renal epithelial cells supported on a permeable synthetic surface may be the first step to further optimization of renal substitution therapy currently used with hemodialysis or hemofiltration. Madin-Darby canine kidney cells, a permanent renal epithelial cell line, were seeded into the lumen of single hollow fibers. Functional confluence of the cells was demonstrated by the recovery of intraluminally perfused 14C-inulin that averaged >98.9% in the cell lined units vs <7.4% in the control noncell hollow fibers during identical pressure and flow conditions. The baseline absolute fluid transport rate averaged 1.4+/-0.4 microl/30 min. To test the dependency of fluid flux with oncotic and osmotic pressure differences across the bioartificial tubule, albumin was added to the extracapillary space, followed by the addition of ouabain, an inhibitor of Na+K+ adenosine triphosphatase, the enzyme responsible for active transport across the renal epithelium. Addition of albumin resulted in a significant increase in volume transport to 4.5+/-1.0 microl/30 min. Addition of ouabain inhibited transport back to baseline levels of 2.1+/-0.4 microl/30 min. These results are the first demonstration that renal epithelial cells have been grown successfully as a confluent monolayer along a hollow fiber, and exhibit functional transport capabilities. The next steps in constructing a bioartificial renal tubule successfully are to develop a multi-fiber bioreactor with primary renal proximal tubule cells that maintain not only transport properties but also differentiated metabolic and endocrine functions, including glucose and ammonia production, and the conversion of vitamin D3 to a more active derivative. A renal tubule device may add critical renal functional components not currently substituted for, thereby improving the treatment regimens for patients with acute and chronic renal failure. PMID:9617948

  9. Apical Orbital Aspergillosis Complicating Giant Cell Arteritis.

    PubMed

    Zhou, Yang; Morgan, Michael L; Almarzouqi, Sumayya J; Chevez-Barrios, Patricia; Lee, Andrew G

    2016-06-01

    A 75-year-old woman with new onset headaches and left vision loss, temporal scalp tenderness, and jaw claudication was found to have biopsy-proven giant cell arteritis (GCA). Despite treatment and improvement with prednisone, she later developed left orbital apex syndrome, and an orbital biopsy revealed aspergillosis. After antifungal treatment, extraocular motility improved although vision in the left eye remained no light perception. Clinicians should be aware that fungal orbital apex disease may mimic or complicate steroid-treated GCA. PMID:26835662

  10. Dynamical Coupling of Pygmy and Giant Resonances

    NASA Astrophysics Data System (ADS)

    Bertulani, Carlos; Brady, Nathan; Aumann, Thomas; Thomas, James

    2016-03-01

    One of the effects overseen in studies of excitation of pygmy resonances is the fact that both pygmy and giant resonances are strongly coupled. This coupling leads to dynamical effects such as the modification of transition probabilities and and cross sections. We make an assessment of such effects by means of the relativistic coupled channels equations developed by our group. Supported by the U.S. NSF Grant No. 1415656 and the U.S. DOE Grant No. DE-FG02-08ER41533.

  11. Giant cystic pheochromocytoma: A silent entity

    PubMed Central

    Gupta, Amit; Bains, Lovenish; Agarwal, Manish Kumar; Gupta, Renu

    2016-01-01

    Pheochromocytoma is a catecholamine secreting tumor that originate from chromaffin cells. Usually, it is solid neoplasm of the adrenal medulla, however cystic pheochromocytoma is a rare neuro-endocrine tumour that is frequently asymptomatic and often diagnosed incidentally on imaging or intra-operatively. Only a few cases of cystic pheochromocytomas have been reported in the world literature. We present a case of giant cystic pheochromocytoma in a 65 years old lady who presented with a large retroperitoneal lump, which is probably the world's third largest pheochromocytoma as per the available indexed literature. PMID:27453669

  12. The worst case: giant exulcerating seminoma.

    PubMed

    Letsch, Markus; Spahn, Martin; Beissert, Matthias; Topp, Max S; Gerharz, Elmar W; Riedmiller, Hubertus

    2010-01-01

    Ten years after his brother had been treated for seminoma, a 36-year-old male presented with a giant exulcerating mass involving the right testis and both inguinal regions. Subsequent biopsy revealed pure seminoma. Staging computed tomography (CT) showed bulky retroperitoneal and pelvic lymph node metastases. After seven courses of cisplatin-based chemotherapy, positron emission tomography suggested residual tumor in the right groin. The suspicious lesion and the right testis were resected showing no vital tumor tissue. Eight months after surgery there were no signs of disease progression at follow-up CT. PMID:20173381

  13. Giant Star Clusters Near Galactic Core

    NASA Technical Reports Server (NTRS)

    2001-01-01

    A video sequence of still images goes deep into the Milky Way galaxy to the Arches Cluster. Hubble, penetrating through dust and clouds, peers into the core where two giant clusters shine more brightly than any other clusters in the galaxy. Footage shows the following still images: (1) wide view of Sagittarius constellation; (2) the Palomar Observatory's 2 micron all-sky survey; and (3) an image of the Arches Cluster taken with the Hubble Space Telescope NICMOS instrument. Dr. Don Figer of the Space Telescope Science Institute discusses the significance of the observations and relates his first reaction to the images.

  14. Stardust from Asymptotic Giant Branch Stars

    NASA Astrophysics Data System (ADS)

    Gail, H.-P.; Zhukovska, S. V.; Hoppe, P.; Trieloff, M.

    2009-06-01

    The formation of dust in the outflows of low- and intermediate-mass stars on the first giant branch and asymptotic giant branch (AGB) is studied and the relative contributions of stars of different initial masses and metallicities to the interstellar medium (ISM) at the instant of solar system formation are derived. These predictions are compared with the characteristics of the parent stars of presolar dust grains found in primitive meteorites and interplanetary dust particles (IDPs) inferred from their isotopic compositions. For this purpose, model calculations for dust condensation in stellar outflows are combined with synthetic models of stellar evolution on the first giant branch and AGB and an evolution model of the Milky Way for the solar neighborhood. The dust components considered are olivine, pyroxene, carbon, SiC, and iron. The corresponding dust production rates are derived for the solar vicinity. From these rates and taking into account dust destruction by supernova shocks in the ISM, the contributions to the inventory of presolar dust grains in the solar system are derived for stars of different initial masses and metallicities. It is shown that stars on the first giant branch and the early AGB are not expected to form dust, in accord with astronomical observations. Dust formation is concentrated in the last phase of evolution, the thermally pulsing AGB. Due to the limited lifetime of dust grains in the ISM only parent stars from a narrow range of metallicities are expected to contribute to the population of presolar dust grains. Silicate and silicon carbide dust grains are predicted to come from parent stars with metallicities not less than about Z ≈ 0.008 (0.6 × solar). This metallicity limit is higher than that inferred from presolar SiC grain isotope data. The population of presolar carbon dust grains is predicted to originate from a wider range of metallicities, down to Z ≈ 0.004. Masses of AGB stars that produce C-rich dust are in the range

  15. Female Urethral Diverticulum Containing a Giant Calculus

    PubMed Central

    Dong, ZhiLong; Wang, Hanzhang; Zuo, LinJun; Hou, MingLi

    2015-01-01

    Abstract Urethral diverticula with calculi have a low incidence as reported in the literature. Diverticulum of female urethra is rare, often discovered due to associated complications. We report a case of diverticulum of the female urethra containing giant calculi in a 62-year-old multiparous woman. She consulted with our office due to dysuria and a hard, painful periurethral mass in the anterior vagina wall. The diverticulum was approached surgically by a vaginal route, and local extraction of the calculi and subsequent diverticulectomy successfully treated the condition. Diagnosis of a complicated diverticulum can be easily achieved if one possesses a high degree of clinical symptoms. PMID:25997056

  16. New Observations of the Giant's Churches

    NASA Astrophysics Data System (ADS)

    Ridderstad, Marianna

    2015-05-01

    Orientations of the axes and gates of 49 Giant's Churches (GCs) were examined. Orientations to both solar and lunar events were discovered. The results especially suggest the importance of full moon events. Comparison between the orientations of the southern and the northern GCs did not reveal great differences. The majority of the GCs are situated on the eastern or southern sides of their ridges, and most of them enclose or are surrounded by cairns. Based on parallels to other North European Neolithic cultures, it is proposed that the GCs went through several phases of construction, the last phase being probably related to ritual activities.

  17. Norway threatens shutdown of giant Ekofisk field

    SciTech Connect

    Not Available

    1992-10-19

    This paper reports that The Norwegian Petroleum Directorate has warned Phillips Petroleum Co. Norway AS it will shut down giant Ekofisk oil field over safety concerns before winter 1995-96. Later that day Phillips, operator of the Ekofisk complex in the Norwegian North Sea, the the threat was intended to speed changes in the field's processing and transportation systems. NPD cited studies carried out by Phillips that revealed aging equipment and inadequate maintenance. Seabed subsidence, which led to several of the field's platforms being jacked up 3 m in 1987, made things worse.

  18. Giant proximity effect in cuprate superconductors.

    PubMed

    Bozovic, I; Logvenov, G; Verhoeven, M A J; Caputo, P; Goldobin, E; Beasley, M R

    2004-10-01

    Using an advanced molecular beam epitaxy system, we have reproducibly synthesized atomically smooth films of high-temperature superconductors and uniform trilayer junctions with virtually perfect interfaces. We found that supercurrent runs through very thick barriers. We can rule out pinholes and microshorts; this "giant proximity effect" (GPE) is intrinsic. It defies the conventional explanation; it might originate in resonant tunneling through pair states in an almost-superconducting barrier. GPE may also be significant for superconducting electronics, since thick barriers are easier to fabricate. PMID:15524925

  19. Giant persistent photoconductivity in rough silicon nanomembranes.

    PubMed

    Feng, Ping; Mönch, Ingolf; Harazim, Stefan; Huang, Gaoshan; Mei, Yongfeng; Schmidt, Oliver G

    2009-10-01

    This paper reports the observation of giant persistent photoconductivity from rough Si nanomembranes. When exposed to light, the current in p-type Si nanomembranes is enhanced by roughly 3 orders of magnitude in comparison with that in the dark and can persist for days at a high conductive state after the light is switched off. An applied gate voltage can tune the persistent photocurrent and accelerate the response to light. By analyzing the band structure of the devices and the surfaces through various coatings, we attribute the observed effect to hole-localized regions in Si nanomembranes due to the rough surfaces, where light can activate the confined holes. PMID:19637888

  20. Asymptomatic Giant Intraventricular Cysticercosis: A Case Report.

    PubMed

    Teerasukjinda, Ornusa; Wongjittraporn, Suwarat; Tongma, Chawat; Chung, Heath

    2016-07-01

    Neurocysticercosis is a growing health problem in the United States and worldwide. Diagnosis and treatment is challenging especially if the physician is not familiar with this condition. The World Health Organization (WHO) estimates that neurocysticercosis affects 50 million people worldwide, especially in developing countries and causes approximately 50,000 deaths annually.1 Neurocysticercosis is of emerging importance in the United States especially in Hawai'i because of immigration from disease-endemic regions.2 We present a case of a young Chinese immigrant male who presented with impressive imaging studies of a giant intraventricular neurocysticercosis. This case emphasizes the importance of recognizing neurocysticercosis, especially in the immigrant population. PMID:27437162