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1

Renal Pelvis and Ureter Cases - MP/H Rules  

Cancer.gov

RP/Ureter Case 1 SURGICAL PATHOLOGY REPORT Surgical Pathology Report October 20, 2007 Specim en: A. Left ureter biopsy B. Uterus and bladder C. Right ureter Final Diagnosis: A. Left ureter biopsy - invasive high grade urothelial carcinoma. B.

2

Indocyanine green for intraoperative localization of ureter.  

PubMed

Intraurethral injection of indocyanine green (ICG; Akorn, Lake Forest, IL) and visualization under near-infrared (NIR) light allows for real-time delineation of the ureter. This technology can be helpful to prevent iatrogenic ureteral injury during pelvic surgery. Patients were scheduled to undergo robot-assisted laparoscopic sacrocolpopexy. Before the robotic surgery started, the tip of a 6-F ureteral catheter was inserted into the ureteral orifice. Twenty-five milligrams of ICG was dissolved in 10-mL of sterile water and injected through the open catheter. The same procedure was repeated on the opposite side. The ICG reversibly stained the inside lining of the ureter by binding to proteins on urothelial layer. During the course of robotic surgery, the NIR laser on the da Vinci Si surgical robot (Intuitive Surgical, Inc, Sunnyvale, CA) was used to excite ICG molecules, and infrared emission was captured by the da Vinci filtered lens system and electronically converted to green color. Thus, the ureter fluoresced green, which allowed its definitive identification throughout the entire case. In all cases of >10 patients, we were able to visualize bilateral ureters with this technology, even though there was some variation in brightness that depended on the depth of the ureter from the peritoneal surface. For example, in a morbidly obese patient, the ureters were not as bright green. There were no intraoperative or postoperative adverse effects attributable to ICG administration for up to 2 months of observation. In our experience, this novel method of intraurethral ICG injection was helpful to identify the entire course of ureter and allowed a safe approach to tissues that were adjacent to the urinary tract. The advantage of our technique is that it requires the insertion of just the tip of ureteral catheter. Despite our limited cohort of patients, our findings are consistent with previous reports of the excellent safety profile of intravenous and intrabiliary ICG. Intraurethral injection of ICG and visualization under NIR light allows for real-time delineation of the ureter. This technology can be helpful to prevent iatrogenic ureteral injury during pelvic surgery. PMID:24835212

Siddighi, Sam; Yune, Junchan Joshua; Hardesty, Jeffrey

2014-10-01

3

Type ii ureteral triplication associated with ectopic ureter  

Microsoft Academic Search

We report a case of type II ureteral triplication associated with ectopic ureter. The ureter, draining the upper renal segment, entered the vagina, and the other two ureters, draining the middle and lower renal segments, had joined and entered the bladder. The anatomic findings are compatible with those predicted by the Weigert-Meyer law. A thorough evaluation of such an anomaly

Dov Engelstein; Pinhas M. Livne; Maya Cohen; Ciro Servadio

1996-01-01

4

[Intestinal plastic surgery of the ureter].  

PubMed

Intestinal plastic surgery for ureteral stricture was made in 25 patients (10 unilateral and 15 bilateral strictures). Stricture of the lower third of both ureters was primarily second to operations for colorectal cancer, urinary bladder diverticulesis and scars after radiotherapy. Unilateral strictures resulted from postradiation changes in 9 patients and a shotgun wound of the ureter in 1 patient. Grafts of an isolated segment of the ileum and the vermiform process on the mesentery were transplanted in 22 and 3 patients, respectively. Postoperative intestinal ileus was observed only in one patient who was treated with relaparotomy, intestinal intubation and abdominal drainage. Another patient was reoperated for failure of ureteroappendicoanastomosis. The results of the reoperations were successful. No lethal outcomes were recorded. Upon 0.5-7 year follow-up, all the patients restored normal urodynamics and function of the affected kidney. Thus, use of an isolated segment of the small intestine ensures repair of the defects of one or both the ureters of any location and length. Intestinal repair in extended ureteral lesion is an operation of choice as it reestablishes urine outflow from the kidney, improves its function, relieves symptoms of chronic pyelonephritis and puts away continuous renal and ureteral fistulas. PMID:15989022

Komiakov, B K; Guliev, B G; Novikov, A I; Dorofeev, S Ia; Lebedev, M A; Al-Issa, A

2005-01-01

5

Type II ureteral triplication associated with ectopic ureter.  

PubMed

We report a case of type II ureteral triplication associated with ectopic ureter. The ureter, draining the upper renal segment, entered the vagina, and the other two ureters, draining the middle and lower renal segments, had joined and entered the bladder. The anatomic findings are compatible with those predicted by the Weigert-Meyer law. A thorough evaluation of such an anomaly is essential for effective management. PMID:8911529

Engelstein, D; Livne, P M; Cohen, M; Servadio, C

1996-11-01

6

[Neuromuscular dysplasia of the ureters in children].  

PubMed

The paper is concerned with disputable aspects of the policy in the diagnosis of neuromuscular ureteral dysplasia (NUD) in children, with indications to NUD conservative treatment and a choice of optimal surgical correction at primary or repeat operations basing on ureteral dilatation. The necessity of the NUD conservative treatment in children with nonaffected renal function has been confirmed by 52 cases of NUD children treated conservatively or surgically. The analysis of surgical outcomes in 34 NUD children and urodynamic pre- and postoperative examinations in 18 of them suggest the following conclusions: 1) the decision on "modelling" of the ureter is feasible only in the course of surgical intervention; 2) in ureteral dilatation less than 5-7 mm "modelling" is unnecessary. In other cases "modelling" is made at primary surgery according to Kalicinski's technique, at resurgery according to Hander. Positive outcomes in primary interventions were registered in 78% of the patients, 62% of the operations were successful in recurrent disease. PMID:7941117

Pugachev, A G; Kudriavtsev, Iu V; Pavlov, A Iu; Osipov, V P; Voronovitski?, V D

1993-01-01

7

Ureteral triplication, contralateral duplication and bilateral extravesical ectopic ureter.  

PubMed

A case of ureteral triplication associated with contralateral ureteral duplication and bilateral extravesical ectopic ureter is reported. The child presented with urinary incontinence. The incidence, classification and embryology of triplication are reviewed. PMID:4032556

Youngson, G G

1985-09-01

8

Brg1 Determines Urothelial Cell Fate during Ureter Development  

PubMed Central

Developing and adult ureters express the epigenetic regulator Brg1, but the role of Brg1 in ureter development is not well understood. We conditionally ablated Brg1 in the developing ureter using Hoxb7-Cre and found that Brg1 expression is upstream of p63, Ppar?, and sonic hedgehog (Shh) expression in the ureteral epithelium. In addition, epithelial stratification in the basal cells required Brg1-dependent p63 expression, whereas terminal differentiation of the umbrella cells required Brg1-dependent Ppar? expression. Furthermore, the loss of ureteric Brg1 resulted in failure of Shh expression, which correlated with reduced smooth muscle cell development and hydroureter. Taken together, we conclude that Brg1 expression unifies three aspects of ureter development: maintenance of the basal cell population, guidance for terminal differentiation of urothelial cells, and proper investment of ureteral smooth muscle cells. PMID:23449535

Weiss, Robert M.; Guo, Songshan; Shan, Alan; Shi, Hongmei; Romano, Rose-Anne; Sinha, Satrajit; Cantley, Lloyd G.

2013-01-01

9

[Ureter triplex with non-functioning upper pole due to ectopic ureterocele and refluxive third ureter bud : case report and review of the literature].  

PubMed

We present the case of an 8-month-old boy with ureter triplication on the left side with non-functional upper pole due to ectopic ureterocele and a refluxive third ureter bud. We performed an upper pole heminephroureterectomy with resection of the ureterocele and of the refluxive third ureter bud and reimplantation of the lower pole ureter using the psoas hitch technique. PMID:18516582

Neisius, A; Schröder, A; Riedmiller, H; Brzezinska, R; Stein, R; Thüroff, J W

2008-11-01

10

The retroperitoneal, inguinal approach to distal part of the ureter  

PubMed Central

Introduction The inguinal approach to the distal part of the ureter allows the surgeon to perform various types of procedures and is considered to be one of the minimally invasive techniques in pediatric surgery. We aim to describe our initial experience with the surgery of the distal ureter performed through an inguinal mini–incision. Material and methods Between March 2012 and June 2013, 8 patients were treated using a minimally invasive inguinal technique. The indications for surgical correction were single system primary obstructive megaureter, obstructive megaureter of the upper pole in a duplex kidney and distal ureteral stones. In all patients with single system obstructive megaureter and significant hydronephrosis, ureterocutaneostomy was performed. In one patient with duplex system primary obstructive megaureter and significant hydronephrosis of the upper pole, ureteroureterostomy of the dilated ureter to the normal caliber ureter in the distal part was performed. In the second patient with duplex system primary obstructive megaureter and reduced marker excretion of the upper pole in renal scintigraphy, ureterocutaneostomy was performed. In both cases of distal ureteral stones, deposits were removed by a simple incision. Results We did not observe any perioperative or postoperative complications. The imaging studies have shown that ureteral dilatation decreased in all but one child in whom the upper pole and the ureter were resected due to lack of function. Conclusions The inguinal approach allows for the adequate visualization of the distal ureter, creating the conditions for implementation of the various procedures, reduces the risk of retrovesical plexus injury and minimizes visible scars. PMID:24982797

Urbanowicz, Wies?aw; Sulis?awski, Janusz; Dobrowolska–glazar, Barbara

2014-01-01

11

Peristomal Pagetoid Spread of Urothelial Carcinoma of the Ureter  

PubMed Central

Patients with ostomy including urinary stoma often develop peristomal complications, especially skin damage. The patient in this case was a 69-year old female with a history of urothelial carcinoma of the bladder and left ureter who underwent transurethral resection of a bladder tumor, nephroureterectomy and cystectomy combined with ureterocutaneostomy. Later, she had recurrence of urothelial carcinoma in the remaining ureter that spread to the peristomal epidermis, with a skin appearance resembling Paget’s disease. We report this case based on its clinical significance since we believe it is the first description of this condition in the literature. PMID:24179661

Ito, Fumio; Kihara, Ken; Shiomi, Koh; Ishizaki, Sumiko; Tanaka, Masaru; Aiba, Motohiko; Fujibayashi, Mariko; Nakazawa, Hayakazu

2013-01-01

12

Herlyn-Weber-Wunderlich syndrome with ectopic ureter in prepubertal female  

PubMed Central

We report a rare case of uterovaginal duplication in a prepubertal female. The patient also had a permeable ureter (ureter with urine passing through it) subtending a poorly functioning kidney with ectopic insertion in the obstructed hemivagina. PMID:24741215

Garge, Saurabh; Bagga, Deepak; Acharya, Sameer Kant; Yadav, Devendra Kumar; Khan, Tanvir Roshan; Kumar, Ram; Kumar, Vinod; Kumar, Srinivas; Gupta, Divya; Prasad, Ashish

2014-01-01

13

Transitional cell carcinoma of the ureter and renal pelvis  

Microsoft Academic Search

Transitional cell carcinoma (TCC) of ureter and renal pelvis is relatively uncommon. Smoking, occupational carcinogens, analgesic abuse, Balkan nephropathy are the risk factors. Cytogenetic studies revealed that the most frequent aberration is the partial or complete loss of chromosome 9. Approximately 20–50% of patients with upper urinary tract (UUT) TCC have bladder cancer at some point on their course, whereas

Ziya Kirkali; Emre Tuzel

2003-01-01

14

Cigarette Smoking and Cancers of the Renal Pelvis and Ureter  

Microsoft Academic Search

A population-based case-control study of renal pelvis and ureter can cers (502 cases, 496 controls) conducted in three areas of the United States found cigarette smoking to be associated with a 3.1-fold increase in risk, with long-term (>45 years) smokers having a 7.2-fold increased risk. Statistically significant dose-response associations were observed for both cancer sites and in both sexes regardless

Joseph K. McLaughlin; Debra T. Silverman; Ann W. Hsing; Ronald K. Ross; Janet B. Schoenberg; Mimi C. Yu; Annette Stemhagen; Charles F. Lynch; William J. Blot; Joseph F. Fraumeni

1992-01-01

15

Application of a temporary ureter clamp for retroperitoneal laparoscopic ureterolithotomy  

Microsoft Academic Search

Introduction  Retroperitoneal laparoscopic ureterolithotomy is a new option to treat upper and middle ureter calculi in selected patients.\\u000a However, migration of the stone and the flow of urine will influence the success.\\u000a \\u000a \\u000a \\u000a Methods  We have developed a new and practical method using a clamp proximally above the stone to fix its position and prevent urine\\u000a flow. Twenty patients had undergone retroperitoneal laparoscopic

Xingqiao Wen; Xiaojuan Li; Jie Situ; Youqiang Fang; Xiaodong Chen; Xingxing Ruan; Yu Wang; Xin Gao

2010-01-01

16

[A case of right triplicate and left duplicate ureters].  

PubMed

Ureteral triplication is a rare anomaly of the urinary tract. A 42-year-old male was found to have right triplicated and left duplicated ureters. The chief complaint was gross hematuria, but it disappeared after admission. Computerized tomographic scan, renal angiography and urine cytology revealed no pathological findings but 3 small aneurysms at the upper pole of the right kidney. Cystoscopic examination showed 3 ureteral orifices on the right side with bleeding from the lowest ureteral orifice. Right retrograde pyelography revealed 3 pelvic systems with calyceal communication of lower and middle pelvic system. Our case is consistent with altered type-D of Smith's classification. PMID:3434498

Gotoh, S; Matsumura, T; Kobayashi, T; Yamada, T; Oshima, H

1987-09-01

17

Physiology and Pharmacology of the Human Ureter: Basis for Current and Future Treatments  

Microsoft Academic Search

Introduction: This article sets out to be a review regarding agents that affect contraction and relaxation of the ureter in order to establish a basis for current and future treatments for upper urinary tract obstruction. Material and Methods: A complete review of the English literature using MEDLINE was performed between 1960 and 2007 on ureter physiology and pharmacology with special

A. Erdem Canda; Burak Turna; G. Mehtap Cinar

2007-01-01

18

Maternal exposure to diethylene glycol monomethyl ether: a possible role in the etiology of retrocaval ureter.  

PubMed

Retrocaval ureter is a very rare condition. In light of the experimental studies, one of the etiologic factors seems to be maternal contact with diethylene glycol monomethyl ether or ethylene glycol monomethyl ether. A case of cardiovascular, skeletal, and retrocaval ureter anomalies caused by possible maternal contact while pregnant with these materials at her work in a textile factory is presented. PMID:12149723

Karaman, M Ihsan; Gürdal, Mesut; Oztürk, Metin; Kanbero?lu, Hüseyin

2002-08-01

19

Totally intracorporeal replacement of the ureter using whole-mount ileum.  

PubMed

Ileal ureter is a suitable treatment option for patients with long ureteral strictures. Minimally invasive techniques have been shown to be as safe as open technique and superior in terms of postoperative recovery. We report the first case of laparoscopic totally intracorporeal replacement of ureter using whole-mount ileum in a patient with right-sided long ureteral stricture. The operative time was 150 minutes, and there were no complications. We have demonstrated the safety and feasibility of laparoscopic intracorporeal ileal ureter with possible advantage of shorter operative time compared with the robotic-assisted technique reported recently. PMID:24749827

Sim, Allen; Todenhöfer, Tilman; Mischinger, Johannes; Halalsheh, Omar; Boettge, Johannes; Rausch, Steffen; Aufderklamm, Stefn; Stenzl, Arnulf; Gakis, Georgios; Schwentner, Christian

2014-10-01

20

Retroperitoneoscopic nephroureterectomy for transitional cell carcinoma of the renal pelvis and ureter: Nagoya experience  

Microsoft Academic Search

ObjectivesTo evaluate the efficacy of our new retroperitoneoscopic nephroureterectomy for patients with transitional cell carcinoma of the renal pelvis and ureter, we present the operative procedure and analysis of the clinical outcome of retroperitoneoscopy in 23 patients.

Yasushi Yoshino; Yoshinari Ono; Ryohei Hattori; Momokazu Gotoh; Osamu Kamihira; Shinichi Ohshima

2003-01-01

21

Developmental and species differences in the response of the ureter to metabolic inhibition  

Microsoft Academic Search

The effect of inhibiting oxidative phosphorylation on electrically stimulated phasic and high-K+ depolarization-induced tonic contractions in ureteric smooth muscle has been investigated. Intracellular [Ca2+] and pH were monitored fluorimetrically with simultaneous tension measurement, in adult and neonatal rat and guinea-pig ureter.\\u000a Little difference was found in the response of adult or neonatal rat ureters; cyanide abolished phasic contractions and intracellular

A. J. Bullock; Susan Wray

1998-01-01

22

Analgesics, Cigarette Smoking, and Other Risk Factors for Cancer of the Renal Pelvis and Ureter1  

Microsoft Academic Search

Results from a population-based case-control study of cancer of the renal pelvis and ureter are reported. Telephone interviews were conducted with 187 residents of Los Angeles County diagnosed with cancer of the renal pelvis and ureter over a 4-year period ending December 31, 1982, and with individually sex-, age- and race-matched neighborhood controls. The major risk factor identified for cancer

Ronald K. Ross; Annlia Paganini-Hill; Joseph Landolph; Vibeke Gerkins; Brian E. Henderson

1989-01-01

23

Intra operative lesion of the pelvic ureter solved in a minimally invasive manner.  

PubMed

Ureteral lesions during open hysterectomy, vaginal hysterectomy or laparoscopic hysterectomy have a rate of 0.2% up to 6%. Multiple complications may occur if the lesion is not recognised intra operatively: hydronephrosis, anuria (bilateral lesion), ureterovaginal fistula, ileus, peritonitis. The rate of recognition of an intra operative ureter lesion is 30% and it could rise up to 90% when cystoscopy with ureteroscopy is used at the end of the intervention. The article presents the case of a 46-year-old patient with uterine fibromatosis, whose pelvic ureter was sectioned during surgery. The lesion was recognised during surgery because, at the end of each intervention, the diuresis was stimulated by injecting Furosemide in order to detect the lesions of the ureters and urinary bladder. PMID:25408763

Stoica, Ra; Enache, T; Iordache, N

2014-09-15

24

Fused ureters in patient with horseshoe kidney and aortic abdominal aneurysm  

PubMed Central

Horseshoe kidney (HSK) is a very common developmental abnormality in the kidney. They are associated with abnormalities like multiple renal arteries, abnormal position of the ureter in the renal pelvis and highly placed ureteropelvic junction. These can result in urological complications. However, the ureters run their separate course and empty individually into the urinary bladder. Surprisingly, anatomical anomalies do occur and can lead to unexpected findings on investigation or surgical treatment. Such anomalies can present diagnostic and management challenges to unsuspecting clinicians. This report deals with one of such anomalies that seem not to have been reported before in the literature. This case is a rare finding of fused ureters over the renal isthmus in a patient with HSK who also has aortic abdominal aneurysm (AAA). Simultaneous occurrences of HSK and AAA have been reported severally in the past, and the authors are paying attention on the ureteral anomaly. PMID:25433080

Obidike, Stephen; Woha, Akeh; Aftab, Fuad

2014-01-01

25

Metachronous Primary Adenocarcinoma of Distal and Proximal Ureter within Two Years  

PubMed Central

Primary adenocarcinoma of the upper urinary tract, particularly of the ureter, is an extremely rare entity. We are reporting on the first case of metachronous appearance in one patient. The 71-year-old man underwent partial ureterectomy (R0 resection) for primary adenocarcinoma of the left distal ureter. 3 years later, nephroureterectomy had to be performed because of metachronous primary adenocarcinoma of the left proximal ureter. Extensive examinations revealed no evidence for further malignancies at both times. Primary adenocarcinoma of the upper urinary tract is rare but should be kept in mind, especially in patients with chronic inflammation and urinary tract obstruction. Due to the low incidence, there is a lack of data regarding its pathogenesis, diagnosis, and optimal treatment. PMID:24982812

Abt, Dominik; Müllhaupt, Gautier; Mordasini, Livio; Diener, Pierre André; Schmid, Hans-Peter

2014-01-01

26

Intra operative lesion of the pelvic ureter solved in a minimally invasive manner  

PubMed Central

Abstract Ureteral lesions during open hysterectomy, vaginal hysterectomy or laparoscopic hysterectomy have a rate of 0.2% up to 6%. Multiple complications may occur if the lesion is not recognised intra operatively: hydronephrosis, anuria (bilateral lesion), ureterovaginal fistula, ileus, peritonitis. The rate of recognition of an intra operative ureter lesion is 30% and it could rise up to 90% when cystoscopy with ureteroscopy is used at the end of the intervention. The article presents the case of a 46-year-old patient with uterine fibromatosis, whose pelvic ureter was sectioned during surgery. The lesion was recognised during surgery because, at the end of each intervention, the diuresis was stimulated by injecting Furosemide in order to detect the lesions of the ureters and urinary bladder.

Stoica, RA; Enache, T; Iordache, N

2014-01-01

27

Comparison of a New Polytetrafluoroethylene-Covered Metallic Stent to a Noncovered Stent in Canine Ureters  

SciTech Connect

The aim of this study was to determine the feasibility of using a newly designed polytetrafluoroethylene (PTFE)-covered metallic stent in the ureter by comparing its effectiveness with that of the noncovered stent in a canine model. We placed 14 stents in the ureters of seven mongrel dogs that weighed 30-40 kg each. The covered and noncovered stents were deployed in the right and left ureters, respectively, of six dogs. In the seventh dog, a covered stent and a double-J catheter were inserted in the right ureter, and a covered stent only was inserted in the left ureter. The first six dogs were sacrificed at 5, 10, and 15 weeks after deployment of the stents (two for each follow-up period), and the seventh dog was sacrificed at 30 weeks. There was no migration or poor expansion of any of the stents observed on plain radiography. On intravenous pyelogram and retrograde pyelogram, all of the covered stents at each follow-up period had patent lumens at the stented segments without hydronephrosis, and the passage of contrast material through it was well preserved. The noncovered stents in the dogs sacrificed at 5 and 10 weeks and one of the two dogs sacrificed at 15 weeks showed near-complete occlusion of the stent lumen due to ingrowth of the soft tissue, and severe hydronephrosis was also noted. The noncovered stent in the other dog sacrificed at 15 weeks showed the passage of contrast material without hydronephrosis, but the lumen of the stent was still nearly occluded by the soft tissue. There was no evidence of hydronephrosis or passage disturbance of the contrast material in both ureters of the dog sacrificed at 30 weeks. We conclude that the newly designed PTFE-covered stent effectively prevented the luminal occlusion caused by urothelial hyperplasia compared to the near-total occlusion of the noncovered stents, and no migration of the covered stents was noted.

Chung, Hwan-Hoon, E-mail: chungmic@korea.ac.kr; Lee, Seung Hwa; Cho, Sung Bum [Ansan Hospital, Korea University College of Medicine, Department of Radiology (Korea, Republic of); Park, Hong Suk [Korea University, Ansan Hospital, Department of Urology (Korea, Republic of); Kim, Young Sik [Korea University, Ansan Hospital, Department of Pathology (Korea, Republic of); Kang, Byung Chul [Ewha Women's University, Mokdong Hospital, Department of Radiology (Korea, Republic of); Frisoli, Joan K.; Razavi, Mahmood K. [Stanford University Medical Center, Department of Vascular and Interventional Radiology (United States)

2008-05-15

28

[Triple ureter. One case. Diagnostic problem and review of the literature (author's transl)].  

PubMed

In the light of a case of right triple ureter in a 5 month old girl, the authors review the embryology of the ureter and describe the different types of triplication. A general review of the literature including 70 cases gives an indication of the circumstances of discovery and the contribution of radiology. The complications of complete ureteral triplication are the same but greater than those of complete duplication and are related to the ectopic position of the ureteral orifices with regard to the trigone. They are dominated by reflux and stasis in the case of high ectopia and by false incontinence (20% of cases) in low ectopia. PMID:874925

Marc, J; Drouillard, J; Bruneton, J N; Tavernier, J

1977-01-01

29

[Ectopic vaginal ureterocele in ureter from the middle caliceal group and homolateral triplication].  

PubMed

We present the case of a 12-year old girl that presented during a four month period urinary incontinence alternating with normal micturitions, vaginal flow and bacteriuria. IVP shows a pyeloureteral duplication in the right side. The superior and inferior calyceal groups meet in a normal ureter whereas the middle calyceal group is open in one megaureter with ureterocele in medial and extravesical situation, probably vaginal or uterine. During operation a third blind ureter was found connected to the "ureterocele" and medial to the ectopic megaureter. A bibliographical survey is made and surgical and embriological data are commented. PMID:6881758

Agra Cadarso, B; Romeo Martínez, C; Rodríguez Costa, A; Luque Mialdea, R; Montero Redondo, A

1983-04-01

30

Lithiasis inside a blind-ending branch of a trifid ureter  

Microsoft Academic Search

A case of lithiasis inside a blind-ending branch of a trifid ureter is presented. This is a very uncommon anomaly and its\\u000a association with lithiasis is not previously reported. The diagnosis was made by means of excretory urography followed by\\u000a computed tomography (CT). The embriology, classification, and clinical aspects of such malformation are discussed.

P. R. Baró; C. Ll. Juliá

1989-01-01

31

Cytokeratin 15 Marks Basal Epithelia in Developing Ureters and Is Upregulated in a Subset of Urothelial Cell Carcinomas  

PubMed Central

The mammalian ureter contains a water-tight epithelium surrounded by smooth muscle. Key molecules have been defined which regulate ureteric bud initiation and drive the differentiation of ureteric mesenchyme into peristaltic smooth muscle. Less is known about mechanisms underlying the developmental patterning of the multilayered epithelium characterising the mature ureter. In skin, which also contains a multilayered epithelium, cytokeratin 15 (CK15), an acidic intermediate filament protein, marks cells whose progeny contribute to epidermal regeneration following wounding. Moreover, CK15+ precursor cells in skin can give rise to basal cell carcinomas. In the current study, using transcriptome microarrays of embryonic wild type mouse ureters, Krt15, coding for CK15, was detected. Quantitative polymerase chain reaction analyses confirmed the initial finding and demonstrated that Krt15 levels increased during the fetal period when the ureteric epithelium becomes multilayered. CK15 protein was undetectable in the ureteric bud, the rudiment from which the ureter grows. Nevertheless, later in fetal development, CK15 was immunodetected in a subset of basal urothelial cells in the ureteric stalk. Superficial epithelial cells, including those positive for the differentiation marker uroplakin III, were CK15-. Transformation-related protein 63 (P63) has been implicated in epithelial differentiation in murine fetal urinary bladders. In wild type fetal ureters, CK15+ cells were positive for P63, and p63 homozygous null mutant ureters lacked CK15+ cells. In these mutant ureters, sections of the urothelium were monolayered versus the uniform multilayering found in wild type littermates. Human urothelial cell carcinomas account for considerable morbidity and mortality. CK15 was upregulated in a subset of invasive ureteric and urinary bladder cancers. Thus, in ureter development, the absence of CK15 is associated with a structurally simplified urothelium whereas, postnatally, increased CK15 levels feature in malignant urothelial overgrowth. CK15 may be a novel marker for urinary tract epithelial precursor cells. PMID:24260555

Tai, Guangping; Ranjzad, Parisa; Marriage, Fiona; Rehman, Samrina; Denley, Helen; Dixon, Jill; Mitchell, Karen; Day, Philip J. R.; Woolf, Adrian S.

2013-01-01

32

Human Papillomavirus DNA in Triple Neoplasms of the Cervix, Perianus and Ureter in One Woman  

Microsoft Academic Search

Background: Multiple malignancies of the urogenital tract have been reported. We investigated the etiological role of human papillomavirus (HPV) in the pathogenesis of urogenital cancers. Case: We present a case of cervical squamous carcinoma in a 64-year-old woman who subsequently developed Bowen’s disease in the perianal skin and transitional cell carcinoma of the ureter. HPV DNA was detected in these

Lee-Wen Huang; Hun-Shan Pan; Yu-Hung Lin; Kuang-Yu Chou

2007-01-01

33

Hernia of the bladder through the broad ligament with renal agenesis and ipsilateral ureter blind ending  

PubMed Central

Hernia through a defect of the broad ligament is extremely rare in children. These defects can result from a developmental defect or a spontaneous rupture of cystic formations remnants of mesonephric ducts or Müller. Genital anomalies associated with unilateral renal agenesis are more common in females. We report the case of a 13 months girl allowed for assessment of recurrent urinary tract infection; abdominal examination did not objectified palpable mass, the external genitalia were without abnormalities. Abdominal ultrasound revealed a left renal space is empty with a retrovesical cyst. Cystography was requested that objectified a large pelvic cystic mass retrovesical communicating with the bladder, there was also a left vesicoureteral reflux. Uro- MRI showed a cystic formation retrovesical communicating with the bladder, the right pelvic kidney; uterus is normal size for age. DMSA scintigraphy confirmed the absence of the left kidney with the right kidney that ensures 100% of total renal function. To surgical exploration we found a hernia of the bladder through the left broad ligament, the uterus was dislocated on the right side; left ovary was hypoplasic; the ipsilateral ureter was blind with renal agenesis, we performed by reduction of the bladder then closing the hernial orifice, dissection of the ureter with its ligation and section at the vesical stoma. The postoperative course was uneventful. Evolution is favorable. This observation illustrates a hernia of the bladder through the broad ligament associated with ovarian hypoplasia, renal agenesis and ipsilateral ureter blind ending; this association was not described to our knowledge in the literature.

El Madi, Aziz; Khattala, Khalid; Rami, Mohammed; Bouabdallah, Youssef

2014-01-01

34

Retroperitoneal Sarcoma Involving Unilateral Double Ureter: Management, Treatment and Psychological Implications  

PubMed Central

The case of a 45-year-old woman who was admitted to our university hospital for polymenorrhea, weight gain and pain in the left iliac region is reported. An abdominal ultrasound revealed a 9.5 × 5.2-cm, hypoechoic and inhomogeneous mass located on the left side of the pelvis and behind the ovary. The patient underwent surgery. The pelvic mass was firmly anchored to the small intestine, colon, sigma and uterine fundus. After removing the adhesions, double ureters, which had been incorporated in the mass, were observed on the left side. Resection of the unilateral double ureters was necessary in order to remove the entire mass, and thereafter, a left salpingoophorectomy was performed. A histological examination showed a malignant retroperitoneal mass. Termino-terminal ureteral anastomosis with two double-J stents was carried out. Total hysterectomy with preservation of the right adenexum and regional lymphadenectomy was performed. The purpose of this case report is to discuss the physical and psychological implications related to the combination of two rare entities: leiomyosarcoma and a double ureter located within the mass. A literature review on the clinical management and psychological aspects from a female cancer patient's perspective undergoing surgery with the aforementioned disorders will be discussed. PMID:24932171

Leanza, Vito; Garraffo, Claudia; Leanza, Gianluca; Leanza, Antonio

2014-01-01

35

Primary mucinous adenocarcinoma of the renal pelvis with carcinoma in situ in the ureter.  

PubMed

Primary epithelial tumor of the renal pelvis is rare and only 100 cases are reported in the literature [1]. Histological examination of the tumor showed glands, cysts, and papillae lined by pseudostratified columnar epithelium with hyperchromatic nuclei. Scattered signet ring-type cells were also seen floating in large pools of extracellular mucin. Sections from the ureter showed a component of adenocarcinoma in situ. No invasive tumor was identified in ureteric tissue. One case was reported with carcinoma in situ of the ureter (2). Immunohistochemically: The tumor showed positivity for CK7, CK20, CK8/18, GATA-3, MSH-2, MSH-6, MLH-1, Ber-EP4, and S-100-P with focal positivity for CDX-2, weak positivity for PMS-2 and negativity in TTF-1 and Her-2. Molecular pathological analysis revealed microsatellite stability and without mutation in K-ras-gene. Thus, a diagnosis of mucinous adenocarcinoma of the renal pelvis with in situ adenocarcinoma of the ureter was made. PMID:24565683

Abbas, Mahmoud; Kramer, Mario W; Spieker, Tilmann; Herrman, Thomas R W; Merseburger, Axel S; Müller, Klaus-Michael; Kuczyk, Marcus A; Becker, Jan U; Kreipe, Hans-Heinrich

2014-03-01

36

A Rare Case of Upper Ureter Rupture: Ureteral Perforation Caused by Urinary Retention  

PubMed Central

Perforation of the ureter is a rare condition that causes a series of problems including retroperitoneal urinoma, urosepsis, abscess formation, infection, and subsequent renal impairment. There are causative factors that induce ureteric rupture, including malignancy, urinary calculi, idiopathic retroperitoneal fibrosis, recent iatrogenic manipulation, external trauma, degenerative kidney conditions, urography with external compression, and spontaneous causes. We report a rare case of ureteric rupture caused by urinary retention. The patient was treated with temporary percutaneous drainage and antibiotics. The present case illustrates that urinary retention can induce not only bladder rupture, but also ureteric rupture. It is thus of paramount importance to effectively manage patients with voiding problems. PMID:22379594

Choi, Seung-Kwon; Lee, Solmin; Kim, Sunchan; Kim, Tae Gu; Yoo, Koo Han; Lee, Hyung-Lae

2012-01-01

37

Hydrogen Sulfide Plays a Key Role in the Inhibitory Neurotransmission to the Pig Intravesical Ureter  

PubMed Central

According to previous observations nitric oxide (NO), as well as an unknown nature mediator are involved in the inhibitory neurotransmission to the intravesical ureter. This study investigates the hydrogen sulfide (H2S) role in the neurogenic relaxation of the pig intravesical ureter. We have performed western blot and immunohistochemistry to study the expression of the H2S synthesis enzymes cystathionine ?-lyase (CSE) and cystathionine ?-synthase (CBS), measurement of enzymatic production of H2S and myographic studies for isometric force recording. Immunohistochemical assays showed a high CSE expression in the intravesical ureter muscular layer, as well as a strong CSE-immunoreactivity within nerve fibres distributed along smooth muscle bundles. CBS expression, however, was not consistently observed. On ureteral strips precontracted with thromboxane A2 analogue U46619, electrical field stimulation (EFS) and the H2S donor P-(4-methoxyphenyl)-P-4-morpholinylphosphinodithioic acid (GYY4137) evoked frequency- and concentration-dependent relaxations. CSE inhibition with DL-propargylglycine (PPG) reduced EFS-elicited responses and a combined blockade of both CSE and NO synthase (NOS) with, respectively, PPG and NG-nitro-L-arginine (L-NOARG), greatly reduced such relaxations. Endogenous H2S production rate was reduced by PPG, rescued by addition of GYY4137 and was not changed by L-NOARG. EFS and GYY4137 relaxations were also reduced by capsaicin-sensitive primary afferents (CSPA) desensitization with capsaicin and blockade of ATP-dependent K+ (KATP) channels, transient receptor potential A1 (TRPA1), transient receptor potential vanilloid 1 (TRPV1), vasoactive intestinal peptide/pituitary adenylyl cyclase-activating polypeptide (VIP/PACAP) and calcitonin gene-related peptide (CGRP) receptors with glibenclamide, HC030031, AMG9810, PACAP6–38 and CGRP8–37, respectively. These results suggest that H2S, synthesized by CSE, is involved in the inhibitory neurotransmission to the pig intravesical ureter, through an NO-independent pathway, producing smooth muscle relaxation via KATP channel activation. H2S also promotes the release of inhibitory neuropeptides, as PACAP 38 and/or CGRP from CSPA through TRPA1, TRPV1 and related ion channel activation. PMID:25415381

Fernandes, Vítor S.; Ribeiro, Ana S. F.; Martínez, Pilar; López-Oliva, María Elvira; Barahona, María Victoria; Orensanz, Luis M.; Martínez-Sáenz, Ana; Recio, Paz; Benedito, Sara; Bustamante, Salvador; García-Sacristán, Albino; Prieto, Dolores; Hernández, Medardo

2014-01-01

38

IgG4-associated inflammatory pseudotumor of ureter: clinicopathologic and immunohistochemical study of 3 cases.  

PubMed

Inflammatory pseudotumors are lesions characterized by proliferation of fibroblasts/myofibroblasts with variable chronic inflammatory cell infiltration. Recent studies have suggested that inflammatory pseudotumor with abundant IgG4-positive plasma cells may be a unique entity associated with systemic IgG4-related sclerosing disease and should be distinguished from other similar lesions such as inflammatory myofibroblastic tumor and fibrohistiocytic-type inflammatory pseudotumor. Localized inflammatory pseudotumor has been rarely reported in the ureter, and IgG4-associated inflammatory pseudotumor of ureter has not been described. We describe herein 3 cases of ureteral inflammatory pseudotumor of IgG4-associated lymphoplasmacytic type, focusing on density of IgG4-positive plasma cells; infiltration pattern of eosinophils and histiocytes; presence of obliterative phlebitis; and immunohistochemical profiles of smooth muscle actin, anaplastic lymphoma kinase, and CD68. Three patients, 45- and 47-year-old men and 84-year-old woman, all presented with flank pain and ureteral narrowing by a mass effect. Microscopic examination of the resected ureters showed suburothelial masslike lesions with fibroblasts/myofibroblasts without atypia, abundant plasma cells, and scattered eosinophils and histiocytes. The lesion of the 47-year-old man showed obliterative phlebitis in addition to the above findings. The lesion of the 84-year-old woman was accompanied by urothelial carcinoma in situ in the overlying urothelium. Spindle cells were diffusely or focally positive for smooth muscle actin but negative for anaplastic lymphoma kinase in all 3 cases. For each case, respectively, an average of 154, 112, and 50 plasma cells per high-power fields were immunoreactive for IgG4, a diagnostic feature of IgG4 inflammatory pseudotumor. We described 3 cases of IgG4-associated inflammatory pseudotumor of ureter with pathologic and immunohistochemical features that are compatible for lymphoplasmacytic type of inflammatory pseudotumor. Further study is needed to characterize any relationship between this entity and systemic sclerosing disease and/or urothelial carcinogenesis. PMID:21334715

Kim, Sun A; Lee, Sang-Ryung; Huh, Jooryung; Shen, Steven S; Ro, Jae Y

2011-08-01

39

Ectopic Ureter  

MedlinePLUS

... January 2011 You are leaving UrologyHealth.org. The Urology Care Foundation has no control over the content of this site. Click OK to proceed. Urology A - Z A Adrenal Gland Disorders Adrenal Medulla ...

40

Investigating the Flow Dynamics in the Obstructed and Stented Ureter by Means of a Biomimetic Artificial Model  

PubMed Central

Double-J stenting is the most common clinical method employed to restore the upper urinary tract drainage, in the presence of a ureteric obstruction. After implant, stents provide an immediate pain relief by decreasing the pressure in the renal pelvis (P). However, their long-term usage can cause infections and encrustations, due to bacterial colonization and crystal deposition on the stent surface, respectively. The performance of double-J stents - and in general of all ureteric stents - is thought to depend significantly on urine flow field within the stented ureter. However very little fundamental research about the role played by fluid dynamic parameters on stent functionality has been conducted so far. These parameters are often difficult to assess in-vivo, requiring the implementation of laborious and expensive experimental protocols. The aim of the present work was therefore to develop an artificial model of the ureter (i.e. ureter model, UM) to mimic the fluid dynamic environment in a stented ureter. The UM was designed to reflect the geometry of pig ureters, and to investigate the values of fluid dynamic viscosity (?), volumetric flow rate (Q) and severity of ureteric obstruction (OB%) which may cause critical pressures in the renal pelvis. The distributed obstruction derived by the sole stent insertion was also quantified. In addition, flow visualisation experiments and computational simulations were performed in order to further characterise the flow field in the UM. Unique characteristics of the flow dynamics in the obstructed and stented ureter have been revealed with using the developed UM. PMID:24498322

Clavica, Francesco; Zhao, Xuefeng; ElMahdy, Motaz; Drake, Marcus J.; Zhang, Xunli; Carugo, Dario

2014-01-01

41

Investigating the flow dynamics in the obstructed and stented ureter by means of a biomimetic artificial model.  

PubMed

Double-J stenting is the most common clinical method employed to restore the upper urinary tract drainage, in the presence of a ureteric obstruction. After implant, stents provide an immediate pain relief by decreasing the pressure in the renal pelvis (P). However, their long-term usage can cause infections and encrustations, due to bacterial colonization and crystal deposition on the stent surface, respectively. The performance of double-J stents - and in general of all ureteric stents - is thought to depend significantly on urine flow field within the stented ureter. However very little fundamental research about the role played by fluid dynamic parameters on stent functionality has been conducted so far. These parameters are often difficult to assess in-vivo, requiring the implementation of laborious and expensive experimental protocols. The aim of the present work was therefore to develop an artificial model of the ureter (i.e. ureter model, UM) to mimic the fluid dynamic environment in a stented ureter. The UM was designed to reflect the geometry of pig ureters, and to investigate the values of fluid dynamic viscosity (?), volumetric flow rate (Q) and severity of ureteric obstruction (OB%) which may cause critical pressures in the renal pelvis. The distributed obstruction derived by the sole stent insertion was also quantified. In addition, flow visualisation experiments and computational simulations were performed in order to further characterise the flow field in the UM. Unique characteristics of the flow dynamics in the obstructed and stented ureter have been revealed with using the developed UM. PMID:24498322

Clavica, Francesco; Zhao, Xuefeng; ElMahdy, Motaz; Drake, Marcus J; Zhang, Xunli; Carugo, Dario

2014-01-01

42

Mucinous adenocarcinoma of the renal pelvis with adenocarcinoma in situ of the ureter.  

PubMed

Primary epithelial tumor of the renal pelvis is rare, and adenocarcinomas account for less than 1% of malignancies arising from the epithelium of the renal pelvis. We describe in this study a case of a 56-year old male patient who presented with an abdominal mass and dull aching pain for one year. A diagnosis of hydronephrosis of the right kidney was made based on imaging studies. Grossly, the entire kidney was converted into a cystic mass measuring 16 × 12 × 10 cm and filled with gelatinous material along with staghorn calculi in the pelvis measuring 7 × 4 × 3 cm. Histological examination of the tumor showed glands, cysts, and papillae lined by pseudostratified columnar epithelium with hyperchromatic nuclei. Scattered signet ring-type cells were also seen floating in large pools of extracellular mucin. Sections from the ureter showed a component of adenocarcinoma in situ. No invasive tumor was identified in ureteric tissue. Thus, a diagnosis of mucinous adenocarcinoma of the renal pelvis with in situ adenocarcinoma of the ureter was made. PMID:21976933

Raphael, Vandana; Sailo, Stephan; Bhuyan, Ashim; Phukan, Mandeep

2011-09-01

43

Ectopic ureter, renal dysplasia, and recurrent epididymitis in an infant: case report and review of the literature  

PubMed Central

Key Clinical Message The most common etiologies of acute scrotum in boys <1 year of age are torsion of the testis or an appendix, urogenital anomalies, and epididymitis. We report an infant with recurrent epididymitis associated with single-system ectopic ureter opening into the seminal vesicle and dysplastic right kidney. Treatment included nephroureterectomy. PMID:25356227

Dudek-Warchol, Teresa; Szmigielska, Agnieszka; Krzemien, Grazyna; Warchol, Stanislaw

2014-01-01

44

Analgesic abuse, renal parenchymal disease and carcinoma of the kidney or ureter.  

PubMed

In a consecutive series of 88 cases of carcinoma of the kidney and upper urinary tract seen at one hospital, 31 had malignant urothelial tumours of the renal pelvis or ureter. Forty-two per cent of these transitional-cell carcinomas occurred in patients with renal papillary necrosis following upon prolonged and heavy analgesic ingestion. Other possible aetiological factors were heavy cigarette smoking (61% of cases), long standing urinary obstruction or infection (23%) and possible occupational exposure (6%); in only four cases (13%) was there no identifiable aetiological factor. Those cases with analgesic nephropathy were characterised by renal functional impairment, hypertension and interstitial nephritis, but there was no difference in the clinical behaviour or pathological appearances of the tumours in the two groups. The clinical and experimental evidence that certain metabolites of phenacetin are carcinogenic is reviewed. PMID:272165

Mahony, J F; Storey, B G; Ibañez, R C; Stewart, J H

1977-10-01

45

Inverted papilloma of the ureter: study of a rare case with emphasis on clinicopathologic implications  

PubMed Central

A 62-year old male patient presented complaining of intermittent macroscopic hematuria. The ultrasonographic investigation revealed a hydronephrosis of remarkable degree with indiscrete renal parenchyma. The abdominal computed tomography scan identified a ureteral lesion with proximal dilatation, hydronephrosis and a functionless ipsilateral renal unit. The retrograde urography showed a 4-cm lesion with multiple filling defects and a smooth contour. The endoscopic examination showed an exophytic lesion, highly suspicious for malignancy. Urine cytology revealed atypia. Right nephroureterectomy was performed and the pathology revealed a ureteral inverted papilloma (UIP). Polymerase chain reaction examination for the presence of human papilloma virus, using GP5+/6+ consensus primers, was negative. The presence UIP should be considered in patients with urotheleal lesions in the ureter when the diagnostic workup for malignancy is inconclusive. The clinical course of the disease seems to be favorable. PMID:23283103

Mertziotis, Nikolaos; Kozyrakis, Diomidis; Petrolekas, Andreas; Terzi, Maria; Kapranos, Nikiforos

2012-01-01

46

Metastatic Prostate Adenocarcinoma Posing as Urothelial Carcinoma of the Right Ureter: A Case Report and Literature Review  

PubMed Central

This is a case report of a 67-year-old patient with distant metastasis of prostate cancer to the right ureter which caused hydronephrosis. At the beginning, both of the cytology of the morning urine and imaging findings were consistent with urothelial carcinoma. Nephroureterectomy was subsequently performed. Interestingly, the pathological examination of the excised ureter revealed that the malignancy was derived from the prostate. No skeletal metastasis was detected. However, after four months of follow-up, several abnormal signal shadows were reported in skeletal scintigraphy and the prostate specific antigen (PSA) was gradually increasing. We present such a case for its unique presentation. A review of the literature is also provided. PMID:25197608

Huang, Tian-bao; Yan, Yang; Liu, Huan; Che, Jian-ping; Wang, Guang-chun; Liu, Min; Zheng, Jun-hua; Yao, Xu-dong

2014-01-01

47

Direct effects of vardenafil on the ureter: in vitro investigation and potential clinical applications of intralumenal administration.  

PubMed

Local intralumenal administration of substances with beneficial effects over the ureter appears to be a very attractive route for the administration of drugs to the urinary system, avoiding systemic adverse reactions associated with per os administration. This work investigates whether vardenafil is a good candidate for local intralumenal ureteral administration. More precisely, we examined the effect of vardenafil on human ureter contractility and on the viability of cultured human urothelial cells (hUC) and bladder smooth muscle cells (hBSMC). Our study revealed that vardenafil induced a dose-depended relaxation of isolated human ureteral tissue. In addition, growth and cell viability of cultured hBSMC and hUC remained unaltered after vardenafil application. Based on the above, this selective phosphodiesterase type 5 inhibitor can be considered as a promising pharmacologic agent for local intralumenal administration in clinical conditions in which ureteral dilation might be beneficial. PMID:23763505

Liatsikos, Evangelos; Kyriazis, Iason; Neuhaus, Jochen; Kallidonis, Panagiotis; Georgiopoulos, Ioannis; Franz, Toni; Al-Aown, Abdulrahman; Sakellaropoulos, George; Stolzenburg, Jens-Uwe

2013-11-01

48

A Novel Type of Ureteral Stents in the Treatment of a Bilateral Iatrogenic Transaction of the Ureters  

PubMed Central

This report illustrates the case of a patient who suffered an iatrogenic complete injury of both ureters after a complex surgical procedure to remove a large sacral chordoma. Ureteral recanalization was achieved with two removable, autoexpandable, and polytetrafluoroethylene covered nitinol stents. To our knowledge, we describe the first application of this type of stents to treat a bilateral ureteral transection. Despite the bad general conditions of the patient, the ureteral stents successfully restored and maintained the bilateral ureteral continuity. PMID:23984172

Mazza, Ernesto; Mondaini, Francesco; Abdulcadir, Dalmar; Raspanti, Claudio; Citone, Michele; Lapini, Alberto

2013-01-01

49

A novel type of ureteral stents in the treatment of a bilateral iatrogenic transaction of the ureters.  

PubMed

This report illustrates the case of a patient who suffered an iatrogenic complete injury of both ureters after a complex surgical procedure to remove a large sacral chordoma. Ureteral recanalization was achieved with two removable, autoexpandable, and polytetrafluoroethylene covered nitinol stents. To our knowledge, we describe the first application of this type of stents to treat a bilateral ureteral transection. Despite the bad general conditions of the patient, the ureteral stents successfully restored and maintained the bilateral ureteral continuity. PMID:23984172

Mazza, Ernesto; Mondaini, Francesco; Abdulcadir, Dalmar; Raspanti, Claudio; Citone, Michele; Lapini, Alberto

2013-01-01

50

Bilateral Single Ectopic Ureters Draining Into a Grossly Dilated Vagina in an Adolescent Female  

PubMed Central

A 16-year-old female presented with dribbling of urine along with voluntary voiding since birth. Renal imaging revealed hydroureteronephrosis on the right side; the uterus and ovary were normal. A radionuclide scan showed a left nonfunctional kidney. On cystovaginoscopy, the urethra was shown to be normal and the urinary bladder was tubular with small capacity and an absent trigone. Although the vagina was capacious, no ureteric orifices were found. Computed tomography corroborated the diagnosis of bilateral, single ectopic ureters draining into a grossly dilated vagina. This case is unique because it is a bilateral single-system ureteral ectopia in a completely differentiated female genital tract that presented late in adolescence. To the best of our knowledge, this is the second such ureteral abnormality reported in the literature so far. The patient underwent ileocystoplasty with right ureteric reimplantation and nephroureterectomy for the left nonfunctional kidney, which histopathology showed to be tuberculosis. The patient is continent with cystometric capacity of more than 300 mL. PMID:23878693

Mandal, Soumendra Nath; Kamal, Mir Reza; Mukherjee, Satyadip; Das, Ranjit Kumar; Karmakar, Dilip

2013-01-01

51

Memokath Metallic Stent in the Treatment of Transplant Kidney Ureter Stenosis or Occlusion  

SciTech Connect

Purpose. To determine the efficacy of the Memokath 051 stent (Engineers and Doctors, Hornbaek, Denmark) in the treatment of recurrent ureteral stenosis or occlusion in transplant kidneys. Methods. From October 1985 through January 2004, 1,131 renal transplantations were performed at our center. Four patients who developed recurrent renal transplant ureter obstruction had nephrostomy catheters placed. Antegrade pyelography showed ureteral stenosis in three cases and complete occlusion in one patient. In each case, a Memokath 051 stent was inserted via an antegrade approach. Mean follow-up was 20 months (range 18-21 months). Creatinine levels were measured and ultrasonography was performed during follow-up. Results. All stent procedures were technically successful. During follow-up, one stent migrated within 10 days after stent insertion and was removed cystoscopically. Another stent had to be removed in the 14th month due to resistant infection, and was replaced with a new Memokath 051 stent which remained patent for another 8 months. The other two stents were fully patent at the 18th and 21st month of follow-up, respectively. Conclusion. Placement of a Memokath 051 stent appears to be a promising treatment alternative to balloon dilation, double-J stents and open surgical intervention for ureteral stenosis or occlusion in kidney transplant recipients. Further study of larger series is necessary.

Boyvat, Fatih, E-mail: fboyvat@baskent-ank.edu.tr, E-mail: boyvatf@yahoo.com; Aytekin, Cuneyt [Baskent University Faculty of Medicine, Department of Radiology (Turkey); Colak, Turan [Baskent University Faculty of Medicine, Department of Nephrology (Turkey); Firat, Ali [Baskent University Faculty of Medicine, Department of Radiology (Turkey); Karakayali, Hamdi; Haberal, Mehmet [Baskent University Faculty of Medicine, Department of General Surgery (Turkey)

2005-04-15

52

The Effect of Terpene Combination on Ureter Calculus Expulsion After Extracorporeal Shock Wave Lithotripsy  

PubMed Central

Purpose Terpene combination (Rowatinex) is known to help with the expulsion of urinary stones. The aim of this study was to determine how Rowatinex affects the expulsion of remnant stones after shock wave lithotripsy (SWL). Materials and Methods Clinical data were collected retrospectively from 499 patients with a diagnosis of ureteral stones who underwent SWL from January 2009 to August 2012. Ureteral stones were diagnosed in all patients by kidney, ureter, and bladder x-ray and abdominal computed tomography (CT). The progress of patients was documented every 2 weeks to confirm remnant stones after SWL. The patients with remnant stones underwent SWL again. Group 1 consisted of patients who were prescribed an analgesic, Tamsulosin 0.2 mg, and Rowatinex. Group 2 consisted of patients who were prescribed only an analgesic and Tamsulosin 0.2 mg. The expulsion rate of urinary stones was compared between groups. Results The expulsion rate of urinary stones was not significantly different between the two groups after 2 weeks. However, after 4 weeks, group 1 had a significantly higher expulsion rate (72.2% compared with 61.1%, p=0.022). Fifteen patients (10.2%) in group 1 and 40 (11.4%) in group 2 had to undergo ureteroscopic removal of the stone (p=0.756). Acute pyelonephritis occurred in one patient (0.7%) in group 1 and in one patient (0.3%) in group 2 (p=0.503). Conclusions The long-term administration of Rowatinex for 4 weeks increased the expulsion rate of urinary stones after SWL. PMID:24466395

Kim, Dai Hee; Goh, Hyeok Jun; Lee, Ho Won; Kim, Kyu Shik; Kim, Yong Tae; Moon, Hong Sang; Lee, Seung Wook

2014-01-01

53

Routes of Absorption in Hydronephrosis: Experimentation with Dyes in the Totally Obstructed Ureter 1  

PubMed Central

In hydronephrosis the contents of the renal pelvis are constantly being changed. The exact mode of the interchange is still obscure. With the hope of obtaining some evidence of this absorption, a series of experiments has been carried out, introducing dyes at various periods in total hydronephrosis. The findings of previous experimental work on the subject are conflicting. Two views are held; one, that absorption occurs solely through the tubular system, and the other, that there is a direct outflow from the renal pelvis into the venous system. In the present work only such an amount of dye was introduced in each instance as to be well within the pelvic capacity of the type of kidney (rabbit). The factor of positive pressure forcing the dye into abnormal channels was thus reduced to a minimum. Two groups of experiments were undertaken. In Group I, the dye was introduced at the outset of the hydronephrosis, and in Group II the dye was introduced at varying periods in the course of an established hydronephrosis. The results obtained would indicate that in total hydronephrosis there are two routes of absorption from the renal pelvis, i.e., lymphatic and tubular. At the outset of complete ureteral obstruction there ensues for the first two or three days an active lymphatic absorption from the walls of the renal pelvis and ureter. After about the third day, tubular absorption commences and continues more actively than the lymphatic. If, however, dye is not introduced till the third day of a hydronephrosis, there is rapid tubular absorption but no lymphatic absorption. With longer periods of hydronephrosis the dye is drawn up the tubule system as far as the convoluted tubules. The further absorption of dye into the general system has not yet been obtained. PMID:19986763

Morison, Duncan M.

1928-01-01

54

Alleviation of Kidney Damage Induced by Unilateral Ureter Obstruction in Rats by Rhodiola rosea  

PubMed Central

Abstract Purpose To evaluate the efficacy of Rhodiola rosea extract in terms of alleviating the renal damage induced by unilateral ureter obstruction (UUO) in rats. Material and Methods Thirty Wistar albino male rats were divided into five groups: (I) Control, (II) UUO 7 days, (III) UUO 7 days+extract,(IV) UUO 14 days, and (V) UUO 14 days+extract. Seven or 14 days after the initiation of the experimental procedure, the left kidneys of rats in all five groups were removed for histological examination, and their blood was drawn for biochemical measurements. Result Median malondialdehyde (MDA) and glutathione peroxidase (GPx) levels were, respectively, 39.4 (5.04) nmol/mL and 25.8 (8.01) nmol/minute/mL in group I, 77.9 (12.38) nmol/mL and 5.8 (1.95) nmol/minute/mL in group II, 48.7 (12.1) nmol/mL and 9.1 (2.3) nmol/minute/mL in group III, 58.5 (23.83) nmol/mL and 8.4 (2.1) nmol/minute/mL in group IV, and 44.8 (4.97) nmol/mL and 13.8 (3.73) nmol/minute/mL in group V. There was a statistically significant difference among the groups in terms of MDA and GPx levels (p<0.05 for both). The median numbers of apoptotic cells were 1 (1), 8 (2.25), 3 (1.25), 23.5 (9), and 7 (I) in groups I, II, III, IV, and V, respectively. There was a statistically siginificant difference among the groups in terms of apoptotic cell number (p<0.05). Conclusion R. rosea extract was shown to alleviate the renal damage induced by UUO through its antioxidant effects. The mechanism by which R. rosea extract causes these effects merits further investigation. PMID:23806024

Terzi, E. Hakan; Kemahli, Eray; Gucuk, Adnan; Tosun, Mehmet; Cetinkaya, Ayhan

2013-01-01

55

Effect of the Ca(2+)-ATPase inhibitor, cyclopiazonic acid, on electromechanical coupling in the guinea-pig ureter.  

PubMed Central

1. We have investigated the effect of the sarcoplasmic reticulum (SR) Ca(2+)-ATPase inhibitor, cyclopiazonic acid (CPA), on electromechanical coupling in the guinea-pig ureter. All experiments were performed in capsaicin-pretreated (10 microM for 15 min) ureters to prevent the release of sensory neuropeptides from afferent nerves. 2. In organ bath experiments, electrical field stimulation (EFS, 10 Hz for 1 s, 5 ms pulse width, 60 V) produced tetrodotoxin- (1 microM) resistant phasic contractions which were enhanced by Bay K 8644 (1 microM) and abolished by nifedipine (10-30 microM). 3. CPA (10 microM) enhanced the EFS-evoked contractions both in the absence and presence of Bay K 8644. The effect of CPA was concentration-dependent between 1 and 30 microM. The response to 10 microM CPA was biphasic: the maximal enhancement (58 +/- 3% increase) was observed within 10-20 min from CPA administration, followed by a decline to a new steady state (25 +/- 5% increase over baseline) at 50-60 min. The effect of CPA was reversed by washout. 4. Ryanodine (100 microM) produced a prompt enhancement of the EFS-evoked contractions of the guinea-pig ureter, which peaked at 42 +/- 3% increase over baseline; the co-administration of CPA (10 microM) and ryanodine (100 microM) produced a peak effect (60 +/- 8% enhancement) which was not different from that produced by CPA alone. With either ryanodine alone or ryanodine plus CPA, the enhancement of the EFS-induced contractions was biphasic, showing a time-course similar to that observed with CPA alone. Tetraethylammonium (10 mM) produced a significantly larger effect (93 +/- 13% increase over baseline) and its effect was sustained throughout the 60 min observation period. 5. In the presence of Bay K 8644, superfusion for 30 min with a low Na+ medium (60% of extracellular Na+ replaced by Li+ or choline) reduced the amplitude of EFS-evoked contractions by 20-35%. In both Li(+)- and choline-substituted media, spontaneous activity developed during superfusion with low Na+ Krebs solution which was suppressed by 10 microM nifedipine. CPA (10 microM) produced a marked enhancement of the EFS-evoked contractions in low-Na+ medium (both Li(+)- and choline-substituted) and this effect was sustained throughout the 60 min observation period.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:7536095

Maggi, C A; Giuliani, S; Santicioli, P

1995-01-01

56

Complex genital malformation: ectopic ureter ending in a supposed mesonephric duct in a woman with renal agenesis and ipsilateral blind hemivagina  

Microsoft Academic Search

We present a clinical case of a patient with left renal agenesis and ipsilateral blind hemivagina who also had one or more atretic ectopic ureters opening into supposed mesonephric duct, which in turn opened into, or joined onto, the ipsilateral hemicervix, continuing with the blind hemivagina. The diagram of this complex genitourinary malformation would strongly support our hypothesis of the

Pedro Acién; Francisco Susarte; Jesús Romero; Joaqu??n Galán; Mar??a-José Mayol; Francisco J. Quereda; Marisa Sánchez-Ferrer

2004-01-01

57

Effect of Overexpression of Glucose-Regulated Protein 78 and Bcl-2 on Recurrence and Survival in Patients With Ureter Tumors  

PubMed Central

Purpose The utility of the expression of glucose-regulated protein 78 (GRP78) in the evaluation of prognosis depends on the type of tumor. Hence, we aimed to examine the impact of expression of GRP78 and Bcl-2, which are used in the existing prognostic evaluation of ureter tumors, in the evaluation of recurrence and survival rates of ureter tumors. Materials and Methods In 53 patients who had undergone radical nephroureterectomy for a ureter tumor from March 2002 to March 2012, age, sex, T stage, nuclear grade, bladder recurrence, and survival rate were analyzed at the time of the patient's surgery depending on the extent of immunohistochemical expression of GRP78 and Bcl-2. Results GRP78 was overexpressed in 25 patients (47.2%). When GRP78 was overexpressed, there was a high T stage (p=0.001) and nuclear grade (p=0.007) and a lot of bladder recurrence (40.0%, p=0.034). Bcl-2 was overexpressed in 16 patients (30.1%), and there were no significant associations with any risk factors (p>0.05, respectively). In the multivariate analysis regarding bladder recurrence, the recurrence rate was higher with higher pT stage (p=0.048) and when GRP78 (p=0.033) was overexpressed. In the Kaplan-Meier survival analysis, although the survival rate was significantly lower in the group in which GRP78 was overexpressed (p=0.03), there was no correlation between Bcl-2 overexpression and survival rate (p=0.07). Conclusions Patients with ureter tumors who had overexpression of GRP78 had a high T stage and nuclear grade, a lot of bladder recurrence, and a low survival rate. Therefore, if GRP78 is overexpressed in ureter tumor patients, active postoperative follow-up should be carried out. PMID:24175040

Park, Chang Hyun; Choi, Mi Sun; Ha, Ji Yong; Kim, Byung Hoon; Park, Choal Hee

2013-01-01

58

Prognostic factors in urothelial renal pelvis and ureter tumours: a multicentre Rare Cancer Network study 1 Presented at the 39th Annual Meeting of the American Society for Therapeutic Radiology and Oncology, Orlando, Florida, 19–23 October 1997. 1  

Microsoft Academic Search

To assess the prognostic factors in patients with transitional-cell carcinoma of the renal pelvis and\\/or ureter, a series of 138 patients with transitional-cell carcinoma of the renal pelvis and\\/or ureter was collected in a retrospective multicentre study. 12 patients with distant metastases were excluded from the statistical evaluation. All but 3 patients underwent radical surgery: nephroureterectomy (n=71), nephroureterectomy and lymphadenectomy

M. Ozsahin; A. Zouhair; S. Villà; G. Storme; B. Chauvet; D. Taussky; D. Gouders; G. Ries; P. Bontemps; P. A. Coucke; R. O. Mirimanoff

1999-01-01

59

Philureter trigoniopsis, a new genus and species (Dactylogyridae, Ancyrocephalinae) from the ureters and urinary bladder of Galaxias maculatus (Osmeriformes: Galaxiidae) in Patagonia (Argentina).  

PubMed

The monotypic Philureter n. gen. (Ancyrocephalinae; Dactylogyridae) is proposed to accommodate Philureter trigoniopsis n. sp. with the following features: presence of a cuplike ventral haptor armed with 14 hooks and 2 anchor/bar complexes; dorsal pair of anchors poorly defined and variable in shape, 1 frequently absent; tandem, intercecal gonads, testis bilaterally lobulated. Philureter trigoniopsis n. sp. is described from the ureters and urinary bladder of Galaxias maculatus (Jenyns, 1842) (Osmeriformes) in Patagonian Andean lakes, Argentina. PMID:11318570

Viozzi, G P; Gutiérrez, P A

2001-04-01

60

Functional characterization of the vertebrate primary ureter: Structure and ion transport mechanisms of the pronephric duct in axolotl larvae (Amphibia)  

PubMed Central

Background Three kidney systems appear during vertebrate development: the pronephroi, mesonephroi and metanephroi. The pronephric duct is the first or primary ureter of these kidney systems. Its role as a key player in the induction of nephrogenic mesenchyme is well established. Here we investigate whether the duct is involved in urine modification using larvae of the freshwater amphibian Ambystoma mexicanum (axolotl) as model. Results We investigated structural as well as physiological properties of the pronephric duct. The key elements of our methodology were: using histology, light and transmission electron microscopy as well as confocal laser scanning microscopy on fixed tissue and applying the microperfusion technique on isolated pronephric ducts in combination with single cell microelectrode impalements. Our data show that the fully differentiated pronephric duct is composed of a single layered epithelium consisting of one cell type comparable to the principal cell of the renal collecting duct system. The cells are characterized by a prominent basolateral labyrinth and a relatively smooth apical surface with one central cilium. Cellular impalements demonstrate the presence of apical Na+ and K+ conductances, as well as a large K+ conductance in the basolateral cell membrane. Immunolabeling experiments indicate heavy expression of Na+/K+-ATPase in the basolateral labyrinth. Conclusions We propose that the pronephric duct is important for the subsequent modification of urine produced by the pronephros. Our results indicate that it reabsorbs sodium and secretes potassium via channels present in the apical cell membrane with the driving force for ion movement provided by the Na+/K+ pump. This is to our knowledge the first characterization of the pronephric duct, the precursor of the collecting duct system, which provides a model of cell structure and basic mechanisms for ion transport. Such information may be important in understanding the evolution of vertebrate kidney systems and human diseases associated with congenital malformations. PMID:20507566

2010-01-01

61

Contribution of ?-adrenoceptor subtypes to relaxation of colon and oesophagus and pacemaker activity of ureter in wildtype and ?3-adrenoceptor knockout mice  

PubMed Central

The smooth muscle relaxant responses to the mixed ?3-, putative ?4-adrenoceptor agonist, (?)-CGP 12177 in rat colon are partially resistant to blockade by the ?3-adrenoceptor antagonist SR59230A suggesting involvement of ?3- and putative ?4-adrenoceptors. We now investigated the function of the putative ?4-adrenoceptor and other ?-adrenoceptor subtypes in the colon, oesophagus and ureter of wildtype (WT) and ?3-adrenoceptor knockout (?3KO) mice.(?)-Noradrenaline and (?)-adrenaline relaxed KCl (30?mM)-precontracted colon mostly through ?1-and ?3-adrenoceptors to a similar extent and to a minor extent through ?2-adrenoceptors. In colon from ?3KO mice, (?)-noradrenaline was as potent as in WT mice but the effects were mediated entirely through ?1-adrenoceptors. (?)-CGP 12177 relaxed colon from ?3KO mice with 2 fold greater potency than in WT mice. The maintenance of potency for (?)-noradrenaline and increase for (?)-CGP 12177 indicate compensatory increases in ?1- and putative ?4-adrenoceptor function in ?3KO mice.In oesophagi precontracted with 1??M carbachol, (?)-noradrenaline caused relaxation mainly through ?1-and ?3-adrenoceptors. (?)-CGP 12177 (2??M) relaxed oesophagi from WT by 61.4±5.1% and ?3KO by 67.3±10.1% of the (?)-isoprenaline-evoked relaxation, consistent with mediation through putative ?4-adrenoceptors.In ureter, (?)-CGP 12177 (2??M) reduced pacemaker activity by 31.1±2.3% in WT and 31.3±7.5% in ?3KO, consistent with mediation through putative ?4-adrenoceptors.Relaxation of mouse colon and oesophagus by catecholamines are mediated through ?1- and ?3-adrenoceptors in WT. The putative ?4-adrenoceptor, which presumably is an atypical state of the ?1-adrenoceptor, mediates the effects of (?)-CGP 12177 in colon, oesophagus and ureter. PMID:10864880

Oostendorp, Jaap; Preitner, Frederic; Moffatt, James; Jimenez, Maria; Giacobino, Jean Paul; Molenaar, Peter; Kaumann, Alberto Julio

2000-01-01

62

Results of a Seven-Year, Single-Centre Experience of the Long-Term Outcomes of Bovine Ureter Grafts Used as Novel Conduits for Haemodialysis Fistulas  

SciTech Connect

Purpose: To report the long-term outcomes of bovine ureter grafts as novel conduits for haemodialysis fistulas. Materials and Methods: Thirty-five patients underwent placement of a total of 40 SynerGraft 100 (SG100; CryoLife Europa{sup Registered-Sign}, Guildford, UK) bovine ureter grafts between April 2002 and February 2009. Prospective data were collected on all patients, including active surveillance with blood flow studies and 6-monthly duplex ultrasound studies. Main outcome measures were primary and secondary patency rates. Results: Mean follow-up time was 97 weeks (range 4-270). Thirteen patients died from unrelated causes during the study period; 12 of these patients had a functioning graft at the time of death. Five patients underwent transplantation, and all had a functioning graft at transplantation. Twelve patients had a functioning graft at the end of the study period. One hundred and ten stenoses were detected, and 97 venoplasty procedures were performed. Of the stenoses, 41.8% were located at the venous anastomosis, 12.7% within the graft, 17.3% in the outflow veins, and 28.1% in central veins. No arterial stenoses were detected. Primary patency rates were 53% at 6 months and 14% at 1 year. Secondary patency rates were 81% at 6 months, 75% at 1 year, and 56% at 2 years. Conclusions: Active surveillance and intervention was able to achieve satisfactory long-term secondary patency for these novel conduits compared with those made of PTFE seen in other studies.

Das, Neelan, E-mail: neelan.das@gmail.com; Bratby, Mark J.; Shrivastava, Vivek [John Radcliffe Hospital, Department of Interventional Radiology (United Kingdom); Cornall, Alison J. [Churchill Hospital, Department of Nephrology (United Kingdom); Darby, Christopher R. [Churchill Hospital, Department of Vascular Surgery (United Kingdom); Boardman, Philip [Churchill Hospital, Department of Interventional Radiology (United Kingdom); Anthony, Susan; Uberoi, Raman [John Radcliffe Hospital, Department of Interventional Radiology (United Kingdom)

2011-10-15

63

Should low-dose computed tomography kidneys, ureter and bladder be the new investigation of choice in suspected renal colic?: A systematic review  

PubMed Central

Introduction: Computed tomography kidneys, ureter and bladder (CTKUB) is the accepted gold standard investigation for suspected renal colic. Dose considerations are particularly pertinent in the context of detecting urolithiasis given the high risk of disease recurrence, which can necessitate multiple radiological examinations over the lifetime of a stone-former. We performed a systematic review of the literature to see whether there was any evidence that reducing the effective radiation dose of a CTKUB compromised the diagnostic accuracy of the scan. Materials and Methods: Relevant databases including MedLine, EMBASE, DARE and the Cochrane Library were searched from inception to October 2012. All English language articles reporting on prospective studies where non-contrast, low-dose CT (LDCT) was used to investigate adults (males and non-pregnant females) presenting with flank pain or suspected urolithiasis were included. LDCT was defined as an effective radiation dose <3 mSv per examination. Results: Our initial search identified 497 records. After removing duplicates, 390 abstracts were screened, of which 375 were excluded, principally because outcomes of interest were not presented. Six papers remained for the final analysis, reporting on a total of 903 patients. Individual studies showed a prevalence of urolithiasis ranging between 36% and 88%, with additional pathologies found in 5-16%. The effective radiation dose of the LDCT techniques used ranged from 0.5 to 2.8 mSv. The sensitivity of LDCT for diagnosing stone disease was 90-97% with a specificity of 86-100%. Conclusions: The sensitivity and specificity of CTKUB for diagnosing urolithiasis remains high, even when the effective radiation dose is lowered. LDCT may miss some small stones (<3 mm), especially in obese patients (>30 kg/m2), but in this group LDCT still identifies most alternative diagnoses. With at least one level 1A and two level 1B studies supporting the use of LDCT, there is Grade A recommendation for its use as the first-line investigation in suspected renal colic in non-obese patients. PMID:24744508

Drake, Tamsin; Jain, Nitin; Bryant, Timothy; Wilson, Iain; Somani, Bhaskar K.

2014-01-01

64

Extrinsic Obstruction of the Ureter  

MedlinePLUS

... Urologic History Museum Awards Job Opportunities Contact Us Urology A - Z Find everything you need to know ... Search All A - Z Patient Information What is Urology? Find a Urologist Healthy Living Tips Common Conditions ...

65

Ureteral triplication with contralateral ureter duplication.  

PubMed

A rare case of ureteral triplication with contralateral duplication is reported. The incidence, embryology, classification and symptomatology are commented. The most relevant literature is reviewed. PMID:1585519

Sánchez-de-Badajoz, E; Ramos, J; Burgos, R

1992-01-01

66

Ultrasound: Renal (Kidneys, Ureters, Bladder) (For Parents)  

MedlinePLUS

... kidney area and images are recorded on a computer. The black-and-white images show the internal ... the images can be seen clearly on the computer screen. A technician (sonographer) trained in ultrasound imaging ...

67

Ureter triplication with contra-lateral partial duplex system.  

PubMed

Ureteral triplication is a rare congenital anomaly of the urinary tract. We report a case of ureteral triplication with contralateral partial kidney duplication in a patient with right loin pain. The development and types of ureteral triplication and the features of type 2 ureteral triplication on intravenous urography and magnetic resonance urography are described. PMID:20527276

Mubarak, M Y; Zainun, A R; Rohaya, M

2009-09-01

68

Robotic surgery of the kidney and ureter in pediatric patients.  

PubMed

Robotic actuators have revolutionized surgery for urologic disorders in pediatric patients. Robotic procedures have become widely available for several different ablative and reconstructive operations in children. The success rates have paralleled those of open surgical techniques and provide the benefit of smaller incisions and less manipulation of tissue during the procedures. Robotics employs increased dexterity, better visualization, and less fatigue, allowing greater precision. We must continue to evolve with the ever-changing advancements in technology and take a keen interest in maintaining our skills to ensure excellent outcomes and patient safety. PMID:23657821

Van Batavia, Jason P; Casale, Pasquale

2013-08-01

69

ATP is released from guinea pig ureter epithelium on distension  

E-print Network

was released from epithelial cells during distension as mechani- cal removal of the urothelium blocked release exocytosis ATP IS RAPIDLY RELEASED from vascular endothelial cells during periods of increased flow, shear from both human and rabbit red blood cells (RBCs) in response to mechanical deforma- tion (48). The ATP

Burnstock, Geoffrey

70

[Elective organ and function preservation in ureter and renal pelvis tumors].  

PubMed

With the technical innovations of smaller, flexible ureteroscopes, color-filtered imaging, and endoscopic laser technology, organ-preserving treatment for upper urinary tract transitional cell carcinoma has become feasible. While in the past, radical nephroureterectomy was the sole gold standard approach for the treatment of upper urinary tract tumors, the endoscopic approach is no longer restricted to only patients with the imperative indication of kidney preservation. Initial clinical results have demonstrated oncologic efficacy of endoscopic management or segmental ureteral resection. However, careful preoperative risk-assessment and close endoscopic follow-up are mandatory. PMID:25148912

Rausch, S; Gakis, G; Bedke, J; Stenzl, A

2014-09-01

71

Urologic emergencies. Conditions affecting the kidney, ureter, bladder, prostate, and urethra.  

PubMed

Prompt, thorough evaluation is needed when patients present with symptoms of renal colic, acute urinary retention, prostatitis, pyelonephritis, and other urologic emergencies. Primary care physicians have an important role in initial workup and treatment. Once the diagnosis is determined, urologic consultation may be necessary for definitive treatment. PMID:8858090

Samm, B J; Dmochowski, R R

1996-10-01

72

Determination of Ureter Stent Appearance on Dual-energy Computed Tomography Scan  

PubMed Central

OBJECTIVE To examine the dual-energy computed tomography (DECT) properties of 7 commonly used ureteral stents to optimize stent selection for calculi monitored using DECT. The use of DECT to evaluate renal and ureteral calculi has recently increased. METHODS Seven stents were individually placed in a fish bowl phantom and imaged using a Siemens Somatom Definition Flash CT scanner. DECT peak tube potentials of 80 and 140 kVp and 100 and 140 kVp were used, reflecting our current dual-energy protocols. These were compared to 31 in vivo stents of known composition. The data were reconstructed on a multimodality Work-Place (Siemens) using CT syngo Post-Processing Suite software. RESULTS The average patient age was 64 years (range 27–90). The average body mass index was 31.9 kg/m2 (range 24–51.6). Of the 27 patients, 4 had uric acid stones and 22 had calcium-based stones; 1 patient had undergone renal transplantation. No difference was seen in the dual-energy characterization of stents from the same manufacturer. All imaged Cook and Bard stents had a dual-energy characterization that approached that of calcium stones (blue). All Boston Scientific and Gyrus ACMI stents had a dual-energy characterization resembling that of uric acid stones (red). CONCLUSION The present study evaluated the stent appearance on DECT for various stent manufacturers. This information will aid in the optimal stent selection for patients undergoing treatment of renal calculi and followed up with DECT. PMID:22921702

Jepperson, Maria A.; Thiel, David D.; Cernigliaro, Joesph G.; Broderick, Gregory A.; Parker, Alexander S.; Haley, William E.

2014-01-01

73

Malignant lymphoma of the ureter: A case report and literature review  

PubMed Central

A 38-year-old male was admitted to Renji Hospital (Shanghai, China) with the major complaint of back pain due to left hydronephrosis. Imaging analysis revealed an area of nodular soft-tissue density in the left ureteral wall. The patient’s left kidney was non-functional. Thus, a left nephroureterectomy was performed for the purpose of pathological diagnosis, and histopathological examination revealed follicular lymphoma. The patient received R-CHOP chemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone) every three weeks. Following six courses of chemotherapy, positron emission tomography-computed tomography revealed that the patient was in complete remission. From this case we showed that in cases where a partial ureteral stenosis with ureteral wall thickening was observed by imaging analysis, further histological examination of tissue samples should be assigned as soon as possible. PMID:24926336

NI, BEI-WEN; ZHONG, LU; WANG, TING; CHEN, FANG-YUAN

2014-01-01

74

The copenhagen case-control study of renal pelvis and ureter cancer: Role of smoking and occupational exposures  

Microsoft Academic Search

95% Cl: 1.0-6.7) and in combination with other types of to- bacco (RR=3.8; 95% Cl: 1.3-11.5). Non-signifscantly increased relative risks were observed for pipe smokers (RR=2.2; 95% Cl: 0.1-97) and for mixed pipe, cigar, and cigarillo smokers (RR=6.5; 95% Cl: 0.4-21.2). A strong dose-effect (p<0.1101) relationship was seen between the lifetime total amount of tobacco smoked and the risk of

O. M. Jbnsen; J. B. Knudsen; J. K. McLaughlin; B. L. Sørensrn

1988-01-01

75

Primary hydatid cyst of the kidney and ureter with hydatiduria in a laboratory worker: a case report.  

PubMed

Hydatid disease is frequent in endemic regions and sheep farming areas. Most common localization of hydatid cyst occurs in liver followed by lungs. Renal hydatid cyst constitutes about 2-4% of all locations. We report a case of left renal hydatid from a laboratory technician admitted in a tertiary care hospital. There were few cases of renal hydatid disease reported in India among general population but to the best of our knowledge never reported from laboratory worker. The possibility of laboratory-acquired infection cannot be ruled out in this case due to lack of precautionary measures and containment facilities in resource-constrained setting. PMID:24555138

Seetharam, Venkatesh; Khanna, Vinay; Jaiprakash, Padmapriya; Kosaraju, Kranthi; Thomas, Joseph; Mukhopadhayay, Chiranjay

2012-01-01

76

Atlantic cod is a common host for myxosporeans, few reported as pathogens eg. Myxobolus aeglefini Auerbach, 1906 (Kabata, 1957)  

E-print Network

in middle trunk kidney Occlusion of collecting ducts & ureters Ureter in head kidney Collecting duct in posterior kidney Ureter in posterior kidney Massive to the epithelium, discharging into the luminal space Ureter in posterior kidney #12

Kane, Andrew S.

77

A case with fistula formation between a perinephric retroperitoneal abscess, a ureter and a descending colon: Successful outcome after conservative management  

PubMed Central

A 72-year-old man diagnosed with hydronephrosis and perinephric abscess because of an impacted urinary stone in the left uretero-pelvic junction was admitted to hospital with high-grade fever. The insertion of a percutaneous drain improved his general condition. Then, imaging from the percutaneous drainage tube revealed a fistula formation between the cavity of the perinephric retroperitoneal abscess, the descending colon, and the left renal pelvis. The patient received conservative management, including insertion of a percutaneous drain, discontinuation of oral intake and antimicrobial chemotherapy. Three days after the percutaneous drainage and discontinuation of oral intake, imaging revealed no apparent fistula. Fistula formation between a perinephric abscess and the descending colon is very rare; this is the first case of a long-term favourable outcome by conservative management. PMID:25295138

Iwamoto, Yoichi; Kato, Masafumi

2014-01-01

78

Ureteral triplication.  

PubMed

A case of ureteral triplication is presented. There was reflux of the middle ureter, which did not end in the kidney, but rather ended blindly. There was atrophic pyelonephritis of the upper pole because of an obstructed ureter, and a normal lower caleceal system and ureter. There were three ureters but only two originated in the kidney and two entered the bladder, with only one ureter originating from the kidney entering the bladder normally. The refluxing ureter and the obstructed upper pole and ureter were removed. PMID:966124

Blumberg, N

1976-08-01

79

Handling and pathology reporting of specimens with carcinoma of the urinary bladder, ureter, and renal pelvis. A joint proposal of the European Society of Uropathology and the Uropathology Working Group  

Microsoft Academic Search

Pathologists play a pivotal role in the diagnosis and in the report of the pathological features related to prognosis. To meet these endpoints, the following issues must be addressed: adequate information about the patient history, proper handling of the specimens, identification of the reliable histopathological techniques necessary to reach the more detailed diagnostic information and evaluation of the prognostic variables,

Antonio Lopez-Beltran; Pier Francesco Bassi; Michele Pavone-Macaluso; Rodolfo Montironi

2004-01-01

80

Ureteral triplication (type I) with vesicoureteral reflux.  

PubMed

Complete triplication of ureter associated with vesicoureteral reflux successfully treated with ureteroureterostomy is described. The principle of the Weigert-Meyer law applies to complete triplication of the ureter. PMID:2296825

Hassan, M A

1990-01-01

81

Veliparib, Paclitaxel, and Carboplatin in Treating Patients With Solid Tumors That Are Metastatic or Cannot Be Removed by Surgery and Liver or Kidney Dysfunction  

ClinicalTrials.gov

Bladder Cancer; Breast Cancer; Endometrial Cancer; Esophageal Cancer; Head and Neck Cancer; Lung Cancer; Melanoma; Ovarian Neoplasm; Testicular Lymphoma; Transitional Cell Cancer of the Renal Pelvis and Ureter; Unspecified Adult Solid Tumor, Protocol Specific; Ureter Cancer; Urethral Cancer

2014-10-02

82

Stages of Vaginal Cancer  

MedlinePLUS

... the inner wall of the bladder on a computer monitor. Ureteroscopy : A procedure to look inside the ureters ... of the inside of the ureter on a computer monitor. Proctoscopy : A procedure to look inside the rectum ...

83

Trastuzumab and Combination Chemotherapy in Treating Patients With Locally Recurrent or Metastatic Urinary Tract Cancer  

ClinicalTrials.gov

Metastatic Transitional Cell Cancer of the Renal Pelvis and Ureter; Recurrent Bladder Cancer; Recurrent Transitional Cell Cancer of the Renal Pelvis and Ureter; Squamous Cell Carcinoma of the Bladder; Stage IV Bladder Cancer; Transitional Cell Carcinoma of the Bladder

2013-01-11

84

Eribulin Mesylate in Treating Patients With Locally Advanced or Metastatic Cancer of the Urothelium and Kidney Dysfunction  

ClinicalTrials.gov

Distal Urethral Cancer; Metastatic Transitional Cell Cancer of the Renal Pelvis and Ureter; Proximal Urethral Cancer; Recurrent Bladder Cancer; Recurrent Transitional Cell Cancer of the Renal Pelvis and Ureter; Recurrent Urethral Cancer; Regional Transitional Cell Cancer of the Renal Pelvis and Ureter; Stage III Bladder Cancer; Stage III Urethral Cancer; Stage IV Bladder Cancer; Stage IV Urethral Cancer; Ureter Cancer; Urethral Cancer Associated With Invasive Bladder Cancer

2014-11-15

85

Bioassay of insect neuropeptide for diuretic and antidiuretic hormone activity in the stable fly, Stomoxys calcitrans  

E-print Network

) upper portion of main segment connected with the transitional segment, (8) lower portion of main segment connected with the ureter. 19 Junction between alimentary canal and Malpighian tubules (ventral aspect): (A) ureter of type A tubule, (8) ureter... crystalline material (Fig. 6). At its base, the apical segment narrows to form a white and yellow transitional segment (Fig. 7), a long yellow main segment (Fig. 8), and a short terminal segment termed the ureter that connects to the hindgut (Fig. 9...

Kang, Hyesook Lee

2012-06-07

86

Gemcitabine Hydrochloride and Cisplatin With or Without Bevacizumab in Treating Patients With Advanced Urinary Tract Cancer  

ClinicalTrials.gov

Distal Urethral Cancer; Metastatic Transitional Cell Cancer of the Renal Pelvis and Ureter; Proximal Urethral Cancer; Recurrent Bladder Cancer; Recurrent Prostate Cancer; Recurrent Transitional Cell Cancer of the Renal Pelvis and Ureter; Recurrent Urethral Cancer; Regional Transitional Cell Cancer of the Renal Pelvis and Ureter; Stage IV Bladder Cancer; Stage IV Prostate Cancer; Stage IV Urethral Cancer; Transitional Cell Carcinoma of the Bladder; Ureter Cancer; Urethral Cancer Associated With Invasive Bladder Cancer

2014-10-16

87

Mathematical Medicine and Biology Page 1 of 24 doi:10.1093/imammb/dqn020  

E-print Network

up the ureter, which, in turn, may be a contributory factor for infections in the renal pelvis. We, permeable, hollow, circular cylinder lying coaxially inside the ureter. The renal pelvis is treated pelvis from the kidney with a prescribed flux. The stent, ureter and renal pelvis are filled with urine

Waters, Sarah

88

Gemcitabine Hydrochloride and Cisplatin or High-Dose Methotrexate, Vinblastine, Doxorubicin Hydrochloride, and Cisplatin in Treating Patients With Urothelial Cancer  

ClinicalTrials.gov

Anterior Urethral Cancer; Localized Transitional Cell Cancer of the Renal Pelvis and Ureter; Posterior Urethral Cancer; Recurrent Bladder Cancer; Recurrent Urethral Cancer; Regional Transitional Cell Cancer of the Renal Pelvis and Ureter; Stage III Bladder Cancer; Transitional Cell Carcinoma of the Bladder; Ureter Cancer; Urethral Cancer Associated With Invasive Bladder Cancer

2014-01-27

89

Ureteric Duplication is not a Contraindication for Robot-Assisted Laparoscopic Radical Cystoprostatectomy and Intracorporeal Studer Pouch Formation  

PubMed Central

Objectives: Ureteric duplication is a rarely seen malformation of the urinary tract more commonly seen in females. Materials and Methods: We report 2 cases of robot-assisted laparoscopic radical cystoprostatectomy (RALRCP) with bilateral extended pelvic lymph node dissection and intracorporeal Studer pouch formation in patients with duplicated right ureters. Results: Two male patients (53 and 68 years old) underwent transurethral resection of a bladder tumor that revealed high-grade muscle invasive transitional cell carcinoma, with no metastases. We performed RALRCP and intracorporeal Studer pouch formation. A duplicated right ureter was observed during the procedures in both patients. Left ureter distal segment was spatulated 2cm long and anastomosed using running 4/0 Vicryl to the right ureter at its bifurcation where it forms a single lumen without spatulation. All 3 ureters were catheterized individually. A Wallace type uretero-ileal anastomosis was performed between the ureters and the proximal part of the Studer pouch chimney. Although ureteric frozen section analysis suggested ureteric carcinoma in situ in patient 1, postoperative pathologic evaluation was normal. Frozen section and final postoperative pathologic evaluations were normal in patient 2. Conclusions: Duplicated ureters might be underdiagnosed on CT. The presence of a duplicated ureter is not a contraindication to RALRCP and intracorporeal Studer pouch formation. The da Vinci-S surgical robot is very safe for performing this complicated procedure. Frozen section analysis of ureters during radical cystectomy for bladder cancer might not reliably diagnose the pathologic condition and might overestimate the disease in the ureters. PMID:22643522

Dogan, Bayram; Atmaca, Ali Fuat; Akbulut, Ziya; Balbay, Mevlana Derya

2011-01-01

90

38 CFR 9.20 - Traumatic injury protection.  

...The term total and permanent loss of urinary system function is defined as damage to the urethra, ureter(s), both kidneys, bladder, or urethral sphincter muscle(s) that requires urinary diversion and/or hemodialysis, either of which is...

2014-07-01

91

Kidney Surgery Codes  

Cancer.gov

Kidney, Renal Pelvis, and Ureter Kidney C649, Renal Pelvis C659, Ureter C669 (Except for M9727, 9733, 9741-9742, 9764-9809, 9832, 9840-9931, 9945-9946, 9950-9967, 9975-9992) Codes 00 None; no surgery of primary site; autopsy ONLY 10 Local tumor

92

Aircraft conflict probe sensitivity to weather forecasts errors  

Microsoft Academic Search

This study investigated the user request evaluation tool's (URET) prediction sensitivity to weather forecast error. A quantitative experiment was designed and performed by the Federal Aviation Administration's Conflict Probe Assessment Team (CPAT) to evaluate the impact of weather forecast errors on URET trajectory and conflict predictions. The experiment used approximately two hours of traffic data recorded at the Indianapolis en

Mike Paglione; Hollis F. Ryan

2007-01-01

93

Ureteric stents: investigating flow and encrustation S L Waters11, K Heaton2  

E-print Network

collects in the funnel-shaped renal pelvis of the kidney and passes down the ureter to the bladder, where flow through the urethra and out of the body. The junctions between the renal pelvis and the ureter is more concentrated and of higher pH than urine in the renal pelvis [2, 3] and, while levels of bacteria

Waters, Sarah

94

Assessment of Tissue Damage due to Mechanical Stresses , Jacob Rosen1  

E-print Network

injury. The goal of this work was to develop a methodology with which to identify stress magnitudes, stresses typically applied in MIS were applied to liver, ureter, and small bowel using a motorized and small bowel as well as neutrophil infiltration in small bowel. Ureter appeared to be more resistant

95

Adult and pediatric urology  

SciTech Connect

This book contains 32 chapters. Come of the chapter titles are: Imaging; Urinary tract infections; Calculus formation; Perioperative care; Renal injuries; Kidney stone surgery; Trauma to the lower urinary tract; renel cystic disease; Bladder cancer; and The ureter.

Gillenwater, J.Y.; Howards, S.S. (Univ of Virginia School of Medicine, Charlottsville, VA (US)); Grayhack, J.T. (Northwestern Univ. Medical School, Northwestern Memorial Hospital, Chicago, IL (US)); Ducket, J.W. (Univ of Pennsylvania School of Medicine, Children's Hospital of Philadelphia, Philadelphia, PA (US))

1987-01-01

96

Laser lithotripsy with a Q-switched alexandrite laser system  

NASA Astrophysics Data System (ADS)

The laser lithotripsy of ureter stones with the Alexan Triptor was introduced into urology in 1989. Pulsenergy, pulsewidth, wavelength, fiber performance, and endoscope performance are important parameters for effective stone disintegration.

Uebelacker, Walter

1992-06-01

97

Pazopanib in Treating Patients With Metastatic Urothelial Cancer  

ClinicalTrials.gov

Distal Urethral Cancer; Proximal Urethral Cancer; Recurrent Bladder Cancer; Recurrent Transitional Cell Cancer of the Renal Pelvis and Ureter; Recurrent Urethral Cancer; Stage IV Bladder Cancer; Transitional Cell Carcinoma of the Bladder; Urethral Cancer Associated With Invasive Bladder Cancer

2014-05-22

98

Review Article Purinergic receptor-mediated effects of adenosine 5 -triphosphate  

E-print Network

nociception in the ureter and bladder, to erectile dysfunction via its action on different `purinergic and bladder urothelium to erectile dysfunction via its action on different `purinergic receptors'.7

Burnstock, Geoffrey

99

Kidney Stones in Children  

MedlinePLUS

... Titles : Kidney Stones in Children Kidney Stones in Children On this page: What is a kidney stone? ... the ureters. [ Top ] Are kidney stones common in children? No exact information about the incidence of kidney ...

100

Ureteral triplication: double extravesical ureteral ectopia.  

PubMed

A 21-month-old girl presented with ureteral triplication, representing an exceptional variant of Smith's type 1. One ureter was intravesical and the other 2 were extravesical (bladder neck and vaginal). PMID:1984066

Luque-Mialdea, R; De Tomas, E; Arrojo, F; Delgado, J; Rodriguez, J; Molina, E; Martin Sanz, L

1991-01-01

101

Cervical Cancer Stage IIIB  

MedlinePLUS

... Cancer Stage IIIB Description: Stage IIIB cervical cancer; drawing shows cancer in the cervix, the vagina, and ... that connect the kidneys to the bladder). The drawing shows the ureter on the right blocked by ...

102

MPH Urinary Rules: Breeze Training Transcript: Feb 16 07  

Cancer.gov

NATIONAL INSTITUTES OF HEALTH NATIONAL CANCER INSTITUTE SURVEILLANCE, EPIDEMIOLOGY AND END RESULTS (SEER) PROGRAM Breeze Session Multiple Primary and Histology Coding Rules—Renal Pelvis, Ureter and Bladder and Other Urinary Sites February 16, 2007

103

Recurrent Urinary Tract Infections and Related Conditions (For Parents)  

MedlinePLUS

... infected with bacteria, VUR can lead to pyelonephritis. hydronephrosis , which is an enlargement of one or both ... severe VUR or a blocked ureter. Kids with hydronephrosis are sometimes at risk of recurrent UTIs and ...

104

Idiopathic retroperitoneal fibrosis of the pancreas versus pancreatic carcinoma.  

PubMed

We report one of few cases of idiopathic retroperitoneal fibrosis of the pancreas, which is different from the classical retroperitoneal fibrosis that affects ureters and vessels that mimicking locally advanced pancreatic carcinoma at presentation. PMID:20699053

Baker, Bilal; Salameh, Habeeb; Daoud, Faiez

2010-10-01

105

Study of the ureterovesical jet flow by means of dupplex Doppler ultrasonography in patients with residual ureteral stone after extracorporeal shock wave lithotripsy.  

PubMed

The aims of our study are to evaluate ureterovesical jet flow Doppler ultrasound (US) in patients with residual ureteral stone after extracorporeal shock wave lithotripsy (ESWL) and to compare with unobstructed contralateral ureter. Patients who have residual ureteral stone in intravenous pyelography (IVP) and/or computed tomography (CT) after ESWL and unobstructed contralateral ureter in 20 patients were prospectively evaluated with Doppler US. The mean peak velocity of the Doppler waveforms was obtained on the residual ureteral stone and contralateral non-obstructed ureter (17.10 +/- 20), (56.0 +/- 32), respectively (P < 0.05). In conclusion, due to the absence of contraindications and side-effects, Doppler US is sensitive and highly specific that can contribute significantly to the diagnosis of residual ureteral stone after ESWL. It can replace IVP and/or CT, in condition where IVP is undesirable and in addition Doppler US can supply a functional investigation of the obstructed ureter. PMID:19940988

Ciftci, Halil; Cece, Hasan; Dusak, Abdurrahim; Savas, Murat; Verit, Ayhan; Yeni, Ercan

2010-02-01

106

MPH Urinary Practicum : Breeze Training Transcript: Feb 20 07  

Cancer.gov

NATIONAL INSTITUTES OF HEALTH NATIONAL CANCER INSTITUTE SURVEILLANCE, EPIDEMIOLOGY AND END RESULTS (SEER) PROGRAM BREEZE SESSION Multiple Primary and Histology Coding Rules—Renal Pelvis, Ureter, Bladder and Other Urinary Sites Practicum February

107

[Mechanisms of action of some physical factors in therapy of patients with urolithiasis].  

PubMed

The authors consider four principal physiotherapeutic complexes applied in stone-eliminating therapy of patients with urolithiasis and mechanisms of action of these physical factors. In all cases of stones detection in the upper urinary tracts lithokinetic therapy begins with therapeutic impacts on the area of the affected kidney and upper ureter followed by the action on the affected part of the ureter. PMID:12945142

Li, A A; Karpukhin, I V

2003-01-01

108

Ultrasound-guided percutaneous antegrade pyelography with computed tomography for the diagnosis of spontaneous partial ureteral rupture in a dog.  

PubMed

A 10-year-old spayed female dalmatian dog developed acute vomiting and abdominal pain. Ultrasound examination of the abdomen showed right hydronephrosis and proximal ureter dilation with mild retroperitoneal free fluid. Computed tomography (CT) of the abdomen confirmed the ultrasonographic findings and revealed, additionally, a right ureteral stone. Spontaneus rupture of the right ureter was confirmed with CT post ultrasound-guided percutaneous antegrade pyelography. Pyeloureteral rupture and the presence of a ureteral stone were confirmed at surgery. PMID:23633712

Specchi, Swan; Lacava, Giuseppe; d'Anjou, Marc-André; Zini, Eric; Auriemma, Edoardo

2012-11-01

109

Laparoscopic Repair of a Ureteric Sciatic Hernia: Report of a Case  

PubMed Central

Ureteric sciatic hernias are extremely rare. Here we report a case of a 78-year-old woman presented with colicky left abdominal pain. Computed tomography revealed a ureteric sciatic hernia, and drip infusion pyelography revealed dilated left ureter with herniation of the ureter into the sciatic foramen. The hernia was successfully repaired laparoscopically. We have described the diagnosis and management of the patient, followed by a review of the literature on sciatic hernias. PMID:24778894

Saisu, Kazuhiro; Tsuru, Nobuo; Homma, Yukio; Ihara, Hiroyuki

2014-01-01

110

Differentiation of urinary stone and vascular calcifications on non-contrast CT images: an initial experience using computer aided diagnosis.  

PubMed

The purpose of this study was to develop methods for the differentiation of urinary stones and vascular calcifications using computer-aided diagnosis (CAD) of non-contrast computed tomography (CT) images. From May 2003 to February 2004, 56 patients that underwent a pre-contrast CT examination and subsequently diagnosed as ureter stones were included in the study. Fifty-nine ureter stones and 53 vascular calcifications on pre-contrast CT images of the patients were evaluated. The shapes of the lesions including disperseness, convex hull depth, and lobulation count were analyzed for patients with ureter stones and vascular calcifications. In addition, the internal textures including edge density, skewness, difference histogram variation (DHV), and the gray-level co-occurrence matrix moment were also evaluated for the patients. For evaluation of the diagnostic accuracy of the shape and texture features, an artificial neural network (ANN) and receiver operating characteristics curve (ROC) analyses were performed. Of the several shape factors, disperseness showed a statistical difference between ureter stones and vascular calcifications (p < 0.05). For the internal texture features, skewness and DHV showed statistical differences between ureter stones and vascular calcifications (p < 0.05). The performance of the ANN was evaluated by examining the area under the ROC curves (AUC, A (z)). The A (z) value was 0.85 for the shape parameters and 0.88 for the texture parameters. In this study, several parameters regarding shape and internal texture were statistically different between ureter stones and vascular calcifications. The use of CAD would make it possible to differentiate ureter stones from vascular calcifications by a comparison of these parameters. PMID:19190962

Lee, Hak Jong; Kim, Kwang Gi; Hwang, Sung Il; Kim, Seung Hyup; Byun, Seok-Soo; Lee, Sang Eun; Hong, Seong Kyu; Cho, Jeong Yeon; Seong, Chang Gyu

2010-06-01

111

[Trans-ureteral pyelostomy: 5 cases].  

PubMed

The authors report 5 cases of extensive loss of substance of the distal ureter due to radiation fibrosis, operative trauma or tumour invasion; these lesions occurred during the course of a genital tumour in 4 cases and rectal prolapse in one case. The lesion was bilateral and radiation-induced in 2 cases and unilateral in 3 cases. The patients presented with renal colic in 2 cases, renal failure in 1 case and infection in 2 cases (pyelonephritis, septic shock). All patients presented with secondary hydronephrosis. The extent of the lesions made vesical anastomosis impossible, especially as the bladder was irradiated and/or absent in 3 cases. Anastomosis of the proximal ureteric stump onto the contralateral ureter was impossible in the presence of bilateral lesions requiring diversion of the contralateral ureter or due to the short donor ureter, or because of the discordant diameter of the two ureters. Transureteropyelostomy was therefore performed in these 5 cases. The postoperative course was uneventful 4 cases, with a transient anastomotic fistula in only one case. Four of the 5 patients achieved long-term survival with an excellent clinical and radiological result. PMID:11296635

Ponthieu, A; Granger, F; Lavilledieu, S; Uzan, E

2001-02-01

112

Does the Mod?f?ed STING Method Increase the Success Rate in the Management of Moderate or H?gh-Grade Reflux?  

PubMed Central

Purpose To evaluate the efficacy of subureteral injection types in patients with middle- to high-grade vesicoureteral reflux (VUR). Materials and Methods Between June 1999 and September 2010, subureteral dextranomer was applied at our clinic to 149 patients (214 refluxing ureters) with grades II, III, and IV VUR. Group 1 consisted of 54 patients (80 ureters), and group 2 consisted of 95 patients (134 ureters). The standard subureteric transurethral injection (STING) procedure was applied to group 1, and the modified STING procedure was applied to group 2. A second and if needed a third injection was applied to unsuccessfully treated patients. The mean follow-up period was 2 years. Patients were evaluated by cystography and ultrasonography in the third month of follow-up. Results VUR was resolved completely after a single injection in 54/80 ureters (67.5%) in group 1 and in 94/134 ureters (70.1%) in group 2. Overall successes after a second or a third injection were 61/80 (76.2%) and 111/134 (82.8%), respectively. There was a statistically significant difference between the groups only for grade IV reflux following multiple injections (p<0.05). Conclusions Endoscopic treatment of VUR is a recommended treatment because it is minimally invasive, efficient, and repeatable. Our study confirmed that a modified STING procedure can be an alternative treatment to the standard technique. PMID:25237464

Yalc?nkaya, Fatih; Altug, Ugur; Sertcelik, Nurettin; Demirel, Fuat

2014-01-01

113

Pulmonary Tumor Thrombotic Microangiopathy Induced by Ureteral Carcinoma: A Necropsy Case Report  

PubMed Central

Background Pulmonary tumor thrombotic microangiopathy (PTTM) is a fatal cancer-related pulmonary complication with rapidly progressing dyspnea and pulmonary hypertension that occasionally induces sudden death. We report the first case of PTTM induced by ureter carcinoma. Case Presentation The patient was an 80-year-old Japanese female with chief complaints of dry cough and dyspnea. An echocardiogram revealed severe pulmonary hypertension. A chest radiograph showed ground glass opacity of bilateral lower lung field predominance, and an abdominal computed tomography scan revealed a left ureter mass suggestive of ureter carcinoma. The patient died of respiratory failure on the eighth day of hospitalization. Postmortem examination indicated that the primary lesion was a left ureter cancer with tumor microemboli extending to both lungs through the right side of the heart. The final diagnosis of this case was PTTM induced by ureter carcinoma. Conclusion The pathogenesis and pathophysiology of PTTM remains obscure with no effective management available. In cases of rapidly progressing respiratory failure with pulmonary hypertension, it is necessary to consider PTTM in the differential diagnosis.

Marumo, Satoshi; Sakaguchi, Masahiro; Teranishi, Takashi; Higami, Yuichi; Koshimo, Yoshiyuki; Kato, Motokazu

2014-01-01

114

Isolated ureteric endometriosis presenting as a ureteric tumor  

PubMed Central

A 32 year old lady presented with recurrent left flank pain for 4 weeks and chronic lower back pain. CT without contrast showed no stones and mild left hydronephrosis. CT of the spine suggested an inflammatory process at L5-S1 vertebra. The diagnosis was supported by a bone scan. Incidentally, the scan showed nonfunctioning left kidney. Diuretic renography confirmed poor perfusion and no excretion. A retrograde study showed narrowing of the ureter at the pelvic brim. Ureteroscopy showed a papillary mass in the lumen of the ureter from which multiple cold cup biopsies were taken. The pathology however was not conclusive. A robotic nephroureterectomy was carried out. Definitive pathology showed intrinsic endometriosis of the ureter. We conclude that endometriosis should be considered in the differential diagnosis of unexplained ureteric obstruction and ureteric lumen filling defects in young women. PMID:24669135

Seyam, Raouf; Mokhtar, Alaa; Al Taweel, Waleed; Al Sayyah, Ahmed; Tulbah, Asma; Al Khudair, Waleed

2014-01-01

115

Urinary Concentration in the Papillary Collecting Duct of the Rat  

PubMed Central

Urine was observed to flow intermittently in the collecting ducts of the extrarenal papilla of antidiuretic rats. The purpose of this investigation was to test Reinking and Schmidt-Nielsen's hypothesis that intermittent flow plays an important role in the production of maximally concentrated urine. Samples of collecting duct fluid were obtained from the base and tip of the papilla by micropuncture through the intact ureter. Fluid osmolality rose sharply from base, 894±120 mosmol/kg H2O?1 (mean±SE), to tip, 1,667±114 (P<0.001), a distance of only 2 mm, and was due exclusively to reabsorption of water. After excision of the ureter, which abolished intermittent flow, osmolality fell modestly at the base to 723±82 mosmol/kg H2O?1 (P < 0.02), but strikingly at the tip to 1,012±103 (P < 0.001). The pelvic ureter was paralyzed by topical verapamil and dimethylsulfoxide, which abolished intermittent flow. Osmolality of urine at the tip was not changed (1,959±184 mosmol/kg H2O?1 before, vs. 1,957±126 after paralysis). The ureter was severed just beyond the papillary tip, a maneuver which preserved intermittent flow but abolished urinary reflux over the papilla. Urinary osmolality fell from 1,876±134 mosmol/kg H2O?1 to 1,284±115 (P < 0.005). These findings demonstrate that when the ureter is intact, over half of the increase in urinary osmolality above isotonicity occurs in the terminal one-fourth of the medullary collecting duct and is due exclusively to water reabsorption (no net solute addition). It is the continuity of the ureter, rather than intermittent flow due to ureteral peristalsis, which is essential for the formation of a maximally concentrated urine. PMID:7054236

Oliver, Richard E.; Roy, Denis R.; Jamison, Rex L.

1982-01-01

116

Laparoscopic removal of a pelvic cyst associated with obstructed megaureter and dysplastic renal remnant.  

PubMed

We report a case of a 41-year-old man with a solitary functioning left kidney and history of chronic pelvic discomfort associated with lower urinary tract symptoms. Imaging revealed a large cystic structure in the pelvis attached to a dilated tortuous ureter on the right with congenital absence of the right kidney. The patient underwent laparoscopic removal of the pelvic cyst and dilated right ureter. Pathological assessment revealed mesonephric remnants representing dysplastic renal tissue attached to a dilated and obstructed megaureter, extending into the bladder wall and forming a large pelvic cyst. The patient's symptoms resolved. A laparoscopic approach represents an excellent surgical option for pelvic pathology. PMID:19424474

Pianezza, Michael L; Estey, Eric P

2009-04-01

117

Laparoscopic removal of a pelvic cyst associated with obstructed megaureter and dysplastic renal remnant  

PubMed Central

We report a case of a 41-year-old man with a solitary functioning left kidney and history of chronic pelvic discomfort associated with lower urinary tract symptoms. Imaging revealed a large cystic structure in the pelvis attached to a dilated tortuous ureter on the right with congenital absence of the right kidney. The patient underwent laparoscopic removal of the pelvic cyst and dilated right ureter. Pathological assessment revealed mesonephric remnants representing dysplastic renal tissue attached to a dilated and obstructed megaureter, extending into the bladder wall and forming a large pelvic cyst. The patient’s symptoms resolved. A laparoscopic approach represents an excellent surgical option for pelvic pathology. PMID:19424474

Pianezza, Michael L.; Estey, Eric P.

2009-01-01

118

Ureteral quintuplication with renal atrophy in an infant after the 1986 Chernobyl nuclear disaster.  

PubMed

Ureteral duplication is a comparatively frequent urinary tract anomaly. Ureteral triplication is rare, but quadruplication is extremely rare. In this study, we describe a case of ureteral quintuplication, the first such report in the English-language literature. A newborn female baby was diagnosed with left ureteral quintuplication. The left ureter was divided into 5 ureters with 5 renal pelvises within approximately 3 cm of the urinary bladder, and trace parenchyma of the kidney was noted. The patient was born within 60 km of the epicenter of the 1986 Chernobyl disaster, 24 years after the catastrophic nuclear accident, and is currently aged 3 years. PMID:24001707

Jurkiewicz, Beata; Z?bkowski, Tomasz; Shevchuk, Dmitrij

2014-01-01

119

Veliparib, Cisplatin, and Gemcitabine Hydrochloride in Treating Patients With Advanced Biliary, Pancreatic, Urothelial, or Non-Small Cell Lung Cancer  

ClinicalTrials.gov

Advanced Adult Primary Liver Cancer; Localized Unresectable Adult Primary Liver Cancer; Metastatic Transitional Cell Cancer of the Renal Pelvis and Ureter; Regional Transitional Cell Cancer of the Renal Pelvis and Ureter; Stage III Bladder Cancer; Stage III Pancreatic Cancer; Stage IIIA Non-small Cell Lung Cancer; Stage IIIB Non-small Cell Lung Cancer; Stage IV Bladder Cancer; Stage IV Non-small Cell Lung Cancer; Stage IV Pancreatic Cancer; Transitional Cell Carcinoma of the Bladder; Unresectable Extrahepatic Bile Duct Cancer; Unresectable Gallbladder Cancer

2013-07-01

120

Studies on the toxicity of biuret to animals  

E-print Network

? out the experiments, and no illneceec or deaths occurredi I slightly higher feed consumption by ths 10. % b1uret-fsd up was noted which was probably an attempt to fulfill thsix energy requirements. uiuret has no useful energy value and the addition... ARALYSIS OF VARZARCE OF QAIRS SOQgoee oZ Variatfon Deggeee ei' FL ee&oa Sma ef Eeen Squares 8~me Total Re tie@a lndividuala 831 6V 33. 5 31. 8 ex i t pu? uret I dns h Xn addition Co ths previously deaoribs4 f'ee4ing study~ two lambe were...

Berry, William T

2012-06-07

121

Intensities of electronic transitions in sulfur dioxide vapor  

E-print Network

as followss 8 cga = gv Ml dc, where M = ? e Z, x, . By expanding the state function P and its complex con)urete in terms of the energy eigenfunctiona m~ and substituting into the above equations we have the following results C C?N?? TA ) 'A (15... as followss 8 cga = gv Ml dc, where M = ? e Z, x, . By expanding the state function P and its complex con)urete in terms of the energy eigenfunctiona m~ and substituting into the above equations we have the following results C C?N?? TA ) 'A (15...

McCray, James Arthur

2012-06-07

122

Ureteral triplication combined with right renal ectopia and ureteral cyst.  

PubMed

Ureteral triplication is one of the rarest malformations of the upper urinary tract. We report the case of a 12-year-old girl with right ureteral triplication combined with renal ectopia and ureteral cyst with stenosis at the junction of the ureteral cyst and distal ureter. The ureteral cyst was tailored and tubularized, and the tight junction was removed, as in Hynes-Anderson ureteropyeloplasty; on reevaluation almost 4 years later, kidney function was normal and computed tomography showed a normal kidney and ureter. PMID:19996658

Xu, Zhe; Li, Zuoqing; Wang, Daohu; Deng, Gaoyan; Su, Cheng; Pan, Jing; Li, Suisheng

2009-01-01

123

The absorption of ultrasonic waves in liquids  

E-print Network

of the cathode ray tube, . 'he scale I wda previous}y cqlibrateh With sn su. tiO, friqu. ~nay signal ssneretor ~hoss frequency cutout vae f&und to bs ss urete within l~. An accuracy cf l4 le not claimed, for the velocities boca tse cons error ls lntrotucsd... of the cathode ray tube, . 'he scale I wda previous}y cqlibrateh With sn su. tiO, friqu. ~nay signal ssneretor ~hoss frequency cutout vae f&und to bs ss urete within l~. An accuracy cf l4 le not claimed, for the velocities boca tse cons error ls lntrotucsd...

Hudson, Paul A

2012-06-07

124

PERISTALTIC FLOW WITH APPLICATION TO URETERAL BIOMECHANICS  

E-print Network

. Compari- son is made with available experimental data. The next study is of streamline patterns with application to the ureter are presented. Also included are results from an experimental peristalsis simulator autonomous differential #12;Joel N. Jim´enez Lozano equations for the particle paths. Local bifurcations

Sen, Mihir

125

ESAIM: PROCEEDINGS, Vol. ?, 2011, 1-10 Editors: Will be set by the publisher  

E-print Network

also be traced back to the late sixties, with the seminal work of Harlow and Amsden [25,26], who Radioprotection et de S^uret´e Nucl´eaire, jean-claude.latche]@irsn.fr c EDP Sciences, SMAI 2011 hal-00636173

Paris-Sud XI, Université de

126

Tbx18 regulates the development of the ureteral mesenchyme  

PubMed Central

Congenital malformations of the urinary tract are a major cause of renal failure in children and young adults. They are often caused by physical obstruction or by functional impairment of the peristaltic machinery of the ureter. The underlying molecular and cellular defects are, however, poorly understood. Here we present the phenotypic characterization of a new mouse model for congenital ureter malformation that revealed the molecular pathway important for the formation of the functional mesenchymal coating of the ureter. The gene encoding the T-box transcription factor Tbx18 was expressed in undifferentiated mesenchymal cells surrounding the distal ureter stalk. In Tbx18–/– mice, prospective ureteral mesenchymal cells largely dislocalized to the surface of the kidneys. The remaining ureteral mesenchymal cells showed reduced proliferation and failed to differentiate into smooth muscles, but instead became fibrous and ligamentous tissue. Absence of ureteral smooth muscles resulted in a short hydroureter and hydronephrosis at birth. Our analysis also showed that the ureteral mesenchyme derives from a distinct cell population that is separated early in kidney development from that of other mesenchymal cells of the renal system. PMID:16511601

Airik, Rannar; Bussen, Markus; Singh, Manvendra K.; Petry, Marianne; Kispert, Andreas

2006-01-01

127

Mesenteric desmoid-type fibromatosis causing secondary hypertension in a young woman  

PubMed Central

This report describes an 18-year-old woman presenting with abdominal distension, left flank pain, and hypertension. She had a huge abdominal mass, diagnosed as a mesenteric desmoid-type fibromatosis, causing compression of the left external iliac vessels and ureter, as well as elevated renin concentration and hypertension. After surgical removal of the mass, all signs improved including hypertension.

Kim, Mi-Seon; Jung, Myung-Chul; Kim, Yong-Bong

2014-01-01

128

The Homunculi and I Lessons from Building Organs on Chips  

E-print Network

the unfathomable complexity that affects our development and growth and individual responses to disease, drugs Digestive Salivary glands Esophagus Stomach Liver Gallbladder Pancreas Intestines Excretory Kidneys Ureters;Organ Silos GallBladder Pancreas Intestines Skin Eyes Thyroid Ears Testis Ovaries Prostate Uterus Spleen

Simaan, Nabil

129

Hydronephrosis in pregnancy: simultaneous depiction of fetal and maternal hydronephrosis by magnetic resonance urography  

Microsoft Academic Search

Magnetic resonance urographic (MRU) techniques possess image quality and diagnostic capability that are improving with increasingly sophisticated imaging sequences and shorter scanning times. We describe the application of a fast breath-hold MR sequence (HASTE) in the assessment of ureteric obstruction in pregnancy. In the patient presented, HASTE MRU was successful in depicting ureteral anatomy and demonstrated dilation of both ureters

Joel M Fradin; Fintan Regan; Ronald Rodriquez; Robert Moore

1999-01-01

130

Laparoscopic removal of a pelvic cyst associated with obstructed megaureter and dysplastic renal remnant  

Microsoft Academic Search

We report a case of a 41-year-old man with a solitary function- ing left kidney and history of chronic pelvic discomfort associ- ated with lower urinary tract symptoms. Imaging revealed a large cystic structure in the pelvis attached to a dilated tortuous ureter on the right with congenital absence of the right kidney. The patient underwent laparoscopic removal of the

Michael L. Pianezza; Eric P. Estey

2009-01-01

131

Career of the Month: An Interview With Urologist Chad DeRosa  

NSDL National Science Digital Library

The organs, tubes, muscles, and nerves that work together to create, store, and carry urine make up the urinary system. Urologists are surgeons that focus on diseases of this system--which includes the kidneys, ureters, bladder, supporting muscles and liga

Sullivan, Megan

2009-11-01

132

Continuous dual-wavelength, high-intensive Nd:YAG laser in operative urology  

NASA Astrophysics Data System (ADS)

A ruby laser with a 0.694 mkm wavelength was used as a source of a new model of laser lithotriptor. The optical irradiation parameters selected included 1 mks duration pulse, frequency from 1 to 5 Hz, energy at an output of up to 120 mJ, transmitted via light guide quartz fiber of 400 kmk. The tip of the light guide was directed to the calculus through a catheterized cystoscope. Light guide position control was done by the presence of a specific acoustic signal accompanying plasma formation. Plasma is not formed by laser action on the ureter wall. In doubtful cases we used roentgenological examination. After lithotripsy and direct processing by irradiation, histological investigations of the ureter wall showed only slight submucosal hemorrhage or revealed no changes. Implantation of the calculus and fiber particles into the ureter wall was not observed. Twenty-nine patients were subjected to lithotripsy of calculus (oxalates, urates, phosphates) in the low and mid-ureter. Usually from 1000 to 3000 impulses were used to destroy the calculus. Calculus fragments passed without assistance (13 patients) or were removed by extractors (7 patients). The recovery of passing of urine and removal of renal colic were observed during lithotripsy if obturation had occurred (8 patients). Ureteral perforation, blood loss, and acute pyelonephritis did not occur.

Reznikov, Leonid L.; Pupkova, Ludmila S.; Miroshnicov, B. I.; Snezhko, D. A.; Nikitichev, A. A.; Pokrovskiy, Vasiliy P.; Gomberg, Vladimir G.

1994-05-01

133

Kidney Stone ProgramKIDNEY STONE PROGRAM STEPHEN DRETLER, MD  

E-print Network

in the lower pole Sources: American Foundation of Urologic Disease; Urology Times; Journal of Urology Generic/ureter Steps for Patient Treatment After Radiologic and Laboratory Studies · Urology consult and admission and Laboratory Studies · Urology consult and admission · Pain medication · Monitoring Possible Interventions

Mootha, Vamsi K.

134

GASTROINTESTINAL ANATOMY Fig. 171. Longitudinal section through the liver  

E-print Network

. The urinary bladder, seen just above the rectum, enters the cloaca ventrally. The dorsally-located kidneys medial to the kidney. The testis of this immature male is still attached to the peritoneum (and is located anatomically ventral to the kidneys). urinary bladder rectumkidney renal veins cloaca ureter colon

135

Kidney Dysplasia National Kidney and Urologic Diseases Information Clearinghouse  

E-print Network

Kidney Dysplasia National Kidney and Urologic Diseases Information Clearinghouse U.S. Department of Health and Human Services NATIONAL INSTITUTES OF HEALTH What is kidney dysplasia? The kidneys are a pair the kidneys to the bladder through tubes called ureters. Kidney dysplasia is a condition that can occur

Baker, Chris I.

136

What I need to know about My Child's Urinary Tract  

E-print Network

Services NATIONAL INSTITUTES OF HEALTH National Kidney and Urologic Diseases Information Clearinghouse #12 Services NATIONAL INSTITUTES OF HEALTH National Kidney and Urologic Diseases Information Clearinghouse #12 includes two kidneys, two ureters, a bladder, and a urethra. The kidneys are a pair of bean- shaped organs

Baker, Chris I.

137

Trifid obstructed megaureter.  

PubMed

A case report of trifid obstructed megaureter in a young girl is presented. Triplication of ureters is one of the rarest malformations of the upper urinary tract and commonly presents with associated urinary tract infections. Obstructed megaureters in a triplicate system is even more uncommon, and only a few cases have been recorded in the world literature. PMID:6868252

Merlini, E

1983-07-01

138

A case of ureteral triplication associated with ureteropelvic junction obstruction  

Microsoft Academic Search

Ureteral triplication is one of the rarest malformations of the upper urinary tract. The association of ureteral triplication\\u000a and obstruction is even rarer. We report a case of ureteral triplication associated with hydronephrosis due to ureteropelvic\\u000a junction (UPJ) obstruction at the middle pole ureter. To our knowledge, such a malformation has not been described previously.

Abdullah Sivrikaya; Ali Çay; Mustafa ?mamoglu; Haluk Sarihan

2007-01-01

139

L’incontinence d’urine par abouchement ectopique de l’uretère chez la fillette  

Microsoft Academic Search

The author has collected 16 cases of ectopic ureter in girls. In one case, the ectopy was bilateral and was associated with a bilateral triplication. The malformation is detected at a very early age: 5 times out of 16 in children less than 3 years old. The clinical investigation under general anesthesia is of prime importance in the diagnosis in

J. Bruezière

1972-01-01

140

Triplicidad ureteral: Una inusual presentación aislada  

Microsoft Academic Search

URETERAL TRIPLICATION, AN UNUSUAL ISOLATED PRESENTATION We report the case of a 26 years old female who presented, as a casual finding, a right complete ureteral triplicity ( probably Campbell's tipe I) with no other associated abnormalities. Despite ureteral duplication is a frequent urological anomaly, the presence of three ureters occur- ring in the same side, in a complete or

A. Villanueva Peña; E. de Diego Rodríguez

2004-01-01

141

Unilateral triplication of the collecting system in a horseshoe kidney.  

PubMed

We report on complete unilateral triplication of the collecting system and ureters in a patient with a horseshoe kidney. One of the ureteral segments was obstructed and the patient presented with urosepsis. To our knowledge, such a malformation has not been described previously. PMID:6887369

Pode, D; Shapiro, A; Lebensart, P

1983-09-01

142

Type I ureteral triplication: an extension of the Weigert-Meyer law.  

PubMed

We report a case of type I ureteral triplication and document the locations of the ureteral orifices corresponding to the renal segments. The ureter from the uppermost renal segment issued onto the urethrovaginal septum and caused wetting. The wetting was cured by high ureteroureterostomy. Our findings are consistent with those expected by the Weigert-Meyer law. PMID:4057381

Zaontz, M R; Maizels, M

1985-11-01

143

Ureteral quadruplication: The fourth case report  

Microsoft Academic Search

Among development abnormalities of the upper urinary tract, ureteral duplication is a very common finding while triplication is quite rare. Ureteral quadruplication is exceedingly unusual; to our knowledge only three cases have been reported over the past 25 years and all of them concerned adult patients. We present a case of unilateral quadruplicated ureters in a 9-month-old infant. Review of

S. Sourtzis; N. Damry; F. Janssen; N. Perlmutter

1994-01-01

144

A case of ureteral triplication associated with ureteropelvic junction obstruction.  

PubMed

Ureteral triplication is one of the rarest malformations of the upper urinary tract. The association of ureteral triplication and obstruction is even rarer. We report a case of ureteral triplication associated with hydronephrosis due to ureteropelvic junction (UPJ) obstruction at the middle pole ureter. To our knowledge, such a malformation has not been described previously. PMID:17436061

Sivrikaya, Abdullah; Cay, Ali; Imamoglu, Mustafa; Sarihan, Haluk

2007-01-01

145

Ureteral triplication and duplicated opposite kidney with refluxing ureterocele.  

PubMed

A case is reported of ureteral triplication with ectopia of two of the ureters and contralateral duplication with a ureterocele. This patient is the youngest that we have found reported with this type of anomaly and the only one presenting with abdominal distention and an intact but refluxing ureterocele. PMID:6644505

Miguelez Lago, C; Gaztambide Casellas, J; Camacho Gonzalez, F; Maderna Graziano, O; Sanchez Diaz, F; Lopez Ruiz, P; Lopez Perez, G A

1983-10-01

146

Postnatal morphology and functional capacity of the kidney following prenatal treatment with dinoseb in rats  

Microsoft Academic Search

Dinoseb has produced alterations that are suggestive of renal damage In mice and rats. Therefore it was of interest to determine the postnatal morphology and functional capacity of the kidney following prenatal treatment with dinoseb in rats. Fetal and neonatal rats treated with dinoseb on gestational d 10–12 had dilated renal pelves and ureters. Kidneys had dilated tubules and excessive

K. M. McCormack; A. Abuelgasim; V. L. Sanger; J. B. Hook

1980-01-01

147

The use of tamsulosin in the medical treatment of ureteral calculi: where do we stand?  

Microsoft Academic Search

It has recently been demonstrated that specific adrenoceptors subtypes (?1A\\/?1D) are prevalent in the distal part of the ureter, a finding supporting the interesting results obtained by different groups with the use of tamsulosin in the treatment of distal ureteral calculi. We performed a prospective randomized study to evaluate the effects of the addition of tamsulosin on our standard pharmacological

Riccardo Autorino; Marco De Sio; Rocco Damiano; Giuseppe Di Lorenzo; Sisto Perdonà; Aniello Russo; Giuseppe Quarto; Luca Cosentino; Massimo D’Armiento

2005-01-01

148

Kidney stones - what to ask your doctor  

MedlinePLUS

A kidney stone is a solid piece of material that forms in your kidney. The kidney stone may be stuck in your ureter (the tube ... from your bladder to outside your body). A stone can block the flow of your urine and ...

149

Utilisation d'un mod`ele d'accident systemique comme referentiel commun `a une analyse de risque  

E-print Network

de trafic ferroviaire. Mots-cl´es-- S^uret´e de fonctionnement, s´ecurit´e, facteurs hu- mains, FRAM, supervision de trafic ferroviaire. I. Introduction Le management des risques industriels est devenu une conduite de syst`emes `a risque, de nombreux travaux sur la psychologie ergonomique (Human factor en Am

Paris-Sud XI, Université de

150

Appendiceal Abscess Revealed by Right Renal Colic and Hydronephrosis  

PubMed Central

Reported is the case of a patient who had an appendiceal abscess revealed by right renal colic with fever and general fatigue. The abdominal computed tomography scan showed hydronephrosis and an appendiceal abscess surrounding and compressing the ureter. The appendix contained a stercolith and was perforated. PMID:21826129

Khallouk, Abdelhak; Ahallal, Younes; Ahsaini, Mustapha; Elfassi, Mohamed Jamal; Farih, Moulay Hassan

2011-01-01

151

Fuzzy signal detection theory: analysis of human and machine performance in air traffic control, and analytic considerations  

Microsoft Academic Search

This paper applies fuzzy SDT (signal detection theory) techniques, which combine fuzzy logic and conventional SDT, to empirical data. Two studies involving detection of aircraft conflicts in air traffic control (ATC) were analysed using both conventional and fuzzy SDT. Study 1 used data from a preliminary field evaluation of an automated conflict probe system, the User Request Evaluation Tool (URET).

ANTHONY MASALONIS; RAJA PARASURAMAN

2003-01-01

152

Treatment of experimental ureteral strictures by endourological ureterotomy and implantation of stents in the porcine animal model  

Microsoft Academic Search

The objective of this study is to evaluate the dilation of the ureter using endoureterotomy and an expanding-sheath double pigtail ureteral stent in the treatment of experimentally induced ureteral strictures in the porcine animal model. This is a new treatment in the ureteral strictures resolution in Veterinary Urology, although it is not a common affection, it usually appears as a

Federico Soria; Fei Sun; Francisco M. Sánchez; Luis J. Ezquerra; Idoia D??az-Güemes; Jesús Usón

2004-01-01

153

[Laparoscopic robot-assisted partial nephrectomy with total ureterectomy in a symptomatic complete duplicated system: advantages of transperitoneal approach].  

PubMed

We report the case of a laparoscopic robot assisted left upper polar partial nephrectomy with total ureterectomy performed in a teenager. A 14 year-old girl was referred to our institution for stress urinary incontinence. The morphological assessment (ultrasound scan and uro-MRI) showed a double collecting system with a complete ureteral duplication complicated by a dysplasia of the upper moiety of the duplex left kidney and a mega ureter. The surgery started on a lateral decubitus position by the upper polar partial nephrectomy and the ureter section behind superior polar renal vessels. The patient was placed in a supine position and the mega ureter was released and sectioned at the level of the distal adynamic segment in the left uterine parameter. The transperitoneal route was chosen as it provides a large workspace and allows the dissection of the ureters into their pelvic portion by a simple repositioning of the robot ports without additional incision and without any modification of the operative field. No intraoperative and postoperative complication was noticed. Laparoscopic robotic assisted surgery in pediatric urology is increasing, and to our knowledge, we reported this technique and surgery for the first time in France and in children. In the reported case, we showed that the robotic minimally invasive surgery in children is an innovative and safe technique for the treatment of symptomatic upper urinary tract malformations. PMID:25176144

Tostivint, V; Doumerc, N; Roumiguie, M; Beauval, J-B; Rischmann, P; Soulie, M; Galinier, P; Bouali, O

2014-10-01

154

Vol. 157, 1915-1919, May 1997 Printed in U.S.A  

E-print Network

tissues, including the prostatic urethra, prostate, bladder, and ureter, with an axial resolution of 16 :t OF UROLOGY Copyright @ 1997 by AMERICAN UROLOGICALAsSOCIATION, lNC. OPTICAL BIOPSY IN HUMAN UROLOGIC TISSUE. BOPPART AND J. G. FUJIMOTO From the Department of Electrical Engineering and Computer Science and Research

Boppart, Stephen

155

Tissue Engineering der Harnröhre und des Harnleiters  

Microsoft Academic Search

Zusammenfassung Erworbene oder angeborene Störungen von Harnröhre und Harnleiter erfordern häufig geeignetes Gewebe zur Rekonstruktion der entsprechenden Defekte. Verschiedene Biomaterialien wurden erfolgreich zur Wiederherstellung von Ureter und Urethra in Tiermodellen und mittlerweile auch klinisch eingesetzt. Azelluläre Matrizes beispielsweise können, wenn sie im Empfängerorgan implantiert werden, dort als Grundgerüst für eine „natürliche“ Geweberegeneration dienen. Resorbierbare Gewebe können auch als Träger zur

S. Corvin; G. Feil; A. Stenzl

2004-01-01

156

Emergency Decompressive Craniotomy with Banked Skull Flap in Subcutaneous Pocket.  

National Technical Information Service (NTIS)

The abdominal KUB (Kidneys, Ureters, and Bladder, also sometimes referred to as 'Flat Plate') demonstrates a smooth, large, calcific opacity in the left lower quadrant (see figure 1). An enteric tube is also noted with its tip in stomach; surgical staples...

B. Adams, B. Singleton, L. Folio, S. Craig

2006-01-01

157

JAMA Patient Page: Kidney Transplantation  

MedlinePLUS

... C I P I E N T Kidney Transplantation Procedure The donor kidney is attached to a blood supply (an artery and a vein), and the ureter (to drain urine from the kidney) is attached to the ... a major operation usually requiring general anesthesia. ...

158

Subject-based Semantic Document Clustering for Digital Forensic Investigations  

E-print Network

Subject-based Semantic Document Clustering for Digital Forensic Investigations Gaby G. Dagher computers has created a demand for special forensic tools that allow investigators to look for evidence by the forensic process at S^uret´e du Qu´ebec (SQ), the Qu´ebec provincial police, we propose a new subject

Fung, Benjamin C. M.

159

Ureteroscopic Treatment of Ureteral Stones: Only an Auxiliary Measure of Extracorporeal Shockwave Lithotripsy or a Primary Therapeutic Option?  

Microsoft Academic Search

Both extracorporeal Shockwave lithotripsy (ESWL) and ureteroscopy are well-established methods in stone treatment; however, the therapeutic procedure in ureteral calculi, especially in the distal third of the ureter, is still controversially discussed. The aim of the present study was to examine the role of ureteroscopy as an auxiliary measure after ESWL and its importance as an alternative therapeutic option in

Avelino Hernandez Osti; Georg Hofmockel; Hubert Frohmüller

1997-01-01

160

Collagen studies in newborn rat kidneys with incomplete ureteric obstruction  

Microsoft Academic Search

Collagen studies in newborn rat kidneys with incomplete ureteric obstruction. Collagen studies in newborn rats with incomplete ureteric obstruction were performed to describe and quantify changes in collagen deposition resulting from urinary tract obstruction at an early developmental age. Incomplete ureteric obstruction was created in three-day-old rats by placing the left ureter in a tunnel formed by the psoas muscle,

Anna Haralambous-Gasser; Danny Chan; Rowan G Walker; Harley R Powell; Gavin J Becker; Colin L Jones

1993-01-01

161

[Tamsulosin in combind treatment of patients with urolithiasis].  

PubMed

In administration of tamsulosine (focusin, Zentiva, Czech Republic) in combined treatment of urolithiasis concrement evacuation after extracorporeal lithotripsy occurred in 83% cases in patients with the concrement stay in the ureter for less than one month. The size of the concrement after successful lithotripsy had no significant effect on subsequent stone-eliminating therapy but long-term stay of the concrement in one place promoted inflammatory and urodynamic disturbances in the ureter treated surgically. The comparative analysis of the contractile function of the distal ureteral comparment in patients given tamsulosin showed a less active (amplitude of the contractions) and passive (tonicity) resistance to urine flow than in patients given a standard therapy. These changes were accompanied with lower pressure in the renal pelvis and suppression of enzymuria. Thus, tamsulosin addition to combined treatment of urolithiasis has a positive effect on ureteral urodynamics, concrement evacuation and functional structures of the kidney by indirectly lowering intrapelvic pressure. PMID:19827185

Maksimov, V A; Khodyreva, L A; Mudraia, I S; Moskalenko, S A; Martov, A G; Stupak, N V; Fakhredinov, G A; Golovanov, S A

2009-01-01

162

[Medical management of acute renal colic - there is more than hydration and Buscopan®...].  

PubMed

Renal colic is generated by hyperperistalsis of the obstructed ureter. Peristalsis is modulated by (among others) alpha-receptors (contraction), beta-receptors (relaxation) and prostaglandins (PG F2alpha: contraction, PG E1/E2: relaxation). Non-steroidal anti-inflammatory drugs (NSAID) are highly effective in pain relief and should always be given in the absence of contraindications. The same is true for metamizole, whereas Buscopan® is not superior to placebo. For most severe pain, opioids are indicated. alpha-blockers and calcium channel blockers dilate the distal ureter and increase the likelihood of spontaneous stone passage by up to 65%. Overhydration of patients has no advantage, but carries the risk of pelvic rupture with urine extravasation and infection. Stones of/above diameter 7 mm are unlikely to pass spontaneously and should be interventionally removed. PMID:21365560

Hess, B

2011-03-01

163

[Ureteral stenting after retrograde ureteroscopy. Experience of Ia?i urological department].  

PubMed

Ureteroscopy is a well-established procedure, which has proven the efficiency for diagnostic purposes, but mostly for ureteric stone removal. The authors describe their strategy after ureteroscopic lithotripsy with Wolf 8 Ch semirigid ureteroscope. Insertion of a double J stent for 2-4 weeks was the rule when there was an important bleeding during the procedure, the fragments were big and could not be extracted, some fragments migrated in upper third of the ureter or renal pelvis, a perforation occurred or it was found a ureteral stenosis. If the stone can be extracted without any problems (in one piece) and the ureter is normal there is no need for ureteral stenting. Having in mind that many patients describe problems with the double J stent (pains, polakiuria, etc) we recommend to insert a stent at the end of ureteroscopy only for selected cases. PMID:14755987

Novac, C; Pricop, C; Costache, C; Negru, Irina; Negru, D; Tomac, I; Ristescu, C; T?nase, Veronica; Bîrleanu, Cristina

2003-01-01

164

Ureteral rupture from aberrant Foley catheter placement: A case report  

PubMed Central

We present the case of a 59 year old female with history of severe neurologic dysfunction from advanced multiple sclerosis who presented with lethargy and oliguria several hours after urethral Foley catheterization. A contrast-enhanced CT scan of the abdomen/pelvis showed an aberrantly placed Foley catheter with its balloon inflated in the proximal left ureter, a rare complication of Foley catheterization with only 5 other cases reported. Incomplete ureteral rupture was demonstrated and confirmed by a followup CT scan in the urographic phase. One of our institution’s Interventional Radiologists then placed a nephroureteral stent across the injured ureter to facilitate healing. The patient expired 9 days after the procedure from unrelated sepsis from a chronic stage IV decubitus ulcer, so long term monitoring could not be performed. Following description of our case, we conduct a literature review of presentations, imaging characteristics, and treatment of ureteral Foley catheter placement. PMID:23372873

Baker, Kevin S; Dane, Bari; Edelstein, Yudell; Malhotra, Ajay; Gould, Elaine

2013-01-01

165

A unique case of kidney's collecting system MALT lymphoma  

PubMed Central

Low-grade B cell lymphomas of mucosa-associated lymphoid tissue (MALT lymphomas) are mostly seen in the gastrointestinal tract. MALT lymphomas involving kidney are extremely rare. We report on a case of MALT lymphomas of the kidney. A 74-year-old woman presented with an episode of gross hematuria and right flank pain. In renal sonography, we found a hypoecho lesion measuring 61 × 58 × 44 mm in the lower pole of right kidney. A computed tomography scan revealed an enlarged hypodense soft tissue measuring 62 × 42 × 37 mm within the pelvic brim of the right kidney, with extension to the proximal portion of the ipsilateral ureter and engulfed it. The patient underwent a right radical nephrectomy. The pathology specimen indicated a lymphoprolifrative disorder involving the kidney and ureter. To obtain a definitive diagnosis, we used an immunohistochemistry, which confirmed the diagnosis of a MALT lymphoma. PMID:24678358

Asgari, Seyed Alaeddin; Aval, Hamidreza Baghani; Asgari, Seyed Ali; Kheradmand, Keyvan

2014-01-01

166

A unique case of kidney's collecting system MALT lymphoma.  

PubMed

Low-grade B cell lymphomas of mucosa-associated lymphoid tissue (MALT lymphomas) are mostly seen in the gastrointestinal tract. MALT lymphomas involving kidney are extremely rare. We report on a case of MALT lymphomas of the kidney. A 74-year-old woman presented with an episode of gross hematuria and right flank pain. In renal sonography, we found a hypoecho lesion measuring 61 × 58 × 44 mm in the lower pole of right kidney. A computed tomography scan revealed an enlarged hypodense soft tissue measuring 62 × 42 × 37 mm within the pelvic brim of the right kidney, with extension to the proximal portion of the ipsilateral ureter and engulfed it. The patient underwent a right radical nephrectomy. The pathology specimen indicated a lymphoprolifrative disorder involving the kidney and ureter. To obtain a definitive diagnosis, we used an immunohistochemistry, which confirmed the diagnosis of a MALT lymphoma. PMID:24678358

Asgari, Seyed Alaeddin; Aval, Hamidreza Baghani; Asgari, Seyed Ali; Kheradmand, Keyvan

2014-01-01

167

In vitro adherence of type 1-fimbriated uropathogenic Escherichia coli to human ureteral mucosa.  

PubMed Central

Type 1-fimbriated Escherichia coli isolated from patients with urinary tract infections adhered in vitro to the epithelial cell surface of an excised human ureter. The bacteria also adhered to a mucous coating and to Formalin-fixed human ureteral mucosa. D-Mannose strongly inhibited such adherence. The bacteria in their nonfimbriated phase lacked the ability to adhere. We concluded that type 1 fimbriae play a role, at least in part, in upper urinary tract infections in humans. Images PMID:2568346

Fujita, K; Yamamoto, T; Yokota, T; Kitagawa, R

1989-01-01

168

ESAIM: M2AN 42 (2008) 303331 ESAIM: Mathematical Modelling and Numerical Analysis DOI: 10.1051/m2an:2008005 www.esaim-m2an.org  

E-print Network

and Jean-Claude Latch´e4 Abstract. We present in this paper a pressure correction scheme for the barotropic Radioprotection et de S^uret´e Nucl´eaire (IRSN), France. jean-claude.latche@irsn.fr Article published by EDP work of Harlow and Amsden [20,21] in the late sixties, who developed an iterative algorithm (the so

Gallouët, Thierry

169

Radiology of obstetric vesicovaginal fistula  

Microsoft Academic Search

The excretory urograms of 70 Nigerian women presenting to the University of Benin Teaching Hospital with obstetric vesicovaginal\\u000a fistula over a 7-year period are analyzed. The common abnormalities are medial deviation of distal ends of ureters (34%);\\u000a discrete but smooth pseudoprostatic bladder base indentation (33%); and calyceal clubbing of varying degrees (19%). Other\\u000a abnormalities observed include hydroureters (18%); bladder calculi

A. I. Akamaguna; J. C. Odita; L. N. Ajabor; E. E. Okpere

1983-01-01

170

Radiology of obstetric vesicovaginal fistula.  

PubMed

The excretory urograms of 70 Nigerian women presenting to the University of Benin Teaching Hospital with obstetric vesicovaginal fistula over a 7-year period are analyzed. The common abnormalities are medial deviation of distal ends of ureters (34%); discrete but smooth pseudoprostatic bladder base indentation (33%); and calyceal clubbing of varying degrees (19%). Other abnormalities observed include hydroureters (18%); bladder calculi (7%); bladder wall calcification (3%), and unilateral nonfunctioning kidneys (3%). PMID:6686363

Akamaguna, A I; Odita, J C; Ajabor, L N; Okpere, E E

1983-01-01

171

Ureteral quadruplication: the fourth case report.  

PubMed

Among development abnormalities of the upper urinary tract, ureteral duplication is a very common finding while triplication is quite rare. Ureteral quadruplication is exceedingly unusual; to our knowledge only three cases have been reported over the past 25 years and all of them concerned adult patients. We present a case of unilateral quadruplicated ureters in a 9-month-old infant. Review of the literature failed to reveal documentation of such a case. PMID:7724291

Sourtzis, S; Damry, N; Janssen, F; Perlmutter, N

1994-01-01

172

A case of ureteral triplication (type 1) associated with vesicoureteral reflux in a solitary kidney  

Microsoft Academic Search

Ureteral triplication is a rare congenital anomaly of the upper urinary tract. It is reported to be associated with an increased\\u000a incidence of congenital anomalies as well as a predisposition to infection and calculus formation. We report a case of type\\u000a 1 variant of ureteral triplication associated with vesicoureteral reflux into lower and mid pole ureters in a solitary kidney.

H. Ander; O. Ziylan; S. Çayan; T. C. Kadio?lu; A. Be?i?ik

1997-01-01

173

Ureteral Triplication Combined with Right Renal Ectopia and Ureteral Cyst  

Microsoft Academic Search

Ureteral triplication is one of the rarest malformations of the upper urinary tract. We report the case of a 12-year-old girl with right ureteral triplication combined with renal ectopia and ureteral cyst with stenosis at the junction of the ureteral cyst and distal ureter. The ureteral cyst was tailored and tubularized, and the tight junction was removed, as in Hynes-Anderson

Zhe Xu; Zuoqing Li; Daohu Wang; Gaoyan Deng; Cheng Su; Jing Pan; Suisheng Li

2009-01-01

174

A case of ureteral triplication (type 1) associated with vesicoureteral reflux in a solitary kidney.  

PubMed

Ureteral triplication is a rare congenital anomaly of the upper urinary tract. It is reported to be associated with an increased incidence of congenital anomalies as well as a predisposition to infection and calculus formation. We report a case of type 1 variant of ureteral triplication associated with vesicoureteral reflux into lower and mid pole ureters in a solitary kidney. To our knowledge ureteral triplication in a solitary kidney has not been described previously. PMID:9413759

Ander, H; Ziylan, O; Cayan, S; Kadio?lu, T C; Be?i?ik, A

1997-01-01

175

Renal Colic Resulting From Renal Calculus Disease  

Microsoft Academic Search

\\u000a Colic describes any severe spastic pain originating from distention or obstruction of a hollow organ. In particular, renal colic refers to sharp paroxysmal pain originating from spasm in or distention of the renal capsule or ureter or pain resulting\\u000a from ureteral obstruction. It is perceived as intermittent sharp pain generally originating from the flank and occasionally\\u000a radiating to the lower

Rajveer S. Purohit; Marshall L. Stoller

176

Retroperitoneal Malignant Solitary Fibrous Tumor of the Small Pelvis Causing Recurrent Hypoglycemia by Secretion of Insulin-like Growth Factor 2  

Microsoft Academic Search

A 28-yr-old man presented with recurrent reduced consciousness, generalized seizures of unknown etiology, recurrent hypoglycemia, psychomotor retardation, and grade 2 ectasia of the left kidney. Abdominal computed tomography (CT) and positron emission tomography (PET) scans demonstrated a well-circumscribed suprapubic pelvic mass, measuring 18×15×11cm, with involvement of para-aortic lymph nodes and dilatation of the left ureter suggestive of an extragonadal testicular

Sigrid Wagner; Francesco Greco; Amir Hamza; Rashid M. Hoda; Hans Jürgen Holzhausen; Paolo Fornara

2009-01-01

177

[Hematuria secondary to arterioureteral fistula. Endovascular treatment].  

PubMed

Presentation of case of patient with macroscopic anemic hematuria caused for the presence of a fistula between the external iliac artery and the ureter. After the diagnosis, a treatment with endovascular mangement was made. The arterioureteral fistulae are a very rare entie, which supposes a vital emergency. The diagnosis depend upon the clinical evidences (complementary explorations rarely provide specific findings). Classic treatment is bases on open surgery, while endovascular treatment may be an alternative with less aggressiveness. PMID:11765553

Marco Pérez, L M; Vigués Julia, F; Trilla Herrera, E; Domínguez Elias, J; Ponce Campuzano, A; González Satué, C; Aguiló Lucia, F; Serrallach i Milá, N

2001-10-01

178

Diffuse Large B-Cell Lymphoma in an Adolescent Male Presenting as Ureteral Stricture  

PubMed Central

Lymphoma may affect the ureter in cases of retroperitoneal involvement. We present a case of an adolescent male found to have non-Hodgkin lymphoma initially presenting as ureteral stricture evident on imaging. He was treated and responded to multiagent chemotherapy with resolution of both the lymphoma and the ureteral stricture. Although rare, non-Hodgkin lymphoma should be included in the differential diagnosis of pediatric patients with noncalculous, idiopathic ureteral strictures. PMID:25093138

Jaeger, Christopher D.; McAlvany, Kelly L.; Zingula, Shannon N.; Kramer, Stephen A.; Granberg, Candace F.

2014-01-01

179

Bilateral Uric Acid Nephrolithiasis and Ureteral Hypertrophy in a Free-ranging River Otter (Lontra canadensis)  

Microsoft Academic Search

We report the first case of uric acid nephrolithiasis in a free-ranging river otter (Lontra canadensis ). A7y r oldmale river otter collected from the Skagit River of western Washington (USA) had bilateral nephrolithiasis and severely enlarged ureters (one of 305 ex- amined (0.33%)). The uroliths were 97% uric acid and 3% protein. Microscopic changes in the kidney were confined

Robert A. Grove; Rob Bildfell; Charles J. Henny; Donald R. Buhler

2003-01-01

180

Venous intravasation of barium into the inferior mesenteric vein mimicking a coloureteral fistula: a case report and literature review.  

PubMed

Venous intravasation of barium following a barium enema is a rare event. We report a case of barium venous intravasation into the inferior mesenteric vein. Because of the close proximity to the course of the left ureter, this condition was interpreted initially as a coloureteral fistula. After further analysis of the original films, and left retrograde pyelography the true diagnosis was established. A literature review of barium intravasation is presented. PMID:2642308

Baer, H M; Siegelbaum, M H; Seidmon, E J; Kendall, A R

1989-01-01

181

Paradigm shift from classic anatomic theories to contemporary cell biological views of CAKUT  

Microsoft Academic Search

Paradigm shift from classic antatomic theories to contemporary cell biological views of CAKUT. Ectopic budding of the ureter from the Wolffian duct is the first ontogenic misstep that leads to many—if not all—congenital anomalies of the kidney and urinary tract (CAKUT). The ectopia results in hypoplastic kidney, ectopia of ureterovesical orifice, urinary outflow obstruction and\\/or reflux. Studies in several mutant

Iekuni Ichikawa; Fumiyo Kuwayama; John C. Pope; F. Douglas Stephens; Yoichi Miyazaki

2002-01-01

182

Platelet Derived Growth Factor-BB is a Potent Mitogen for Rat Ureteral and Human Bladder Smooth Muscle Cells: Dependence in Lipid Rafts for Cell Signaling  

Microsoft Academic Search

PurposeFibromuscular tissues of the detrusor\\/bladder body (B), trigone (T) and ureter (U) display distinct patterns of tissue remodeling in pathologic contexts, however the mechanisms underlying these observations are unknown. In this study we asked whether B, T and U smooth muscle cells (SMC) respond to several SMC growth factors and explored the role of caveolae\\/lipid raft membrane microdomains in signaling

MAXIMILIAN STEHR; ROSALYN M. ADAM; JOSEPH KHOURY; LIYAN ZHUANG; KEITH R. SOLOMON; CRAIG. A. PETERS; MICHAEL R. FREEMAN

2003-01-01

183

Prosthetic Sphincter Controls Urination  

NASA Technical Reports Server (NTRS)

People who lost muscular control of urinary canal through disease or injury aided by prosthetic sphincter. Implanted so it surrounds uretha, sphincter deflated and inflated at will by wearer to start and stop urina tion. Operating pressure adjusted after implantation to accommodate growth or atrophy of urinary canal and prevent tissue damage from excess pressure. Principle adapted to other organs, such as colon, ureter, or ileum.

Tenny, John B., Jr

1986-01-01

184

Pitfalls of cholescintigraphy. A case report  

SciTech Connect

A /sup 99m/Tc PIPIDA scan was performed in a young auto accident victim who had a transient rise in serum bilirubin level. Initially, the stasis of activity in the right ureter was mistaken for activity in the common bile duct. Misinterpretation of biliary imaging studies can be prevented with awareness of pitfalls and readiness to obtain delayed images and additional images in different projections.

Strickler, S.; Park, H.M.

1982-12-01

185

Endoscopic holmium laser treatment for ureterolithiasis  

PubMed Central

Introduction The rapid development and invention of ever more technologically advanced ureterorenoscopes as well as other instruments used in fragmenting ureteral stones have made the traditional surgical treatment of ureterolithiasis very rare. Material and methods We investigated 727 patients treated for ureterolithiasis. 769 ureteroscopic lithotripsies (URSL) with the holmium laser were performed. We evaluated the relation of the stone size, the section of the ureter involved, length of time of the stone within the ureter and the condition of the urinary tract to the results of the ureterolithiasis treatment. Results A good result of breaking up the stone and passing its fragments out of the ureter within 3 months following the first URSL was observed in 642 (90.9%) out of 706 patients. The remaining 64 (9.1%) patients required additional procedures: ESWL was performed on 44 patients; URSL was repeated for 20 patients. The most serious early post-URSL complications involved: urinary tract infection with symptoms of urosepsis in 10 patients, leading to death in 1 case, ureteral perforation in 3 patients, including 1 case presenting a periureteral leak that necessitated a surgical intervention. Conclusions URSL with the holmium laser is an effective and safe method for treating ureterolithiasis. PMID:24578918

Sosnowski, Marek

2012-01-01

186

Intraoperative electron-beam radiotherapy and ureteral obstruction  

SciTech Connect

Purpose: To quantify the risk of ureteral obstruction (UO) after intraoperative electron-beam radiotherapy (IOERT). Methods and Materials: One hundred forty-six patients received IOERT of 7.5 to 30 Gy to 168 ureters; 132 patients received external radiotherapy. Results: Follow-up ranged from 0.01 to 19.1 years (median, 2.1 years). The rates of clinically apparent type 1 UO (UO from any cause) after IOERT at 2, 5, and 10 years were 47%, 63%, and 79%, respectively. The rates of clinically apparent type 2 UO (UO occurring at least 1 month after IOERT, excluding UO caused by tumor or abscess and patients with stents) at 2, 5, and 10 years were 27%, 47%, and 70%, respectively. Multivariate analysis revealed that the presence of UO before IOERT (p < 0.001) was associated with an increased risk of clinically apparent type 1 UO. Increasing IOERT dose (p < 0.04) was associated with an increased risk of clinically apparent type 2 UO. UO rates in ureters not receiving IOERT at 2, 5, and 10 years were 19%, 19%, and 51%, respectively. Conclusions: Risk of UO after IOERT increases with dose. However, UO risk for ureters not receiving IOERT was also high, which suggests an underlying risk of ureteral injury from other causes.

Miller, Robert C. [Division of Radiation Oncology, Mayo Clinic, Rochester, MN (United States); Haddock, Michael G. [Division of Radiation Oncology, Mayo Clinic, Rochester, MN (United States); Petersen, Ivy A. [Division of Radiation Oncology, Mayo Clinic, Rochester, MN (United States); Gunderson, Leonard L. [Department of Radiation Oncology, Mayo Clinic, Scottsdale, Arizona (United States); Furth, Alfred F. [Cancer Center Statistics Unit, Mayo Clinic, Rochester, MN (United States)

2006-03-01

187

Ureteral Reconstruction With Bowel Segments: Experience With Eight Patients in a Single Institute  

PubMed Central

Purpose Although replacement of the ureter with a bowel segment is indicated for large ureteral defects, it is still a challenging technique for urologists. We present our experience and outcome of ureteral reconstruction using bowel segments. Materials and Methods Ureteral reconstruction with bowel segments was performed in eight patients in our institute between 1969 and 2009. We investigated the position and length of the ureteral defect and methods of reconstruction as well as the patients' backgrounds, postoperative complications, and clinical outcomes. Results Five patients underwent ureteral replacement with isolated ileal segments alone. In one patient, the ureter was reconstructed by using the Yang-Monti procedure with the ileum. A colon segment was used in two patients who required bladder augmentation for tuberculous contracted bladder at the same time. Metabolic acidosis occurred in three patients having a solitary kidney and the ureter had to be replaced by a relatively long intestinal segment. Two patients who received preoperative radiation therapy were required to undergo additional operations. Long-term cancer-free survival was achieved in one patient who underwent ileal substitution for low-grade renal pelvic cancer. Conclusions Although ureteral replacement with a bowel segment is a challenging and useful procedure, attention must be paid to the possibility of metabolic acidosis, which is likely to occur in patients having a solitary kidney with renal insufficiency or in patients requiring a long intestinal segment for reconstruction. In addition, preoperative radiation therapy for the pelvic organs may cause postoperative complications.

Takeuchi, Motoi; Tsukamoto, Taiji

2014-01-01

188

A peculiar complication of suprapubic catheterization: Recurrent ureteral obstruction and hydronephrosis  

PubMed Central

Context Suprapubic cystostomy (SPC) catheterization is a common and important technique for the management of vesicular drainage, especially in patients with neurogenic bladder. Some serious complications include bowel perforation and obstruction. Findings A 55-year-old man with C6 American Spinal Injury Association B tetraplegia and a urethral stricture requiring a chronic SPC was admitted for recurrent urosepsis. Computed tomography (CT) of the abdomen revealed severe right hydronephrosis and hydroureter due to obstruction of the right distal ureter by the SPC tip. The SPC (30 French/10-mm silicone catheter with a 10-ml balloon) was removed and replaced with a similar suprapubic catheter (30 French/10-mm silicone catheter with an 8-ml balloon). Symptoms recurred 2 months later and he was readmitted for urosepsis. CT of the abdomen again revealed severe right hydronephrosis and hydroureter due to obstruction of the right distal ureter by the SPC tip. The SPC was removed, and the patient was given a 14 French/4.67-mm urethral silicone catheter with a 5-ml balloon. Follow-up CT of the abdomen 2 months later showed complete resolution of the hydronephrosis and hydroureter. Of note, urodynamic studies 2 years earlier revealed an extremely small bladder with a capacity less than 20 ml. Conclusion This case illustrates that obstruction of the ureter by the tip of an SPC can be a cause of recurrent hydronephrosis and urosepsis. PMID:23809534

Adeyemo, Bamidele; Makovitch, Steven; Foo, Dominic

2013-01-01

189

Critical role of cyclooxygenase-2 activation in pathogenesis of hydronephrosis caused by lactational exposure of mice to dioxin  

SciTech Connect

Congenital hydronephrosis is a serious disease occurring among infants and children. Besides the intrinsic genetic factors, in utero exposure to a xenobiotic, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), has been suggested to induce hydronephrosis in rodents owing to anatomical obstruction in the ureter. Here, we report that hydronephrosis induced in mouse pups exposed lactationally to TCDD is not associated with anatomical obstruction, but with abnormal alterations in the subepithelial mesenchyma of the ureter. In the kidneys of these pups, the expressions of a battery of inflammatory cytokines including monocyte chemoattractant protein (MCP)-1, tumor necrosis factor {alpha} (TNF{alpha}) and interleukin (IL) -1{beta} were up-regulated as early as postnatal day (PND) 7. The amounts of cyclooxygenase (COX) -2 mRNA and protein as well as prostaglandin E2 (PGE{sub 2}) were conspicuously up-regulated in an arylhydrocarbon-receptor-dependent manner in the TCDD-induced hydronephrotic kidney, with a subsequent down-regulation of the gene expressions of Na{sup +} and K{sup +} transporters, NKCC2 and ROMK. Daily administration of a COX-2 selective inhibitor to newborns until PND 7 completely abrogated the TCDD-induced PGE{sub 2} synthesis and gene expressions of inflammatory cytokines and electrolyte transporters, and eventually prevented the onset of hydronephrosis. These findings suggest an essential role of COX-2 in mediating the TCDD action of inducing hydronephrosis through the functional impairment rather than the anatomical blockade of the ureter.

Nishimura, Noriko [Research Center for Environmental Risk, National Institute for Environmental Studies, Tsukuba 305-8506 (Japan)], E-mail: nishimura.noriko@nies.go.jp; Matsumura, Fumio; Vogel, Christopher F.A. [Department of Environmental Toxicology and Center for Environmental Health Sciences, University of California, Davis, CA 95616 (United States); Nishimura, Hisao [Department of Human Sciences, Aichi Mizuho University, Toyota 470-0394 (Japan); Yonemoto, Junzo [Research Center for Environmental Risk, National Institute for Environmental Studies, Tsukuba 305-8506 (Japan); Yoshioka, Wataru [Laboratory of Environmental Health Sciences, Center for Disease Biology and Integrative Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033 (Japan); Tohyama, Chiharu [Research Center for Environmental Risk, National Institute for Environmental Studies, Tsukuba 305-8506 (Japan); Laboratory of Environmental Health Sciences, Center for Disease Biology and Integrative Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033 (Japan)], E-mail: mtohyama@mail.ecc.u-tokyo.ac.jp

2008-09-15

190

Case-Control Study of Arsenic in Drinking Water and Kidney Cancer in Uniquely Exposed Northern Chile  

PubMed Central

Millions of people worldwide are exposed to arsenic in drinking water. The International Agency for Research on Cancer has concluded that ingested arsenic causes lung, bladder, and skin cancer. However, a similar conclusion was not made for kidney cancer because of a lack of research with individual data on exposure and dose-response. With its unusual geology, high exposures, and good information on past arsenic water concentrations, northern Chile is one of the best places in the world to investigate the carcinogenicity of arsenic. We performed a case-control study in 2007–2010 of 122 kidney cancer cases and 640 population-based controls with individual data on exposure and potential confounders. Cases included 76 renal cell, 24 transitional cell renal pelvis and ureter, and 22 other kidney cancers. For renal pelvis and ureter cancers, the adjusted odds ratios by average arsenic intakes of <400, 400–1,000, and >1,000 µg/day (median water concentrations of 60, 300, and 860 µg/L) were 1.00, 5.71 (95% confidence interval: 1.65, 19.82), and 11.09 (95% confidence interval: 3.60, 34.16) (Ptrend < 0.001), respectively. Odds ratios were not elevated for renal cell cancer. With these new findings, including evidence of dose-response, we believe there is now sufficient evidence in humans that drinking-water arsenic causes renal pelvis and ureter cancer. PMID:23764934

Ferreccio, Catterina; Smith, Allan H.; Durán, Viviana; Barlaro, Teresa; Benítez, Hugo; Valdés, Rodrigo; Aguirre, Juan José; Moore, Lee E.; Acevedo, Johanna; Vásquez, María Isabel; Pérez, Liliana; Yuan, Yan; Liaw, Jane; Cantor, Kenneth P.; Steinmaus, Craig

2013-01-01

191

Endoscopic Management of Vesicoureteral Reflux in Children in Kosova  

PubMed Central

Introduction: Vesicoureteral reflux (VUR) in children has been treated with subureteric deflux injection of Deflux (dextranomer hyaluronic acid copolymer) since 2009. The aim of this study was to analyze the results of endoscopic treatment of VUR in our clinic. Methods: Between March 2009 and December 2013, fifty-five children underwent endoscopic subureteral injection of Deflux in 78 ureters. Two months postoperatively voiding cystourethrogram (VCUG) was performed. This study examined the disappearance of VUR and urinary tract infection (UTI) as well as the quality of life during long-term follow-up. Results: The study included 55 patients (40 females and 15 males) with 78 refluxing ureters. There were 22 refluxed ureters altogether and 33 children had a unilateral reflux (two duplicated systems). All patients were treated, from the age 6 months up to 12 years old. The mean age of patients was 5.2 years. There has been no complications, but with few recurrences. In 6 patients (16.6%), endoscopic treatment with deflux was done twice, while in three patients (8.5%), the endoscopic treatment with deflux was performed three times, because of recurrence. Conclusion: We recommend the use of endoscopic Deflux injection as first line treatment for children with VUR. Endoscopic subureteral injection of Deflux is a minimally invasive method for VUR treatment in pediatric patients and is associated with low morbidity. PMID:25132708

Berisha, Murat; Hyseni, Nexhmi; Statovci, Sejdi; Grajqevci, Salih; Xhiha, Butrint

2014-01-01

192

Syntactic methods of shape feature description and its application in analysis of medical images  

NASA Astrophysics Data System (ADS)

The paper presents specialist algorithms of morphologic analysis of shapes of selected organs of abdominal cavity proposed in order to diagnose disease symptoms occurring in the main pancreatic ducts and upper segments of ureters. Analysis of the correct morphology of these structures has been conducted with the use of syntactic methods of pattern recognition. Its main objective is computer-aided support to early diagnosis of neoplastic lesions and pancreatitis based on images taken in the course of examination with the endoscopic retrograde cholangiopancreatography (ERCP) method and a diagnosis of morphological lesions in ureter based on kidney radiogram analysis. In the analysis of ERCP images, the main objective is to recognize morphological lesions in pancreas ducts characteristic for carcinoma and chronic pancreatitis. In the case of kidney radiogram analysis the aim is to diagnose local irregularity of ureter lumen. Diagnosing the above mentioned lesion has been conducted with the use of syntactic methods of pattern recognition, in particular the languages of shape features description and context-free attributed grammars. These methods allow to recognize and describe in a very efficient way the aforementioned lesions on images obtained as a result of initial image processing into diagrams of widths of the examined structures.

Ogiela, Marek R.; Tadeusiewicz, Ryszard

2000-02-01

193

Bilateral uric acid nephrolithiasis and ureteral hypertrophy in a free-ranging river otter (Lontra canadensis)  

USGS Publications Warehouse

We report the first case of uric acid nephrolithiasis in a free-ranging river otter (Lontra canadensis). A 7 yr old male river otter collected from the Skagit River of western Washington (USA) had bilateral nephrolithiasis and severely enlarged ureters (one of 305 examined [0.33%]). The uroliths were 97% uric acid and 3% protein. Microscopic changes in the kidney were confined to expansion of renal calyces, minor loss of medullary tissue, and multifocal atrophy of the cortical tubules. No inflammation was observed in either kidney or the ureters. The ureters were enlarged due to marked hypertrophy of smooth muscle plus dilation of the lumen. Fusion of the major calyces into a single ureteral lumen was several cm distal to that of two adult male otters used as histopathologic control specimens. This case report is part of a large contaminant study of river otters collected from Oregon and Washington. It is important to understand diseases and lesions of the otter as part of our overall evaluation of this population.

Grove, Robert A.; Bildfell, Rob; Henny, Charles J.; Buhler, D.R.

2003-01-01

194

Bilateral uric acid nephrolithiasis and ureteral hypertrophy in a free-ranging river otter (Lontra canadensis).  

PubMed

We report the first case of uric acid nephrolithiasis in a free-ranging river otter (Lontra canadensis). A 7 yr old male river otter collected from the Skagit River of western Washington (USA) had bilateral nephrolithiasis and severely enlarged ureters (one of 305 examined [0.33%]). The uroliths were 97% uric acid and 3% protein. Microscopic changes in the kidney were confined to expansion of renal calyces, minor loss of medullary tissue, and multifocal atrophy of the cortical tubules. No inflammation was observed in either kidney or the ureters. The ureters were enlarged due to marked hypertrophy of smooth muscle plus dilation of the lumen. Fusion of the major calyces into a single ureteral lumen was several cm distal to that of two adult male otters used as histopathologic control specimens. This case report is part of a large contaminant study of river otters collected from Oregon and Washington. It is important to understand diseases and lesions of the otter as part of our overall evaluation of this population. PMID:14733290

Grove, Robert A; Bildfell, Rob; Henny, Charles J; Buhler, Donald R

2003-10-01

195

Efficacy of combining flexible and rigid ureteroscopy for transurethral lithotripsy.  

PubMed

Transurethral lithotripsy (TUL) is a common procedure in urology. However, controversy persists about how to deal with stones pushed up into kidney from the ureter during the procedure of TUL. This study investigated the efficacy of combining flexible ureteroscopy and rigid ureteroscopy for pushed-up stones into kidney during TUL. Fotry-one patients underwent TUL by a single surgeon from July 2007 to May 2009. Eight cases resulted in pushed-up stones during operation or involved existing kidney stones. We used a Zero-tip or Litho Catch Basket catheter and a flexible ureteroscope to carry these stones in kidney down into the ureter where the rigid ureteroscope could then reach and handle the stone for lithotripsy or being taken away. A Lithoclast system was used for lithotripsy. Five cases involved stones pushed up during surgery and 3 cases involved stones already in the kidney in detail. We pulled the stones down into the ureter in all cases and successfully completed lithotripsy or removed the stone, thus avoiding the performance of additional extracorporeal shock wave lithotripsy (ESWL). In conclusions, combined use of flexible ureteroscopy and rigid ureteroscopy for upper urinary tract stones pushed up into the kidney during TUL or renal stones could be useful for avoiding additional ESWL. PMID:21063143

Shigemura, Katsumi; Yasufuku, Tomihiko; Yamashita, Masuo; Arakawa, Soichi; Fujisawa, Masato

2010-01-01

196

Long-term results after endoscopic VUR-treatment using dextranomer / hyaluronic acid copolymer - 5-year experience in a single-center  

PubMed Central

Background A number of bulking agents have been used for the endoscopic correction of vesicoureteral reflux in children. We present our long-term results of endoscopic use of dextranomer/hyaluronic acid copolymer (Deflux®) for VUR treatment in children. Patients and methods Between 2004 and 2008, 21 children underwent endoscopic subureteral injection of Deflux® in 30 ureters as an outpatient procedure. Twelve children had unilateral reflux (2 duplicated systems) and nine had bilateral reflux. Median age was 5-years (6-months to 14.9-years). Six weeks postoperatively, a voiding cystourethrogram was performed. This study examined the disappearance of VUR and urinary tract infection (UTI) in the long-term follow-up as well as QoL (questionnaire of the parents). Results No intra- or postoperative complications had been noticed. In 25 ureters (83%), VCUG showed no VUR 6-weeks postoperatively. Three children received a 2nd injection (two successful). After a median follow-up of 2.5 years, 27 ureters in 17 children (90%) had no urinary tract infection and VUR. The questionnaire results in regard to quality of life (QoL) were very good in the successfully treated children and the parents would choose the same treatment option again. Conclusion Subureteral injection of Deflux® for children with VUR is an effective treatment option with a low complication rate. PMID:24578870

Seibold, Joerg; Werther, Maren; Alloussi, Saladin H.; Aufderklamm, Stefan; Gakis, Georgios; Todenhofer, Tilman; Stenzl, Arnulf

2011-01-01

197

Lower urinary tract development and disease  

PubMed Central

Congenital Anomalies of the Lower Urinary Tract (CALUT) are a family of birth defects of the ureter, the bladder and the urethra. CALUT includes ureteral anomalies such as congenital abnormalities of the ureteropelvic junction (UPJ) and ureterovesical junction (UVJ), and birth defects of the bladder and the urethra such as bladder-exstrophy-epispadias complex (BEEC), prune belly syndrome (PBS), and posterior urethral valves (PUV). CALUT is one of the most common birth defects and is often associated with antenatal hydronephrosis, vesicoureteral reflux (VUR), urinary tract obstruction, urinary tract infections (UTI), chronic kidney disease and renal failure in children. Here, we discuss the current genetic and molecular knowledge about lower urinary tract development and genetic basis of CALUT in both human and mouse models. We provide an overview of the developmental processes leading to the formation of the ureter, bladder, and urethra, and different genes and signaling pathways controlling these developmental processes. Human genetic disorders that affect the ureter, bladder and urethra and associated gene mutations are also presented. As we are entering the post-genomic era of personalized medicine, information in this article may provide useful interpretation for the genetic and genomic test results collected from patients with lower urinary tract birth defects. With evidence-based interpretations, clinicians may provide more effective personalized therapies to patients and genetic counseling for their families. PMID:23408557

Rasouly, Hila Milo; Lu, Weining

2013-01-01

198

Pharmacological options for the treatment of acute ureteric colic. An in vitro experimental study.  

PubMed

The effects of opiate and non-steroidal anti-inflammatory agents on the in vitro canine ureter were compared using a new model for the assessment of ureteric pharmacology. A pressure measuring catheter attached to a pressure transducer and pre-calibrated pen recorder was ligated into the lumen of 2.5 cm segments of normal canine ureter. The segments were immersed in an organ bath at physiological pH and temperature and spontaneous contractility was observed in 90% of them. Morphine had a spasmogenic effect on ureteric activity which was unaffected by naloxone. This effect was similar to that of histamine and prostaglandin F2 alpha and was abolished by chlorpheniramine but not by cimetidine. Pethidine produced a transient stimulation followed by inhibition of ureteric activity which was unaffected by naloxone. Both indomethacin and diclofenac produced an abrupt inhibition which was reversible with prostaglandin F2 alpha. These data suggest that pethidine or a non-steroidal anti-inflammatory agent may by virtue of their spasmolytic effects be a superior choice of therapy for the acutely obstructed ureter. PMID:8499982

Lennon, G M; Bourke, J; Ryan, P C; Fitzpatrick, J M

1993-04-01

199

Family Caregiver Palliative Care Intervention in Supporting Caregivers of Patients With Stage II-IV Gastrointestinal, Gynecologic, and Urologic Cancers  

ClinicalTrials.gov

Healthy, no Evidence of Disease; Localized Transitional Cell Cancer of the Renal Pelvis and Ureter; Metastatic Transitional Cell Cancer of the Renal Pelvis and Ureter; Psychosocial Effects of Cancer and Its Treatment; Recurrent Bladder Cancer; Recurrent Cervical Cancer; Recurrent Colon Cancer; Recurrent Gastric Cancer; Recurrent Ovarian Epithelial Cancer; Recurrent Ovarian Germ Cell Tumor; Recurrent Pancreatic Cancer; Recurrent Rectal Cancer; Recurrent Renal Cell Cancer; Recurrent Transitional Cell Cancer of the Renal Pelvis and Ureter; Recurrent Urethral Cancer; Recurrent Uterine Sarcoma; Regional Transitional Cell Cancer of the Renal Pelvis and Ureter; Stage II Bladder Cancer; Stage II Renal Cell Cancer; Stage II Urethral Cancer; Stage IIA Cervical Cancer; Stage IIA Colon Cancer; Stage IIA Gastric Cancer; Stage IIA Ovarian Epithelial Cancer; Stage IIA Ovarian Germ Cell Tumor; Stage IIA Pancreatic Cancer; Stage IIA Rectal Cancer; Stage IIA Uterine Sarcoma; Stage IIB Cervical Cancer; Stage IIB Colon Cancer; Stage IIB Gastric Cancer; Stage IIB Ovarian Epithelial Cancer; Stage IIB Ovarian Germ Cell Tumor; Stage IIB Pancreatic Cancer; Stage IIB Rectal Cancer; Stage IIB Uterine Sarcoma; Stage IIC Colon Cancer; Stage IIC Ovarian Epithelial Cancer; Stage IIC Ovarian Germ Cell Tumor; Stage IIC Rectal Cancer; Stage III Bladder Cancer; Stage III Pancreatic Cancer; Stage III Renal Cell Cancer; Stage III Urethral Cancer; Stage IIIA Cervical Cancer; Stage IIIA Colon Cancer; Stage IIIA Gastric Cancer; Stage IIIA Ovarian Epithelial Cancer; Stage IIIA Ovarian Germ Cell Tumor; Stage IIIA Rectal Cancer; Stage IIIA Uterine Sarcoma; Stage IIIB Cervical Cancer; Stage IIIB Colon Cancer; Stage IIIB Gastric Cancer; Stage IIIB Ovarian Epithelial Cancer; Stage IIIB Ovarian Germ Cell Tumor; Stage IIIB Rectal Cancer; Stage IIIB Uterine Sarcoma; Stage IIIC Colon Cancer; Stage IIIC Gastric Cancer; Stage IIIC Ovarian Epithelial Cancer; Stage IIIC Ovarian Germ Cell Tumor; Stage IIIC Rectal Cancer; Stage IIIC Uterine Sarcoma; Stage IV Bladder Cancer; Stage IV Gastric Cancer; Stage IV Ovarian Epithelial Cancer; Stage IV Ovarian Germ Cell Tumor; Stage IV Pancreatic Cancer; Stage IV Renal Cell Cancer; Stage IV Urethral Cancer; Stage IVA Cervical Cancer; Stage IVA Colon Cancer; Stage IVA Rectal Cancer; Stage IVA Uterine Sarcoma; Stage IVB Cervical Cancer; Stage IVB Colon Cancer; Stage IVB Rectal Cancer; Stage IVB Uterine Sarcoma; Ureter Cancer

2014-06-12

200

Application of syntactic methods of pattern recognition for data mining and knowledge discovery in medicine  

NASA Astrophysics Data System (ADS)

This paper presents and discusses possibilities of application of selected algorithms belonging to the group of syntactic methods of patten recognition used to analyze and extract features of shapes and to diagnose morphological lesions seen on selected medical images. This method is particularly useful for specialist morphological analysis of shapes of selected organs of abdominal cavity conducted to diagnose disease symptoms occurring in the main pancreatic ducts, upper segments of ureters and renal pelvis. Analysis of the correct morphology of these organs is possible with the application of the sequential and tree method belonging to the group of syntactic methods of pattern recognition. The objective of this analysis is to support early diagnosis of disease lesions, mainly characteristic for carcinoma and pancreatitis, based on examinations of ERCP images and a diagnosis of morphological lesions in ureters as well as renal pelvis based on an analysis of urograms. In the analysis of ERCP images the main objective is to recognize morphological lesions in pancreas ducts characteristic for carcinoma and chronic pancreatitis, while in the case of kidney radiogram analysis the aim is to diagnose local irregularities of ureter lumen and to examine the morphology of renal pelvis and renal calyxes. Diagnosing the above mentioned lesion has been conducted with the use of syntactic methods of pattern recognition, in particular the languages of description of features of shapes and context-free sequential attributed grammars. These methods allow to recognize and describe in a very efficient way the aforementioned lesions on images obtained as a result of initial image processing of width diagrams of the examined structures. Additionally, in order to support the analysis of the correct structure of renal pelvis a method using the tree grammar for syntactic pattern recognition to define its correct morphological shapes has been presented.

Ogiela, Marek R.; Tadeusiewicz, Ryszard

2000-04-01

201

[Surgical treatment of iatrogenic lesions of the urinary tracts and their complications].  

PubMed

The article presents results of surgical treatment of 167 patients with iatrogenic urinary tract lesions made in the course of various surgical interventions. Ureteral trauma was detected in 106 (63.5%), urinary bladder trauma--in 44 (26.3%), urethral trauma--in 5 (3.0%) and trauma of the bladder and ureters--in 12 (7.2%) patients. Endoureterotomy was made in 7 (4.0%) patients with short ureteral stricture, intraoperative correction of ureteral injuries was made in 8 (4.6%) cases. Ureteroplasty according to the technique designed by the authors was conducted in one female patient. A variant of ureterocystoanastomosis (UCA) was created in 67 (38.8%) patients. Reconstruction of the urinary tract with an ileal graft was performed in 16 (9.3%) patients, with the appendix--in 4 (2.3%) patients. Intestinal plastic correction of the ureters and urinary bladder was made in 2 (1.2%) patients. In trauma of the urinary bladder in 3 (1.7%) patients it was sutured, 41 (23.7%) patients underwent transvaginal vesicofistuloraphy. Electrocoagulation of the vesicovaginal fistula and colpocleisis were performed in 8 (4.6%) patients. Plastic surgery of vesicorectal and urethrovaginal fistula was conducted in 3 (1.7%) and 5 (2.9%) patients, respectively. In postoperative period after reconstructive operations complications developed in 17 (10.2%) patients. Conservative treatment of the complications was carried out in 11 (6.6%) patients, reoperations were made in 6 (3.6%) patients: resection of the stricture of appendicocystoanastomosis with reanastomosis (n = 1), repeat UCA (n = 1), revesicofistuloraphy (n = 1) and electrocoagulation of recurrent fistula (n = 3). Rehabilitation was achieved in 98.8% patients. Obstruction of the ureters and urogenital fistulas are prevailing complications (93.4%) of iatrogenic injury of the urinary tract. Operations of choice in such complications are UCA and transvaginal fistuloraphy, respectively. PMID:17722613

Komiakov, B K; Guliev, B G; Rodygin, L M

2007-01-01

202

Endoscopic spray cryotherapy for genitourinary malignancies: safety and efficacy in a porcine model  

PubMed Central

Objective: To examine the effects and safety of using endoscopic spray cryotherapy (ESC) on bladder, ureteral, and renal pelvis urothelium in a live porcine model. Subjects and methods: ESC treatments were systematically applied to urothelial sites in the bladder, ureter, and renal pelvis of eight female Yorkshire swine in a prospective trial. Freeze–thaw cycles ranged from 5 to 60 s/cycle for one to six cycles using a 7 French cryotherapy catheter. Tissue was evaluated histologically for treatment-related effects. Acute physiologic effects were evaluated with pulse oximetry, Doppler sonography, and postmortem findings. Results: In bladder, treatment depth was inconsistent regardless of dose, demonstrating urothelial necrosis in one, muscularis propria depth necrosis in two, and full thickness necrosis in all remaining samples. In ureter, full thickness necrosis was seen in all samples, even with the shortest spray duration (5 s/cycle for six cycles or 30 s/cycle for one cycle). Treatment to the renal pelvis was complicated by adiabatic gas expansion of liquid nitrogen to its gaseous state, resulting in high intraluminal pressures requiring venting to avoid organ perforation, even at the lowest treatment settings. At a planned dose of 5 s/cycle for six cycles of the first renal pelvis animal, treatment was interrupted by sudden and unrecoverable cardiopulmonary failure after three cycles. Repeated studies replicated this event. Ultrasound and immediate necropsy confirmed the creation of a large gaseous embolism and reproducible cardiopulmonary effects. Conclusion: ESC in a porcine urothelial treatment model results in full-thickness tissue necrosis in bladder, ureter, and renal pelvis at a minimal treatment settings of 5 s/cycle for six cycles. Adiabatic gas expansion may result in fatal pyelovenous gas embolism and collateral organ injury, as seen in both animals receiving treatment to the renal pelvis in this study. These results raise safety concerns for use of ESC as a treatment modality in urothelial tissues with current device settings. PMID:23730328

Power, Nicholas E.; Silberstein, Jonathan L.; Tarin, Tatum; Au, Joyce; Thorner, Daniel; Ezell, Paula; Monette, Sebastien; Fong, Yuman; Rusch, Valerie; Finley, David

2013-01-01

203

Retroperitoneal teratoma with somatic malignant transformation: A papillary renal cell carcinoma in a testicular germ cell tumour metastasis following platinum-based chemotherapy  

PubMed Central

Background Malignant transformation describes the phenomenon in which a somatic component of a germ cell teratoma undergoes malignant differentiation. A variety of different types of sarcoma and carcinoma, all non-germ cell, have been described as a result of malignant transformation. Case presentation A 33-year-old man presented with a left testicular mass and elevated tumour markers. Staging investigations revealed retroperitoneal lymphadenopathy with obstruction of the left ureter and distant metastases. Histopathology from the left radical orchiectomy showed a mixed germ cell tumour (Stage III, poor prognosis). The ureter was stented and four cycles of cisplatin, etoposide and bleomycin chemotherapy administered. After initial remission, the patient recurred four years later with a large retroperitoneal mass involving the renal vessels and the left ureter. Left retroperitoneal lymph node dissection with en-bloc resection of the left kidney was performed. Histopathology revealed a germ cell tumour metastasis consisting mainly of mature teratoma. Additionally, within the teratoma a papillary renal cell carcinoma was found. The diagnosis was supported by immunohistochemistry showing positivity for AMACR, CD10 and focal expression of RCC and CK7. There was no radiological or histo-pathological evidence of a primary renal cell cancer. Conclusions To the best of our knowledge, malignant transformation into a papillary renal cell carcinoma has not been reported in a testicular germ cell tumour metastasis following platinum-based chemotherapy. This histological diagnosis might have implications for potential future therapies. In the case of disease recurrence, renal cell cancer as origin of the recurrent tumour has to be excluded because renal cell carcinoma metastases would not respond well to the classical germ cell tumour chemotherapy regimens. PMID:23402579

2013-01-01

204

Which one is safer - performing a laparoscopic hysterectomy with a tissue fusion device involving diagnostic cystoscopy or traditional abdominal hysterectomy with ureteral dissection?  

PubMed Central

Introduction It still remains an unanswered question whether, in the absence of gynecological malignancy and under elective conditions, to perform abdominal hysterectomy (AH), offering a safer approach, or to perform a laparoscopic hysterectomy (LH) procedure. Aim We aimed to compare LH operations performed with a tissue fusion device accompanied by intraoperative diagnostic cystoscopy with traditional AH operations involving bilateral ureteral dissection. Material and methods The integrity of the ureters, ureteral peristalsis and the diameter of the ureters were examined during AH by inspection. At the end of LH, the bladder wall was systematically evaluated by cystoscopy and a jet of urine spurting was noted from both ureteral orifices. Results The operation time was longer in patients who underwent LH + CYS (p = 0.0001). The decline in hematocrit and hemoglobin levels in the postoperative period was significantly higher in patients who underwent AH + UD (p = 0.0001 and p = 0.002, respectively). No significant difference was found between the two groups in terms of ureteral injury, bowel injury or bladder injury (p = 0.378, p = 1.000 and p = 1.000, respectively). There was no statistically significant difference between the two groups in terms of mean body temperature and postoperative blood transfusion requirements (p = 0.051 and p = 0.210, respectively). Mean parenteral analgesic requirement and length of hospital stay were significantly different between the groups (p = 0.005 and p = 0.0001). No statistically significant difference was found between the two groups in terms of postoperative cardiopulmonary complications, re-operation rate or occurrence of genitourinary fistula (p = 1.000, p = 1.000 and p = 1.000, respectively). Conclusions We concluded that LH performed with a tissue fusion device involving diagnostic cystoscopy yields major and minor complication rates similar to safely performed AH operations preserving ureters. PMID:24501597

Yildiz, Gazi; Caglar, Mete; Alt?ntas, Rasit; Dilbaz, Serdar; Yildiz, Pinar; Kumru, Selahattin; Ustun, Yusuf

2013-01-01

205

Percutaneous Radiofrequency Ablation of a Small Renal Mass Complicated by Appendiceal Perforation  

SciTech Connect

Percutaneous radiofrequency ablation (RFA) has gained wide acceptance as nephron-sparing therapy for small renal masses in select patients. Generally, it is a safe procedure with minor morbidity and acceptable short-term oncologic outcome. However, as a result of the close proximity of vital structures, such as the bowel, ureter, and large vessels, to the ablative field, complications regarding these structures may occur. This is the first article describing appendiceal perforation as a complication of computed tomography-guided RFA despite hydrodissection. When performing this innovative and promising procedure one should be aware of the possibility of particular minor and even major complications.

Boone, Judith, E-mail: j.boone@amc.uva.nl [Antoni van Leeuwenhoek Hospital, Department of Radiology, Netherlands Cancer Institute (Netherlands); Bex, Axel, E-mail: a.bex@nki.nl [Antoni van Leeuwenhoek Hospital, Department of Urology, Netherlands Cancer Institute (Netherlands); Prevoo, Warner, E-mail: w.prevoo@nki.nl [Antoni van Leeuwenhoek Hospital, Department of Radiology, Netherlands Cancer Institute (Netherlands)

2012-06-15

206

Hollow waveguide for urology treatment  

NASA Astrophysics Data System (ADS)

The aim of our work was the application of the special sealed hollow waveguide system for the urology treatment - In our experimental study we have compared the effects of Ho:YAG (wavelength 2100 nm) and Er:YAG (wavelength 2940 nm) laser radiation both on human urinary stones (or compressed plaster samples which serve as a model) fragmentation and soft ureter tissue incision in vitro. Cyclic Olefin Polymer - coated silver (COP/Ag) hollow glass waveguides with inner and outer diameters 700 and 850 ?m, respectively, were used for the experiment. To prevent any liquid to diminish and stop the transmission, the waveguide termination was utilized.

Jelínková, H.; N?mec, M.; Koranda, P.; Pokorný, J.; K?hler, O.; Drlík, P.; Miyagi, M.; Iwai, K.; Matsuura, Y.

2010-02-01

207

Stentless pediatric ureteroscopic holmium: YAG laser stone disintegration: is gravels retrieval an issue?  

Microsoft Academic Search

Purpose  To evaluate the safety and efficacy of stentless pediatric ureteroscopic holmium laser stone disintegration without gravels\\u000a retrieval.\\u000a \\u000a \\u000a \\u000a \\u000a Patients and methods  From Feb 2007 to Feb 2010, 21 children (12 boys and 9 girls) with unilateral single stone ureter, with an average age of 8.5 years\\u000a (range 4–12 years), were treated with 6.9 Fr semirigid ureteroscope for a stone size ranged from 5 to

W. Gamal; M. Aldahshoury; A. Hammady; Mohamed Hussein; M. Osman; Ahmed Mmdouh; A. Abouzeid

208

Antegrade ureteral intussusception: a rare complication of percutaneous endopyelotomy.  

PubMed

Ureter intussusception is a rarely reported event and is usually secondary to a ureteral lesion. We report a case of a 15-year-old boy developing antegrade ureteral intussusception secondary to percutaneous endopyelotomy performed for pelvicaliceal junction obstruction. The most appropriate treatment is likely to be surgical excision coupled with pyeloplasty reconstruction or nephrectomy if renal function is beyond salvage. To our knowledge, this has never been reported, and we believe that awareness of this complication should be made known to urologists. PMID:15596208

Chiong, Edmund; Consigliere, David

2004-12-01

209

Kidney stone and urinary bladder telangiectasia in a patient with TAR syndrome.  

PubMed

TAR syndrome is a congenital malformation syndrome characterized by bilateral absence of the radius and thrombocytopenia. The known urinary anomalies are duplex ureter, dilatation of renal pelvis, horseshoe kidney and functional problems like vesicoureteral reflux and pyelonephritis. In this report of a case with TAR syndrome, a kidney stone and bladder telangiectasia were found coincidentally during the investigation of hematuria. TAR syndrome is discussed in the light of the medical literature. To our knowledge, no case has been reported demonstrating nephrolithiasis and bladder telangiectasia in TAR patients. PMID:19102062

Akil, Ipek; Gözmen, Salih; Yilmaz, Omer; Taneli, Can

2008-01-01

210

[Ureteral triplication, an unusual isolated presentation].  

PubMed

We report the case of a 26 years old female who presented, as a casual finding, a right complete ureteral triplicity (probably Campbell's tipe I) with no other associated abnormalities. Despite ureteral duplication is a frequent urological anomaly, the presence of three ureters occurring in the same side, in a complete or incomplete form, is a true rarity, with less than 100 cases publicated up to date. The present case is singular, not only because of its exceptional presentation but also because no other urological or extraurological anomalies were associated and no clinical manifestations were present. The most relevant literature is reviewed. PMID:15666520

Villanueva Peña, A; De Diego Rodríguez, E

2004-01-01

211

Quantitative multiplexing with nano-self-assemblies in SERS  

E-print Network

quantitative information from spectra with multiple peaks where visual inspection is difficult (Figure 4a,b). At first a set of SERS data comprising triplicates of thirty different aqueous mixtures was collected for training the predictive numerical models... , where the concentrations of DA, EPI and 5HT were varied, while the concentration of CB[7] was held constant. A broad range of concentrations were chosen, between 0.5 × 10-6 M and 10 × 10-6 M, to include expected clinical uretic concentrations...

Kasera, Setu; Herrmann, Lars O.; del Barrio, Jesús; Baumberg, Jeremy J.; Scherman, Oren A.

2014-01-01

212

Seizure developed after palonosetron intravenous injection during recovery from general anesthesia -A case report-  

PubMed Central

Seizure associated with antiemetics is rare. We report seizure associated with a 5-HT3 receptor antagonist in a 38 years old female. The patient underwent ureterorenoscopic lithotripsy due to left upper ureter stone. After operation, the patient complained of nausea in the postanesthetic recovery unit. In order to subside symptom, the patient was administrated 5-HT3 receptor antagonist, palonosetron, 0.075 mg intravenously. Shortly after administration of that, the patient developed generalized tonic-clonic seizures. The symptom was subsided after midazolam and thiopental sodium were injected. But 40 minutes later, seizure recurred and subsided with midazolam again. The patient recovered completely without any specific sequelae. PMID:22949988

Park, Pyung-Gul; Shin, Hwa-Yong; Kang, Hyun; Jung, Yong Hun; Woo, Young-Cheol; Kim, Jin-Yun; Koo, Gill Hoi; Park, Sun Gyoo

2012-01-01

213

[Radical laparoscopic nephroureterectomy].  

PubMed

As with the increasingly common presence of laparoscopic surgery in renal adenocarcinoma, the same situation is also occurring with radical management of tumours of the upper urothelium. In this type of clinical condition, it is important to emphasize the different ways to mobilise the distal ureter (with transuretral resection or unroofing, pure laparoscopy, or open), and to take into account that this tumour has the highest risk of implantation at the ports of entry. Here, we conduct a literature review and up-date of the different approaches to the distal urethra. PMID:16884102

Fariña Pérez, L A

2006-05-01

214

An unusual presentation of bilateral Hutch diverticula.  

PubMed

Summary Hutch diverticula are rare congenital diverticula. The general consensus is that they occur secondary to a congenital failure of normal muscle development around the ureteral orifice where Waldeyer sheath anatomically covers the space between the intravesical ureter and muscular layer of the bladder. Our case highlights the radiological appearance of Hutch diverticula and the need for contrast-enhanced imaging to enable accurate evaluation and diagnosis. It illustrates how the presence of periureteric diverticula can contribute to ureteric obstruction and calculus formation; complicate the interpretation of renal tract imaging and the subsequent management of renal calculi. PMID:24859560

Fanning, Deirdre Mary; Morrin, Martina; Power, Richard

2014-01-01

215

Untitled  

Cancer.gov

Salivary glands Nasopharynx Other oral cavity and pharynx Esophagus Stomach Colon Rectum Liver, gallbladder, and other biliary tract Liver Gallbladder Other biliary tract Pancreas Nose, nasal cavity, and sinuses Larynx Lung, trachea, bronchus, and pleura Bones and joints Connective tissue Melanoma of skin Other skin Breast1 Bladder Kidney, renal pelvis, and ureter Eye Brain and other nervous system Thyroid gland Other endocrine glands Hodgkin's disease Non-Hodgkin's lymphoma Multiple myeloma Leukemia Other and unspecified cancers 0.1 1 10 20 49 Figure 1b.

216

UPJ Obstruction in the Adult Population: Are Crossing Vessels Significant?  

PubMed Central

Ureteropelvic junction (UPJ) obstruction describes various causes of impaired drainage at the UPJ. Regardless of the cause, the end result is the same: impedance in the normal flow of urine from the renal pelvis into the proximal ureter, resulting in caliectasis and hydronephrosis. This may lead to progressive deterioration of renal function and, thus, often requires intervention to relieve the obstruction and restore the normal flow of urine. Defining the pertinent anatomy, the degree of obstruction, and differential renal function is key to determining whether and when intervention is necessary. PMID:16985690

Grasso, Michael; Caruso, Robert P; Phillips, Courtney K

2001-01-01

217

A case of McKusick-Kaufman Syndrome.  

PubMed

We are reporting a rare case of McKusick- Kaufman Syndrome in a ten-month old female infant from Addis Ababa with difficulty of urination often days duration. Clinical exam revealed supra-pubic mass with tenderness and had left hand postaxial polydactily. Ultrasound and CT scans showed the mass to be hydrometrocolpos posterior to the bladder. Intravenous urography revealed a lower abdomen-pelvic mass displacing and compressing the ureters with bilateral hydronephrosis. Further pelvic exam under anaesthesia revealed hydrometrocolpos with vaginal agenesis. This, to the best knowledge of the authors, is the first ever reported case of the syndrome in Ethiopia. PMID:21991762

Zewdneh, Daniel; Shewarega, Zelalem

2011-07-01

218

Fetal hydrocolpos leading to Pierre Robin sequence: an unreported effect of oligohydramnios sequence.  

PubMed

The presence of distal atretic vagina causing accumulation of fluid and mucus secretions in the proximal vaginal cavity resulted in fetal hydrocolpos. Obstructive uropathy developed gradually because of direct compression of hydrocolpos on bilateral lower ureters, resulting in oligohydramnios from decreased urine formation. Oligohydramnios inhibited normal mandibular development with resulting cleft palate and glossoptosis (Pierre Robin Sequence). The development of sequence of events in this case indicates Pierre Robin Sequence as another effect of Oligohydramnios Sequence arising out of deformational forces acting on cranio-facial structures. PMID:12556934

Aggarwal, Sandeep; Kumar, Ajay

2003-01-01

219

Endovascular Management of Ureteroarterial Fistula: A Rare Potentially Life Threatening Cause of Hematuria  

PubMed Central

Ureteroarterial fistula is a rare, potentially life-threatening cause of hematuria characterized by an abnormal channel between a ureter and artery. The rarity of this condition, complexity of predisposing risk factors and intermittence of symptoms may delay or obscure its diagnosis. With a high index of suspicion and careful angiographic evaluation, embarking on this condition is not only possible but sets the stage for curative intervention. We report a case of a ureteroarterial fistula presenting with intermittent hematuria, successfully diagnosed at angiography and managed with endovascular stent graft placement.

Copelan, Alexander; Chehab, Monzer; Cash, Charles; Korman, Howard; Dixit, Purushottam

2014-01-01

220

Pelvic Nephroureterectomy for Renal Cell Carcinoma in an Ectopic Kidney  

PubMed Central

We present a case of an ectopic renal tumor in a 61-year-old morbidly obese man with a pelvic kidney found after presenting with hematuria and irritative voiding symptoms. The mass, along with the ectopic kidney and ureter, was radically resected through an open operation that involved removing both them and the renal vessels from the underlying iliac vessels. Pathological analysis demonstrated an 8.3?cm papillary renal cell carcinoma (RCC) with oncocytic features, Fuhrman nuclear grade 3, with angiolymphatic invasion and negative margins. The patient has been recurrence-free for over four years since tumor resection. PMID:23150838

Baldie, Kevin G.; Al-Qassab, Usama A.; Ritenour, Chad W.; Issa, Muta M.; Osunkoya, Adeboye O.; Petros, John A.

2012-01-01

221

[Hydronephrosis as a complication of appendicitis: a case report].  

PubMed

A case of right hydronephrosis as a complication of appendicitis is reported. The patient was a 63-year-old male, whose chief complaints were pollakisuria and dysuria. Roentgenographic examination revealed right hydronephrosis due to stenosis of right lower ureter and intrapelvic tumor at the right side. Exploration revealed an abscess in the pelvic cavity, and pathologic examination disclosed periappendiceal perforation and an old inflamed appendix. A review of the literature revealed that it is difficult to diagnose the appendicitis without typical symptoms. PMID:8918669

Kubo, M; Taguchi, K; Fujisue, H; Fujisue, K

1996-09-01

222

Obturator Hernia with Ureteral Entrapment  

PubMed Central

Obturator hernia of the ureter is uncommon. Computed tomography of a 77-year-old woman with sudden-onset lower left abdominal pain and urinary symptoms showed an obturator hernia with ureteral entrapment. Obturator hernia is a diagnostic challenge because the hernial mass is very insidious. It should be suspected in emaciated, multiparous, elderly women presenting with unexplained pain in the groin, hip, thigh or knee. High levels of clinical suspicion of high-risk patients and recourse to investigation by computed tomography are important, as delay in diagnosis and treatment is associated with increased morbidity and mortality. PMID:24926229

Izzo, Matteo; Regusci, Luca; Fasolini, Fabrizio

2014-01-01

223

Assessment of local structural disorders of the bladder wall in partial bladder outlet obstruction using polarized light imaging  

PubMed Central

Partial bladder outlet obstruction causes prominent morphological changes in the bladder wall, which leads to bladder dysfunction. In this paper, we demonstrate that polarized light imaging can be used to identify the location of obstruction induced structural changes that other imaging modalities fail to detect. We induced 2-week and 6-week partial outlet obstruction in rats, harvested obstructed bladders, then measured their retardances while distended to high pressures and compared them to controls. Our results show that the retardance of the central part of the ventral side (above the ureters) closer to the urethra can be used as a potential metric of the distending bladder obstruction. PMID:24575354

Alali, Sanaz; Aitken, Karen J.; Schröder, Annette; Gribble, Adam; Bagli, Darius J.; Vitkin, I. Alex

2014-01-01

224

Pathology Case Study: Bladder Mass in a 73-Year-Old Male  

NSDL National Science Digital Library

This case study, from the University of Pittsburgh School of Medicine's Department of Pathology, presents information about a 73-year-old male patient. According to the patient's history, he has a "history of invasive papillary transitional cell carcinoma with excessive muscular invasion and angiolymphatic invasion." Both gross and microscopic images of the prostate, bladder, pelvic lymph nodes, and the right and left pelvic ureter are provided in this case. Using these images and the provided patient history, students can test their knowledge of pathology and compare their diagnostic findings with the official findings in the "Final Diagnosis" section.

Hakam, Ardeshir

2007-07-26

225

Pathological and therapeutic significance of cellular invasion by Proteus mirabilis in an enterocystoplasty infection stone model  

Microsoft Academic Search

Proteus mirabilis infection often leads to stone formation. We evaluated\\u000a how bacterium-mucin adhesion, invasion, and intracellular crystal\\u000a formation are related to antibiotic sensitivity and may cause frequent\\u000a stone formation in enterocystoplasties. Five intestinal (Caco-2, HT29,\\u000a HT29-18N2, HT29-FU, and HT29-MTX) and one ureter cell line (SV-HUC-1) were\\u000a incubated in artificial urine with five Proteus mirabilis strains.\\u000a Fluorescence-activated cell sorting (FACS), laser

Rejiv B. Mathoera; Dik J. Kok; Cees M. Verduin; J. M. Nijman

2002-01-01

226

Emphysematous pyelonephritis in a diabetic patient with obstructed kidney.  

PubMed

Emphysematous pyelonephritis (EPN) is an acute, rare, inflammatory disease, which typically occurs in patients who suffer from diabetes mellitus. We report the case of a patient who was admitted to the Department of Urology with septic signs, in whom, after performing computed tomography, the diagnosis of EPN was established. The patient underwent organ-preserving treatment, which consisted of pyelolithotomy with nephrostomy, and the insertion of a double J catheter into the left ureter. The importance of the classification of EPN is also discussed. The need for individualized procedures is highlighted. PMID:25147731

Kutwin, Piotr; Konecki, Tomasz; Jab?onowski, Zbigniew

2014-01-01

227

Abdominal Hysterectomy: A New Approach for Conventional Procedure  

PubMed Central

Objective: The present comparative study helps in developing a new approach to conventional hysterectomy procedure so as prevent intra-operative and Post-operative complications during the procedure. Methods: Ligation of uterine and ovarian arteries was performed, prior to abdominal hysterectomy procedures, in Group A (n-1000) and conventional method of abdominal hysterectomy in Group B (n-450) from January 2000 to December 2009. It was a prospective study. Results: In Group A it was noted that traumatic injury to (L) uterine vessel was present in 4 (0.4%) cases and (R) uterine vessel in 3 (0.3%) cases without any noticeable injury to the ovarian vessels, ureters or bladder as compared to in Group B where injury to (L) uterine was noted in 11 (2.4%) cases, ureters in 1 (0.1%) case, bladder in 6(1.5%) cases, hematoma in 10 (2.2%). Post-operative complications were found to be uneventful in Group A. Conclusion: The Present study concludes that ligation of uterine and ovarian arteries, prior to conventional abdominal hysterectomy procedures is found to be extremely safe procedure thereby reducing the risk of intra-operative and post- operative complications. PMID:24959484

Dutta, Indranil

2014-01-01

228

Current status of metal stents for managing malignant ureteric obstruction.  

PubMed

Obstruction of the ureters caused by extrinsic compression from a primary tumour or retroperitoneal lymph node masses is not unusual in the course of advanced pelvic malignancies. Most of the cases are of gynaecological or gastrointestinal origin, and the situation can be aggravated by peri-ureteric fibrosis, a long-term adverse event of previous chemotherapy or radiotherapy. Undoubtedly upper urinary tract decompression and maintenance of ureteric patency, even as a palliative measure, is important in managing these patients. Options for upper tract decompression include percutaneous nephrostomy, retrograde stenting and open urinary diversion. Plastic stents have long been used for managing malignant ureteric obstruction, but their overall success remains limited. Plastic stents often fail to be placed correctly, require regular exchange, and are faced with a high incidence of encrustation and migration. For these reasons plastic stents have been unsuccessful for long-term maintenance of ureteric patency. To overcome these limitations metal stents were introduced and recently developed in an effort to ensure better long-term patency of the obstructed ureter, fewer hospital admissions for stent change and better overall quality of life. In the present review the clinical applications of different types of metal stents are discussed, with a specific focus on the latest advances and the future options for managing malignant ureteric obstruction. PMID:20067458

Sountoulides, Petros; Kaplan, Adam; Kaufmann, Oskar Grau; Sofikitis, Nikolaos

2010-04-01

229

Management of iatrogenic ureteral injury  

PubMed Central

Iatrogenic injury to the ureter is a potentially devastating complication of modern surgery. The ureters are most often injured in gynecologic, colorectal, and vascular pelvic surgery. There is also potential for considerable ureteral injury during endoscopic procedures for ureteric pathology such as tumor or lithiasis. While maneuvers such as perioperative stenting have been touted as a means to avoid ureteral injury, these techniques have not been adopted universally, and the available literature does not make a case for their routine use. Distal ureteral injuries are best managed with ureteroneocystostomy with or without a vesico-psoas hitch. Mid-ureteral and proximal ureteral injuries can potentially be managed with ureteroureterostomy. If the distal segment is unsuitable for anastomosis then a number of techniques are available for repair including a Boari tubularized bladder flap, transureteroureterostomy, or renal autotransplantation. In rare cases renal autotransplantation or ureteral substitution with gastrointestinal segments may be warranted to re-establish urinary tract continuity. Laparoscopic and minimally invasive techniques have been employed to remedy iatrogenic ureteral injuries. PMID:24883109

Burks, Frank N.

2014-01-01

230

OCT-aided anastomosis platform study in the rodent model  

NASA Astrophysics Data System (ADS)

Anastomosis is one of the most commonly performed procedure in the clinical environment that involves tubular structures, such as blood vessel, lymphatic vessel, seminal duct and ureter. Suture based anastomosis is still the foundation for most basic surgical training and clinical operation, although alternate techniques have been developed and under development. For those tubular-structure-anastomosis, immediate real-time post-operative evaluation of the surgical outcome is critical to the success of surgery. Previously evaluation is mostly based on surgeons' experience. Fourier-domain optical coherence tomography is high-speed, high-resolution noninvasive 3D imaging modality that has been widely used in the biomedical research and clinical study. In this study we used Fourier-domain optical coherence tomography as an evaluation tool for anastomosis of lymphatic vessels, ureter and seminal duct in rodent model. Immediate post-operative and long term surgical site data were collected and analyzed. Critical clinical parameters such as lumen patency, anastomosed site narrowing and suture error detection are provided to surgeons.

Huang, Yong; Tong, Dedi; Zhu, Shan; Wu, Lehao; Ibrahim, Zuhaib; Lee, WP Andrew; Brandacher, Gerald; Kang, Jin U.

2014-02-01

231

Noncancer disease incidence in atomic bomb survivors, 1958-1998.  

PubMed

We examined the relationships between the incidence of noncancer diseases and atomic bomb radiation dose using the longitudinal data for about 10,000 Adult Health Study (AHS) participants during 1958-1998. The current report updates the analysis we presented in 1993 with 12 additional years of follow-up. In addition to the statistically significant positive linear dose-response relationships detected previously for the incidence of thyroid disease (P < 0.0001), chronic liver disease and cirrhosis (P = 0.001), and uterine myoma (P < 0.00001), we also found a significant positive dose response for cataract (P = 0.026), a negative linear dose-response relationship for glaucoma (P = 0.025), and significant quadratic dose-response relationships for hypertension (P = 0.028) and for myocardial infarction among survivors exposed at less than 40 years of age (P = 0.049). Significant radiation effects for calculus of the kidney and ureter were evident for men but not for women (test of heterogeneity by sex: P = 0.007). Accounting for smoking and drinking did not alter the results. Radiation effects for cataract, glaucoma, hypertension, and calculus of the kidney and ureter in men are new findings. These results attest to the need for continued follow-up of the aging A-bomb survivors to fully elucidate the effects of radiation exposure on the occurrence of noncancer diseases. PMID:15161358

Yamada, Michiko; Wong, F Lennie; Fujiwara, Saeko; Akahoshi, Masazumi; Suzuki, Gen

2004-06-01

232

Laparoscopic resection aided by preoperative 3-D CT angiography for rectosigmoid colon cancer associated with a horseshoe kidney: A case report.  

PubMed

We herein report a case of laparoscopic high anterior resection with D3 lymph node dissection for rectosigmoid colon cancer with a horseshoe kidney. A 65-year-old Japanese man referred to our hospital for rectosigmoid colon cancer was found to have a horseshoe kidney on a CT scan. On 3-D CT angiography, an aberrant renal artery was visualized feeding the renal isthmus that arises from the aorta just below the root of the inferior mesenteric artery (IMA). Laparoscopic anterior rectal resection with D3 lymph node dissection was performed. During the operation, the IMA, left ureter, left gonadal vessels and hypogastric nerve plexus could be seen passing over the horseshoe kidney isthmus. With the aid of preoperative 3-D CT angiography, the root of the IMA was identified on the temporal side of the isthmus and divided safely just above the hypogastric nerve. As a horseshoe kidney is often accompanied by aberrant renal arteries and/or abnormal running of the ureter, 3-D CT angiography is useful for determining the location of these structures and avoiding intraoperative injury. PMID:25354377

Maeda, Yoshiaki; Shinohara, Toshiki; Nagatsu, Akihisa; Futakawa, Noriaki; Hamada, Tomonori

2014-11-01

233

Islet1 Deletion Causes Kidney Agenesis and Hydroureter Resembling CAKUT  

PubMed Central

Islet1 (Isl1) is a transcription factor transiently expressed in a subset of heart and limb progenitors. During studies of limb development, conditional Isl1 deletion produced unexpected kidney abnormalities. Here, we studied the renal expression of Isl1 and whether it has a role in kidney development. In situ hybridization revealed Isl1 expression in the mesenchymal cells surrounding the base of the ureteric bud in mice. Conditional deletion of Isl1 caused kidney agenesis or hypoplasia and hydroureter, a phenotype resembling human congenital anomalies of the kidney and urinary tract (CAKUT). The absence of Isl1 led to ectopic branching of the ureteric bud out from the nephric duct or to the formation of accessory buds, both of which could lead to obstruction of the ureter-bladder junction and consequent hydroureter. The abnormal elongation and poor branching of the ureteric buds were the likely causes of the kidney agenesis or hypoplasia. Furthermore, the lack of Isl1 reduced the expression of Bmp4, a gene implicated in the CAKUT-like phenotype, in the metanephric region before ureteric budding. In conclusion, Isl1 is essential for proper development of the kidney and ureter by repressing the aberrant formation of the ureteric bud. These observations call for further studies to investigate whether Isl1 may be a causative gene for human CAKUT. PMID:23641053

Kaku, Yusuke; Ohmori, Tomoko; Kudo, Kuniko; Fujimura, Sayoko; Suzuki, Kentaro; Evans, Sylvia M.; Kawakami, Yasuhiko

2013-01-01

234

Retrograde Positive Contrast Urethrocystography of the Fish Urogenital System  

PubMed Central

The radiological differences between the urinary tract of??Dicentrarchus labrax, Sparus aurata, Tinca tinca, and Cyprinus carpio are shown. In fresh water teleosts the urinary bladder is sigmoid and a short urethra leads to the urinary pore. Genital and anal pores are present. In Sparus aurata the urinary bladder has a globoid shape. In Dicentrarchus labrax the urinary bladder is smaller and elongate. In both marine teleosts a single urogenital pore is visible. Positive contrast was used to survey the urogenital system and evaluate shape and size of the bladder, urethra, ureter, and gonadal ducts. Results demonstrate the morphological variability of the urinary bladder and the craniodorsal entry of the ureters into the bladder. It is envisaged that this work will provide baseline information for further imaging studies for investigating the urogenital morphology and can be applied to identify disorders in fishes. Furthermore, the main interest of this study is that it demonstrates the morphological variability of the lower urinary system that exists between different species of fishes. PMID:25180198

Pugliese, Michela; Pietro, Simona Di; Zaccone, Daniele; Giorgianni, Pietro; Bonfiglio, Rossella

2014-01-01

235

[A case of ammonium acid urate urinary stone].  

PubMed

We report a case of ammonium acid urate urinary stone. A 32-year-old woman with no past medical history presented with right back pain. The kidney-ureter-bladder X-ray and computed tomography revealed right ureteral and bilateral renal stones. The right ureteral stone was excreted spontaneously without treatment. The left renal stone was too large to be excreted and required extracorporeal shock-wave lithotripsy (ESWL). The analysis of the excreted stone revealed that it consisted of pure ammonium acid urate. Flakes of the left renal stone by ESWL were impacted in the left lower ureter and also rapidly grew in the left kidney. The right renal stone grew rapidly and right hydronephrosis developed due to the newly-formed right ureteral stone. As post-renal acute renal failure developed subsequently, ureteral stents were placed bilaterally. We finally treated the bilateral ureteral stone with transurethral ureterolithotripsy, the right renal stone with ESWL and the left renal stone with percutaneous nephrolithotripsy. During the course, dietary instruction was intervened for hyperuricemia. Although there were a few stones left after ESWL, they were halfway excreted without rapid growth of stones. PMID:19048938

Seike, Kensaku; Nishida, Yasuyuki; Yamamoto, Naoki; Maeda, Shin-ichi

2008-10-01

236

Combined endoscopic surgery in the prone-split leg position for successful single-session removal of an encrusted ureteral stent: a case report  

PubMed Central

Introduction Although encrusted stents may lead to some unwanted complications including urinary tract obstruction, urinary sepsis, and potential loss of kidney function, there is currently no consensus on the most efficient method for managing stents that are intentionally left in situ. This is the first report describing the management of an encrusted stent using combined endoscopic surgery in the prone split-leg position in a single session. Case presentation A 47-year-old Asian man presented with left flank pain and macrohematuria. The patient had undergone left ureteral stenting three years previously for the treatment of left ureteral stones and hydronephrosis; however, he was lost to follow-up before the treatment for the ureter stones was completed. Therefore, the ureteral stent and stones were not removed. An abdominal radiograph and a noncontrast computed tomography scan showed encrustation along the retained stent with stone burdens in the kidney and ureter. The ureteral stent could not be removed by cystoscopy after shock wave lithotripsy of the left ureteral stones. Therefore, endoscopic lithotripsy combined with flexible ureteroscopy and miniature nephroscopy was performed with the patient in the prone split-leg position. All the stones and the encrusted ureteral stent were successfully removed in a single session. Conclusions In this case, percutaneous nephrolithomy in addition to flexible ureteroscopy was preferred because severe encrustation of the proximal stent and ureteral stones complicated the therapeutic strategy. Combined endoscopic techniques in the prone split-leg position can achieve successful and safe management of encrusted stents. PMID:24742133

2014-01-01

237

A case of gross haematuria due to an ureteric-iliac artery fistula.  

PubMed

A case of gross haematuria due to an ureteric-iliac artery fistula We report a case of a 75-year-old man presented with gross haematuria and left hydronephrosis due to an ureteric iliac- artery fistula . Medical history included a previous positioning of aorto-bisiliac graft and an iliac artery stent placed to exclude an hypogastric aneurysm. A retrograde pyelography revealed a compression of the middle ureter and an extravasation of contrast at that level, for this reason a double J stent was inserted. Contrast-enhanced computed tomography showed the presence of a fistula between the left ureter and the internal iliac. The patient underwent endovascular treatment using a stent-graft with the subsequent patient's recovery. Ureteric iliac-artery fistula is a rare condition and it generally manifests with life threatening gross bleeding. We suggest a multidisciplinary clinical approach in order to achieve the best results for the patient and to avoid severe complications. Endovascular techniques have been demonstrated to be effective and rapid in the treatment of this emergency condition; ureteral stenting is also recommended. PMID:24395028

Madonia, Massimo; Russo, Giorgio Ivan; Trignano, Emilio; Paliogiannis, Panagiotis; Cimino, Sebastiano; Corbu, Carlo; Morgia, Giuseppe

2013-12-01

238

[Successful combination chemotherapy of gemcitabine plus nedaplatin for invasive ureteral squamous cell carcinoma].  

PubMed

A 77-year-old female was indicated pelvic mass and hydronephrosis when her examination of advanced gastric cancer. Computed tomography revealed left ureteral dilatation and mass around the left ureter. Laparotomy biopsy was abandoned because of her low cardiac function. Thereafter, hemorrhagic stool was observed and colonoscopy revealed hemorrhagic mucosal protrusion at sigmoid colon. This lesion was diagnosed as squamous cell carcinoma by pathology of biopsy specimen. Colonic invasion of other organ carcinoma was suspected by colonoscopic findings. Retrograde pyelogram revealed a defect of left lower ureter. Positron emission tomography revealed the mass excluding sigmoid colon and high value (SUV max was 10.3) at the mass. Therefore, it was diagnosed invasive ureteral squamous cell carcinoma and she was treated with 2 cycles of combination chemotherapy consisting of gemcitabine (800 mg/m2: day 1 and 8) and nedaplatin (60 mg/m2: day 1). During the chemotherapy, only cytopenia (grade 4: CTCAE guidelines) was observed. About 4 months after 2 courses of chemotherapy, the tumor size was reduced by almost 100% (CR; RECIST guidelines). Thereafter, recurrence of pelvic mass was not observed. PMID:25158556

Yamada, Yasutaka; Kohno, Mitsuru; Namura, Kazuhiro; Sawada, Takuto; Fujikawa, Atsushi; Ota, Junichi; Moriyama, Masatoshi

2014-07-01

239

[A case of locally advanced sigmoid colon cancer treated with neoadjuvant chemoradiotherapy].  

PubMed

The patient was a 38-year-old woman who visited our hospital complaining of nausea and abdominal pain. A colonoscopy revealed an advanced cancer in the sigmoid colon. A computed tomography (CT) scan showed left hydronephrosis and lymph node metastasis to the left iliopsoas muscle and left ureter. No distant metastasis was found. Since the surgical margins were likely to be positive with a one-stage resection, 3 cycles of FOLFOX4 (folinic acid, fluorouracil, and oxaliplatin)were administered after creating a transverse loop colostomy. Although the tumor decreased in size, the surgical margins were still suspected to be positive. For further regional tumor control, radiotherapy (1.8 Gy/day for 25 days) to the medial region of the left iliac bone and oral UFT/LV (uracil and tegafur/Leucovorin)were administered. A partial response(PR)was determined in accordance with the Response Evaluation Criteria in Solid Tumors(RECIST). Sigmoidectomy with partial resection of the left ureter was performed by laparotomy. The histologic response was assessed as Grade 2 and all surgical margins were negative. Preoperative chemoradiotherapy may be an effective therapeutic option for locally advanced colon cancer resistant to conventional preoperative chemotherapy. PMID:25248907

Yoshitomi, Mami; Hashida, Hiroki; Nomura, Akinari; Ueda, Shugo; Terajima, Hiroaki; Osaki, Nobuhiro

2014-09-01

240

Medical Management of Retroperitoneal Fibrosis  

PubMed Central

Background: Small series and case reports suggest that a combination of mycophenolate mofetil and prednisone is an efficatious and safe treatment for patients with retroperitoneal fibrosis. Objective: To describe the outcomes of patients with retroperitoneal fibrosis treated with a combination of prednisone and mycophenolate mofetil. Design: Prospective, case series. Patients: 31 patients with retroperitoneal fibrosis. Setting: Single-center tertiary care facility. Intervention: Prednisone 40 mg administered daily and tapered over 6 months and mycophenolate mofetil 1,000 mg given twice daily. Measurement: Clinical course, laboratory assessment, measurement of periaortic mass. Results: Systemic symptoms resolved in all patients. Eighty-nine percent of patients had a 25 % or greater reduction in periaortic mass. Eighteen patients had 32 obstructed ureters. Thirty of these ureters were free of obstruction after an average of 513 days of therapy. Laboratory abnormalities of elevated erythrocyte sedimentation rate and serum creatinine and decreased hemoglobin levels normalized in all patients. Recurrent disease occurred in 2 of 28 patients. Conclusion: Combined prednisone and mycophenolate mofetil appears to be an effective therapeutic option for patients with retroperitoneal fibrosis. PMID:23303996

Scheel, Paul J.; Sozio, Stephen M.; Feeley, Nancy

2012-01-01

241

Anodized 20 nm diameter nanotubular titanium for improved bladder stent applications  

PubMed Central

Materials currently used for bladder applications often suffer from incomplete coverage by urothelial cells (cells that line the interior of the bladder and ureter) which leads to the continuous exposure of the underlying materials aggravating an immune response. In particular, a ureteral (or sometimes called an ureteric or bladder) stent is a thin tube inserted into the ureter to prevent or treat obstruction of urine flow from the kidney. The main complications with ureteral stents are infection and blockage by encrustation, which can be avoided by promoting the formation of a monolayer of urothelial cells on the surface of the stent. Nanotechnology (or the use of nanomaterials) may aid in urothelialization of bladder stents since nanomaterials have been shown to have unique surface energetics to promote the adsorption of proteins important for urothelial cell adhesion and proliferation. Since many bladder stents are composed of titanium, this study investigated the attachment and spreading of human urothelial cells on different nanotextured titanium surfaces. An inexpensive and effective scaled up anodization process was used to create equally distributed nanotubular surfaces of different diameter sizes from 20–80 nm on titanium with lengths approximately 500 nm. Results showed that compared to untreated titanium stents and 80 nm diameter nanotubular titanium, 20 nm diameter nanotubular titanium stents enhanced human urothelial cell adhesion and growth up to 3 days in culture. In this manner, this study suggests that titanium anodized to possess nanotubular surface features should be further explored for bladder stent applications. PMID:21499419

Alpaslan, Ece; Ercan, Batur; Webster, Thomas J

2011-01-01

242

Biological consequences of fiber fragmentation with pulsed laser lithotripsy  

NASA Astrophysics Data System (ADS)

Fiber tip breakage during urinary and biliary laser lithotripsy has been recognized to occur with several laser types. This phenomenon has also been seen with Q-switched Nd:YAG laser lithotripsy. Our aim was to determine the biological consequences of this event in the canine ureter and bile duct. In an excised tissue preparation, urinary and biliary stones were impacted in a canine ureter and common bile duct. Three and four hundred micron quartz laser fibers were placed in direct contact with the stone. Normal saline coaxial irrigation was initiated at 75 xal/min. A Q-switched Nd:YAG laser was activated at repetition rates from 1O-30 Hz. and pulse energies from 10-30 mJ. The tissue was sectioned and microscopic examination of the fragmentation site was performed. Histological exam revealed the persistence of large numbers of fiber fragments in the lumen and imnbedded in the epithelium at the lithotripsy site. Fragments varied greatly in size and appeared to have angular, sharp edges We conclude that irrigation can not be relied upon to remove the fiber fragments from the lithotripsy sites and that the biological consequences of fiber fragmentation may be greater than previously believed. Glass fragments "blown" into the epitheliumu will often result in glass granulomas, which may eventually cause obstruction of closed lumninal structures. This raises serious concern for the presence of any fiber breakage during laser lithotripsy.

Bruhn, Erich W.; Go, Peter M. N. Y. H.; McClane, Robert W.; Hunter, John G.; Straight, Richard C.

1990-06-01

243

Ontogeny and osmoregulatory function of the urinary system in the Persian sturgeon, Acipenser persicus (Borodin, 1897).  

PubMed

The structure of the kidney and the localization of Na(+), K(+)-ATPase (NKA) immunopositive cells were examined throughout the postembryonic development of the Persian sturgeon, Acipenser persicus, from newly hatched prelarvae (10mm) to 20 days post hatch (20 DPH) larvae (31mm). Investigations were conducted through histology and immunohistochemistry by using the light and immunofluorescence microscopy. The pronephros was observed in newly hatched prelarvae. The cells lining the distal pronephric tubules and their collecting ducts showed laterally expressed NKA immunofluorescence that later extended throughout the whole cytoplasm. Mesonephrogenous placodes and pre-glomeruli were distinguished at 2 DPH along the collecting ducts posteriorly. Their tubules were formed and present in kidney mesenchyma, differentiated into neck, proximal, distal and collecting segments at 7 DPH when NKA immunopositive cells were observed. Their distal and collecting tubules showed an increasing immunofluorescence throughout their cytoplasm while the glomeruli remained unstained. From D 9 to D 17, the epithelial layer of pronephric collecting duct changed along the mesonephros to form ureters. Ureters, possessing isolated strong NKA immunopositive cells, appeared as two sac-like structures hanging under the trunk kidney. Since NKA immunopositive cells were not observed on the tegument or along the digestive tract of newly hatched prelarva, and also the gills are not formed yet, the pronephros is the only osmoregulatory organ until 4 DPH. At the larval stage, the pronephros and mesonephros are functional osmoregulatory organs and actively reabsorb necessary ions from the filtrate. PMID:25024093

Abadi, Z Taghizadeh Rahmat; Khodabandeh, S; Charmantier, G; Charmantier-Daures, M; Lignot, J H

2014-10-01

244

Ultrasound-guided antegrade access during laparoscopic pyeloplasty in infants less than one year of age: A point of technique  

PubMed Central

BACKGROUND: Access to urethras and ureters of infants may be hazardous and injurious through an endoscopic route. Placement and removal of stents in infants requires anaesthesia and access through these small caliber urethras. We describe our technique of placing antegrade splint during a laparoscopic pyeloplasty in these infants. MATERIALS AND METHODS: An ultrasound-guided percutaneous renal access is obtained. Telescopic metal two part needle is passed into the kidney over a guide wire. A second guide wire is passed through the telescopic metal two part needle. The tract is dilated with 14 Fr screw dilator. Over one guide wire, a 5 Fr ureteric catheter is passed and coiled in the renal pelvis. Over the other wire, a 14 Fr malecot catheter is placed as nephrostomy. Laparoscopic pyeloplasty is then done. During pyelotomy, the ureteric catheter is pulled and advanced through the ureter before the pyeloplasty is completed. The ureteric catheter thus acts as a splint across the anastomosis. Ureteric catheter is removed on the 3rd post operative day and nephrostomy is clamped. Nephrostomy is removed on 4th post operative day if child is asymptomatic. The modified technique was successfully done in five patients aged less than one year old. All patients tolerated the procedure well. Post operative period was uneventful in all. CONCLUSION: Ultrasound-guided ante grade nephroureteral ureteral splint for infant laparoscopic pyeloplasty is safe. It avoids the need for urethral instrumentation for insertion and removal of stents in these small patients. PMID:22837602

Ganpule, Arvind; Bhattu, Amit; Mishra, Shashikant; Desai, Mahesh R

2012-01-01

245

Urolithiasis in a captive group of Tammar wallabies (Macropus eugenii).  

PubMed

Urolithiasis is a well-known disease of the urogenital system in domestic animals, and it has also been described in captive and free-ranging wildlife. This article reports 15 cases of urolithiasis in a captive group of Tammar wallabies (Macropus eugenii) between 2004 and 2011. The analyzed stones were composed of pure calcium carbonate (n?=?5), calcium carbonate with traces of calcium phosphate (n?=?6), carbonate apatite (n?=?2), and carbonate apatite mixed with calcium oxalate (n?=?2). In 12 out of 15 cases uroliths were situated only in the renal pelvis; in two cases they were found in the renal pelvis and the ureter; while in one case in the ureter only. No common infectious agents were identified either by microbiological or histopathological methods. Although the exact cause remains unknown, the repetitive occurrence of calcium carbonate urolithiasis suggests husbandry-related causes. To the best of the authors' knowledge, this is the first report on recurrent appearance of urolithiasis in a captive group of Tammar wallabies. Zoo Biol. 33:455-458, 2014. © 2014 Wiley Periodicals Inc. PMID:25105843

Liptovszky, Mátyás; Sós, Endre; Bende, Balázs; Perge, Edina; Molnár, Viktor

2014-09-01

246

Laparoscopic Ureteroneocystostomy and Vesicopsoas Hitch for Infiltrative Endometriosis  

PubMed Central

Objective: To report a series of laparoscopic vesicopsoas hitch procedures performed for the treatment of infiltrative ureteral endometriosis. Methods: A retrospective chart review of 6 women with severe endometriosis and ureteral obstruction caused by infiltrative disease of the distal ureter was performed. The patients underwent successful laparoscopic ureteroneocystostomy and vesicopsoas hitch. Results: Five of the 6 patients had a history of endometriosis, and their obstructions were diagnosed during prior surgeries. The other patient was diagnosed with severe endometriosis of the rectum, bladder, and ureter at the time of the procedure. She was referred for evaluation of an incidental finding of hydroureter and hydronephrosis. Three patients were treated with gonadotrophin-releasing hormone (GnRH) analog for at least 3 months preoperatively. Five patients had ureteral stents in place prior to the psoas hitch surgery. No intraor postoperative complications occurred. All patients had a normal cystogram performed 10 to 14 days postoperatively prior to Foley catheter removal. Stents were kept in place for 6 to 8 weeks, and an intravenous pyelogram (IVP) was done 2 weeks after removal. All patients had a normal renal ultrasound, computer tomography, or intravenous pyelogram at least 1 year postoperatively. Conclusion: Laparoscopic vesicopsoas hitch can be a safe and effective alternative to the laparotomy with the known benefits of laparoscopy. PMID:14974654

Malik, Shazia; Nezhat, Farr; Nezhat, Camran

2004-01-01

247

Retrospective study of endoscopic treatment in children with primary vesicoureteral reflux and multivariate analysis of factors for failure.  

PubMed

Abstract Objective. The aim of this study was to investigate endoscopic treatment in children with primary vesicoureteral reflux (VUR) and conduct a multivariate analysis of factors for failure. Material and methods. Between August 2006 and January 2012, 216 children (32 boys and 184 girls) with primary VUR (grades I-IV) who underwent endoscopic treatment were analysed. Patients with grade V VUR were excluded. Hydrodistension tests and intraureteral injection techniques were performed, if applicable. Urinary ultrasound and voiding cystourethrography were studied 3-6 months after surgery. Univariate and multivariate logistic regression were used for statistical analyses. Results. In total, 172 children (21 boys and 151 girls) were enrolled, and 280 ureters were treated (108 bilateral, 64 unilateral; three with grade I, 34 with grade II, 214 with grade III and 29 with grade IV VUR). The median (± SD) age was 7.8 ± 3.1 years (boys 7 ± 3.1 years, girls 7.9 ± 3.1 years). The mean (± SD) follow-up was 24.4 ± 4.1 months (boys 28.2 ± 8.1 months, girls 21.4 ± 4.1 months). Mean injected volume per ureter was 1.8 ± 0.5 ml. A single injection resolved the reflux in 79.6% and a second injection resolved it in 90.4% of ureters. Eight children (4.6%) had postoperative febrile urinary tract infections (fUTIs). Postoperative fUTIs were significantly associated with failures in injection (p < 0.001). Renal scars were significantly associated with postoperative fUTI (p = 0.006). Haematuria occurred in three children (minor complication); a non-functional kidney was observed in one child (major complication) and a laparoscopic nephrectomy was performed. Fourteen children underwent ureteroneocystostomy owing to unsuccessful VUR treatment. Conclusions. Endoscopic injection of small-diameter microsphere (80-120 ?m) non-animal dextranomer-hyaluronic acid copolymer seems to be an effective treatment for VUR. Only postoperative fUTI and the presence of a renal scar were correlated with failed endoscopic treatment of VUR. PMID:25028806

Akin, Yigit; Gulmez, Hakan; Güntekin, Erol; Baykara, Mehmet; Yucel, Selcuk

2014-12-01

248

Experience in 100 patients with an ileal low pressure bladder substitute combined with an afferent tubular isoperistaltic segment.  

PubMed

Between April 1985 and April 1993, 100 consecutive men underwent lower urinary tract reconstruction after cystectomy. An ileal low pressure reservoir using the Goodwin cup-patch principle was combined with an afferent ileal tubular segment. The early complication rate was 11%, including 2 postoperative deaths due to septicemia. After a median followup of 27 months (range 3 to 96) 14 patients required surgery for late complications (intestinal obstruction, urethral stricture or tumor recurrence, hernia or ureteral stenosis). A total of 32 patients died of metastatic bladder cancer and 7 died of other causes. The functional capacity of the bladder substitute was increased to the desired 450 to 500 ml. after 3 to 12 months, which was paralleled by improving urinary continence. After 1 year 92% of the patients were continent by day and after 2 years 80% were continent at night. Upper tract surveillance with excretory urography, renal ultrasound and serum creatinine estimation has shown 4 left ureteral strictures but not significant upper tract deterioration or ureteral recurrence. Significant reflux was not observed during video urodynamics unless the reservoir was overfilled. During voiding, by outlet relaxation and straining if necessary, the intra-abdominal pressure increase with straining acted equally on the reservoir and ureters. Therefore, unlike voiding with a normal bladder, no isolated intravesical pressure increase occurred and, thus, there was no reflux from the reservoir. The combination of an ileal low pressure reservoir with an afferent isoperistaltic ileal segment and an open end-to-side ureteroileal anastomosis allows for radical cancer surgery with resection of the ureters where they cross the iliac vessels and minimizes the risk of ureteral stenosis. The unidirectional peristalsis of the ureters and the afferent tubular ileal segment seem to protect the upper urinary tract sufficiently. The surgical technique is straightforward and allows for later conversion to an ileal conduit if necessary. The functional results of the bladder substitute are comparable to other similar reservoir techniques, provided that the patients are carefully selected, well rehabilitated and meticulously followed. PMID:7776455

Studer, U E; Danuser, H; Merz, V W; Springer, J P; Zingg, E J

1995-07-01

249

Fictional Islam: A Literary Review and Comparative Essay on Islam in Science Fiction and Fantasy  

E-print Network

,os pue erueura'to3 ;o stdacuor )Iurelsl ol s)irol asaql Jo suollf,euuo) aqr srq8l1q8rq e>1s'{zg dessa aqt tnoq8norqr dlalJos uetdoln B Jo lueuqsllqelsa eq] ;o opads lalou s(JEN apqn. .urelsfs uerdo]n peqsrlqelse ue uo sasnroJ .{e1d s,;r,e6 leID uI ra... reql raueld qtua^ala uE reAoJSIp '{aqr ppo'r't a,rau slql ut dels PaPualxa Jlaql SuIrnCI .plJoM puo)as eqt IIer .{aqi'urets.{s rets e ra^o)srp .{aqr 'raqdoJd eql Jo luef,sE aql ol JelIuIs 'uoTsu./Jsvq'qn1 "q leql uolsslul srq uo areds lalno uI 3ur1a...

Hankins, Rebecca

2010-01-07

250

Robotic-Assisted Laparoscopic Treatment of Bowel, Bladder, and Ureteral Endometriosis  

PubMed Central

Background: Endometriosis commonly affects the pelvic organs but can also affect organs outside the pelvis and is then termed extragenital endometriosis. Cases: Successful robotically assisted laparoscopic management of extragenital endometriosis, specifically, endometriosis of the bowel, bladder, and ureter in 5 patients. Conclusion: A substantial body of evidence supports the laparoscopic approach as the preferred method for many procedures; yet, a majority of procedures today still are performed by laparotomy. This preference for open procedures is likely due to the lack of trained endoscopic surgeons, the difficulty in obtaining proper instruments, and the long learning curve of operative laparoscopy. The recent advent of computer-enhanced technology may provide the bridge necessary for more surgeons to incorporate laparoscopic surgery in the treatment of complex cases. PMID:21985730

Hajhosseini, Babak; King, Louise P.

2011-01-01

251

Renal dysplasia with unilateral renal agenesis in a dog.  

PubMed

This report describes a renal dysplastic lesion associated with renal agenesis in a 3-year-old dog with chronic renal failure. Haematological examination revealed non-regenerative anaemia, azotaemia, increased creatinine and hyperphosphataemia. At necropsy, the right kidney and right ureter could not be identified. The left kidney was slightly enlarged, with a reduced cortico-medullary ratio. Histologically, the medulla of the left kidney had persistent mesenchyme and primitive tubules (tall pseudostratified columnar epithelium), dilated collecting ducts lined by flattened epithelium, and adenomatoid proliferation of cuboidal epithelium; fetal or immature glomeruli could not be identified. To our knowledge, this is the first report of a renal dysplastic lesion with unilateral agenesis in animals. PMID:15899491

Morita, T; Michimae, Y; Sawada, M; Uemura, T; Araki, Y; Haruna, A; Shimada, A

2005-07-01

252

Peristaltic pumping and irreversibility of a Stokesian viscoelastic fluid  

NASA Astrophysics Data System (ADS)

Peristaltic pumping by wavelike contractions is a fundamental biomechanical mechanism for fluid and material transport and is used in the esophagus, intestine, oviduct, and ureter. While peristaltic pumping of a Newtonian fluid is well understood, in many important settings, as in the fluid dynamics of reproduction, the fluids have non-Newtonian responses. Here, we present a numerical method for simulating an Oldroyd-B fluid coupled to contractile, moving walls. A marker and cell grid-based projection method is used for the fluid equations and an immersed boundary method is used for coupling to a Lagrangian representation of the deforming walls. We examine numerically the peristaltic transport of a highly viscous Oldroyd-B fluid over a range of Weissenberg numbers and peristalsis wavelengths and amplitudes.

Teran, Joseph; Fauci, Lisa; Shelley, Michael

2008-07-01

253

Comprehensive renal scintillation procedures in spinal cord injury: comparison with excretory urography  

SciTech Connect

A /sup 131/iodine orthoiodohippurate comprehensive renal scintillation procedure was performed and compared to results of excretory urography in 200 spinal cord injury patients. No severe urographic abnormalities were undetected by the comprehensive renal scintillation procedure. Only 1.4 per cent of renal units had greater than minimal pyelocaliectasis or ureterectasis in the presence of a normal radionuclide examination. A relatively large number of abnormalities were detected on the renal scintillation procedure when the excretory urogram was normal. Serial followup will be required to determine the significance of these findings but present data suggest that a comprehensive renal scintillation procedure and a plain film of the kidneys, ureters and bladder may be used for screening upper urinary tract abnormalities in lieu of an excretory urogram. This is particularly advantageous for the spinal cord injury population, since there have been no toxic or allergic reactions reported, no bowel preparation or dehydration is required and there is relatively low radiation exposure.

Lloyd, L.K.; Dubovsky, E.V.; Bueschen, A.J.; Witten, D.M.; Scott, J.W.; Kuhlemeier, K.; Stover, S.L.

1981-07-01

254

A huge bladder calculus causing acute renal failure.  

PubMed

We present a 39-year-old man with repeated urinary tract infection and lower abdominal pain. Kidney-ureter-bladder (KUB) and IVU film showed a huge 450-g elliptical pelvic calculus that was surgically removed with excellent results. Surgical intervention by cystolithotomy or endoscopic cystolithotripsy can achieve satisfactory results. Bladder outlet obstruction should be treated simultaneously. Bladder stone is a common disease, but it is rare for such a calculus to be so large as to cause bilateral hydronephrosis. Close follow-up, however, is mandatory because the recurrence of urolithiasis is high in those patients with voiding problems and recurrent urinary infection. To the best of our knowledge, this is the largest bladder stone in a human male. PMID:20033143

Wei, Wuran; Wang, Jia

2010-08-01

255

[Two rare case reports of ureteral triplication].  

PubMed

Triplication of the upper urinary tract is rare. It is classified according to its extent and four types have been documented. Since the first description of ureteral triplication by Wrany only about a hundred cases have been reported in the literature. Paediatric cases are very few and female patients seem more concerned. The embryological event resulting in ureteral triplication derives from multiple ureteral buds arising from the Wolffian duct with fissuring of one or more of them. We report on two cases of ureteral triplication. The first one associated with an extravesical ectopic ureter and a dysplasic kidney. Diagnosis was particularly difficult and treatment consisted of total nephrectomy. The second case was associated with an upper pole hydronephrosis and a partial nephrectomy was realized. PMID:11859577

Bouhafs, A; Dubois, R; Chaffange, P; Laboure, S; Valla, J S; Dodat, H

2002-01-01

256

[A case of bilateral ureteral triplication].  

PubMed

Ureteral triplication is a rare congenital anomaly of the urinary tract, although ureteral duplication is rather common. Bilateral ureteral triplications are even rare anomalies. A five-year-old girl with a history of urinary tract infection and episodes of fever and lower abdominal pain was admitted to our hospital for further examination of microscopic hematuria. An excretory urogram (IVP) revealed bilateral 3 pelves and ureters, and cystoscopic examination showed 2 ureteral orifices on each side. Both sides of bilateral ureteral triplications in our case belonged to type B of Smith's classification. Ureteral triplication was first reported by Wraný in 1870. Since then 84 cases have been reported and among them 3 cases had bilateral ureteral triplications. In this article, the classification and the development of ureteral triplication are reviewed briefly. PMID:4025084

Shoda, R; Ejiri, S; Fujita, T; Wada, N

1985-03-01

257

[Radical surgery in unseccessfully irradiated cervix carcinoma?].  

PubMed

When radiological treatment in carcinoma of the cervix has failed radical operation may still be technically feasible in certain cases. They are, however, always prone to complications resulting from tissue damage due both to radiation and surgery. Among the 6 cases described there was one double-sided necrotic fistula of the ureters and two vesical-colonic-vaginal fistulae. In two patients we observed extended necroses of the pelvic tissue 5 and 7 weeks respectively after the operation with preceding telecobalt therapy; in one case this resulted in bleeding to death. There was only one case without any complications. This had been treated before by contact therapy only without additional percutaneous radition. From this we would like to draw the conclusion that one should refrain from secondary radical operation after telecobalt therapy. The question remaine to be discussed whether in these cases ultra-radical exenteration can be successful. PMID:1220445

Helbing, W; Woraschk, A

1975-01-01

258

Percutaneous Radiofrequency Ablation for Treatment of Recurrent Retroperitoneal Liposarcoma  

SciTech Connect

Percutaneous CT-guided radiofrequency ablation (RFA) is becoming more and more established in the treatment of various neoplasms, including retroperitoneal tumors of the kidneys and the adrenal glands. We report the case of RFA in a patient suffering from the third relapse of a retroperitoneal liposarcoma in the left psoas muscle. After repeated surgical resection and supportive radiation therapy of a primary retroperitoneal liposarcoma and two surgically treated recurrences, including replacement of the ureter by a fraction of the ileum, there was no option for further surgery. Thus, we considered RFA as the most suitable treatment option. Monopolar RFA was performed in a single session with a 2-cm umbrella-shaped LeVeen probe. During a 27-month follow-up period the patient remained free of tumor.

Keil, Sebastian, E-mail: keil@rad.rwth-aachen.de; Bruners, Philipp [RWTH Aachen University, Department of Diagnostic Radiology, University Hospital (Germany); Brehmer, Bernhard [RWTH Aachen University, Department of Urology, University Hospital (Germany); Mahnken, Andreas Horst [RWTH Aachen University, Department of Diagnostic Radiology, University Hospital (Germany)

2008-07-15

259

[Ureteral jet in patients with benign prostatic hypertrophy: prognostic evaluation during single and combined therapy].  

PubMed

By color-Doppler ultrasound it's possible to visualize urine flow jet from ureter into the bladder. Aim of the study was to evaluate of ureteral jet in patients with benign prostatic hyperplasia before, during and after with one or two drugs medical therapy. Thirteen patients, aged 51-63 years, were studied; they were not affected by metabolic, hepatic, renal diseases and by prostate inflammation. Eco color Doppler p.w. (Toshiba SSA 270A) with a convex probe of 3.5 MHz was used. A transabdominal ultrasound study was performed, prostate volume measured and ureteral jet visualized before and along treatment (at six months interval) with Finasteride and at the end of treatment. Successively, in four patients, with relapse of prostatic synptomatology, a transabdominal ultrasound study was performed, before and along a treatment with Finasteride, 5 mg/die (Finastid, Neopharmed) and Terazosin hydrochloride, 5 mg/die (Teraprost, Malesci), and at the end of treatment. PMID:9162355

Sperandeo, M; Sperandeo, G; Carella, M; Bianco, G; Cera, A; Scarale, M G; Viola, M

1996-12-01

260

Modern management of stone disease in patients with a solitary kidney  

PubMed Central

Analysing the data available in the literature, contemporary methods of treatment of nephrolithiasis are limited to the methods of minimally invasive percutaneous nephrolithotomy (PCNL) and ureterorenoscopic lithotripsy (URSL), not excluding their use in the presence of developmental abnormalities and kidney impairment only. Minimally invasive methods have become standard procedures. A complement to ineffective URSL and PCNL treatment is extracorporeal shock wave lithotripsy. This is confirmed by 30 years of observation in the only treatment of kidney calculi by Alken launched in 1981 and continued by Jones et al. Before the era of endoscopic procedures (PCNL and URSL) effectively removed the only deposits in the kidney in open operations. Minimally invasive treatments are recommended for patients with localized deposits in the pelvicalyceal system or solitary kidney ureter. They are recognized as safe and effective treatment in a solitary kidney in particular in patients who have already been operated on. PMID:23255993

Tkocz, Micha?; Ziaja, Damian

2011-01-01

261

Primary renal lymphoma—a case report  

PubMed Central

Primary renal lymphoma is a rare entity representing less than 1% of lesions in the kidney. We present the case of a 42-year-old male who was evaluated for pain and a mass in the abdomen. The computed tomogram of the abdomen showed a large lobulated homogeneously enhancing mass lesion of about 14×12×18 cm, involving the whole of the left kidney and encasing the left renal vessels and ureter. The patient underwent a biopsy, and the histopathology was diffuse large B cell lymphoma, positive for LCA, CD20, PAX 5, Bcl 2 and negative for SIgM, CD33, CD34, CD5, Tdt, with MIB 1 labelling index of 40%. He received chemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone (R CHOP) for eight cycles followed by radiation to the residual mass and achieved complete remission. Currently, he is alive and in remission at 28 months. PMID:25371707

Geetha, N; Shahid, Abdul; Rajan, Varun; Jacob, Priya Mary

2014-01-01

262

Botryoid Wilms' tumor: a case report and review of the literature  

PubMed Central

Here, we report a new case of botryoid Wilms’ tumor, a 4-year-old boy, who was referred to us with a chief complaint of dysuria and gross hematuria. The computed tomography and radical nephroureterectomy showed that a botryoid sarcoma-like appearance occupied the right renal pelvis and extended into the bladder. Histologic examination further confirmed this case was a mixed type of Wilms’ tumor. In a word, we demonstrated a rare case of botryoid Wilms’ tumor, which extended from the renal pelvis into the ureter and bladder, then some degenerative and necrotic tissue with calcification discharged from urethra. Postoperative adjuvant chemotherapy was executed. At 24-month follow-up, there was no evidence of recurrence. PMID:23687909

2013-01-01

263

Foreign body granulomas simulating recurrent tumors in patients following colorectal surgery for carcinoma: a report of two cases.  

PubMed

We report here two cases of foreign body granulomas that arose from the pelvic wall and liver, respectively, and simulated recurrent colorectal carcinomas in patients with a history of surgery. On contrast-enhanced CT and MR images, a pelvic wall mass appeared as a well-enhancing mass that had invaded the distal ureter, resulting in the development of hydronephrosis. In addition, a liver mass had a hypointense rim that corresponded to the fibrous wall on a T2-weighted MR image, and showed persistent peripheral enhancement that corresponded to the granulation tissues and fibrous wall on dynamic MR images. These lesions also displayed very intense homogeneous FDG uptake on PET/CT. PMID:19412522

Kim, Sang Won; Shin, Hyeong Cheol; Kim, Il Young; Baek, Moo Joon; Cho, Hyun-Deuk

2009-01-01

264

Onset of hydronephrosis and lower urinary tract symptoms in a previously healthy young man: Phyllodes tumour of the prostate as a potential diagnosis.  

PubMed

We report the case of a 50-year-old healthy man with early onset of micturition symptoms associated with an elevated total prostate-specific antigen. On physical examination, we found an enlarged prostate; a first-line ultrasound of the urinary tract revealed local disease which covered the entire small pelvis. A computed tomography scan confirmed the presence of a 12.5 × 11.0 × 9.5-cm multicystic prostatic mass, compressing the bladder and pelvic ureters, associated with right hydronephrosis. Renal function was preserved and prostatic biopsies was negative for malignant disease. The mass was completely removed through transvesical approach and histological analysis diagnosed a low-grade phyllodes tumour of the prostate. The patient was free of local recurrence and metastasis 36 months after surgery. PMID:25210565

Ferrari, Matteo; Capitanio, Umberto; Rizzo, Nathalie; Freschi, Massimo; Montorsi, Francesco; Rigatti, Patrizio

2014-07-01

265

Primary extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue type with malakoplakia in the urinary bladder: a case report  

PubMed Central

Primary malignant lymphoma of the urinary bladder is a rare disease constituting less than 1% of neoplasms of the urinary bladder. The most prevalent histological subtype is extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue type (MALT lymphoma). It is frequently associated with chronic cystitis and predominantly occurs in females. On the other hand, malakoplakia is thought to be a reactive granulomatous lesion occurring most prevalently in the genitourinary tracts. It is frequently found in females and often associated with bacterial infection in immunosuppressive status. Here we report a rare case of concurrent primary MALT lymphoma and malakoplakia in the urinary bladder in a 78-year-old Japanese female. Presumably, both lymphoma and malakoplakia are considered to be involved in the antecedent cystitis and might contribute to the development of the urinary bladder tumor of the patient, leading to the occlusion of the right ureter with subsequent hydronephrosis. PMID:25197410

Matsuda, Ikuo; Zozumi, Masataka; Tsuchida, Yasu-aki; Kimura, Naomi; Liu, Ning-Ning; Fujimori, Yoshihiro; Okada, Masaya; Hashimoto, Takahiko; Yamamoto, Shingo; Hirota, Seiichi

2014-01-01

266

Emphysematous cystitis in a patient with type 2 diabetes mellitus.  

PubMed

A 62-year-old woman with a history of poorly controlled type 2 diabetes mellitus was admitted to our hospital with a 3-week history of mild fever, vomiting, and anorexia. Abdominal computed tomography (CT) showed bilateral hydronephrosis and gas accumulation in the urinary bladder wall and left ureter. Laboratory tests showed leukocytosis and elevated C-reactive protein level. Urine culture showed heavy growth of Escherichia coli. The final diagnosis was emphysematous cystitis. The patient was treated with systemic antibiotics and drainage using a urethral catheter. The clinical and radiographic findings resolved rapidly, and she was discharged from the hospital on day 28. Emphysematous cystitis is a relatively rare urinary tract infection associated with gas formation, and has the potential for a serious outcome if untreated. Early detection by imaging studies such as CT is important in providing prompt treatment and favorable clinical outcome. PMID:21519371

Toyota, Noriko; Ogawa, Daisuke; Ishii, Keita; Hirata, Kyoji; Wada, Jun; Shikata, Kenichi; Makino, Hirofumi

2011-04-01

267

A complex case of abdominal pain in a patient with pelviureteric junction obstruction  

PubMed Central

Pelviureteric junction (PUJ) obstruction is a condition frequently encountered in both adult and pediatric patients. Congenital abnormalities and crossing lower-pole renal vessels are the most common underlying pathologies in both men and women. This report presents a case of a young woman who was complaining of intermittent abdominal pain in whom right-sided hydronephrosis was diagnosed. The patient was scheduled for a laparoscopic right-sided Anderson-Hynes pyeloplasty. During the procedure a partly extraperitoneal appendix, with extensive adhesions to the posterior abdominal wall abutting on the ureter just below the obstructed PUJ, was identified. The patient underwent dismembered laparoscopic Anderson-Hynes pyeloplasty with concurrent appendectomy for likely dual pathologies being responsible for her symptoms. PMID:25097699

Wolak, Przemyslaw; Obarzanowski, Mateusz; Chlosta, Piotr

2014-01-01

268

The first use of Resonance® metallic ureteric stent in a case of obstructed transplant kidney  

PubMed Central

INTRODUCTION To date, double JJ stent is the mainstay ureteric stent used in a transplant kidney. We herein report the first use of Resonance® metallic ureteric stent to manage ureteric obstruction in a transplant kidney. PRESENTATION OF CASE A 45-year-old lady underwent an uneventful living related donor renal transplantation. Due to post-operative pelvi-ureteric obstruction and recurrent obstruction following multiple distal stent migration and expulsion necessitated frequent nephrostomy insertion and antegrade stenting, she underwent challenging but successful retrograde insertion of a 12 centimetres long and size 6.0 French Cook Resonance® metallic ureteric stent which was performed under general anaesthesia. DISCUSSION Metallic ureteric stents are a fairly recent introduction to modern urology and they have been successfully used in the management of benign and malignant obstruction of ureter. CONCLUSION This is the first case of therapeutic metallic ureteric stent insertion in a transplant kidney. PMID:24858983

Abdulmajed, Mohamed I.; Jones, Vaughan W.; Shergill, Iqbal S.

2014-01-01

269

Congenital Seminal Vesicle Cyst Associated with Ipsilateral Renal Agenesis  

PubMed Central

Purpose A seminal vesicle cyst in combination with ipsilateral renal agenesis is rarely encountered. We present cases of this disease entity with symptoms, which were treated with a laparoscopic approach as a minimally invasive surgical treatment. Materials and Methods We experienced 4 patients with seminal vesicle cysts and ipsilateral renal agenesis. The mean age was 45.8 years. Chief complaints were perineal pain and hematospermia. Seminal vesicle cysts and remnant ureters were excised by laparoscopic surgery with transperitoneal approaches. Results The mean operative time was 133.8 minutes. The mean hospital stay was 6.8 days. There were no operative complications or transfusions. Conclusion In our report, patients of congenital seminal vesicle cyst associated with renal agenesis are presented. Laparoscopy is considered a minimal invasive management of these combined anomalies, providing a good image and an easy approach. PMID:19718406

Kim, Hun Soo; Rim, Joung Sik

2009-01-01

270

Role of urine in the spawning of female rose bitterling, Rhodeus ocellatus ocellatus.  

PubMed

This study clarified the spawning mechanism of female rose bitterling, Rhodeus ocellatus ocellatus, with special emphasis on the physical role of urine. Ovulated females ingested a significantly greater quantity of water by drinking than non-ovulated fish. The body weight of ovulated females increased about 1.3% while it decreased 1.0% in non-ovulated females. Urine volume in the urinary bladder increased rapidly before spawning, synchronized with the spawning cycle. On the other hand, little urine remained in specimens which had completed spawning. Histological observation demonstrated that the oviduct and the ureter joined at the proximal part of the ovipositor. On the basis of these anatomical and physiological results, it is proposed that urine plays the physical role of pushing the ovulated eggs through the elongated ovipositor during spawning. PMID:24197076

Matsubara, T

1994-11-01

271

Diagnosis and treatment of carcinosarcoma of the renal pelvis: A case report  

PubMed Central

Carcinosarcoma is a rare type of renal pelvis malignancy, the diagnosis of which requires the presence of malignant epithelial and mesenchymal components. The prognosis of this disease is extremely poor due to its rapid progression and widespread metastases. The present study describes a case of carcinosarcoma involving the right renal pelvis in a 73-year-old female who presented with intermittent hematuria and right-flank pain that had persisted for one month. Computed tomography revealed a 2.4×2.5 cm mass in the right renal pelvis, which was diagnosed as a right renal pelvic tumor. Laparoscopic radical resection of the right kidney and ureter was performed. Following surgery, immunohistochemical analysis showed positive reactions for epithelial and mesenchymal markers. Based on these findings, the patient was diagnosed with carcinosarcoma. Thus, immunohistochemical analysis is a critical method for the accurate diagnosis of carcinosarcoma. PMID:24959298

DONG, BIAO; ZHANG, JIAN-JIAN; CHEN, CHAO; WANG, YUAN-TAO; ZHAI, XIU-YU; FU, YAO-WEN; ZHOU, HONG-LAN

2014-01-01

272

Retroperitoneal Malignant Peripheral Nerve Sheath Tumor Replacing an Absent Kidney in a Child  

PubMed Central

Malignant peripheral nerve sheath tumors (MPNSTs) are nonrhabdomyosarcoma soft tissue sarcomas with rare occurrence in children specially in the retroperitoneum. We describe a young child who presented with an abdominal mass. Both ultrasound and computed tomography revealed a large right-sided abdominal mass in the anatomic place of right kidney, while no kidney or ureter was observed at that side. He underwent surgical resection of the tumor with a primary impression of Wilms tumor. To the authors' knowledge, this is the first case of retroperitoneal malignant peripheral nerve sheath tumor and absent kidney. This case suggests the very rare probability of association of MPNSTs in children with genitourinary tract anomalies such as renal agenesis. PMID:24392233

Alavi, Samin; Arzanian, M. T.; Nilipour, Yalda

2013-01-01

273

Population dynamics of Philureter trigoniopsis (Monogenea: Ancyrocephalinae) from urinary organs of Galaxias maculatus (Osmeriformes: Galaxiidae) in a cold temperate Andean Patagonian lake (Argentina).  

PubMed

Philureter trigoniopsis parasitizes the ureters and urinary bladder of Galaxias maculatus in Patagonian Andean lakes. To investigate factors associated with variation in the prevalence and intensity of this monogenean, fish were sampled periodically over 2 yr in Lake Gutiérrez. Prevalence and mean intensity are higher in smaller fishes than in larger ones. A seasonal pattern was observed, with peak recruitment and peak mean intensity occurring in early spring (September), followed by lows in late summer (January-February). Galaxias maculatus length classes are spatially segregated due to seasonal migrations, so the annual infection cycle is characterized by higher prevalence and intensity from late winter to early summer in the smaller fish from the deep zone of the lake. PMID:16539018

Viozzi, Gustavo P; Semenas, Liliana G; Gutiérrez, Pablo

2005-12-01

274

Peristaltic pumping of solid particles immersed in a viscoelastic fluid  

NASA Astrophysics Data System (ADS)

Peristaltic pumping of fluid is a fundamental method of transport in many biological processes. In some instances, particles of appreciable size are transported along with the fluid, such as ovum transport in the oviduct or kidney stones in the ureter. In some of these biological settings, the fluid may be viscoelastic. In such a case, a nonlinear constitutive equation to describe the evolution of the viscoelastic contribution to the stress tensor must be included in the governing equations. Here we use an immersed boundary framework to study peristaltic transport of a macroscopic solid particle in a viscoelastic fluid governed by a Navier-Stokes/Oldroyd-B model. Numerical simulations of peristaltic pumping as a function of Weissenberg number are presented. We examine the spatial and temporal evolution of the polymer stress field, and also find that the viscoelasticity of the fluid does hamper the overall transport of the particle in the direction of the wave.

Chrispell, John; Fauci, Lisa

2010-11-01

275

Onset of hydronephrosis and lower urinary tract symptoms in a previously healthy young man: Phyllodes tumour of the prostate as a potential diagnosis  

PubMed Central

We report the case of a 50-year-old healthy man with early onset of micturition symptoms associated with an elevated total prostate-specific antigen. On physical examination, we found an enlarged prostate; a first-line ultrasound of the urinary tract revealed local disease which covered the entire small pelvis. A computed tomography scan confirmed the presence of a 12.5 × 11.0 × 9.5-cm multicystic prostatic mass, compressing the bladder and pelvic ureters, associated with right hydronephrosis. Renal function was preserved and prostatic biopsies was negative for malignant disease. The mass was completely removed through transvesical approach and histological analysis diagnosed a low-grade phyllodes tumour of the prostate. The patient was free of local recurrence and metastasis 36 months after surgery. PMID:25210565

Ferrari, Matteo; Capitanio, Umberto; Rizzo, Nathalie; Freschi, Massimo; Montorsi, Francesco; Rigatti, Patrizio

2014-01-01

276

Comparison of radiation sensitivity for three cell lines as measured by the cloning assay and the micro-nucleus test.  

PubMed

The correlation between cell killing and the induction of micro-nuclei was studied for three cell lines after treatment with gamma radiation to investigate whether the frequency of micro-nucleated cells can be used to determine the radiation sensitivity of a cell type. R1 rat rhabdomyosarcoma cells showed a higher sensitivity for the induction of proliferative death than RUC rat ureter carcinoma cells and V79 Chinese hamster cells which had a similar radiation sensitivity. The frequencies of micro-nucleated cells were measured at 48 hours after the treatment. It was determined by time-lapse cinematography that almost all the cells in the treated cultures had divided at that time. Our results indicate that for these cell lines the correlation between the effectiveness for cell killing and the induction of micro-nuclei was the same, within the experimental errors. PMID:2260014

Stap, J; Aten, J A

1990-11-01

277

Myxosporidan parasites for pumpkinseed (Lepomis gibbosus L.) from Ontario.  

PubMed

Five species of myxosporideans were found in pumpkinseed (Lepomis gibbosus L.) from Ryan Lake, Algonquin Park, Ontario. Myxobolus osburni Herrick 1936 was found in pancreatic tissue. Myxobilatus ohioensis (Herrick 1941) Davis 1944 was found in the ureters and urinary bladder. Three new species are described, namely, Myxobolus uvuliferis sp. n. (in the fibrous capsule surrounding the metacercariae of Uvulifer ambloplitis (Hughes 1927), Myxobolus magnaspherus sp. n. (in the parietal peritoneum) and Myxobolus dechtiari sp. n. (in the gills). Myxobolus uvuliferis sp. n. is most similar to M. osburni, but its spores are subspherical and not spherical. Myxobolus magnaspherus sp. n. is most similar to Myxobolus gigas Auerbach 1906, but its spores are wider than long, and they have exceedingly long polar filaments. Myxobolus dechtiari sp. n. is similar to Myxobolus karelicus Petruschewsky 1940 but it lacks an intercapsular appendix. PMID:407348

Cone, D K; Anderson, R C

1977-08-01

278

Successful removal of an intravesical electrical wire cable.  

PubMed

A few previous reports have described cases wherein electrical wire cables were inserted into the male urethra and bladder. Electrical wire cables are available at home and are easy to insert. However, after they coil in the patient's bladder, they are difficult to remove. In February 2013, a 30-year-old man presented to the emergency room of SMG-SNU Boramae Medical Center with a urethral foreign body. He had inserted an electrical wire cable into his urethra for the purpose of masturbation, despite having a regular sex partner and no underlying disease. A kidney-ureter-bladder radiography showed a tangled wire in his bladder and urethra. On the next day, we tried to remove the wire cystoscopically, but this proved to be impossible because of complex coiling and the slippery surface of the wire. A Pfannenstiel incision was made to remove the foreign body. No postoperative complications were noted. PMID:25237664

Ahn, Hyunsoo; Son, Hwancheol

2014-08-01

279

Pelvic sacral and hemi lumbar spine resection of low grade pelvic chondrosarcoma: a multistage procedure involving vascular bypass, spine fixation and vascular exclusion.  

PubMed

Peripheral chondrosarcoma is a rare tumor particularly insidious when arising from the pelvis, becoming symptomatic later in time when surgery may be too difficult and dangerous due to this complex area. In the present case, the tumor arose from an exostosis located on the medial surface of the left iliac wing. Its diameter was 25 cm × 20 cm × 15 cm, adhering to the last three vertebrae, involving the left iliac vein and artery, displacing the left ureter. In a similar case, a hindquarter amputation is indicated but, if the patient refuses, a resection remains possible. In this paper, we describe a multistage technique consisting of an extra-anatomic vascular bypass, a lumbar stabilization, a neurovascular bundles anterior isolation and a postero-lateral resection of this mass. After a five-year follow-up, the patient is alive and able to stand and walk with support, after undergoing twice lung metastasis removal. PMID:24074762

Zoccali, C; Marolda, G; Di Francesco, A; Favale, L; Salducca, N; Biagini, R

2013-11-01

280

Nephrectomy in an Asian small-clawed otter (Amblonyx cinereus) with pyelonephritis and hydronephrosis secondary to ureteral obstruction.  

PubMed

A 10-yr-old, captive, intact male Asian small-clawed otter (Amblonyx cinereus) with a history of bilateral nephrolithiasis was presented for acute-onset lethargy and inappetance of 5 days duration. On physical examination, the otter was about 8% dehydrated and a palpable fluid wave was present in the abdomen. An abdominal ultrasound revealed hydronephrosis of the left kidney and a hyperechoic structure present within the lumen of the left ureter, causing an obstruction. A urinalysis revealed struvite crystalluria, bacteriuria, and an elevated pH. Following 4 days of antibiotic therapy, a left ureteronephrectomy was performed. Upon opening the kidney to retrieve calculi, a large amount of purulent material was noted within the renal pelvis. To the authors' knowledge, this is the first documented case of a nephrectomy in an Asian small-clawed otter. Nephrectomy should be considered as a viable option for treatment of ureteral obstruction, hydronephrosis, or severe pyelonephritis. PMID:25314845

Higbie, Christine T; Carpenter, James W; Armbrust, Laura J; Klocke, Emily; Almes, Kelli

2014-09-01

281

Optimization of dosimetry and safety using the holmium laser for urology  

NASA Astrophysics Data System (ADS)

The holmium laser has become accepted as a versatile instrument for urological applications, such as prostate resection, urethrotomy, tumor coagulation and lithotripsy. Presently, more powerful lasers have become available generating pulses up to 4 J at 80 W. The necessity of these high power systems in urology is ambiguous. In this study, the dosimetry as to efficacy and especially safety was investigated for various applications. The holmium laser ((lambda) equals 2.1 micrometer) emits its energy in 350 microsecond pulses which instantly turn water into vapor. Using high-speed photography explosive vapor bubbles with diameters over 10 mm were captured. The mechanical force of these bubbles, effectively fragments stones but may dilate and rupture a small lumen like the ureter. After implosion of the bubble, the energy of vaporization turns into heat. Depending on pulse energy and pulse repetition rate, tissue can be thermally affected up to 5 mm. For soft tissue applications, e.g., urethrotomy, prostatectomy or tumor coagulation, pulse energies of 0.5 - 1.5 J were applied at a high repetition rate (20 - 40 Hz) to provide sufficient coagulative and hemostatic effects. At higher pulse energies, the fiber tip was vibrating vigorously and the tissue was ripped to pieces decreasing hemostasis and visibility. For hard tissue applications, bursts of 0.5 J pulses at 5 Hz, proved to be sufficient to fragment all types of stones (including cystine) in the ureter and the bladder without mechanical or thermal damage to surrounding tissue. At higher settings, targeting the stone was less controlled and effective due to 'jumping' of the fiber tip with resulting mechanical and thermal trauma to the surrounding tissue. The holmium laser can be used effectively to coagulate and cut soft tissue and fragment stones at relatively low energy and power settings, thus minimizing the risk of complications.

van Swol, Christiaan F. P.; Verdaasdonck, Rudolf M.; Zeijlemaker, Bram Y. W.; Grimbergen, Matthijs C. M.; Boon, Tom A.

1998-07-01

282

Clinical effectiveness of the PolyScope(TM) endoscope system combined with holmium laser lithotripsy in the treatment of upper urinary calculi with a diameter of less than 2 cm  

PubMed Central

The aim of this study was to evaluate the clinical value of the PolyScope™ endoscope system in the treatment of upper urinary calculi with a diameter of <2 cm. A total of 86 patients hospitalized with upper urinary tract calculi were included. The patients were placed under general or spinal anesthesia and in a lithotomy position. Following the dilation of the ureter, a guide wire was inserted under the direct vision of an F8/9.8 rigid ureteroscope, and an F12/14 flexible ureteral access sheath was positioned along the guide wire. Holmium laser lithotripsy was subsequently performed, using an F8.0 ‘PolyScope’ modular flexible ureteroscope. Plain film of the kidney-ureter-bladder (KUB) was performed 1 day subsequent to the surgery, in order to determine the result of the lithotripsy and the position of the double-J stent which was inserted after after holmium laser lithotripsy. In addition, in certain patients, KUB radiography was performed 2–4 weeks subsequent to the surgery, and extracorporeal shockwave lithotripsy (ESWL) was performed if the diameter of the residual stones was >6 mm. Lithotripsy was successful in 77 patients and the duration of the surgery ranged between 25 and 80 min (mean duration, 42 min). Little bleeding was observed. Three patients presented with a slight fever following the surgery; however, no ureteral perforation, high fever or septicemia was observed among the patients following anti-inflammatory treatment. The stone-free rate (SFR) of the single-pass lithotripsy was 89.5% (77/86) and the SFR with ESWL was 96.5% (83/86). The study demonstrated that the F8 modular flexible ureteroscope was safe, convenient and effective for the lithotripsy of upper-tract calculi. PMID:24137232

GU, SI-PING; HUANG, YUN-TENG; YOU, ZHI-YUAN; ZHOU, XIAOMING; LU, YI-JIN; HE, CAO-HUI; QI, JUAN

2013-01-01

283

Effect of unilateral ureteral obstruction and anti-angiotensin II treatment on renal tubule cell apoptosis and interstitial fibrosis in rats.  

PubMed

Unilateral ureteral obstruction (UUO) results in a number of pathophysiological and morphological changes in the renal parenchyma, including interstitial inflammation and fibrosis, apoptotic changes of tubular and interstitial cells. Recent studies have indicated an association between renin-angiotensin system and apoptotic alterations in the kidney after unilateral obstructive nephropathy. In this study, the effect of ACE inhibitors and AT1 receptor antagonists on tubular cell apoptosis and interstitial fibrosis in obstructive nephropathy after UUO in rats was investigated. The study was conducted on Wistar rats with unilaterally ligated ureter and sham operated animals (control group). The rats with UUO were treated with ACE inhibitor (cilazapril) or AT1 receptor antagonists (losartan) and control group was treated with H2O. Sham-operated animals were treated in the same way. Tubular and interstitial cell apoptosis was detected morphologically by hematoxylin and eosin (HE) staining and terminal deoxynucleotidyl transferase-mediated nick end-labeling (TUNEL). The area of intersitial fibrosis was determined using computer-assisted image processing after Gomory silver impregnation of paraffin sections. All experimental animal groups with unilateral ureter ligation showed a significantly increased number of apoptotic tubular and interstitial cells in the obstructed kidney compared with the contralateral, unobstructed kidney. Histomorphometric analysis of renal interstitial fibrotic changes in the groups of rats treated with losartan or water showed a statistically significant difference (p < 0.05) between the operated and sham--operated animals. In conclusion, following UUO there is a significantly increased number of apoptotic tubular cells and interstitial fibrosis in the ipsilateral kidney compared with the contralateral kidney. ACE inhibitors and AT1 receptor antagonists could not decrease the extent of renal cells apoptosis and interstitial fibrosis after UUO. PMID:25144992

Radovi?, Nikola; Aralica, Gorana; Ljubanovi?, Danica Galesi?; Jelec, Vjekoslav; Kontek, Mladen

2014-06-01

284

Efficiency of percutaneous nephrolithotomy in pediatric patients using adult-type instruments.  

PubMed

To evaluate the efficiency of percutaneous nephrolithotomy using adult-type instruments in children with kidney stones. Between September 2004 and October 2009, 18 children (19 renal units) underwent percutaneous nephrolithotomy using adult-type instruments. Following percutaneous access under fluoroscopy, 20-30F tract dilatation was performed (1,92,427F), and lithotripters were used. Postoperatively, kidney-ureter-bladder X-ray and antegrade pyelography were performed to evaluate residual stones and contrast passage to the bladder. 8 boys and 10 girls with a mean age of 9.8 ± 4.56 years were evaluated. Mean stone burden was 338 ± 196.21 mm². Stones were located in the left and right kidneys in 16 (84.2%) and 3 (16.8%) patients, respectively. Horse-shoe kidney was present in one patient. Mean operation (including cystoscopy) and fluoroscopy times were 106 ± 49.60 and 5.2 ± 2.14 min, respectively. Postoperatively, 10(52.6%) patients were stone free and 4 (21.1%) patients had clinically insignificant stones. Saline extravasation developed in three patients and surgery was aborted in one patient. Stone fragments migrated into the ureter in two patients and managed by additional endourological interventions. Nephrostomy catheters were kept for a mean of 2.6 ± 1.12 days. Four patients required blood transfusion due to bleeding. Postoperative fever of <39°C developed in five patients and >39°C in one patient. Mean hospitalization time was 5.3 ± 3.12 days. Overall, 73.7% of our patients were stone free, including patients with clinically insignificant stones. Particularly in children with a high-stone burden, the use of adult-type instruments might have a positive impact on stone-free rate, operation time and fluoroscopy time without increasing the complication rate. PMID:21814769

Dogan, Bayram; Atmaca, Ali Fuat; Canda, Abdullah Erdem; Isgoren, Abidin Egemen; Akbulut, Ziya; Balbay, Mevlana Derya

2012-06-01

285

Single-Surgeon Experience With Robot-Assisted Ureteroneocystostomy for Distal Ureteral Pathologies in Adults  

PubMed Central

Purpose To demonstrate our technical approach for robot-assisted ureteroneocystostomy (R-UNC) for benign and malignant distal ureteral pathologies. Materials and Methods Between January 2009 and January 2013, a total of 10 patients underwent R-UNC in the distal ureter by a single surgeon. Indications for R-UNC were as follows: idiopathic (3), fistula (2), iatrogenic (2), malignancy (2), and chronic vesicoureteral reflux (1). Results Tension-free anastomosis was attained in all 10 R-UNC procedures. A psoas hitch was performed in 6/10 cases (60%). Intravesical and extravesical reimplantations were completed in 5/10 (50%) and 5/10 cases (50%), respectively. A nonrefluxing ureter was constructed in 2/10 cases (20%). The patients' mean age was 52.9±16.6 years, their mean body mass index was 30.8±6.3 kg/m2, the mean operative time was 211.7±69.3 minutes, mean estimated blood loss was 102.5±110.8 mL, and mean length of stay was 2.8±2.3 days. There were no intraoperative complications. There was one Clavien-Dindo grade I and one Clavien-Dindo grade II postoperative complication. The mean postoperative follow-up duration was 28.5±15.5 months. Two patients had recurrence of ureteral strictures at 3 months postoperatively and were managed successfully with balloon dilation. Conclusions Our technique for R-UNC demonstrates good perioperative outcomes. However, underlying periureteral inflammation and pelvic adhesions may predispose patients for stricture recurrence after R-UNC. PMID:23956826

Lee, Ziho; Sehgal, Shailen; Llukani, Elton; Reilly, Christopher; Doumanian, Leo; Mydlo, Jack; Lee, David Inkoo

2013-01-01

286

Comparative gene expression profiling analysis of urothelial carcinoma of the renal pelvis and bladder  

PubMed Central

Background Urothelial carcinoma (UC) can arise at any location along the urothelial tract, including the urethra, bladder, ureter, or renal pelvis. Although tumors arising in these various locations have similar morphology, it is unclear whether the gene expression profiles are similar between the upper-tract (ureter and renal pelvis) and lower-tract (bladder and urethra) carcinomas. Because differences may facilitate different screening and treatment modalities, we sought to examine the relationship between urothelial carcinoma of the renal pelvis (rUC) and urothelial carcinoma of the bladder (bUC). Methods Fresh tumor tissue was collected from patients with bUC (n = 10) and benign mucosa from the bladder of individuals undergoing resection for non-UC conditions (n = 7). Gene expression profiles from these samples were determined using high-throughput Affymetrix gene expression microarray chips. Bioinformatic approaches were used to compare the gene expression profiles of these samples with those of rUC samples and normal kidney samples that had been described previously. Results Using unsupervised analytic approaches, rUC and bUC were indistinguishable. Yet when a supervised analytic approach was used, a small number of differentially expressed genes were identified; these differences were most likely limited to a single pathway--the chloride ion binding activity pathway--which was more frequently activated in rUC than in bUC. Conclusions We found that the gene expression profiles of UCs from the upper and lower tract were extremely similar, suggesting that similar pathogenic mechanisms likely function in the development of these tumors. The differential expression of genes in the identified pathway may represent a new avenue for detection of upper-tract tumors. PMID:21159190

2010-01-01

287

Efficacy of extracorporeal shockwave lithotripsy using Dornier SII in different levels of ureteral stones  

PubMed Central

Objective: The objective of this study was to evaluate the efficacy and safety of the Dornier lithotripter S II system in the treatment of ureteral calculi. Patients and Methods: A total of 97 cases which consists of 54 males and 43 females with ureteral stones were treated by extracorporeal shock wave lithotripsy (ESWL). Mean age was 42.6 years. Inclusion criteria were solitary radiopaque ureteral stones of radiological stone size of ?1 cm. The stones were not impacted, with normal kidney functions. Procedure time, number of shocks, energy used, number of sessions and complications were reported. The outcome of ESWL was also recorded. Results: Stones were in the abdominal (upper ureter) in 50% of patients, in pelvic (middle ureter) in 47% of patients. All patients had unilateral stones and the mean stone size in maximum length was) 10 mm). Good dye excretion passing the stone was noted in all patients. Mild hydronephrosis was found in 85% of cases. A total of 49 cases were treated by a single session, while in 35% of cases two sessions were enough and 16% received three sessions. The average number of shocks per session was 3125. The average number of shocks per patient was 5962.5 shocks and average energy was 204.3 Joules. The overall stone-free rate 3 months after lithotripsy was 94%. After a single session of lithotripsy, 49 patients (49%) became stone-free. Stone free rates after ESWL for upper, middle ureteral stones were 94%, 95.7% respectively. Additional procedures were needed in only 6 cases (6%) to render patients stone-free after lithotripsy. No serious complications occurred. Conclusion: The Dornier lithotripter S II is very effective in the treatment of ureteral calculi with no major complications. PMID:25371614

Elkholy, Mohamed M.; Ismail, Hassan; Abdelkhalek, Mohamed A.; Badr, Mohamad M.; Elfeky, Mohamed M.

2014-01-01

288

Non-catheter simple noninvasive bladder draining method with no costs  

PubMed Central

Objectives: To develop a simple, rapid (8 min) non-invasive non-catheter method for draining urine from the bladder, with no introduction of infection. This is of interest to men with incomplete or no bladder emptying, and also to those with a large diverticulum. There are no running costs. It could also be cautiously explored for use by neo-bladder patients and for use in various conditions of poor detrusor function. Materials and Methods: This method is based on postural drainage used in physiotherapy. A carefully graded application of pressure, kneeling, with torso horizontal, facing downwards, supported by a 12-inch square stool-top, gave passive low-pressure voiding. If the abdominal contents approximate to a non-elastic viscous fluid, such pressure is transmitted uniformly everywhere (isostatic) and so will be equal both outside and inside the bladder, and, both outside and inside the ureters connected to it. Even if this assumption is not made, calculations show that the pressure is normally less than would cause upper tract damage. Starting with a low force was important for avoiding any upper tract damage (ureter dilation, and possible refluxing back into the kidney). Initially, a partial pre-emptying by normal urination was done (if feasible). A final stage employed a simple plastic crescent shape. Website:www.ebbflow.org.uk/Page_12x.htm. Results: Average residual bladder volumes were 43 mL. Conclusions: The method was tested for four years on one patient with low-pressure chronic retention and found successful: no complications, infections, or adverse effects. PMID:20877615

Hocking, M. G.

2010-01-01

289

Pelvic actinomycosis presenting as a malignant pelvic mass: a case report  

PubMed Central

Abstract Introduction Pelvic actinomycosis constitutes 3% of all human actinomycosis infections. It is usually insidious, and is often mistaken for other conditions such as diverticulitis, abscesses, inflammatory bowel disease and malignant tumors, presenting a diagnostic challenge pre-operatively; it is identified post-operatively in most cases. Here we present a case that presented as pelvic malignancy and was diagnosed as pelvic actinomycosis post-operatively. Case presentation A 48-year-old Caucasian Turkish woman presented to our clinic with a three-month history of abdominal pain, weight loss and difficulty in defecation. She had used an intra-uterine device for 16 years, however it had recently been removed. The rectosigmoidoscopy revealed narrowing of the lumen at 12 cm due to a mass lesion either in the wall or due to an extrinsic lesion that prevented the passage of the endoscope. On examination, there was no gynecological pathology. Magnetic resonance imaging showed a mass, measuring 5.5 × 4 cm attached to the rectum posterior to the uterus. The ureter on that side was dilated. Surgically there was a pelvic mass adhered to the rectum and uterine adnexes, measuring 10 × 12 cm. It originated from uterine adnexes, particularly ones from the left side and formed a conglomerated mass with the uterus and nearby organs; the left ureter was also dilated due to the pelvic mass. Because of concomitant tubal abscess formation and difficulty in dissection planes, total abdominal hysterectomy and bilateral salphingo-oophorectomy was performed (our patient was 48 years old and had completed her childbearing period). The cytology revealed inflammatory cells with aggregates of Actinomyces. Penicillin therapy was given for six months without any complication. Conclusions Pelvic actinomycosis should always be considered in patients with a pelvic mass especially in ones using intra-uterine devices, and who have a history of appendectomy, tonsillectomy or dental infection. Surgeons should be aware of this infection in order to avoid excessive surgical procedures. PMID:21272333

2011-01-01

290

Risks of Colorectal and Other Cancers After Endometrial Cancer for Women With Lynch Syndrome  

PubMed Central

Background Lynch syndrome is an autosomal dominantly inherited disorder caused by germline mutations in DNA mismatch repair (MMR) genes. Previous studies have shown that MMR gene mutation carriers are at increased risk of colorectal, endometrial, and several other cancers following an initial diagnosis of colorectal cancer. We estimated cancer risks following an endometrial cancer diagnosis for women carrying MMR gene mutations. Methods We obtained data from the Colon Cancer Family Registry for a cohort of 127 women who had a diagnosis of endometrial cancer and who carried a mutation in one of four MMR genes (30 carried a mutation in MLH1, 72 in MSH2, 22 in MSH6, and 3 in PMS2). We used the Kaplan-Meier method to estimate 10- and 20-year cumulative risks for each cancer. We estimated the age-, country-, and calendar period–specific standardized incidence ratios (SIRs) for each cancer, compared with the general population. Results Following endometrial cancer, women carrying MMR gene mutations had the following 20-year risks of other cancer cancers: colorectal cancer (48%, 95% confidence interval [CI] = 35% to 62%); cancer of the kidney, renal pelvis, or ureter (11%, 95% CI = 3% to 20%); urinary bladder cancer (9%, 95% CI = 2% to 17%); and breast cancer (11%, 95% CI = 4% to 19%). Compared with the general population, these women were at statistically significantly elevated risks of colorectal cancer (SIR = 39.9, 95% CI = 27.2 to 58.3), cancer of the kidney, renal pelvis, or ureter (SIR = 28.3, 95% CI = 11.9 to 48.6), urinary bladder cancer (SIR = 24.3, 95% CI = 8.56 to 42.9), and breast cancer (SIR = 2.51, 95% CI = 1.17 to 4.14). Conclusions Women with Lynch syndrome who are diagnosed with endometrial cancer have increased risks of several cancers, including breast cancer. PMID:23385444

2013-01-01

291

Acoustic performance and clinical use of a fibreoptic hydrophone.  

PubMed

Initial clinical experience with the use of an optical fibre hydrophone for in vivo ultrasound dosimetry is reported. The hydrophone, originally described by Beard and Mills (1997), operates as an extrinsic, low-finesse Fabry-Perot optical sensor where acoustically-induced thickness changes in a polymer film modulate the phase difference between light beams reflected from the two surfaces of the film. The pressure waveforms from the sensor are compared with those from a calibrated piezoelectric polymer membrane hydrophone. The sensor is found to have a frequency resonance at around 12 MHz, corresponding to the thickness mode of the 50-micron polymer film. The directional responses at 0.16 MHz, 1.0 MHz and 5.0 MHz are found to be similar to those predicted for a plane piston receiver with the same diameter as that of the polymer film (400 microns). The performance of the sensor as a broad-band hydrophone is degraded by the relatively low acoustical impedance of the adhesive used in the fibre-film bond. The hydrophone was used in the clinic for measurement of acoustic pressures within the ureter of 4 patients undergoing clinical extracorporeal shock-wave lithotripsy on a Dornier HM3 lithotripter. Pressures in the range 0.5 to 5.0 MPa were recorded in the ureter at positions over 10 cm from the renal pelvis. Problems related to the clinical use of the sensor, including instability in the sensitivity of the sensor following handling and its mechanical strength in high-amplitude acoustic fields, are discussed. PMID:9483782

Coleman, A J; Draguioti, E; Tiptaf, R; Shotri, N; Saunders, J E

1998-01-01

292

Fos expression in spinothalamic and postsynaptic dorsal column neurons following noxious visceral and cutaneous stimuli.  

PubMed

The spinothalamic tract (STT) has been classically viewed as the major ascending pathway for pain transmission while the dorsal column (DC) was thought to be involved primarily in signaling innocuous stimuli. Recent clinical studies have shown that limited midline myelotomy, which transects fibers in the DC, offers good pain relief in patients with visceral cancer pain. Experimental studies provided evidence that a DC lesion decreases the activation of thalamic neurons by visceral stimuli and suggested that this effect is due to transection of the axons of postsynaptic dorsal column (PSDC) neurons. In our study, Fos protein expression in retrogradely labeled STT and PSDC neurons in the lumbosacral enlargement in rats was used as an anatomical marker of enhanced activation to compare the role of these neurons in cutaneous and visceral pain. The noxious stimuli used were intradermal injection of capsaicin and distention of the ureter. Retrogradely labeled PSDC neurons were found in laminae III-IV and in the vicinity of the central canal. STT neurons were located in laminae I, III-VII and X. Ureter distention evoked Fos expression in PSDC and STT neurons located in all laminae in which retrogradely labeled cells were found, with the maximum in the L(2) spinal segment. The Fos-positive PSDC neurons represented a significantly higher percentage of the retrogradely labeled PSDC neurons (19.3+/-2.3% SEM) than of the STT Fos-positive neurons (13.2+/-1.5% SEM). Intradermal capsaicin injection also evoked Fos expression in both PSDC and STT neurons, but with no significant difference between these two, when expressed as a percentage of the retrogradely labeled cells (11.6+/-2.9% SEM, 10.8+/-1.1% SEM). These results show that both PSDC and STT neurons are activated by cutaneous and visceral noxious stimuli. Their particular role in transmission and modulation of painful stimuli needs to be investigated further. PMID:12855335

Palecek, J; Paleckova, V; Willis, W D

2003-07-01

293

Incidence of Benign Results After Laparoscopic Radical Nephroureterectomy  

PubMed Central

Background and Objectives: Studies of patients with benign pathologic lesions who underwent laparoscopic radical nephroureterectomy (RNU) with preoperative suspicion of upper urinary tract urothelial carcinoma are lacking. The aim of this retrospective cross-sectional study was to evaluate the incidence of benign pathologic lesions on laparoscopic RNU for upper urinary tract tumors that are presumed to be urothelial carcinoma. The clinicopathologic characteristics of these lesions were also determined. Methods: Between January 2004 and December 2010, 244 patients underwent laparoscopic RNU for possible upper urinary tract urothelial carcinoma at our institute. Seven (2.9%) had benign lesions at the final pathologic examination. The preoperative features of these patients were investigated, including imaging findings, urine cytologic results, and ureteroscopic findings. Results: The 7 patients comprised 5 men and 2 women. The lesions were located in the ureter in 5 patients and in the renal pelvis in 2. All patients underwent preoperative voided urine cytology and cystoscopy. Two patients underwent preoperative ureteroscopy. In 1 patient, definite pathologic lesions were not identified in the surgical specimen. Urinary tract tuberculosis was diagnosed in 1 patient, inflammatory pseudotumor in 2, and fibroepithelial polyps in 1. In 2 patients, stones were detected (stone with atypical papillary urothelial hyperplasia and polypoid ureteritis with ureter stone, respectively) after laparoscopic RNU. Conclusion: Benign pathologic lesions were detected in 7 patients (2.9%) who had undergone laparoscopic RNU for upper urinary tract tumors that were presumed to be urothelial carcinoma. The description of these false-positive cases will help improve the preoperative counseling of these patients.

Hong, Sungwoo; Kwon, Taekmin; You, Dalsan; Jeong, In Gab; Hong, Bumsik; Hong, Jun Hyuk; Ahn, Hanjong

2014-01-01

294

EXPERIMENTAL PYELONEPHRITIS  

PubMed Central

A study has been made of the effect of ureteral ligation on the susceptibility of the kidney to pyogenic infection. In most experiments a strain of E. coli was employed as the test organism, being injected intravenously in varying quantity either before or after ureteral ligation. A few experiments were also carried out with S. marcescens. Preliminary observations were made on the distribution and persistence of E. coli following its inoculation into the blood stream of normal rats. Rapid reduction in number of bacteria in the circulation occurred during the first 30 minutes, but bacteriemia persisted at a comparatively low level for at least 48 hours. Large proportions of the inoculated bacteria were arrested and apparently destroyed in the liver, spleen, and lungs. Comparatively small numbers were deposited in the kidneys; nevertheless, these continued to be demonstrable during the 1st week, without notable tendency to increase or decrease, then disappeared during the 2nd week. There was no acceleration in rate of disposal of the bacteria in the kidney when a second injection was made 1 week after the first. In rats with one ureter ligated the number of bacteria lodging in the kidneys after intravenous inoculation did not differ from that found in normal animals. It appears, therefore, that the increased susceptibility of the obstructed kidney to infection via the blood stream is not attributable to an increased trapping of circulating bacteria. 4 to 6 hours after the intravenous injection, however, an increased number of bacteria could be demonstrated in the obstructed kidney, apparently due to local multiplication, and by the end of 24 hours purulent infection was usually obvious. A comparatively large number of bacteria was required to cause infection, even in the kidney with obstruction. This appeared to be related to the small proportion of the intravenous inoculum which lodged in the kidney initially. Although bacteria could be demonstrated in the normal kidney for a week or more following intravenous injection it was not possible to induce active infection with equal regularity by ligating the ureter throughout this time. During the first 3 days the majority of obstructed kidneys developed infection, but after 5 or more days this occurred in only a small proportion of animals so treated. The reason for the difference, in relation to interval between intravenous injection and time of ligation, is not apparent. When the ureter was ligated but no intravenous injection of bacteria was given, staphylococcal infection developed in the obstructed kidney within 2 weeks in about one-third of the animals. Reasons are given for the belief that this was blood-borne infection, and not the result of contamination at the time of operation. Staphylococci were not recovered from the normal rat kidney. These "spontaneous" staphylococcal infections seldom developed when E. coli was injected intravenously at the time of ureteral ligation. PMID:13376805

Guze, Lucien B.; Beeson, Paul B.

1956-01-01

295

En route Spacing Tool: Efficient Conflict-free Spacing to Flow-Restricted Airspace  

NASA Technical Reports Server (NTRS)

This paper describes the Air Traffic Management (ATM) problem within the U.S. of flow-restricted en route airspace, an assessment of its impact on airspace users, and a set of near-term tools and procedures to resolve the problem. The FAA is committed, over the next few years, to deploy the first generation of modem ATM decision support tool (DST) technology under the Free-Flight Phase-1 (FFp1) program. The associated en route tools include the User Request Evaluation Tool (URET) and the Traffic Management Advisor (TMA). URET is an initial conflict probe (ICP) capability that assists controllers with the detection and resolution of conflicts in en route airspace. TMA orchestrates arrivals transitioning into high-density terminal airspace by providing controllers with scheduled times of arrival (STA) and delay feedback advisories to assist with STA conformance. However, these FFPl capabilities do not mitigate the en route Miles-In-Trail (MIT) restrictions that are dynamically applied to mitigate airspace congestion. National statistics indicate that en route facilities (Centers) apply Miles-In-Trail (MIT) restrictions for approximately 5000 hours per month. Based on results from this study, an estimated 45,000 flights are impacted by these restrictions each month. Current-day practices for implementing these restrictions result in additional controller workload and an economic impact of which the fuel penalty alone may approach several hundred dollars per flight. To mitigate much of the impact of these restrictions on users and controller workload, a DST and procedures are presented. The DST is based on a simple derivative of FFP1 technology that is designed to introduce a set of simple tools for flow-rate (spacing) conformance and integrate them with conflict-probe capabilities. The tool and associated algorithms are described based on a concept prototype implemented within the CTAS baseline in 1995. A traffic scenario is used to illustrate the controller's use of the tool, and potential display options are presented for future controller evaluation.

Green, S.

1999-01-01

296

Light microscopic morphometry of the kidneys of fourteen avian species.  

PubMed Central

Kidney volume and the volume proportions of the cortex, medulla, blood vessels larger than capillaries and ureter and ureteral ducts were investigated in 61 birds from 14 species representing passeriformes, psittaciformes, podicipediformes, anseriformes, galliformes, and columbiformes. The kidneys were fixed in situ by perfusion via their arterial supply. Kidney volume and body weight were strongly correlated (r = 0.991); the allometric function relating kidney volume (Vk) to body weight (W) was: Vk = 13.96W0.902. Histological sections of one kidney from each bird were analysed by point counting with a Zeiss integrating eyepiece to estimate the volume proportions and subsequently the absolute volumes of the main components of the kidney. The avian kidney was found to consist of a very large cortex (range 71-81%), a relatively small medulla (range 5-15%), blood vessels larger than capillaries (range 10-13%). For all the birds, the mean volume proportions of the kidney components were as follows: cortex, 77%; medulla, 10%; blood vessels larger than capillaries, 12%; ureter and ureteral ducts, 1%. The values for the absolute volume of each of the main components of the kidney were well correlated with body weight. The allometric equations and correlation coefficients (r) relating: (a) the volume of cortex (Vc) and the body weight (W) was Vc = 10.06W0.914, r = 0.991; (b) the volume of medulla (Vm) and body weight was Vm = 2.27W0.795, r = 0.974; (c) the volume of blood vessels larger than capillaries (Vb) and body weight was Vb = 1.76W0.894, r = 0.988. All the birds were divided into two groups in the following five sets: (a) passeriform and non-passeriform orders; (b) galliform and non-galliform orders; (c) small and large birds weighing less than and more than 500 g respectively; (d) aquatic and non-aquatic birds; (e) desert and non-desert birds. In the two groups of each set the differences between kidney volume per gram body weight and those between the respective percentage proportions of cortex, medulla and blood vessels larger than capillaries were assessed by Student's t-test. The differences between kidney volume per gram body weight were significant for all sets except desert and non-desert birds; those between the respective percentage proportions of cortex and medulla were significant for all sets; those between the percentage proportions of blood vessels larger than capillaries were significant only in desert and non-desert birds.(ABSTRACT TRUNCATED AT 400 WORDS) Images Fig. 1 PMID:2808116

Warui, C N

1989-01-01

297

Prenatal diagnosis of a rare form of congenital mid-ureteral stricture: a case report and literature revisited  

PubMed Central

Background Congenital mid-ureteral stricture is a rare malformation of the ureter leading to prenatal and neonatal hydronephrosis. Site characterization of the narrowing is important to optimize the surgical approach to the newborn affected by hydronephrosis. Case presentation We report a female EM with a rare form of hydronephrosis, (i.e. mid-ureteral stricture) which was detected early during pregnancy by imaging techniques. During fetal life both conventional fetal Ultrasound and maternal Magnetic Resonance Imaging (MRI) were used to diagnose the obstruction. Magnetic Resonance pyelography and retrograde Ureteropyelography were performed after delivery and before surgical correction and confirmed the finding. Furthermore, we revisited the literature using online MEDLINE and EMBASE databases. The literature reported only a few cases of prenatal diagnosis of early onset mid-ureteral stricture. Conclusion Mid-ureteral stricture is a rare cause of prenatal hydronephrosis. The diagnosis should not be delayed in order to apply the appropriate surgical approach. As a result, we showed the usefulness of fetal MRI and postnatal Magnetic Resonance pyelography, in the event that radionuclide renography with Tc-MAG3 was less informative, to allow the detection of the site of ureteral narrowing. Intrasurgical retrograde ureteropyelography confirmed these findings. PMID:17559650

Brugnara, Milena; Cecchetto, Mariangela; Manfredi, Riccardo; Zuffante, Michele; Fanos, Vassilios; Pietrobelli, Angelo; Zaffanello, Marco

2007-01-01

298

Longitudinal assessment of mouse renal injury using high-resolution anatomic and magnetization transfer MR imaging.  

PubMed

The purpose of this study is to evaluate the utility of high-resolution non-invasive endogenous high-field MRI methods for the longitudinal structural and quantitative assessments of mouse kidney disease using the model of unilateral ureter obstruction (UUO). T1-weighted, T2-weighted and magnetization transfer (MT) imaging protocols were optimized to improve the regional contrast in mouse kidney. Conventional T1 and T2 weighted images were collected in UUO mice on day 0 (~3h), day 1, day 3 and day 6 after injury, on a 7 T small animal MRI system. Cortical and medullary thickness, corticomedullary contrast and Magnetization Transfer Ratio (MTR) were assessed longitudinally. Masson trichrome staining was used to histologically assess changes in tissue microstructure. Over the course of UUO progression there were significant (p<0.05) changes in thickness of cortex and outer medulla, and regional changes in T2 signal intensity and MTR values. Histological changes included tubular cell death, tubular dilation, urine retention, and interstitial fibrosis, assessed by histology. The MRI measures of renal cortical and medullary atrophy, cortical-medullary differentiation and MTR changes provide an endogenous, non-invasive and quantitative evaluation of renal morphology and tissue composition during UUO progression. PMID:25093632

Wang, Feng; Jiang, Rosie; Takahashi, Keiko; Gore, John; Harris, Raymond C; Takahashi, Takamune; Quarles, C Chad

2014-11-01

299

Vesicoureteral reflux in pediatric age: where are we today?  

PubMed

Although the diagnosis of vesicoureteral reflux and of reflux nephropathy is a well-established and shared procedure, its treatment nowadays is still very controversial. New developments on the knowledge of pathophysiology of renal damage associated to reflux opened the way towards a different diagnostic work-up and different therapeutic approaches. Recently, the "top-down" diagnostic approach has gained wider interest, versus the "down-top" protocol. The attention has recently focused on the renal parenchyma damage and less interest has been given to the presence and the radiological degree of vesicoureteral reflux. The review criteria were based on an in-depth search of references conducted on PubMed, using the terms "vesicoureteral reflux", "children", "incidence", "etiology", "diagnosis", "treatment" and "outcomes". The selection of the papers cited in this review was influenced by the content and the relevance to the points focused in the article.Conservative approaches include no treatment option with watchful waiting, long-term antibiotic prophylaxis and bladder rehabilitation. The operative treatment consists of endoscopic, open, laparoscopic and robotic procedures to stop the refluxing ureter.No final consensus has been achieved in literature yet, and further studies are necessary in order to better define the subset of children at risk of developing progression of renal damage.This review aims to clarify the diagnostic management and the urological-nephrological treatment of reflux in pediatric age, on the basis of a review of the best-published evidence. PMID:25083520

Altobelli, Emanuela; Gerocarni Nappo, Simona; Guidotti, Michele; Caione, Paolo

2014-01-01

300

Crossed fused renal ectopia: Challenges in diagnosis and management  

PubMed Central

Aim: Crossed fused renal ectopia is a rare congenital malformation, which is reported to be usually asymptomatic but may have varied presentations. This survey was conducted to study the clinical profile and the challenges posed in the management of this entity. Materials and Methods: Retrospective analysis of 6 patients diagnosed to have crossed fused renal ectopia during 1997-2010. The diagnosis was confirmed during surgical exploration in one patient. In one patient it was detected on antenatal ultrasonography and in the other 4 patients it was detected during investigations for abdominal pain, abdominal mass, anorectal malformation and urinary tract infection. Results: The left moiety was crossed and fused with the right moiety in 4 cases. Ultrasonography was found to be a good screening investigation with useful diagnostic contributions from CT scans, radionuclide scintigraphy and magnetic resonance urography. Micturating cystourethrography revealed presence of VUR in 4 cases, 3 of whom have undergone ureteric reimplantation. Two patients required pyeloplasty for pelviureteric junction obstruction; in one of these patients the upper ureter was entrapped in the isthmus. In one patient, a non-functioning moiety resulted in nephrectomy. All children were asymptomatic at last follow-up with stable renal functions. Conclusions: Crossed fused renal ectopia was detected in most patients during investigation for other problems. It was found more commonly in boys. The left moiety was crossed to the right in the majority of cases. Associated urological problems were found in most cases and required the appropriate surgical management. PMID:23599575

Solanki, Shailesh; Bhatnagar, Veereshwar; Gupta, Arun K.; Kumar, Rakesh

2013-01-01

301

Locally aggressive colonic and rectal cancer ,clinical trial  

PubMed Central

This clinical trial studies local invasions from primary colonic and rectal cancers (urinary bladder, abdominal wall, small bowls, uterus, vagina, stomach, bile tract, spleen, duodenum, pancreas, ureters, kidneys), with or without undiscovered metastasis. Primary locally aggressive colonic and rectal cancers include tumors that are staged T4N1–2Mx on diagnosis, and are often associated with a lower prognosis than earlier cancers. [2] Diagnosis is based on thorough clinical evaluation, imagistic support: abdominal XR with contrast (barium enema), colonoscopy, abdominal and pelvic ultrasound exam, endoscopic endolumenal ultrasound exam, abdominal and pelvic CT / IRM with contrast (administrated both orally and intravenously), PET Scan, and intra–operatory confirmation. [3] The primary symptom was pain. Locally aggressive colonic and rectal cancers, primary or secondary, can extend to any visceral or parietal structure. The ability to perform a total resection is based upon anatomical localization and on the fixation of other organs to the lesion. Identifying the anatomical extension provides a better appreciation of the purpose of the tumoral resection. [1] Radical nuanced surgery is the base of treatment of the locally aggressive colon–rectal cancer. The studies have shown that in certain localizations of the colon–rectal cancer, the locally aggressive forms can be better controlled by using multimodal therapy, including radiotherapy, either external or guided intraoperatory radiotherapy and chemotherapy with much better results. [5] PMID:20945823

Ion, D; serban, MB; Ciurea, M

2010-01-01

302

Urinary tract endometriosis: Review of 19 cases  

PubMed Central

Aim: The aim of our study was to evaluate the treatment outcomes of medical and surgical management of urinary tract endometriosis. Materials and Methods: Urinary tract endometriosis patients enrolled between Jan 2006 and May 2010 were retrospectively reviewed. Preoperative datas (mode of presentation, diagnosis, imaging), intraoperative findings (location and size of lesion), postoperative histopathology and follow-up were recorded and results were analyzed and the success rate of different modalities of treatment was calculated. Results: In our study, of nineteen patients, nine had vesical involvement and ten had ureteric involvement. Among the vesical group, the success rate of transurethral resection followed by injection leuproide was 60% (3/5), while among the partial cystectomy group, the success rate was 100%. Among patients with ureteric involvement, success rate of distal ureterectomy and reimplantation was 100%, laparoscopic ureterolysis with Double J stenting followed by injection leuprolide was 75% while that of Gonadotropin- releasing hormone (GnRh) analogue alone was 67%. Conclusion: One should have a high index of suspicion with irritative voiding symptoms with or without hematuria, with negative urine culture, in all premenopausal women to diagnose urinary tract endometriosis. Partial cystectomy is a better alternative to transurethral resection followed by GnRh analogue in vesical endometriosis. Approach to the ureter must be individualised depending upon the severity of disease and dilatation of the upper tract to maximise the preservation of renal function. PMID:22346093

Kumar, Suresh; Tiwari, Punit; Sharma, Pramod; Goel, Amit; Singh, Jitendra P.; Vijay, Mukesh K.; Gupta, Sandeep; Bera, Malay K.; Kundu, Anup K.

2012-01-01

303

Diagnostic accuracy of magnetic resonance voiding cystourethrography for detecting vesico-ureteral reflux in children and adolescents  

PubMed Central

Background: The purpose of the present study is to determine the accuracy of magnetic resonance voiding cystourethrography (MRVCUG) for diagnosis of vesicoureteral reflux (VUR) in children and adolescents with recurrent urinary tract infection (UTI). Materials and Methods: During the cross-sectional study from May 2009 to June 2011, 30 patients’ (60 kidney-ureter units) MRVCUG findings by 1.5 T magnetic resonance imaging (MRI) were compared with voiding cystourethrography (VCUG) findings in patients with urinary tract infection. The sensitivity, specificity, positive and negative predictive values for MRVCUG were calculated. Findings: The sensitivity, specificity, positive and negative predictive values and accuracy for MRVCUG for detecting VUR were respectively 92.68% (95% CI: 80.57-97.48%), 68.42% (95% CI: 46.01-84.64%), 86.36% (95% CI: 71.95-94.33%), 81.25% (95% CI: 53.69-95.02%), and 85% (95% CI: 80.40-89.60%. The level of agreement between MRVCUG and VCUG findings for diagnosis VUR was very good (P < 0.001, according to Cohen's kappa value = 0.638). Studying correlation of low grade VUR (grade I and II) and high grade VUR (grade III-V) showed a very good agreement between MRVCUG and VCUG findings (P < 0.001, Cohen's kappa value = 0.754). Conclusion: MRVCUG could accurately reveal the presence and severity of VUR, especially in cases with high-grade (grade III-V) VUR in both children and adolescents. PMID:23900240

Hekmatnia, Ali; Merrikhi, Alireza; Farghadani, Maryam; Barikbin, Roozbeh; Hekmatnia, Farzaneh; Nezami, Nariman

2013-01-01

304

[Urinary diversion in patients treated with pelvic irradiation: transverse colon conduit revisited].  

PubMed

In patients receiving pelvic irradiation for gynecological or genitourinary malignancies, urinary diversion is sometimes required for complete resection of malignancies or treatment of urological complications by irradiation. We report our attempts to promote healing and prevent complications by urinary diversion using a transverse colon conduit in cases in which urinary reconstruction was performed with irradiated lower abdominal organs such as small intestine or distal ureters. Between 2008 and 2012, 9 patients with pelvic irradiation received transverse colon conduit urinary diversion. Six patients received diversion for genitourinary complications, while 3 patients received complete resection of pelvic malignancies. Colostomy formation and lithotripsy of vesical stones were simultaneously performed in 4 cases. Wallace method was adopted for ureterointestinal anastomosis. There was no operative mortality. Although acute pyelonephritis, ileus, wound dehiscence and pelvic abscess formation were seen as postoperative complications, all but two improved without any additional procedure. Cases of pelvic abscess or wound dehiscence were treated by abscess drainage. In observation periods, no patients required urinary stent placement and none suffered from defecation problems. We think that transverse colon conduit can be a viable option for patients with pelvic irradiation history, affording them reasonable quality of life postoperatively. PMID:25179985

Matsui, Yoshiyuki; Kanematsu, Akihiro; Negoro, Hiromitsu; Kobayashi, Takashi; Terada, Naoki; Sugino, Yoshio; Yamasaki, Toshinari; Inoue, Takahiro; Kamba, Tomomi; Yoshimura, Koji; Ogawa, Osamu

2014-08-01

305

Tubular expression of heat shock protein 27 inhibits fibrogenesis in obstructive nephropathy  

PubMed Central

Morphological changes that occur during kidney injury involve actin skeleton remodeling. Here we tested whether heat shock protein 27 (HSP27), a small stress response protein involved in cytoskeletal remodeling, protects the kidney from tubulointerstitial fibrosis in obstructive nephropathy. Tubular cell HSP27 immunostaining was significantly increased in human kidneys with ureteropelvic junction obstruction; supporting the clinical relevance of our studies. To develop an animal model for mechanistic studies we generated transgenic mice that specifically overexpress human HSP27 in renal tubules, under the kidney androgen-regulated protein promoter, and determined the effects of HSP27 overexpression on epithelial-to-mesenchymal transition and tubulointerstitial fibrosis following unilateral ureteral obstruction. This was associated with decreased fibrogenesis as evidenced by significant declines in phosphorylated p38MAPK, collagen III, ?-smooth muscle actin, 4-hydroxynonenal, and reduced trichrome staining following obstruction. Notably, E-cadherin and ?-catenin remained at the cell membrane of tubular cells in transgenic mice with an obstructed ureter. Monocyte/macrophage infiltration, however, was not significantly affected in these transgenic mice. Thus, tubular HSP27 inhibits fibrogenesis in obstructive nephropathy. Further studies are needed to determine pathways regulating the interactions between HSP27 and the E-cadherin-?-catenin complex. PMID:22971995

Vidyasagar, Aparna; Reese, Shannon; Hafez, Omeed; Huang, Ling-Jin; Swain, William; Jacobson, Lynn; Torrealba, Jose; Chammas, Pierre-Emmanuel; Wilson, Nancy A.; Djamali, Arjang

2012-01-01

306

OA03.04. To evaluate the effect of "Kadalikandadi kshara yoga" in the management of vataja ashmari"  

PubMed Central

Purpose: In current surgical practice we are facing problems in treating Ashmari disease effectively even with all modernized facilities, and are insufficient to reduce the prevalence of Ashmari and health care cost. Method: 20 diagnosed cases of Vataja Ashmari were selected for study and recorded through proforma designed for single group of observational study. And To evaluate the effect of “Kadalikandadi kshara yoga” in the management of Vataja Ashmari” Drug has administered through orally with water. Result: In this series of 20 patients of Ashmari, 20% patients were cured i.e. their stone was removed. 30% patients were markedly improved i.e. either their only stone was removed or it was broken into pieces or they showed 100% relief in their symptoms. 25% patients either showed reduction in the size of the stone or marked relief in their sign and symptoms. Remaining 25% patients showed no reduction in the size of the stone. Conclusion: The stones, which are passed, are maximum from ureter. Which shows significant level expelling action of the trailed drug. From the study it can be concluded that the action of the drug is encouraging in subjective part rather than objective, however duration of the treatment should be considered.

Waddar, B Sujata; Annigeri, Satish; Hemanthakumar, P

2013-01-01

307

Locally aggressive colonic and rectal cancer--clinical trial.  

PubMed

This clinical trial studies local invasions from primary colonic and rectal cancers (urinary bladder, abdominal wall, small bowls, uterus, vagina, stomach, bile tract, spleen, duodenum, pancreas, ureters, kidneys), with or without undiscovered metastasis. Primary locally aggressive colonic and rectal cancers include tumors that are staged T4N1-2Mx on diagnosis, and are often associated with a lower prognosis than earlier cancers. Diagnosis is based on thorough clinical evaluation, imagistic support: abdominal XR with contrast (barium enema), colonoscopy, abdominal and pelvic ultrasound exam, endoscopic endolumenal ultrasound exam, abdominal and pelvic CT/IRM with contrast (administrated both orally and intravenously), PET Scan, and intra-operatory confirmation. The primary symptom was pain. Locally aggressive colonic and rectal cancers, primary or secondary, can extend to any visceral or parietal structure. The ability to perform a total resection is based upon anatomical localization and on the fixation of other organs to the lesion. Identifying the anatomical extension provides a better appreciation of the purpose of the tumoral resection. Radical nuanced surgery is the base of treatment of the locally aggressive colon-rectal cancer. The studies have shown that in certain localizations of the colon-rectal cancer, the locally aggressive forms can be better controlled by using multimodal therapy, including radiotherapy, either external or guided intraoperatory radiotherapy and chemotherapy with much better results. PMID:20945823

Radu, Victor; Ion, Daniel; Serban, Mihai Bogdan; Ciurea, Mircea

2010-01-01

308

Endoscopic surgery and telemedicine in microgravity: developing contingency procedures for exploratory class spaceflight  

NASA Technical Reports Server (NTRS)

OBJECTIVES: The risk of a urinary calculus during an extended duration mission into the reduced gravity environment of space is significant. For medical operations to develop a comprehensive strategy for the spaceflight stone risk, both preventive countermeasures and contingency management (CM) plans must be included. METHODS: A feasibility study was conducted to demonstrate the potential CM technique of endoscopic ureteral stenting with ultrasound guidance for the possible in-flight urinary calculus contingency. The procedure employed the International Space Station/Human Research Facility ultrasound unit for guide wire and stent localization, a flexible cystoscope for visual guidance, and banded, biocompatible soft ureteral stents to successfully stent porcine ureters bilaterally in zero gravity (0g). RESULTS: The study demonstrated that downlinked endoscopic surgical and ultrasound images obtained in 0g are comparable in quality to 1g images, and therefore are useful for diagnostic clinical utility via telemedicine transmission. CONCLUSIONS: In order to be successful, surgical procedures in 0g require excellent positional stability of the operating surgeon, assistant, and patient, relative to one another. The technological development of medical procedures for long-duration spaceflight contingencies may lead to improved terrestrial patient care methodology and subsequently reduced morbidity.

Jones, J. A.; Johnston, S.; Campbell, M.; Miles, B.; Billica, R.

1999-01-01

309

Urinary Tract Effects After Multifocal Nonthermal Irreversible Electroporation of the Kidney: Acute and Chronic Monitoring by Magnetic Resonance Imaging, Intravenous Urography and Urinary Cytology  

SciTech Connect

Purpose: The nonthermal irreversible electroporation (NTIRE) is a novel potential ablation modality for renal masses. The aim of this study was the first evaluation of NTIRE's effects on the renal urine-collecting system using intravenous urography (IVU) and urinary cytology in addition to histology and magnetic resonance imaging (MRI). Methods: Eight percutaneous NTIRE ablations of the renal parenchyma, including the calyxes or pelvis, were performed in three male swine. MRI, IVU, histology, and urinary cytology follow-ups were performed within the first 28 days after treatment. Results: MRI and histological analysis demonstrated a localized necrosis 7 days and a localized scarification of the renal parenchyma with complete destruction 28 days after NTIRE. The urine-collecting system was preserved and showed urothelial regeneration. IVU and MRI showed an unaltered normal morphology of the renal calyxes, pelvis, and ureter. A new urinary cytology phenomenon featured a temporary degeneration by individual vacuolization of detached transitional epithelium cells within the first 3 days after NTIRE. Conclusions: This first urographical, urine-cytological, and MRI evaluation after porcine kidney NTIRE shows multifocal parenchyma destruction while protecting the involved urine-collecting system with regenerated urothelial tissue. NTIRE could be used as a targeted ablation method of centrally located renal masses.

Wendler, Johann Jakob, E-mail: johann.wendler@med.ovgu.de [University of Magdeburg, Department of Urology (Germany); Pech, Maciej [University of Magdeburg, Department of Radiology and Nuclear Medicine (Germany); Porsch, Markus; Janitzky, Andreas [University of Magdeburg, Department of Urology (Germany); Fischbach, Frank [University of Magdeburg, Department of Radiology and Nuclear Medicine (Germany); Buhtz, Peter; Vogler, Klaus [University of Magdeburg, Institute of Pathology (Germany); Huehne, Sarah [University of Magdeburg, Department of Urology (Germany); Borucki, Katrin [University of Magdeburg, Institute of Clinical Chemistry (Germany); Strang, Christof [University of Magdeburg, Department of Anaesthesiology (Germany); Mahnkopf, Dirk [Institute of Medical Technology and Research (Germany); Ricke, Jens [University of Magdeburg, Department of Radiology and Nuclear Medicine (Germany); Liehr, Uwe-Bernd [University of Magdeburg, Department of Urology (Germany)

2012-08-15

310

Bowel endometriosis: Colorectal surgeon's perspective in a multidisciplinary surgical team  

PubMed Central

Endometriosis is a gynecological condition that presents as endometrial-like tissue outside the uterus and induces a chronic inflammatory reaction. Up to 15% of women in their reproductive period are affected by this condition. Deep endometriosis is defined as endometriosis located more than 5 mm beneath the peritoneal surface. This type of endometriosis is mostly found on the uterosacral ligaments, inside the rectovaginal septum or vagina, in the rectosigmoid area, ovarian fossa, pelvic peritoneum, ureters, and bladder, causing a distortion of the pelvic anatomy. The frequency of bowel endometriosis is unknown, but in cases of bowel infiltration, about 90% are localized on the sigmoid colon or the rectum. Colorectal involvement results in alterations of bowel habits such as constipation, diarrhea, tenesmus, dyschezia, and, rarely, rectal bleeding. Differential diagnosis must be made in case of irritable bowel syndrome, solitary rectal ulcer syndrome, and a rectal tumor. A precise diagnosis about the presence, location, and extent of endometriosis is necessary to plan surgical treatment. Multidisciplinary laparoscopic treatment has become the standard of care. Depending on the size of the lesion and site of involvement, full-thickness disc excision or bowel resection needs to be performed by an experienced colorectal surgeon. Long-term outcomes, following bowel resection for severe endometriosis, regarding pain and recurrence rate are good with a pregnancy rate of 50%.

Wolthuis, Albert M; Meuleman, Christel; Tomassetti, Carla; D'Hooghe, Thomas; de Buck van Overstraeten, Anthony; D'Hoore, Andre

2014-01-01

311

Genome-Wide ENU Mutagenesis in Combination with High Density SNP Analysis and Exome Sequencing Provides Rapid Identification of Novel Mouse Models of Developmental Disease  

PubMed Central

Background Mice harbouring gene mutations that cause phenotypic abnormalities during organogenesis are invaluable tools for linking gene function to normal development and human disorders. To generate mouse models harbouring novel alleles that are involved in organogenesis we conducted a phenotype-driven, genome-wide mutagenesis screen in mice using the mutagen N-ethyl-N-nitrosourea (ENU). Methodology/Principal Findings ENU was injected into male C57BL/6 mice and the mutations transmitted through the germ-line. ENU-induced mutations were bred to homozygosity and G3 embryos screened at embryonic day (E) 13.5 and E18.5 for abnormalities in limb and craniofacial structures, skin, blood, vasculature, lungs, gut, kidneys, ureters and gonads. From 52 pedigrees screened 15 were detected with anomalies in one or more of the structures/organs screened. Using single nucleotide polymorphism (SNP)-based linkage analysis in conjunction with candidate gene or next-generation sequencing (NGS) we identified novel recessive alleles for Fras1, Ift140 and Lig1. Conclusions/Significance In this study we have generated mouse models in which the anomalies closely mimic those seen in human disorders. The association between novel mutant alleles and phenotypes will lead to a better understanding of gene function in normal development and establish how their dysfunction causes human anomalies and disease. PMID:23469164

Caruana, Georgina; Farlie, Peter G.; Hart, Adam H.; Bagheri-Fam, Stefan; Wallace, Megan J.; Dobbie, Michael S.; Gordon, Christopher T.; Miller, Kerry A.; Whittle, Belinda; Abud, Helen E.; Arkell, Ruth M.; Cole, Timothy J.; Harley, Vincent R.; Smyth, Ian M.; Bertram, John F.

2013-01-01

312

Clonal, Self-Renewing and Differentiating Human and Porcine Urothelial Cells, a Novel Stem Cell Population  

PubMed Central

Although urothelial progenitor-like cells have been described in the human urinary tract, the existence of stem cells remains to be proven. Using a culture system that favors clonogenic epithelial cell growth, we evaluated and characterized clonal human urothelial cells. We isolated human urothelial cells that were clonogenic, capable of self-renewal and could develop into fully differentiated urothelium once re-implanted into the subcapsular space of nude mice. In addition to final urothelial cell differentiation, spontaneous formation of bladder-like microstructures was observed. By examining an epithelial stem cell signature marker, we found p63 to correlate with the self-renewal capacity of the isolated human urothelial clonal populations. Since a clinically relevant, long-term model for functional reconstitution of human cells does not exist, we sought to establish a culture method for porcine urothelial cells in a clinically relevant porcine model. We isolated cells from porcine ureter, urethra and bladder that were clonogenic and capable of self-renewal and differentiation into fully mature urothelium. In conclusion, we could isolate human and porcine cell populations, behaving as urothelial stem cells and showing clonogenicity, self-renewal and, once re-implanted, morphological differentiation. PMID:24587183

Larsson, Hans M.; Gorostidi, Francois; Hubbell, Jeffrey A.; Barrandon, Yann; Frey, Peter

2014-01-01

313

Kidney-specific drug delivery system for renal fibrosis based on coordination-driven assembly of catechol-derived chitosan.  

PubMed

Renal fibrosis is a common progressive kidney disease, and there is a lack of efficient treatment for the condition. In this study, we designed a kidney-specific nanocomplex by forming coordination-driven assembly from catechol-derived low molecular weight chitosan (HCA-Chi), metal ions and active drug molecules. The coordination activities of various metals and ligands, cytotoxicity, immunogenicity and biodistribution of HCA-Chi were investigated. Autofluorescent doxorubicin (DOX) was selected to fabricate HCA-Chi-Cu-DOX ternary nanocomplex for investigating cellular uptake behavior, transmembrane and targeting properties. The nanodevice demonstrated satisfactory stability under normal physiological conditions and pH-responsive drug release in acidic environments. Uptake of HCA-Chi-Cu-DOX by HK-2 cells was dependent on exposure time, concentration, and temperature, and was inhibited by blockers of megalin receptor. Tissue distribution showed that HCA-Chi-Cu-DOX nanocomplex was specifically accumulated in kidney with a renal relative uptake rate (r(e)) of 25.6. When active anti-fibrosis compound emodin was installed in HCA-Chi-Zn-emodin and intravenously injected to the ureter obstructed mice, obvious attenuation of fibrotic progression was exhibited. It was concluded that HCA-Chi coordination-driven nanocomplex showed special renal targeting capacity and could be utilized to develop drug delivery systems for treating renal fibrosis. PMID:24862442

Qiao, Hongzhi; Sun, Minjie; Su, Zhigui; Xie, Ying; Chen, Minglei; Zong, Li; Gao, Yahan; Li, Huipeng; Qi, Jianping; Zhao, Qun; Gu, Xiaochen; Ping, Qineng

2014-08-01

314

Retroperitoneal laparoscopic technique in treatment of complex renal stones: 75 cases  

PubMed Central

Background In most hospitals, several options for the management of renal stones are available: shockwave lithotripsy, endourologic treatment, or surgery. Choice of treatment is based on the anatomic characteristics of the patient, and the location and size of the stones. In this study we assessed a retroperitoneal laparoscopic technique for treatment of complex renal stones. Methods Seventy-five patients, including 53 men and 22 women with a mean age of 47.8 years (range 18–74 y), underwent retroperitoneal laparoscopy for the treatment of complex renal stones between July 2006 and November 2012 in our hospital. Results The retroperitoneal laparoscopic procedures for treatment of complex renal stones were completely successful in 73 cases, while 2 cases converted to open surgery. The operative time was 85–190 min with a mean of 96 min. The estimated blood lost was 20–400 mL with a mean of 80 mL. After the operation 7 patients experienced urinary leakage. Ultrasonography, x-ray of the kidney, ureter and bladder, and intravenous urography were reviewed at post-procedural follow-up at 6–82 months. No hydronephrosis aggravation was found, and there was no calculus recurrence. Conclusion The merits of retroperitoneal laparoscopy for the treatment of complex renal stones include sparing the nephron, less bleeding, short hospitalization, quick postoperative recovery, and controllable procedure after training Success depends on the experience of surgeons and judicious selection of cases. PMID:24491207

2014-01-01

315

Structure of the corpuscles of Stannius in the euryhaline teleost Takifugu niphobles (Tetraodontiformes, Teleostei), with special regard to vascularization and extravascular channel system.  

PubMed

Vascularization and the extravascular channel system of the corpuscles of Stannius in a euryhaline teleost, Takifugu niphobles, were studied by scanning electron microscopy of the vascular corrosion cast, and histochemistry of exogenously injected horseradish peroxidase as a macromolecular tracer. The corpuscles were apposed to the caudal part of the ureter, away from the mesonephric kidney, and were supplied with arterioles from the genital artery running ventrally as a ramus of the dorsal aorta. Elaborate capillary networks irrigating the glandular lobules were collected by the venules to drain into the posterior cardinal veins. Electron microscopic examination of the glands demonstrated two types of secretory cells, type-1 cells with large granules, and type-2 cells with smaller granules. The type-1 cells, predominating in the gland, occasionally showed exocytosis of the secretory granules, mainly into intercellular spaces between adjoining cells. Exocytosis was also evident in the type-2 cells. The tracer molecule injected was visualized histochemically within the capillary lumina and intercellular spaces throughout the gland. The labelled spaces intercommunicated with each other to form an extensive extravascular channel system as a diffusing pathway within the gland. The possible role of this system in hormone transport and/or storage was discussed. PMID:2244688

Chiba, A

1990-01-01

316

Clinical experience and results of ESWL treatment for 3,093 urinary calculi with the Storz Modulith SL 20 lithotripter at the Singapore general hospital.  

PubMed

We study the outcome of 2,700 patients treated for 3,093 urinary calculi over a period of 60 months. All patients underwent Extracorporeal Shock Wave Lithotripsy (ESWL) treatment using the Storz Modulith SL20, predominantly on an outpatient basis (99.9% using intravenous pethidine for analgesia). The treatment outcome of 1,666 renal calculi and 1,427 ureteric calculi were analysed and stratified according to size and site. Follow-up status at 3 months was available for 91.8% of patients. For renal calculi, the overall success rate was 81% (re-treatment rate 29.7%). The majority of failures were stones larger than 2 cm and those situated in the lower pole of the renal calyces. The overall success rate for ureteric calculi is 85% with similar clearance rates throughout the ureter (re-treatment rate 22.8%). Failures were predominantly with stones larger than 2 cm. For the entire series, the morbidity rate requiring hospital admission was 2.9%, there was no mortality. The commonest cause for admission was for pain control (1.8%). To our knowledge, our experience with this lithotriptor is the largest to date. We have demonstrated that ESWL with Storz Modulith SL20 is safe, well tolerated and highly effective for the treatment of urolithiasis. PMID:12487741

Tan, Y M; Yip, S K; Chong, T W; Wong, M Y C; Cheng, C; Foo, K T

2002-01-01

317

Hydronephrosis and renal failure following inadequate management of neuropathic bladder in a patient with spinal cord injury: Case report of a preventable complication  

PubMed Central

Background Condom catheters are indicated in spinal cord injury patients in whom intravesical pressures during storage and voiding are safe. Unmonitored use of penile sheath drainage can lead to serious complications. Case report A 32-year old, male person, sustained complete paraplegia at T-11 level in 1985. He had been using condom catheter. Eleven years after sustaining spinal injury, intravenous urography showed no radio-opaque calculus, normal appearances of kidneys, ureters and bladder. Blood urea and Creatinine were within reference range. A year later, urodynamics revealed detrusor pressure of 100?cm water when detrusor contraction was initiated by suprapubic tapping. This patient was advised intermittent catheterisation and take anti-cholinergic drug orally; but, he wished to continue penile sheath drainage. Nine years later, this patient developed bilateral hydronephrosis and renal failure. Indwelling urethral catheter drainage was established. Five months later, ultrasound examination of urinary tract revealed normal kidneys with no evidence of hydronephrosis. Conclusion Spinal cord injury patients with high intravesical pressure should not have penile sheath drainage as these patients are at risk for developing hydronephrosis and renal failure. Intermittent catheterisation along with antimuscarinic drug should be the preferred option for managing neuropathic bladder. PMID:23014062

2012-01-01

318

Optically triggered solid state driver for shock wave therapy  

NASA Astrophysics Data System (ADS)

Shock wave lithotripsy (SWL) represents one of several first-line therapies for the treatment of stones located in the kidneys and ureters. Additional applications for shock wave therapy are also under exploration, including non-urinary calculi, orthopedics, and neovascularization. Except for the elimination of a large water bath in which the treatment is performed, current procedures remain largely unchanged, with one of the original commercial devices (the Dornier HM3) still considered a gold standard for comparison. To accelerate research in this area, Coleman, et al. published an experimental electrohydraulic shock wave generator capable of simulating the acoustic field generated by the HM3. We propose a further update of this system, replacing the triggered spark gap with an optically triggered solid state switch. The new system has better reliability, a wider operating range, and reduced timing jitter allowing synchronization with additional acoustic sources under exploration for improving efficacy and reducing injury. Originally designed for exciting electrohydraulic spark electrodes, the system can also be adapted for driving piezoelectric and electromagnetic sources.

Duryea, Alexander P.; Roberts, William W.; Cain, Charles A.; Hall, Timothy L.

2012-10-01

319

Bilateral ureteral obstruction revealing a benign prostatic hypertrophy: a case report and review of the literature  

PubMed Central

Introduction Prostatic hyperplasia is the most frequent tumor in men older than 50 years of age. Bilateral hydronephrosis secondary to benign prostatic hypertrophy is a rare condition most often due to vesicoureteral reflux. Herein we report a case of a patient with bilateral hydronephrosis with distal ureter obstruction caused by detrusor hypertrophy due to prostatic hyperplasia, our analysis of the clinical data and a review of the relevant published literature. Case presentation We report a case of a 65-year-old Berber man with clinically significant storage, bladder-emptying symptoms and bilateral low back pain with renal biologic failure and bilateral ureterohydronephrosis, distal ureteral stenosis, detrusor hypertrophy and prostate hyperplasia without significant post-void residual urine volume visualized by abdominal sonography. The patient underwent bilateral JJ stent insertion with transurethral resection of the prostate. The patient was discharged 3 days after surgery without any obvious complications. At his 3-month follow-up examination, the JJ stent was removed and the patient had comfortable urination without renal failure. Conclusion This is an extremely rare condition that has important diagnostic considerations because of the possibility of comorbid severe obstructive uropathy and chronic renal failure. PMID:24513237

2014-01-01

320

Observations on the sexual segment of the kidney of snakes with emphasis on ultrastructure in the yellow-bellied sea snake, Pelamis platurus.  

PubMed

The sexual segment of the kidney (SSK) is an accessory sex structure in male lizards and snakes (Squamata). We describe histology of the SSK in 12 species of snakes, including one from the basal Scolecophidia, Leptotyphlops dulcis, and from the more advanced Alethinophidia, species from the Acrochordidae (Acrochordus granulatus), Homalopsidae (Cerberus rynchops), Uropeltidae (Teretrurus sanguineus), and eight species from the Elapidae, including six species of sea snakes. We also describe the ultrastructure of the SSK of the sea snake, Pelamis platurus. The SSK of L. dulcis does not include the ureter but does include distal convoluted tubules (DCTs) and collecting ducts. In all other snakes examined, the SSK is limited to the DCTs and does not differ in histology by any consistent character. We found apparently mature individuals of several species with inactive SSKs. Hypertrophied SSKs give positive reactions for protein secretions but variable reactions for carbohydrates. Ultrastructure of the SSK of P. platurus reveals nuclei situated medially in the epithelium and mature electron dense secretory vacuoles in other areas of the cytoplasm. Product release is apocrine. Junctional complexes only occur at the luminal border, and intercellular canaliculi become widened and are open basally. No cytologically unique characters occur in the SSK of P. platurus. The ancestral condition of the SSK in squamates is the presence of simple columnar epithelium specialized for secretion of a protein + carbohydrate product that matures and is released seasonally. PMID:22396145

Sever, David M; Rheubert, Justin L; Gautreaux, Jillian; Hill, Toren G; Freeborn, Layla R

2012-05-01

321

A trial placement of a prophylactic ureteral catheter during the excision of a huge pelvic mass with incidental cystotomy  

PubMed Central

Ureteral injuries are one of the major complications following gynecologic surgeries. They are serious, troublesome, often associated with significant morbidity, and are one of the most common causes for legal action against gynecologic surgeons. The reported rates of injury depend on the vigilance of diagnosis, type of surgery and other risk factors. We present a case of a 48 year old obese Caucasian female with no significant past medical history who came in with back pain and progressive abdominal swelling for the past three months and was found to have a very large pelvic mass. After preoperative evaluation, including: medical history, physical exam, and imaging studies showing a heterogenous mass 24.6 x 33.0 x 43.1, we predicted that the risk of urinary tract injuries was very high. We used preoperative prophylactic bilateral ureteral catheters to prevent injury. A surgical oncologist was consulted and an exploratory laparotomy was performed with removal of the large multi–lobulated pelvic mass + total abdominal hysterectomy, bilateral salpingo–oophorectomy, and appendectomy all performed at the same time. Patient had an incidental cystotomy during the procedure, which was repaired intra–operatively. The ureters remained intact with no injuries. The importance of thorough preoperative identification, evaluation and anticipation of ureteral injuries will be discussed in detail. PMID:24707391

2013-01-01

322

Screening of the toxic effects of a high melamine dose on the biochemical hematological and histopathological investigations in male rats.  

PubMed

Screening of the toxic effect of a high oral melamine dose (30,000 ppm supplemented in the diet) was performed for 28 days on male rats. The morphology, anatomy, complete blood count (CBC), serum electrolytes, kidney function, serum proteins, serum bilirubin, serum liver enzymes, catalase, glutathion-S-transferase, lipid peroxide, serum melamine concentration, total body weight, food intake, food efficiency ratio (FER), body weight gain percentage (BWG%), body weight gain, water consumption, and histopathological examinations of kidney, urinary bladder, testis, liver, heart, and spleen were investigated. The melamine-supplemented rats turned yellow and showed different degrees of hypertrophy and congestion, particularly the kidney and the ureter as a result of melamine toxicity. The CBC showed minimal changes in the melamine-supplemented groups. Na and Cl were decreased, whereas K, P, and Ca were increased. Serum creatinine, uric acid, and urea were elevated. Liver function enzymes were nonsignificantly affected. Catalase and glutathion-S-transferase were decreased, whereas lipid peroxide was increased in the kidney tissue homogenate. It was also noted that serum protein was decreased and serum bilirubin was increased. Histopathologically, most examined organs were severely injured specially the kidneys, liver, and testes. PMID:24253415

El Rabey, Haddad A; Al-Sieni, Abdulbasit I; Majami, Abdullah A

2014-11-01

323

Minimal deviation mucinous adenocarcinoma of the uterine cervix that proved difficult to differentiate from endometrial cancer: A case report  

PubMed Central

Minimal deviation adenocarcinoma (MDA), also known as adenoma malignum of the uterine cervix, accounts for only ~1% of uterine cervical adenocarcinomas. Adenoma malignum of the uterine cervix was initially described by Gusserow in 1870. Using magnetic resonance imaging (MRI), MDA appears as multilocular lesions with solid components that extend from the endocervical glands to the deep cervical stroma. Cytological evaluation and biopsies have low detection rates, therefore, it is difficult to diagnose MDA accurately prior to treatment. The current study describes a rare case of MDA that was difficult to differentiate from endometrial adenocarcinoma of the corpus uteri preoperatively, as the endometrial biopsy results suggested a well-differentiated endometrioid adenocarcinoma and MRI did not show typical images for MDA. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed under the diagnosis of endometrial cancer, and the mass was subsequently diagnosed as MDA of the uterine cervix by pathological examination of the hysterectomy specimen. Postoperatively, although two types of adjuvant chemotherapy were performed, the remaining tumor continued to grow, causing obstruction of the bilateral ureters and leading to bilateral hydronephrosis. The patient is currently alive with the disease 10 months following the surgery. PMID:25364411

NISHII, YUKO; FUKUDA, TAKESHI; IMAI, KENJI; YAMAUCHI, MAKOTO; HASHIGUCHI, YASUNORI; ICHIMURA, TOMOYUKI; YASUI, TOMOYO; SUMI, TOSHIYUKI

2014-01-01

324

Esrrg functions in early branch generation of the ureteric bud and is essential for normal development of the renal papilla  

PubMed Central

Congenital anomalies of the kidney and urinary tract (CAKUTs) are common disorders of human development affecting the renal parechyma, renal pelvis, ureter, bladder and urethra; they show evidence of shared genetic aetiology, although the molecular basis of this remains unknown in the majority of cases. Breakpoint mapping of a de novo, apparently balanced, reciprocal translocation associated with bilateral renal agenesis has implicated the gene encoding the nuclear steroid hormone receptor ESRRG as a candidate gene for CAKUT. Here we show that the Esrrg protein is detected throughout early ureteric ducts as cytoplasmic/sub-membranous staining; with nuclear localization seen in developing nephrons. In 14.5–16.5 dpc (days post-conception) mouse embryos, Esrrg localizes to the subset of ductal tissue within the kidney, liver and lung. The renal ductal expression becomes localized to renal papilla by 18.5 dpc. Perturbation of function was performed in embryonic mouse kidney culture using pooled siRNA to induce knock-down and a specific small-molecule agonist to induce aberrant activation of Esrrg. Both resulted in severe abnormality of early branching events of the ureteric duct. Mouse embryos with a targeted inactivation of Esrrg on both alleles (Esrrg?/?) showed agenesis of the renal papilla but normal development of the cortex and remaining medulla. Taken together, these results suggest that Esrrg is required for early branching events of the ureteric duct that occur prior to the onset of nephrogenesis. These findings confirm ESRRG as a strong candidate gene for CAKUT. PMID:21138943

Berry, Rachel; Harewood, Louise; Pei, Liming; Fisher, Malcolm; Brownstein, David; Ross, Allyson; Alaynick, William A.; Moss, Julie; Hastie, Nicholas D.; Hohenstein, Peter; Davies, Jamie A.; Evans, Ronald M.; FitzPatrick, David R.

2011-01-01

325

Nlrp3 Prevents Early Renal Interstitial Edema and Vascular Permeability in Unilateral Ureteral Obstruction  

PubMed Central

Progressive renal disease is characterized by tubulo-interstitial injury with ongoing inflammation and fibrosis. The Nlrp3 inflammasome contributes to these pathophysiological processes through its canonical effects in cytokine maturation. Nlrp3 may additionally exert inflammasome-independent effects following tissue injury. Hence, in this study we investigated potential non-canonical effects of Nlrp3 following progressive renal injury by subjecting WT and Nlrp3-deficient (?/?) mice to unilateral ureter obstruction (UUO). Our results revealed a progressive increase of renal Nlrp3 mRNA in WT mice following UUO. The absence of Nlrp3 resulted in enhanced tubular injury and dilatation and an elevated expression of injury biomarker NGAL after UUO. Moreover, interstitial edema was significantly elevated in Nlrp3?/? mice. This could be explained by increased intratubular pressure and an enhanced tubular and vascular permeability. In accordance, renal vascular leakage was elevated in Nlrp3?/? mice that associated with reduced mRNA expression of intercellular junction components. The decreased epithelial barrier function in Nlrp3?/? mice was not associated with increased apoptosis and/or proliferation of renal epithelial cells. Nlrp3 deficiency did not affect renal fibrosis or inflammation. Together, our data reveal a novel non-canonical effect of Nlrp3 in preserving renal integrity and protection against early tubular injury and interstitial edema following progressive renal injury. PMID:24454932

Pulskens, Wilco P.; Butter, Loes M.; Teske, Gwendoline J.; Claessen, Nike; Dessing, Mark C.; Flavell, Richard A.; Sutterwala, Fayyaz S.; Florquin, Sandrine; Leemans, Jaklien C.

2014-01-01

326

Multichannel impedance monitoring for evaluation of alpha-adrenoblocker effect on the ureteral function in patients with stone disease  

NASA Astrophysics Data System (ADS)

The study of distal ureter function was carried out on patients with stones in the upper urinary tract, who underwent ureteroscopy and lithotripsy procedures. The parameters of ureteral peristalsis such as peristalsis amplitude, peristalsis rate, ureteral wall tone, contractile wave duration, and its direction obtained by multichannel impedance ureterography were assessed and compared from two groups of patients. The group I patients received tamsulosin in addition to standard regimen, while the group II patients matched according to the stone size and location were managed without tamsulosin medical therapy. In comparison with group II, the group I patients demonstrated smaller average peristalsis amplitude (0.60±0.08 vs 0.81±0.06 Ohm), shorter contractions (7.1±0.3 vs 7.7±0.3 s), greater peristalsis rate (3.3±0.3 vs 2.8±0.2 per minute), and diminished ureteral tone (4.0±0.5 vs 4.7±0.2 Ohm-1). Incidence of the retrograde contractile waves was two-fold greater in the group II, while normal antegrade regular contractions were 30% more frequent in the group I. In addition, our results showed that the effect of tamsulosin on ureteral function was manifested in the patients with different stone size and location in the upper urinary tract, and it depended pronouncedly on individual ureteral tone and contractility parameters.

Apolikhin, O. I.; Khodyreva, L. A.; Mudraya, I. S.; Kirpatovsky, V. I.; Serdyuk, A. A.

2010-04-01

327

Increased Phosphorylation of PI3K/Akt/mTOR in the Obstructed Kidney of Rats with Unilateral Ureteral Obstruction  

PubMed Central

The present study aimed to investigate changes in the mammalian target of rapamycin (mTOR) signaling pathway in the obstructed kidney of rats with unilateral ureteral obstruction (UUO). Male Sprague-Dawley rats were unilaterally obstructed by ligation of the left proximal ureter for 7 days. Control rats were treated in the same way except that no ligature was made. The expression levels of phosphorylated phosphatidylinositol 3-kinase (PI3K), Akt, and mTOR were determined in the kidney by semiquantitative immunoblotting. The protein expression levels of transforming growth factor (TGF)-?1, Bax, and Bcl-2 were also determined in the kidney. The phosphorylation of PI3K, Akt, and mTOR was increased in the kidney of ureteral obstruction rats compared with the control. In the obstructed kidney, the protein expression of TGF-?1 and Bax was also increased, whereas Bcl-2 expression was decreased. In conclusion, the phosphorylation of PI3K/Akt/mTOR was increased in the obstructed kidney of rats with UUO. PMID:24400212

Ma, Seong Kwon; Joo, Soo Yeon; Kim, Chang Seong; Choi, Joon Seok; Bae, Eun Hui; Lee, JongUn

2013-01-01

328

Shared Copy Number Variation in Simultaneous Nephroblastoma and Neuroblastoma due to Fanconi Anemia  

PubMed Central

Concurrent emergence of nephroblastoma (Wilms Tumor; WT) and neuroblastoma (NB) is rare and mostly observed in patients with severe subtypes of Fanconi anemia (FA) with or without VACTER-L association (VL). We investigated the hypothesis that early consequences of genomic instability result in shared regions with copy number variation in different precursor cells that originate distinct embryonal tumors. We observed a newborn girl with FA and VL (aplasia of the thumbs, cloacal atresia (urogenital sinus), tethered cord at L3/L4, muscular ventricular septum defect, and horseshoe-kidney with a single ureter) who simultaneously acquired an epithelial-type WT in the left portion of the kidney and a poorly differentiated adrenal NB in infancy. A novel homozygous germline frameshift mutation in PALB2 (c.1676_c1677delAAinsG) leading to protein truncation (pGln526ArgfsX1) inherited from consanguineous parents formed the genetic basis of FA-N. Spontaneous and induced chromosomal instability was detected in the majority of cells analyzed from peripheral lymphocytes, bone marrow, and cultured fibroblasts. Bone marrow cells also showed complex chromosome rearrangements consistent with the myelodysplastic syndrome at 11 months of age. Array-comparative genomic hybridization analyses of both WT and NB showed shared gains or amplifications within the chromosomal regions 11p15.5 and 17q21.31-q25.3, including genes that are reportedly implicated in tumor development such as IGF2, H19, WT2, BIRC5, and HRAS. PMID:23112754

Serra, A.; Eirich, K.; Winkler, A.K.; Mrasek, K.; Gohring, G.; Barbi, G.; Cario, H.; Schlegelberger, B.; Pokora, B.; Liehr, T.; Leriche, C.; Henne-Bruns, D.; Barth, T.F.; Schindler, D.

2012-01-01

329

Effects of renal pelvic high-pressure perfusion on nephrons in a porcine pyonephrosis model  

PubMed Central

The aim of this study was to investigate the effects of various renal pelvic pressure gradients on nephrons with purulent infection. Five miniature test pigs were selected. One side of the kidney was used to prepare the pyonephrosis model and the other side was used as the healthy control. A piezometer and a water fill tube were inserted into the renal pelvis through the ureter. Prior to perfusion, punctures were made on the healthy and purulent sides of the kidneys to obtain tissues (as controls). Subsequently, a puncture biopsy was conducted on the kidneys at five pressure levels: 10, 20, 30, 40 and 50 mmHg. Once the renal pelvic pressure had increased, the healthy and injured kidneys presented pathological changes, including dilation of the renal tubule and capsule and compression of the renal glomerulus. When the renal pelvic pressure exceeded 20 mmHg, the injured kidney presented more damage. Electron microscopy revealed that the increase in pressure resulted in the following: the podocyte gap widened, the epithelial cells of the renal capsule separated from the basement membrane, the basement membrane thickness became uneven, the continuity of the basement membrane was interrupted at multiple positions and the renal tubule microvillus arrangement became disorganised. The manifestations in the pyonephrosis model were more distinct compared with those in the healthy kidney. As the renal pelvic pressure exceeds 20 mmHg under a renal purulent infection status, the nephrons become damaged. The extent of the damage is aggravated as the pressure is increased. PMID:23737886

WANG, JIAN; ZHOU, DA-QING; HE, MENG; LI, WEN-GANG; PANG, XIANG; YU, XIAO-XIANG; JIANG, BO

2013-01-01

330

Large-Amplitude Peristaltic Pumping of a Viscoelastic Fluid  

NASA Astrophysics Data System (ADS)

Peristaltic pumping by wave-like musculuar contractions is a fundamental biomechanical mechanism for fluid and material transport, and is used in the esophagus, intestine, oviduct and ureter. While peristaltic pumping of a Newtonian fluid is well understood, in many important applications (as in the fluid dynamics of reproduction) the fluids have non-Newtonian responses. Recent work has focused on large wave-length peristalsis of Oldroyd fluids. To study the problem more generally, we have developed a numerical method for simulating an Oldroyd-B fluid coupled to a deforming elastic membrane. A MAC grid-based projection method is used for the fluid equations and an immersed boundary method is used for coupling to a Lagrangian elastic representation of the deforming walls. We examine numerically the peristaltic transport of a viscous Oldroyd-B fluid over a range of Weissenberg numbers and peristalsis wave-lengths, and demonstrate fundamentally different and important behavior in the presence of large amplitude, short-wavelength peristalsis. We also demonstrate the loss of flow reversibility, and its consequences, due to fluid visco-elasticity.

Teran, Joseph; Fauci, Lisa; Shelley, Michael

2006-11-01

331

Three common presentations of ascariasis infection in an urban Emergency Department.  

PubMed

In the United States, approximately 4 million people per year are infected with Ascaris lumbricoides. We reviewed the common presentations of complications of Ascariasis infection in the Emergency Department (ED) and the diagnostic tools and treatment available. This was a retrospective case review conducted on all patients diagnosed with Ascariasis (using ICD-9 codes) over a 6-year period at Los Angeles County and University of Southern California Medical Center. Three patients with distinct complications secondary to Ascariasis were chosen, and all ED and inpatient records were reviewed. The patient's age, sex, race, presenting symptoms, data, outcome, and ED course and diagnosis were recorded. The three cases included a periappendiceal abscess, Loeffler's syndrome, and biliary colic/choledocholithiasis. The first patient underwent a computed tomography-guided drainage of the abscess. The second patient received supportive care and antibiotic therapy secondary to a superimposed bacterial pneumonia. The third patient underwent endoscopic retrograde cholangiopancreatography with sphincterotomy. All three patients had a stool ova and parasites positive for A. lumbricoides, and all received a 3-day course of mebendazole. Symptomatic cases of Ascariasis may present to EDs in the United States. Important diagnostic tools for the ED include chest X-ray, X-ray of the kidney-ureter-bladder and ultrasonography. Single-dose medications given in the ED are very effective in eradicating A. lumbricoides infection, thus avoiding hospitalization. PMID:11207407

Valentine, C C; Hoffner, R J; Henderson, S O

2001-02-01

332

TERT promoter mutations in renal cell carcinomas and upper tract urothelial carcinomas  

PubMed Central

TERT promoter mutations are identified in many malignancies including bladder cancer (BC) and upper tract urothelial carcinoma (UTUC). In contrast, no mutations were found in renal cell carcinoma (RCC) as reported in a recent study. Because the mutant TERT promoter in urine DNA was recently tested as a marker for BC, it is important to ascertain whether these mutations are truly absent in RCCs. Here we determined TERT promoter mutations in 109 patients with RCC and 14 patients with UTUC. The mutations were found in 9/96 (9.3%) clear cell RCC (ccRCC) tumors and 1/8 (13%) chromophobe RCC tumors. Among ccRCC patients, the mutation was correlated with the advanced stages and metastasis, and higher TERT expression. Among UTUCs, the mutation was detected in tumors from 3/5 (60%) patients with renal pelvic cancer and 1/9 (11%) patients with ureter cancer. The mutation was also detected in 1 of 4 urine samples from patients with mutation+ UTUC. Collectively, TERT promoter mutations do occur in RCCs and are associated with aggressive disease. The mutation is more frequent in renal pelvic cancer. Thus, the mutant TERT promoter found in urine may come from not only BC, but also RCC or UTUC. PMID:24742867

Liu, Jikai; Liu, Cheng; Wang, Chang; Ge, Nan; Ren, Hongbo; Yan, Keqiang; Hu, Sanyuan; Bjorkholm, Magnus; Fan, Yidong; Xu, Dawei

2014-01-01

333

Laparoscopic approach for an intra-abdominal kidney allograft nephrectomy after pediatric transplantation: a case report.  

PubMed

We report a case of minimally invasive nephrectomy of a kidney transplanted into the abdominal cavity in a child. A 15-year-old girl underwent transplantation with a cadaveric donor kidney due to congenital pyelonephritis, vesicoureteral reflux, and secondary bladder atrophy. The transplant was complicated by hyperacute rejection, cytomegalovirus infection, and anastomotic stenosis of the Bricker neobladder. After recurrent urinary tract infections, the patient was reintroduced to hemodialysis in 2010. After pneumo-peritoneum, we placed 2 10-mm trocars in the hypochondrium and left side and 2 5-mm in the left iliac fossa and right upper quadrant. The transplanted kidney was skeletonized, the artery and vein were cut to the end-to-side anastomoses to the juxta-renal aorta and cava using an automatic 35-mm, stapler, and the ureter was dissected and closed with clips. Via a Pfannestiel minilaparotomy we extracted the allograft. The patient was discharged on the third postoperative day. After 4 months of follow-up, she is alive an on dialysis. Laparoscopic nephrectomy of a kidney transplanted into the abdominal cavity is feasible and safe in centers with skilled minimally invasive techniques. PMID:22974901

Pagano, D; Cintorino, D; Li Petri, S; di Francesco, F; Ricotta, C; Argento, J; Echeverri, G J; Bertani, T; Riva, S; Gridelli, B G; Spada, M

2012-09-01

334

Nanoparticles for urothelium penetration and delivery of the histone deacetylase inhibitor belinostat for treatment of bladder cancer  

PubMed Central

Nearly 40% of patients with non-invasive bladder cancer will progress to invasive disease despite locally-directed therapy. Overcoming the bladder permeability barrier (BPB) is a challenge for intravesical drug delivery. Using the fluorophore coumarin (C6), we synthesized C6-loaded poly(lactide-co-glycolide) (PLGA) nanoparticles (NPs), which were surface modified with a novel cell penetrating polymer, poly(guanidinium oxanorbornene) (PGON). Addition of PGON to the NP surface improved tissue penetration by 10-fold in intravesically-treated mouse bladder and ex vivo human ureter. In addition, NP-C6-PGON significantly enhanced intracellular uptake of NPs compared to NPs without PGON. To examine biological activity, we synthesized NPs that were loaded with the histone deacetylase (HDAC) inhibitor belinostat (NP-Bel-PGON). NP-Bel-PGON exhibited a significantly lower IC50 in cultured bladder cancer cells, and sustained hyperacetylation, when compared to unencapsulated belinostat. Xenograft tumors treated with NP-Bel-PGON showed a 70% reduction in volume, and a 2.5-fold higher intratumoral acetyl-H4, when compared to tumors treated with unloaded NP-PGON. PMID:23764660

Martin, Darryl T.; Hoimes, Christopher J.; Kaimakliotis, Hristos Z.; Cheng, Christopher J.; Zhang, Ke; Liu, Jingchun; Wheeler, Marcia A.; Kelly, W. Kevin; Tew, Greg N.; Saltzman, W. Mark; Weiss, Robert M.

2013-01-01

335

Diagnosis of ovarian vein syndrome (OVS) by computed tomography (CT) imaging: a retrospective study of 11 cases.  

PubMed

This article aims to explore the characteristics of computed tomography (CT) images of ovarian vein syndrome (OVS). The approval of the research ethics committee and the written informed consent of the patients were obtained. The CT images of 11 patients who had been diagnosed with OVS were retrospectively analyzed. All patients were examined with CT urogram, both plain CT scans and enhanced CT scans (including arterial phase, venous phase, and secretory phase). The datum was pulled into a computer workstation for post-processing. Ureteral obstruction at the position and ureteral dilation above it, where the ovarian vein crosses over the ureter, were found in all 11 patients. In addition, 4 patients presented with right upper ureteric calculi, 10 with right renal calculi (including 8 patients with multiple renal calculi that also had obvious uronephrosis), and 2 with a urinary calculus or cystolith. The diameter of the ovarian vein in them ranged from 5 mm to 13 mm. Varicose veins around the uterus were found in 2 patients, and the diameter of the left ovarian vein was larger than 7 mm in 1 patient.In conclusion, analysis of CT images is a vital method in diagnosing OVS. PMID:25101988

Wang, Ruizhi; Yan, Yan; Zhan, Songhua; Song, Litao; Sheng, Weihua; Song, Xu; Wang, Xiaolin

2014-08-01

336

Pathology and first occurrence of the kidney trematode Paratanaisia bragai (Santos, 1934) Freitas, 1959 (Digenea: Eucotylidae) in Phasianus colchicus L., 1758, from Brazil.  

PubMed

The kidney trematode Paratanaisia bragai is reported for the first time parasitizing the ring-necked pheasant (Phasianus colchicus L., 1758) and the pathological alterations associated to the parasitism are referred on the basis of 50 specimens of this bird from backyard flocks in 11 counties of the state of Rio de Janeiro, Brazil after clinical examination, necropsies, and histopathological analysis. The counting of the kidney flukes was based on worms recovered from one of the kidneys, since the other was fixed in 10% formalin and then routinely processed for histopathological procedures. The prevalence of P. bragai was of 22%, with a mean intensity of 44.3, mean abundance of 9.7, and range of infection of 3-153. Parasitized birds did not present with clinical signs and kidney gross lesions. Microscopic lesions were mild and characterized by dilatation of the renal medullary collecting ducts, occasional flattening of the lining epithelium of the ducts and inflammatory reaction of variable intensity with granulocytes around the ureter branches and medullary collecting ducts. The severity and pattern of the microscopic lesions seem not to be associated to the size of the worm burden and could be related to the mechanic action of the parasites, without traumatism, in despite of the presence of the tegumentar spines in specimens of P. bragai. PMID:16113870

Gomes, Delir Corrêa; Menezes, Rodrigo Caldas; Tortelly, Rogério; Pinto, Roberto Magalhães

2005-05-01

337

Factors influencing the failure of extracorporeal shock wave lithotripsy with Piezolith 3000 in the management of solitary ureteral stone.  

PubMed

Studies of predictive factors of extracorporeal shockwave lithotripsy (ESWL) failure in patients with ureteral stones have not yielded results sufficient to prevent ESWL failure. The present study investigated patients with ureteral stone and analyzed the predictive factors of ESWL failure. Ninety patients with ureteral stone treated from January 2006 to June 2012 using ESWL for ureteral stone were enrolled. Patient's demographic data including age, gender, body mass index (BMI), symptoms and calculous characteristics including location, size, episode and the grade of hydronephrosis were recorded. Statistical results were performed using univariate and multivariate analyses for the predictive factors of ESWL failure. In univariate analysis, calculous location, size, and grade of hydronephrosis between two groups displayed significant differences (p < 0.05). The predictive factors of ESWL failure were BMI >25 kg/m(2) [Odds ratio (OR) = 3.5, 95% confidence interval (CI) 1.1-11.0], calculous size ? 1 cm (OR = 10.5, 95% CI 3.0-36.2), calculous location (mid-ureter; OR = 8.49, 95% CI 1.5-45.7) and severe grade of hydronephrosis (OR = 12.3, 95% CI 1.9-79.5). In conclusions, ESWL failure can be predicted in cases of obesity, calculous size exceeding 1 cm, mid-ureteral stone and severe hydronephrosis. When we consider calculous management in patients with these risk factors, initial surgical approach is recommended instead of ESWL. PMID:24496560

Hwang, Insang; Jung, Seung-Il; Kim, Kwang Ho; Hwang, Eu Chang; Yu, Ho Song; Kim, Sun-Ouck; Kang, Taek Won; Kwon, Dong Deuk; Park, Kwangsung

2014-06-01

338

Safe vaginal delivery in a renal transplant recipient: A case report  

PubMed Central

Here, we aimed to present a case of safe vaginal delivery in a renal transplant recipient and to mention the possible additional risks of caesarean section in such cases. A 40 year-old patient (G4P3), who had undergone renal transplantation 5 years ago, was admitted to our clinic at 392/7 weeks of pregnancy. The transplanted kidney at right iliac fossa was sonographically normal except for grade 1 hydronephrosis; the proximity of vascular anastomoses between the transplanted kidney and iliac vessels to the lower segment of the uterus was remarkable. There was no contraindication for vaginal delivery and it was believed that there would be a possible risk of injury to the transplanted kidney with caesarean delivery. The patient delivered a healthy baby weighing 3540 grams. There is a risk of injury to the renovascular and ureter anastomoses in renal transplant recipients during caesarean delivery. Normal vaginal delivery without abdominal compression is the safest method of delivery in these patients. If a situation that can necessitate internal iliac artery ligation or caesarean hysterectomy such as placenta accreata is expected, surgery should be performed in a centre where the renal transplant surgeon can oversee the surgery. PMID:24976780

Özlü, Tülay; Dönmez, Melahat Emine; Da??stan, Emine; Tekçe, Hikmet

2014-01-01

339

A quick and simple method to close vascular, biliary, and urinary tract incisions using the new Vascular Closure Staples: a preliminary report.  

PubMed

Traditional suture reconstruction of tubular organs creates a perforating needle injury, leaves suture material on the endothelial or mucosal surfaces, and is cumbersome when done endoscopically. One alternative method of reconstruction of tubular organs could use the new nonpenetrating clip to create an everted closure. In five pigs, a longitudinal incision of the infrarenal aorta, inferior vena cava, left ureter, gallbladder, and the common bile duct (in two) was closed with Vascular Closure Staples (VCS-clips). Four weeks after surgery, all ten blood vessels remained patent with no thrombosis. There was a well-healed wound with continuous intimal layer. The ureteral, gallbladder, and common bile duct wounds healed without leakage or obstruction in all animals. There was complete mucosal bridging of the wound, although in some specimens one or two clips were exposed to the lumen. The VCS-clips are easily and quickly applied and are safe insofar as can be determined by short-term follow-up. PMID:8662439

Leppäniemi, A K; Wherry, D C; Soltero, R G; Pikoulis, E; Hufnagel, H V; Fishback, N; Rich, N M

1996-07-01

340

Cysts of the lower male genitourinary tract: embryologic and anatomic considerations and differential diagnosis.  

PubMed

Cysts of the lower male genitourinary tract are uncommon and usually benign. These cysts have different anatomic origins and may be associated with a variety of genitourinary abnormalities and symptoms. Various complications may be associated with these cysts, such as urinary tract infection, pain, postvoiding incontinence, recurrent epididymitis, prostatitis, and hematospermia, and they may cause infertility. Understanding the embryologic development and normal anatomy of the lower male genitourinary tract can be helpful in evaluating these cysts and in tailoring an approach for developing a differential diagnosis. There are two main groups of cysts of the lower male genitourinary tract: intraprostatic cysts and extraprostatic cysts. Intraprostatic cysts can be further classified into median cysts (prostatic utricle cysts, müllerian duct cysts), paramedian cysts (ejaculatory duct cysts), and lateral cysts (prostatic retention cysts, cystic degeneration of benign prostatic hypertrophy, cysts associated with tumors, prostatic abscess). Extraprostatic cysts include cysts of the seminal vesicle, vas deferens, and Cowper duct. A variety of pathologic conditions can mimic these types of cysts, including ureterocele, defect resulting from transurethral resection of the prostate gland, bladder diverticulum, and hydroureter and ectopic insertion of ureter. Accurate diagnosis depends mainly on the anatomic location of the cyst. Magnetic resonance imaging and transrectal ultrasonography (US) are excellent for detecting and characterizing the nature and exact anatomic origin of these cysts. In addition, transrectal US can play an important therapeutic role in the management of cyst drainage and aspiration, as in cases of prostatic abscess. PMID:23842975

Shebel, Haytham M; Farg, Hashim M; Kolokythas, Orpheus; El-Diasty, Tarek

2013-01-01

341

Remote control of renal physiology by the intestinal neuropeptide pigment-dispersing factor in Drosophila  

PubMed Central

The role of the central neuropeptide pigment-dispersing factor (PDF) in circadian timekeeping in Drosophila is remarkably similar to that of vasoactive intestinal peptide (VIP) in mammals. Like VIP, PDF is expressed outside the circadian network by neurons innervating the gut, but the function and mode of action of this PDF have not been characterized. Here we investigate the visceral roles of PDF by adapting cellular and physiological methods to the study of visceral responses to PDF signaling in wild-type and mutant genetic backgrounds. We find that intestinal PDF acts at a distance on the renal system, where it regulates ureter contractions. We show that PdfR, PDF's established receptor, is expressed by the muscles of the excretory system, and present evidence that PdfR-induced cAMP increases underlie the myotropic effects of PDF. These findings extend the similarities between PDF and VIP beyond their shared central role as circadian regulators, and uncover an unexpected endocrine mode of myotropic action for an intestinal neuropeptide on the renal system. PMID:22778427

Talsma, Aaron D.; Christov, Christo P.; Terriente-Felix, Ana; Linneweber, Gerit A.; Perea, Daniel; Wayland, Matthew; Shafer, Orie T.; Miguel-Aliaga, Irene

2012-01-01

342

Tissue engineering and stem cells: basic principles and applications in urology.  

PubMed

To overcome problems of damaged urinary tract tissues and complications of current procedures, tissue engineering (TE) techniques and stem cell (SC) research have achieved great progress. Although diversity of techniques is used, urologists should know the basics. We carried out a literature review regarding the basic principles and applications of TE and SC technologies in the genitourinary tract. We carried out MEDLINE/PubMed searches for English articles until March 2010 using a combination of the following keywords: bladder, erectile dysfunction, kidney, prostate, Peyronie's disease, stem cells, stress urinary incontinence, testis, tissue engineering, ureter, urethra and urinary tract. Retrieved abstracts were checked, and full versions of relevant articles were obtained. Scientists have achieved great advances in basic science research. This is obvious by the tremendous increase in the number of publications. We divided this review in two topics; the first discusses basic science principles of TE and SC, whereas the second part delineates current clinical applications and advances in urological literature. TE and SC applications represent an alternative resource for treating complicated urological diseases. Despite the paucity of clinical trials, the promising results of animal models and continuous work represents the hope of treating various urological disorders with this technology. PMID:20969644

Shokeir, Ahmed A; Harraz, Ahmed M; El-Din, Ahmed B Shehab

2010-12-01

343

Urothelial cell culture: stratified urothelial sheet and three-dimensional growth of urothelial structure.  

PubMed

Urothelial cells line the urinary tract, including the renal pelvis, ureters, bladder, superior urethra, and the central ducts of the prostate. They are highly specialized epithelial cell types possessing unique features, imparting important functional roles in the urinary system. They act as a permeability barrier and protect underlying muscle tissues from the caustic effects of urine while also expanding with bladder filling to adjust urine pressures. The multilayered urothelium is typically structured with differentiated, mature surface cells and less mature basal cells. The basal cell layer contains tissue-specific stem cells able to self-renew for the lifetime of the mammal and also produces a pool of maturing cells for tissue homeostasis. Maintaining regenerative basal cells in a culture facilitates urothelial cell growth in vitro. Additionally, epithelial-mesenchymal communication, epithelial-matrix interactions, and cytokines/growth factors are required to maintain the normal structure and function of mature urothelial cells in vitro and to induce stem cell differentiation into urothelial cells. These cultures are useful to study the biology and physiology of the urinary tract, particularly for the development of cell-based tissue engineering strategies in urology. This chapter describes methods for the isolation of urothelial cells and their maintenance in monolayer culture, and methods for the production of multilayer urothelial cell sheets and three-dimensional cocultures of urothelial and mesenchymal cells. PMID:23097119

Zhang, Yuanyuan; Atala, Anthony

2013-01-01

344

Clonal, self-renewing and differentiating human and porcine urothelial cells, a novel stem cell population.  

PubMed

Although urothelial progenitor-like cells have been described in the human urinary tract, the existence of stem cells remains to be proven. Using a culture system that favors clonogenic epithelial cell growth, we evaluated and characterized clonal human urothelial cells. We isolated human urothelial cells that were clonogenic, capable of self-renewal and could develop into fully differentiated urothelium once re-implanted into the subcapsular space of nude mice. In addition to final urothelial cell differentiation, spontaneous formation of bladder-like microstructures was observed. By examining an epithelial stem cell signature marker, we found p63 to correlate with the self-renewal capacity of the isolated human urothelial clonal populations. Since a clinically relevant, long-term model for functional reconstitution of human cells does not exist, we sought to establish a culture method for porcine urothelial cells in a clinically relevant porcine model. We isolated cells from porcine ureter, urethra and bladder that were clonogenic and capable of self-renewal and differentiation into fully mature urothelium. In conclusion, we could isolate human and porcine cell populations, behaving as urothelial stem cells and showing clonogenicity, self-renewal and, once re-implanted, morphological differentiation. PMID:24587183

Larsson, Hans M; Gorostidi, Francois; Hubbell, Jeffrey A; Barrandon, Yann; Frey, Peter

2014-01-01

345

Tissue engineering of a genitourinary tubular tissue graft resistant to suturing and high internal pressures.  

PubMed

The aim of this study was to evaluate the possibility of constructing a fully autologous tissue-engineered tubular genitourinary graft (TTGG) and to determine its mechanical and physiological properties. Dermal fibroblasts (DFs) were expanded and cultured in vitro with sodium ascorbate to form fibroblast sheets. The sheets were then wrapped around a tubular support to form a cylinder. After maturation, urothelial cells (UCs) were seeded inside the DF tubes, and the constructs were placed in a bioreactor. The TTGGs were then characterized according to histology, immuno-histochemistry, Western blot, cell viability, resistance to suture, and burst pressure. Results obtained were encouraging on all levels. All layers of the TTGGs had merged, and a pluristratified urothelium coated the luminal surface of the tubes. The burst pressure of non-sutured TTGGs was measured and found to be, on average, three times as resistant as that of porcine urethras. Suturing was accomplished without difficulty. Results have shown that our construct can sustain an entire week of pulsatile stimulation without loss of mechanical or histological integrity. The tissue-engineering technique used to produce this model seems promising for bioengineering a urethra or ureter graft and could open a doorway to new possibilities for their reconstruction. PMID:18759664

Magnan, Martine; Lévesque, Philippe; Gauvin, Robert; Dubé, Jean; Barrieras, Diego; El-Hakim, Assaad; Bolduc, Stéphane

2009-01-01

346

Kidney Stones  

PubMed Central

The prevalence of kidney stones has steadily risen during this century; passage of a calculus and a positive family history increase the probability of recurrence. Findings from recent studies on the cause of renal calculi have stressed crystallization and crystal aggregation of stone minerals from supersaturated urine, rather than excessive organic matrix. Absence of normal urine inhibitors of calcium salts is also stressed. Formation of calcium oxalate stones is the major problem. Therapy with decreased calcium and oxalate intake, thiazides, phosphate salts and allopurinol in various combinations has substantially decreased the prevalence of recurrent stones. The rationale for the use of allopurinol is that uric acid salts enhance the tendency for calcium oxalate to crystallize from supersaturated urine. The hypercalciuria seen in 30 percent to 40 percent of patients with oxalate stones is usually caused by intestinal hyperabsorption of calcium. Although patients with uric acid calculi constitute only a small fraction of those in whom stones form, they represent a group in whom good medical therapy, based on sound physiologic principles, has proved extremely successful. Renal tubular syndromes lead to nephrocalcinosis and lithiasis through hypercalciuria, alkaline urine and hypocitraturia, the latter an inhibitor of calcium salt precipitation. Recent advances in surgical techniques are discussed, including the rationale for removing staghorn calculi. The ileal ureter and coagulum pyelolithotomy deserve special emphasis. ImagesFigure 2.Figure 4.Figure 5.Figure 7. PMID:7385835

Kleeman, Charles R.; Coburn, Jack W.; Brickman, Arnold S.; Lee, David B. N.; Narins, Robert G.; Ehrlich, Richard M.

1980-01-01

347

Radiation-induced endometriosis in Macaca mulatta  

SciTech Connect

Female rhesus monkeys received whole-body doses of ionizing radiation in the form of single-energy protons, mixed-energy protons, X rays, and electrons. Endometriosis developed in 53% of the monkeys during a 17-year period after exposure. Incidence rates for endometriosis related to radiation type were: single-energy protons, 54%; mixed-energy protons, 73%; X rays, 71%; and electrons, 57%. The incidence of endometriosis in nonirradiated control monkeys was 26%. Monkeys exposed to single-energy protons, mixed-energy protons, and X rays developed endometriosis at a significantly higher rate than control monkeys (chi 2, P less than 0.05). Severity of endometriosis was staged as massive, moderate, and minimal. The incidence of these stages were 65, 16, and 19%, respectively. Observations of clinical disease included weight loss in 43% of the monkeys, anorexia in 35%, space-occupying masses detected by abdominal palpation in 55%, abnormal ovarian/uterine anatomy on rectal examination in 89%, and radiographic evidence of abdominal masses in 38%. Pathological lesions were endometrial cyst formation in 69% of the monkeys, adhesions of the colon in 66%, urinary bladder in 50%, ovaries in 86%, and ureters in 44%, focal nodules of endometrial tissue throughout the omentum in 59%, and metastasis in 9%. Clinical management of endometriosis consisted of debulking surgery and bilateral salpingo-oophorectomy combined in some cases with total abdominal hysterectomy. Postoperative survival rates at 1 and 5 years for monkeys recovering from surgery were 48 and 36%, respectively.

Fanton, J.W.; Golden, J.G. (USAF School of Aerospace Medicine, Brooks AFB, TX (USA))

1991-05-01

348

[Can selective alpha-blockers help the spontaneous passage of the stones located in the uretero-bladder junction?].  

PubMed

The majority of ureteral stones at presentation in hospital are located within the distal ureter. Knowing that only half of the stones 4 to 5.9 mm will pass spontaneously, we tried to see: if we can facilitate this elimination for the stones smaller than 8 mm by selectve alpha-blockers (alfuzosin and tamsulosin) which induce relaxation of the smooth muscle of uretrotrigonal area and if there is any difference between these two drugs, concerning efficiency and tolerance. The inclusion criteria for each group were: stone size between 4 and 8 mm--even patients with steinstrasse--and previous, at least 2 weeks of expulsion treatment with nonsteroidal antiinflammatory and antispasmodic agents and Rowatinex. The results were encouraging: almost all the patients eliminated the stones without any pain in the first 5-10 days of treatment (only two patients from alfuzosin group did not tolerate this drug). We believe that both alfuzosin and tamsulosin have a crucial impact in spontaneous painless elimination of the stones smaller than 8 mm located in the uretero-bladder junction. PMID:15688769

Pricop, C; Novac, C; Negru, D; Ilie, Cristina; Pricop, Adriana; T?nase, Veronica

2004-01-01

349

Teratologic evaluation of dermally applied diethylene glycol monomethyl ether in rabbits.  

PubMed

Diethylene glycol monomethyl ether (DEGME) was applied to the skin of pregnant rabbits on Days 6 through 18 of gestation in order to assess the fetotoxic and teratogenic potential by the dermal route. Rabbits were treated with 0, 50, 250, or 750 mg/kg/day of DEGME, and fetuses were examined for external, visceral, and skeletal alterations. Topical application of the highest dose, 750 mg/kg/day, produced slight embryotoxicity, fetotoxicity, and toxicity in the maternal animal. Maternal effects were characterized by decreased weight gain and a concurrent physiologic decrease in red blood cells and packed cell volume values. In addition, a slight increase in embryonic resorptions was observed. The fetal alterations observed, mild forelimb flexure, slight-to-moderate dilation of the renal pelvis, retrocaval ureter, cervical spurs, and delayed ossification of the skull and sternebral bones, are considered to be indicative of fetotoxicity but not teratogenicity. Slight fetotoxicity in the form of delayed ossification of the skull and cervical spurs was seen in the 250 mg/kg/day dose group. No adverse maternal, embryonic, or fetal effects were observed at 50 mg/kg/day. PMID:3732673

Scortichini, B H; John-Greene, J A; Quast, J F; Rao, K S

1986-07-01

350

Damage of Stone Baskets by Endourologic Lithotripters: A Laboratory Study of 5 Lithotripters and 4 Basket Types  

PubMed Central

Background. In some cases, the ureteral stone is simultaneously stabilized by a stone basket when endourologic lithotripsy is performed. This stabilization can be either on purpose or by accident. By accident means that an impaction in the ureter occurs by an extraction of a stone with a basket. A stabilization on purpose means to avoid a retropulsion of the stone into the kidney during lithotripsy. At this part of the operation, stone baskets have been frequently damaged. This severing of wires can lead to ureteral trauma because of hook formation. Material and Methods. In a laboratory setting, the time and the pulse numbers were measured until breaking the wires from four different nitinol stone baskets by using five different lithotripsy devices. The endpoint was gross visibledamage to the wire and loss of electric conduction. Results. The Ho:YAG laser and the ultrasonic device were able to destroy almost all the wires. The ballistic devices and the electrohydraulic device were able to destroy thin wires. Conclusion. The operating surgeon should know the risk of damagefor every lithotripter. The Ho:YAG-laser and the ultrasonic device should be classified as dangerous for the basket wire with all adverse effects to the patient. PMID:24288527

Brinkmann, Ralf; Jocham, Dieter

2013-01-01

351

Do environmental differences between lakes in northwestern Argentinean Patagonia affect the infection of Philureter trigoniopsis (monogenea) in Galaxias maculatus (osmeriformes)?  

PubMed

Philureter trigoniopsis is the only parasite found in the ureters and urinary bladder of Galaxias maculatus in Patagonian Andean lakes. The dynamics of this endoparasitic monogenean were studied in Lake Gutiérrez, a body of water with scarce shoreline vegetation, where the host has an annual cycle of migration to the deep pelagic zone of the lake. To compare variations of the infection related to differences between lakes, G. maculatus specimens were sampled monthly with baited traps from September 1998 to November 1999 in Lake Moreno, which is an oligotrophic body of water with emergent shoreline vegetation and where the fish do not migrate to the deep pelagic areas of the lake. In addition, data for summer infections of P. trigoniopsis from 10 Andean Patagonian lakes that differ in aquatic vegetation, depth, and area were compared. In Lake Moreno prevalence of P. trigoniopsis showed a seasonal pattern, with 1-yr-old fish exhibiting the highest values of prevalence and mean intensity. Negative correlations between water temperature and prevalence and between age of fish and abundance were found. Our results suggest that age of fish may be the main factor structuring the distribution of P. trigoniosis in populations of G. maculatus. At the regional level the relationship between the infection and the characteristics of the lakes was also observed, with prevalence and mean intensity of P. trigoniopsis in G. maculatus higher in large deep lakes without macrophytes. PMID:18576893

Viozzi, G P; Semenas, L G

2009-02-01

352

[Urinary diversion using a Maizels catheter (K.I.S.S.S.) in pyeloplasty].  

PubMed

The increasing interest and progress showed by the surgical treatment of the ureteropelvic junction obstruction, have evidenced some problems that have not completely solved. Problem in which there is division in opinion concerns the role of splinting with or without nephrostomy in pyeloplasty. A strong impulse for proximal urinary diversion after pyeloplasty derived from data provided by Caine and Hermann (1), who have demonstrated in cineradiographic studies that the normal ureteral peristalsis did not return for about 3 weeks after anastomosis. The authors, who use systematically urinary diversion in pyeloplasty, emphasize the usefulness of the Kidney Internal Stent Splint Set (K.I.S.S.S.). This device developed by Max Maizels, From Children's Memorial Hospital Chicago USA, is employed after pyeloplasty, when kidney drainage is mandatory for the success of the procedure. The set contains: sof-flex stent, 55 cm. long: closed segment 25 cm. long, with 12 cm. malleable tapered positioning stylet; "cut-out" segment 30 cm. long. Silicone retention disc with pull-tie; Luer-lock adapter; 10 Fr. polyvinylchloride connecting tube 30 cm long. Introduction with the malleable stylet is the same as a nephrostomy interoperatively placed. The closed portion of the stent is sutured with adsorbable suture to the renal capsule and is performed as a nephrostomy drainage catheter. The "cut-out" portion is advanced interoperatively into the ureter. The K.I.S.S.S. explains essentially a twofold function: first to defend the neo-anastomosis, secondly like a nephrostomy drainage. PMID:8330059

Bono, P; Pozzi, E; De Francesco, O; Broggini, P; Roggia, A

1993-04-01

353

Percutaneous Nephroscopic Surgery  

PubMed Central

With the development of techniques for percutaneous access and equipment to disintegrate calculi, percutaneous nephroscopic surgery is currently used by many urologists and is the procedure of choice for the removal of large renal calculi and the management of diverticula, intrarenal strictures, and urothelial cancer. Although it is more invasive than shock wave lithotripsy and retrograde ureteroscopic surgery, percutaneous nephroscopic surgery has been successfully performed with high efficiency and low morbidity in difficult renal anatomies and patient conditions. These advantages of minimal invasiveness were rapidly perceived and applied to the management of ureteropelvic junction obstruction, calyceal diverticulum, infundibular stenosis, and urothelial cancer. The basic principle of endopyelotomy is a full-thickness incision of the narrow segment followed by prolonged stenting and drainage to allow regeneration of an adequate caliber ureter. The preferred technique for a calyceal diverticulum continues to be debated. Excellent long-term success has been reported with percutaneous, ureteroscopic, and laparoscopic techniques. Each approach is based on the location and size of the diverticulum. So far, percutaneous ablation of the calyceal diverticulum is the most established minimally invasive technique. Infundibular stenosis is an acquired condition usually associated with inflammation or stones. Reported series of percutaneously treated infundibular stenosis are few. In contrast with a calyceal diverticulum, infundibular stenosis is a more difficult entity to treat with only a 50-76% success rate by percutaneous techniques. Currently, percutaneous nephroscopic resection of transitional cell carcinoma in the renal calyx can be applied in indicated cases. PMID:20495691

2010-01-01

354

Tbx18 is essential for normal development of vasculature network and glomerular mesangium in the mammalian kidney.  

PubMed

Tbx18 has been shown to be essential for ureteral development. However, it remains unclear whether it plays a direct role in kidney development. Here we addressed this by focusing on examining the pattern and contribution of Tbx18+ cells in the kidney and its role in kidney vascular development. Expression studies and genetic lineage tracing revealed that Tbx18 is expressed in renal capsule, vascular smooth muscle cells and pericytes and glomerular mesangial cells in the kidney and that Tbx18-expressing progenitors contribute to these cell types. Examination of Tbx18(-/-) kidneys revealed large reduction in vasculature density and dilation of glomerular capillary loops. While SMA+ cells were reduced in the mutant, PDGFR?+ cells were seen in early capillary loop renal corpuscles in the mutant, but fewer than in the controls, and further development of the mesangium failed. Analysis of kidney explants cultured from E12.5 excluded the possibility that the defects observed in the mutant were caused by ureter obstruction. Reduced proliferation in glomerular tuft and increased apoptosis in perivascular mesenchyme were observed in Tbx18(-/-) kidneys. Thus, our analyses have identified a novel role of Tbx18 in kidney vasculature development. PMID:24727670

Xu, Jinshu; Nie, Xuguang; Cai, Xiaoqiang; Cai, Chen-Leng; Xu, Pin-Xian

2014-07-01

355

Retroperitoneal fibrosis associated with propranolol: a case report; is corticosteroid administration necessary after ureterolysis?  

PubMed Central

Introduction: Retroperitoneal fibrosis is a rare disease. It can be primary (Ormond’s disease) or secondary to inflammation, malignancy or some drugs. Beta-adrenergic blockers including propranolol can cause the retroperitoneal fibrosis disease. Case: A 44-year-old woman who was taking propranolol for 13 years came to our center with complaints of oliguria and uremia symptoms (malaise, nausea and vomiting). After some investigations, it was found that the disease was retroperitoneal fibrosis. In the first step, she was treated with corticosteroids and then because of inadequate response, bilateral ureterolysis was performed. Then, an additional course of corticosteroid therapy was required after surgery. Conclusion: Retroperitoneal fibrosis is an unknown cause disease that can involve ureters and can cause obstructive symptoms. The imaging procedure of choice for diagnosis is abdominal CT scanning with oral and intravenous contrast agents. Corticosteroids are the first option for treatment, however, if they are not effective and in case of severe obstruction, ureterolysis can be performed. Beta- adrenergic blocker drugs that are widely used in heart diseases can be a cause of retroperitoneal fibrosis. PMID:25340131

Shirani, Majid; Davoudian, Azadeh; Sharifi, Abolghasem

2013-01-01

356

Iron chelation by deferoxamine prevents renal interstitial fibrosis in mice with unilateral ureteral obstruction.  

PubMed

Renal fibrosis plays an important role in the onset and progression of chronic kidney diseases (CKD). Although several mechanisms underlying renal fibrosis and candidate drugs for its treatment have been identified, the effect of iron chelator on renal fibrosis remains unclear. In the present study, we examined the effect of an iron chelator, deferoxamine (DFO), on renal fibrosis in mice with surgically induced unilateral ureter obstruction (UUO). Mice were divided into 4 groups: UUO with vehicle, UUO with DFO, sham with vehicle, and sham with DFO. One week after surgery, augmented renal tubulointerstitial fibrosis and the expression of collagen I, III, and IV increased in mice with UUO; these changes were suppressed by DFO treatment. Similarly, UUO-induced macrophage infiltration of renal interstitial tubules was reduced in UUO mice treated with DFO. UUO-induced expression of inflammatory cytokines and extracellular matrix proteins was abrogated by DFO treatment. DFO inhibited the activation of the transforming growth factor-?1 (TGF-?1)-Smad3 pathway in UUO mice. UUO-induced NADPH oxidase activity and p22(phox) expression were attenuated by DFO. In the kidneys of UUO mice, divalent metal transporter 1, ferroportin, and ferritin expression was higher and transferrin receptor expression was lower than in sham-operated mice. Increased renal iron content was observed in UUO mice, which was reduced by DFO treatment. These results suggest that iron reduction by DFO prevents renal tubulointerstitial fibrosis by regulating TGF-?-Smad signaling, oxidative stress, and inflammatory responses. PMID:24586712

Ikeda, Yasumasa; Ozono, Iori; Tajima, Soichiro; Imao, Mizuki; Horinouchi, Yuya; Izawa-Ishizawa, Yuki; Kihira, Yoshitaka; Miyamoto, Licht; Ishizawa, Keisuke; Tsuchiya, Koichiro; Tamaki, Toshiaki

2014-01-01

357

Activation of platelet-activating factor receptor exacerbates renal inflammation and promotes fibrosis.  

PubMed

Platelet-activating factor (PAF) is a lipid mediator with important pro-inflammatory effects, being synthesized by several cell types including kidney cells. Although there is evidence of its involvement in acute renal dysfunction, its role in progressive kidney injury is not completely known. In the present study, we investigated the role of PAF receptor (PAFR) in an experimental model of chronic renal disease. Wild-type (WT) and PAFR knockout (KO) mice underwent unilateral ureter obstruction (UUO), and at kill time, urine and kidney tissue was collected. PAFR KO animals compared with WT mice present: (a) less renal dysfunction, evaluated by urine protein/creatinine ratio; (b) less fibrosis evaluated by collagen deposition, type I collagen, Lysyl Oxidase-1 (LOX-1) and transforming growth factor ? (TGF-?) gene expression, and higher expression of bone morphogenetic protein 7 (BMP-7) (3.3-fold lower TGF-?/BMP-7 ratio); (c) downregulation of extracellular matrix (ECM) and adhesion molecule-related machinery genes; and (d) lower levels of pro-inflammatory cytokines. These indicate that PAFR engagement by PAF or PAF-like molecules generated during UUO potentiates renal dysfunction and fibrosis and might promote epithelial-to-mesenchymal transition (EMT). Also, early blockade of PAFR after UUO leads to a protective effect, with less fibrosis deposition. In conclusion, PAFR signaling contributes to a pro-inflammatory environment in the model of obstructive nephropathy, favoring the fibrotic process, which lately will generate renal dysfunction and progressive organ failure. PMID:24492283

Correa-Costa, Matheus; Andrade-Oliveira, Vinicius; Braga, Tarcio T; Castoldi, Angela; Aguiar, Cristhiane F; Origassa, Clarice S T; Rodas, Andrea C D; Hiyane, Meire I; Malheiros, Denise M A C; Rios, Francisco J O; Jancar, Sonia; Câmara, Niels O S

2014-04-01

358

Nlrp3 prevents early renal interstitial edema and vascular permeability in unilateral ureteral obstruction.  

PubMed

Progressive renal disease is characterized by tubulo-interstitial injury with ongoing inflammation and fibrosis. The Nlrp3 inflammasome contributes to these pathophysiological processes through its canonical effects in cytokine maturation. Nlrp3 may additionally exert inflammasome-independent effects following tissue injury. Hence, in this study we investigated potential non-canonical effects of Nlrp3 following progressive renal injury by subjecting WT and Nlrp3-deficient (-/-) mice to unilateral ureter obstruction (UUO). Our results revealed a progressive increase of renal Nlrp3 mRNA in WT mice following UUO. The absence of Nlrp3 resulted in enhanced tubular injury and dilatation and an elevated expression of injury biomarker NGAL after UUO. Moreover, interstitial edema was significantly elevated in Nlrp3-/- mice. This could be explained by increased intratubular pressure and an enhanced tubular and vascular permeability. In accordance, renal vascular leakage was elevated in Nlrp3-/- mice that associated with reduced mRNA expression of intercellular junction components. The decreased epithelial barrier function in Nlrp3-/- mice was not associated with increased apoptosis and/or proliferation of renal epithelial cells. Nlrp3 deficiency did not affect renal fibrosis or inflammation. Together, our data reveal a novel non-canonical effect of Nlrp3 in preserving renal integrity and protection against early tubular injury and interstitial edema following progressive renal injury. PMID:24454932

Pulskens, Wilco P; Butter, Loes M; Teske, Gwendoline J; Claessen, Nike; Dessing, Mark C; Flavell, Richard A; Sutterwala, Fayyaz S; Florquin, Sandrine; Leemans, Jaklien C

2014-01-01

359

Alpha-Lipoic Acid Attenuates Renal Injury in Rats with Obstructive Nephropathy  

PubMed Central

This study was established to determine the possible protective effects of alpha-lipoic acid (ALA), a powerful antioxidant, on renal injury in obstructive nephropathy. Male Sprague-Dawley rats were assigned into sham-operated unilateral ureteral obstruction (UUO) and UUO treated with ALA groups. ALA 60?mg/kg was injected intraperitoneally 2 days before UUO induction and continued afterward for 7 days. Renal function, oxidative stress markers, nitric oxide, transforming growth factor-1 (TGF-?1), and histological changes were evaluated at the end of the experiment. Obstruction of the ureter resulted in renal dysfunction as indicated by significant increases in blood urea nitrogen and serum creatinine. Nonobstructed contralateral kidneys in all groups examined did not show any morphological or biochemical alterations. In untreated UUO group, the obstructed kidney developed marked hydronephrosis, leukocyte infiltration, and severe interstitial fibrosis. These functional and structural changes were associated with significant increases in tissue levels of malondialdehyde, nitric oxide, and TGF-?1 but decreases in reduced glutathione and total antioxidant capacity. Pretreatment with ALA significantly minimized all the changes elicited by ureteral obstruction. These findings demonstrate that ALA supplementation attenuates renal injury in rats with obstructive nephropathy and further suggest that oxidative stress inhibition is likely to be involved in the beneficial effects of this compound. PMID:24288661

Leelarungrayub, Dolrawee; Thamprasert, Kamthorn

2013-01-01

360

Proteoglycan metabolism associated with mouse metanephric development: morphologic and biochemical effects of beta-D-xyloside  

SciTech Connect

Morphology and de novo incorporation of (/sup 35/S)sulfate into proteoglycans were studied in fetal mouse kidneys at the onset of organogenesis. Branching morphogenesis and nephron development in organ culture and in vivo were associated with de novo synthesis of chondroitin-SO/sub 4/ and heparan-SO/sub 4/ proteoglycans. The role of proteoglycan metabolism in metanephrogenesis was then studied by analysis of the effects of p-nitrophenyl-beta-D-xylopyranoside (beta-D-xyloside) on renal development and proteoglycan metabolism. Incubation of fetal kidneys in beta-D-xyloside at concentrations of 1.0 and 0.5 mM, but not at 0.1 mM, caused inhibition of ureteric branching and markedly diminished synthesis of a large Mr 2.0 X 10(6) Da chondroitin-SO/sub 4/ proteoglycan. Incorporation of (/sup 35/S)sulfate was stimulated at all beta-D-xyloside concentrations, reflecting synthesis of xyloside initiated dermatan-/sup 35/SO/sub 4/ chains. In contrast to dramatic effects on chondroitin-SO/sub 4/ synthesis and ureteric branching, beta-D-xyloside had no effect on heparan-SO/sub 4/ synthesis or on development of the glomerulus and glomerular basement membrane. We thus characterize the proteoglycans synthesized early in the course of renal organogenesis and describe observations which suggest an association between metabolism of chondroitin-SO/sub 4/ proteoglycan and development of the ureter.

Platt, J.L.; Brown, D.M.; Granlund, K.; Oegema, T.R.; Klein, D.J.

1987-10-01

361

Holmium Laser Incision Technique for Ureteral Stricture Using a Small-Caliber Ureteroscope  

PubMed Central

Background and Objectives: The holmium laser has a short absorption depth in tissue and possesses excellent properties both in ablation and hemostasis. We have performed endoscopic incision for ureteral stricture using the holmium laser through a small-caliber ureteroscope. Methods: This method was used on five patients and seven ureters. The etiology of the stricture was stone scar in two patients, ureteroenteroanastomosis of Indiana urinary pouch in two, and primary in one. We used an 8F semi-rigid or 6.9F flexible ureteroscope. No prior procedures, such as balloon dilation, were necessary in any of the cases. The stricture was incised with the holmium laser using a 365-?m fiber through the working channel of the ureteroscope. The holmium laser operated at a wavelength of 2100 nm, with an output of 1.0J/pulse at a rate of 10 Hz. After completion of the incision, a 12F Double-J catheter was left in for six weeks. Results: The mean operative time was 89 minutes. The stricture resolved completely in all cases at an average follow-up of 8.6 months. Conclusions: The holmium laser incision for ureteral stricture using a small-caliber ureteroscope is an easy-to-perform, safe and effective procedure. PMID:10987397

Mitsui, Kenji; Taki, Tomohiro; Mizumoto, Hiroyuki; Yoshiaki, Yamamda; Honda, Nobuaki; Fukatsu, Hidetoshi

2000-01-01

362

Aberrant differentiation of urothelial cells in patients with ureteropelvic junction obstruction  

PubMed Central

Aim: To investigate the urothelial changes in the pathogenesis of ureteropelvic junction obstruction (UPJ-O). Methods: A total of 12 patients of UPJ-O were respectively studied. The expression of Annexin A7, Annexin A11, EGFR, Keratin 5, uroplakin III, and SMA in the urothelium of obstructed UPJ segment and of the normal ureter below the obstructed segment were determined by immunofluorescence. Transmission electron microscopy was used to determine the morphological changes in UPJ epithelium in compared to normal ureteral epithelium. Results: We found that Annexin A7, Annexin A11, EGFR, Keratin 5, and SMA were upregulated, while uroplakin III was downregulated in the urothelium of UPJ-O patients. Furthermore, ultrastructural analyses showed that intercellular spaces between urothelial cells were dilated and the number of microvilli on superficial cells was increased in UPJ-O patients. Conclusions: We propose that a disrupted urothelial barrier in UPJ-O may results in urothelial inflammatory response and truncated differentiated urothelial cells, which may play an important role in the development and pathogenesis of UPJO.

Hou, Teng; Yang, Xiong; Hai, Bo; Li, Bing; Li, Wencheng; Pan, Feng; Chen, Min; Zeng, Fuqing; Han, Xiaomin

2014-01-01

363

Pulmonary Embolism with Abdominal Pain and ST Elevation: A Case Report  

PubMed Central

Pulmonary embolism is considered as a great masquerader due to its frequent nonspecific signs and symptoms. Typically pulmonary embolism is under-diagnosed or over-diagnosed. In this study a patient with pulmonary embolism is reported in which the patient exhibited two unusual manifestations namely; right upper quadrant abdominal pain and ST-T elevation in anterior precordial leads. Due to the fact that the patient did not display typical pulmonary embolism symptoms and its major risk factors, extensive workup to discern the cause was carried out. The examination included abdominal sonography, kidney ureter and bladder Computed Tomography scan (CT-scan) and coronary angiography. Eventually after a six-day delay, pulmonary embolism was diagnosed by spiral chest CT scan. This case and several other similar reports underlines the fact that while various other common causes may exist for right upper abdominal pain, one should always consider pulmonary embolism as a possible cause especially when backed up with ECG finding. PMID:25031494

Fallahi, Mohammad Javad; Masoompour, Seyed Masoom; Mirzaee, Mehdi

2014-01-01

364

Do New Vessel Sealing Devices and Harmonic Ace Increase Ureteric Injury in Total Laparoscopic Hysterectomy?  

PubMed Central

Objectives: To compare the risk of ureteric injury in total laparoscopic hysterectomy (TLH) using new vessel sealing devices (VSDs) and harmonic scalpel with simple scissors, bipolar and suturing. This was an evaluation of 1209 cases, carried out from May 1999 to April 2010. Design and Setting: A retrospective comparative study was carried out at a tertiary gynecological endoscopic unit. Materials and Methods: Out of 1209 patients, who had hysterectomies for various indications, TLH was done in 892 patients, 273 had vaginal hysterectomy and 44 had abdominal hysterectomy. We evaluated the incidence of ureteric injury in these cases. Results: There was no mortality. In the group of vaginal and abdominal hysterectomy, there were no ureteric injuries. In the TLH group, we had 390 cases with simple scissors, bipolar and suturing with no ureteric injury. In 502 cases, new VSDs, e.g., plasma kinetic gyrus, Martin Maxim with Robi grasper, with or without harmonic 5 mm scalpel/ace were used. There were five ureteric injuries, all on the right side (one double ureter): first case was with Martin Maxim and Robi grasper, two with plasma kinetic gyrus 10 mm trissector, one with harmonic scalpel and the last one with scissors. We evaluated the reasons for such ureteric injuries, with experienced laparoscopic surgeons and the best possible set up. There were seven conversions to open surgery out of 892 cases of TLH, more due to poor case selection. PMID:22442518

Trivedi, Prakash; D'Costa, Sylvia; Shirkande, Preeti; Wahi, Meenu; Kumar, Shilpi

2009-01-01

365

Bitter triggers acetylcholine release from polymodal urethral chemosensory cells and bladder reflexes.  

PubMed

Chemosensory cells in the mucosal surface of the respiratory tract ("brush cells") use the canonical taste transduction cascade to detect potentially hazardous content and trigger local protective and aversive respiratory reflexes on stimulation. So far, the urogenital tract has been considered to lack this cell type. Here we report the presence of a previously unidentified cholinergic, polymodal chemosensory cell in the mammalian urethra, the potential portal of entry for bacteria and harmful substances into the urogenital system, but not in further centrally located parts of the urinary tract, such as the bladder, ureter, and renal pelvis. Urethral brush cells express bitter and umami taste receptors and downstream components of the taste transduction cascade; respond to stimulation with bitter (denatonium), umami (monosodium glutamate), and uropathogenic Escherichia coli; and release acetylcholine to communicate with other cells. They are approached by sensory nerve fibers expressing nicotinic acetylcholine receptors, and intraurethral application of denatonium reflexively increases activity of the bladder detrusor muscle in anesthetized rats. We propose a concept of urinary bladder control involving a previously unidentified cholinergic chemosensory cell monitoring the chemical composition of the urethral luminal microenvironment for potential hazardous content. PMID:24843119

Deckmann, Klaus; Filipski, Katharina; Krasteva-Christ, Gabriela; Fronius, Martin; Althaus, Mike; Rafiq, Amir; Papadakis, Tamara; Renno, Liane; Jurastow, Innokentij; Wessels, Lars; Wolff, Miriam; Schütz, Burkhard; Weihe, Eberhard; Chubanov, Vladimir; Gudermann, Thomas; Klein, Jochen; Bschleipfer, Thomas; Kummer, Wolfgang

2014-06-01

366

A proliferation-dependent bystander effect in primary porcine and human urothelial explants in response to targeted irradiation.  

PubMed

The aim of this study was to test whether radiation-induced bystander effects are involved in the response of multicellular systems to targeted irradiation. A primary explant technique was used that reconstructed the in vivo microarchitecture of normal urothelium with proliferating and differentiated cells present. Sections of human and porcine ureter were cultured as explants and irradiated on day 7 when the urothelial outgrowth formed a halo around the tissue fragment. The Gray Cancer Institute charge particle microbeam facility allowed the irradiation of individual cells within the explant outgrowth with a predetermined exact number of (3)He(2+) ions (which have very similar biological effectiveness to alpha-particles). A total of 10 individual cell nuclei were irradiated with 10 (3)He(2+) ions either on the periphery, where proliferating cells are located, or at the centre of the explant outgrowth, which consisted of terminally differentiated cells. Samples were fixed 3 days after irradiation, stained and scored. The fraction of apoptotic and micronucleated cells was measured and a significant bystander-induced damage was observed. Approximately 2000-6000 cells could be damaged by the irradiation of a few cells initially, suggesting a cascade mechanism of cell damage induction. However, the fraction of micronucleated and apoptotic cells did not exceed 1-2% of the total number of the cells within the explant outgrowth. It is concluded that the bystander-induced damage depends on the proliferation status of the cells and can be observed in an in vitro explant model. PMID:12618888

Belyakov, O V; Folkard, M; Mothersill, C; Prise, K M; Michael, B D

2003-03-10

367

Obstructive uropathy and acute renal failure due to ureteral calculus in renal graft: a case report  

PubMed Central

Introduction Obstructive uropathy caused by kidney stones is quite rare in transplant kidneys. Clinical case The authors report the case of a patient, previously gastrectomized for gastric carcinoma. He underwent renal transplantation using uretero-ureterostomy, and presented an episode of acute renal failure 7 years after surgery. Ultrasound (US) examination showed no sign of rejection but allowed detection of moderate hydronephrosis in the transplant kidney. Subsequent computed tomography (CT) revealed a kidney stone in the middle ureter at the crossing of the iliac vessels. The patient therefore urgently underwent percutaneous nephrostomy of the graft and recovered diuresis and renal function. The patient was transferred to the Transplant Center where he underwent ureterotomy with removal of the stone and subsequent ureteropyelostomy. Also transureteral resection of the prostate (TURP) was performed due to urinary retention of prostatic origin. Histological examination showed prostate carcinoma, Gleason stage 3, which was treated conservatively using radiotherapy without suspension of the administered low dose of immunotherapy. Discussion Calculosis is one of the least common causes of obstructive uropathy in transplant kidneys. In the described case, US examination performed after onset of renal insufficiency led to subsequent radiological investigation and resulting interventional procedures (nephrostomy and surgical removal of the stone) with complete recovery of pre-existing renal function. PMID:23397045

Lusenti, T.; Fiorini, F.; Barozzi, L.

2009-01-01

368

Interleukin-12 and Trastuzumab in Treating Patients With Cancer That Has High Levels of HER2/Neu  

ClinicalTrials.gov

Advanced Adult Primary Liver Cancer; Anaplastic Thyroid Cancer; Bone Metastases; Carcinoma of the Appendix; Distal Urethral Cancer; Fallopian Tube Cancer; Gastrinoma; Glucagonoma; Inflammatory Breast Cancer; Insulinoma; Liver Metastases; Localized Unresectable Adult Primary Liver Cancer; Lung Metastases; Male Breast Cancer; Malignant Pericardial Effusion; Malignant Pleural Effusion; Metastatic Gastrointestinal Carcinoid Tumor; Metastatic Parathyroid Cancer; Metastatic Transitional Cell Cancer of the Renal Pelvis and Ureter; Newly Diagnosed Carcinoma of Unknown Primary; Occult Non-small Cell Lung Cancer; Pancreatic Polypeptide Tumor; Primary Peritoneal Cavity Cancer; Proximal Urethral Cancer; Pulmonary Carcinoid Tumor; Recurrent Adenoid Cystic Carcinoma of the Oral Cavity; Recurrent Adrenocortical Carcinoma; Recurrent Adult Primary Liver Cancer; Recurrent Anal Cancer; Recurrent Bladder Cancer; Recurrent Breast Cancer; Recurrent Carcinoma of Unknown Primary; Recurrent Cervical Cancer; Recurrent Colon Cancer; Recurrent Endometrial Carcinoma; Recurrent Esophageal Cancer; Recurrent Extrahepatic Bile Duct Cancer; Recurrent Gallbladder Cancer; Recurrent Gastric Cancer; Recurrent Gastrointestinal Carcinoid Tumor; Recurrent Islet Cell Carcinoma; Recurrent Malignant Testicular Germ Cell Tumor; Recurrent Mucoepidermoid Carcinoma of the Oral Cavity; Recurrent Non-small Cell Lung Cancer; Recurrent Ovarian Epithelial Cancer; Recurrent Pancreatic Cancer; Recurrent Parathyroid Cancer; Recurrent Prostate Cancer; Recurrent Rectal Cancer; Recurrent Renal Cell Cancer; Recurrent Salivary Gland Cancer; Recurrent Small Intestine Cancer; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Thyroid Cancer; Recurrent Transitional Cell Cancer of the Renal Pelvis and Ureter; Recurrent Urethral Cancer; Recurrent Vaginal Cancer; Recurrent Vulvar Cancer; Skin Metastases; Small Intestine Adenocarcinoma; Somatostatinoma; Stage III Adenoid Cystic Carcinoma of the Oral Cavity; Stage III Adrenocortical Carcinoma; Stage III Bladder Cancer; Stage III Cervical Cancer; Stage III Colon Cancer; Stage III Endometrial Carcinoma; Stage III Esophageal Cancer; Stage III Follicular Thyroid Cancer; Stage III Gastric Cancer; Stage III Malignant Testicular Germ Cell Tumor; Stage III Mucoepidermoid Carcinoma of the Oral Cavity; Stage III Ovarian Epithelial Cancer; Stage III Pancreatic Cancer; Stage III Papillary Thyroid Cancer; Stage III Prostate Cancer; Stage III Rectal Cancer; Stage III Renal Cell Cancer; Stage III Salivary Gland Cancer; Stage III Squamous Cell Carcinoma of the Larynx; Stage III Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage III Squamous Cell Carcinoma of the Nasopharynx; Stage III Squamous Cell Carcinoma of the Oropharynx; Stage III Vaginal Cancer; Stage III Vulvar Cancer; Stage IIIA Anal Cancer; Stage IIIA Breast Cancer; Stage IIIA Non-small Cell Lung Cancer; Stage IIIB Anal Cancer; Stage IIIB Breast Cancer; Stage IIIB Non-small Cell Lung Cancer; Stage IV Adenoid Cystic Carcinoma of the Oral Cavity; Stage IV Adrenocortical Carcinoma; Stage IV Anal Cancer; Stage IV Bladder Cancer; Stage IV Breast Cancer; Stage IV Colon Cancer; Stage IV Endometrial Carcinoma; Stage IV Esophageal Cancer; Stage IV Follicular Thyroid Cancer; Stage IV Gastric Cancer; Stage IV Mucoepidermoid Carcinoma of the Oral Cavity; Stage IV Non-small Cell Lung Cancer; Stage IV Ovarian Epithelial Cancer; Stage IV Pancreatic Cancer; Stage IV Papillary Thyroid Cancer; Stage IV Prostate Cancer; Stage IV Rectal Cancer; Stage IV Renal Cell Cancer; Stage IV Salivary Gland Cancer; Stage IV Squamous Cell Carcinoma of the Larynx; Stage IV Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IV Squamous Cell Carcinoma of the Nasopharynx; Stage IV Squamous Cell Carcinoma of the Oropharynx; Stage IVA Cervical Cancer; Stage IVA Vaginal Cancer; Stage IVB Cervical Cancer; Stage IVB Vaginal Cancer; Stage IVB Vulvar

2013-02-27

369

Alternatives to Conventional Enterocystoplasty in Children: A Critical Review of Urodynamic Outcomes  

PubMed Central

Alternatives to conventional enterocystoplasty have been developed in order to avoid the most common complications derived from contact of the urine with intestinal mucosa. In this article critically we review the literature on the topics: ureterocystoplasty, detrusorectomy, detrusorotomy, seromuscular gastroenterocystoplasty, use of off the shelf biomaterials, and bladder augmentation by bioengineering. Recognizing the difficulty of deciding when a child with a history of posterior urethral valves requires and augmentation and that the development of a large megaureter in cases of neurogenic dysfunction represents a failure of initial treatment, we conclude that ureterocystoplasty can be useful in selected cases when a large dilated ureter is available. Seromuscular colocystoplasty lined with urothelium (SCLU) has been urodynamically effective in several series when the outlet resistance is high and no additional intravesical procedures are necessary. Seromuscular gastrocystoplasty lined with urothelium seems to offer no distinct advantages and involves a much more involved operation. The use of seromuscular segments without urothelial preservation, with or without the use of an intravesical balloon has been reported as successful in two centers but strict urodynamic evidence of its effectiveness is lacking. The published evidence argues strongly against the use of detrusorectomy or detrusorotomy alone because of the lack of significant urodynamic benefits. Two recent reports discourage the use of small intestinal submucosa patches because of a high failure rate. Finally, research into the development of a bioengineered bladder constructed with cell harvested from the same patient continues but is fraught with technical and conceptual problems. In conclusion of the methods reviewed, only ureterocystoplasty and SCLU have been proven urodynamically effective and reproducible. PMID:24400271

Gonzalez, Ricardo; Ludwikowski, Barbara M.

2013-01-01

370

Characteristics of adherence of enteroaggregative Escherichia coli to human and animal mucosa.  

PubMed Central

An Escherichia coli strain (serotype O127a:H2) that had been isolated from a child with diarrhea in Thailand and that was negative for the virulence factors of the four categories of diarrheagenic E. coli (enterotoxigenic, enteropathogenic, enteroinvasive, and enterohemorrhagic) and that showed an aggregative pattern of adherence to HeLa cells was investigated for adherence to native or Formalin-fixed human and animal mucosa. The hemagglutinating activity and adherence ability of the bacteria were resistant to D-mannose and were strictly regulated by environmental conditions. Genetic data supported the close relation between the hemagglutinating activity and adherence ability. In accordance with the adherence pattern on tissue-cultured cells, the bacteria adhered to human and animal mucosa, as evidenced by a direct gold-labeling analysis. In human intestines, Formalin-fixed mucous coatings, epithelial cells of colonic mucosa, epithelial cells of ileal single lymphoid follicles and Peyer's patches, and the absorptive cells of jejunal or ileal villi provided adherence targets. Adherence to M cells in the Peyer's patch-associated epithelium was also confirmed. The adherence levels to native jejunal or ileal human villi were low, as was the case with the corresponding Formalin-fixed villi. In human urinary tract, the superficial epithelial cells of both native and Formalin-fixed ureter provided striking adherence targets. In animal (porcine and rabbit) small intestines, the bacteria adhered to the native villi to a lesser extent than to the Formalin-fixed villi. The adherence levels were compared with those of enterotoxigenic E. coli with colonization factor antigen (CFA)/I pili or CFA/II pili. The data suggested unique mucosa adherence characteristics of the enteroaggregative E. coli strain. The possibility of the adherence ability as a virulence factor was discussed. Images PMID:1680107

Yamamoto, T; Endo, S; Yokota, T; Echeverria, P

1991-01-01

371

Pax8, a murine paired box gene expressed in the developing excretory system and thyroid gland.  

PubMed

Several mouse genes designated 'Pax genes' contain a highly conserved DNA sequence homologous to the paired box of Drosophila. Here we describe the isolation of Pax8, a novel paired box containing clone from an 8.5 day p.c. mouse embryo cDNA library. An open reading frame of 457 amino acids (aa) contains the 128 aa paired domain near the amino terminus. Another conserved region present in some other paired box genes, the octapeptide Tyr-Ser-Ile-Asn-Gly-Leu-Leu-Gly, is located 43 aa C-terminal to the paired domain. Using an interspecies backcross system, we have mapped the Pax8 gene within the proximal portion of mouse chromosome 2 in a close linkage to the surf locus. Several developmental mutations are located in this region. In situ hybridization was used to determine the pattern of Pax8 expression during mouse embryogenesis. Pax8 is expressed transiently between 11.5 and 12.5 days of gestation along the rostrocaudal axis extending from the myelencephalon throughout the length of the neural tube, predominantly in two parallel regions on either side of the basal plate. We also detected Pax8 expression in the developing thyroid gland beginning at 10.5 days of gestation, during the thyroid evagination. In the mesonephros and metanephros the expression of Pax8 was localized to the mesenchymal condensations, which are induced by the nephric duct and ureter, respectively. These condensations develop to functional units, the nephrons, of the kidney. These data are consistent with a role for Pax8 in the induction of kidney epithelium. The embryonic expression pattern of Pax8 is compared with that of Pax2, another recently described paired box gene expressed in the developing excretory system. PMID:1723950

Plachov, D; Chowdhury, K; Walther, C; Simon, D; Guenet, J L; Gruss, P

1990-10-01

372

Predicting Factors for Stent Failure-Free Survival in Patients With a Malignant Ureteral Obstruction Managed With Ureteral Stents  

PubMed Central

Purpose To determine predictive factors for stent failure-free survival in patients treated with a retrograde ureteral stent for a malignant ureteral obstruction. Materials and Methods We retrospectively reviewed 71 patients who underwent insertion of a cystoscopic ureteral stent due to a malignant ureteral obstruction between May 2004 and June 2011. Performance status, type of cancer, hydronephrosis grade, location of the obstruction, presence of bladder invasion, C-reactive protein (CRP), serum albumin, and inflammation-based prognostic score (Glasgow prognostic score, GPS) were assessed using a Cox proportional regression hazard model as predicting factors for stent failure. Results A univariate analysis indicted that hypoalbuminemia (<3.5 g/dL; hazard ratio [HR], 2.43; 95% confidence interval [CI], 1.21 to 4.86; p=0.012), elevated CRP (?1 mg/dL; HR, 4.79; 95% CI, 2.0 to 11.1; p=0.001), and presence of a distal ureter obstruction (HR, 3.27; 95% CI, 1.19 to 8.95; p=0.021) were associated with stent failure-free survival. A multivariate analysis revealed that the presence of a mid and lower ureteral obstruction (HR, 3.27; 95% CI, 1.19 to 8.95; p=0.007), GPS ?1 (HR, 7.22; 95% CI, 2.89 to 18.0; p=0.001), and elevated serum creatinine before ureteral stent placement (>1.2 mg/dL; HR, 2.16; 95% CI, 1.02 to 4.57; p=0.044) were associated with stent failure-free survival. Conclusions A mid or lower ureteral obstruction, GPS ?1, and serum creatinine before ureteral stent insertion >1.2 mg/dL were unfavorable predictors of stent failure-free survival. These factors may help urologists predict survival time. PMID:23700497

Yu, Seong Hyeon; Ryu, Je Guk; Jeong, Se Heon; Jang, Won Seok; Hwang, In Sang; Yu, Ho Song; Kim, Sun-Ouck; Jung, Seung Il; Kang, Taek Won; Kwon, Dong Deuk; Park, Kwangsung; Hwang, Jun Eul; Kim, Geun Soo

2013-01-01

373

Commentary on "tissue-specific mutagenesis by N-butyl-N-(4-hydroxybutyl) nitrosamine as the basis for urothelial cell carcinogenesis." He Z, Kosinska W, Zhao ZL, Wu XR, Guttenplan JB, Department of Basic Science, New York University Dental College, NY, USA.: Mutat Res 2012;742(1-2):92-5 [Epub 2011 Dec 4].  

PubMed

Bladder cancer is one of the few cancers that have been linked to carcinogens in the environment and tobacco smoke. Of the carcinogens tested in mouse chemical carcinogenesis models, N-butyl-N-(4-hydroxybutyl)nitrosamine (BBN) is one that reproducibly causes high-grade, invasive cancers in the urinary bladder, but not in any other tissues. However, the basis for such a high-level tissue-specificity has not been explored. Using mutagenesis in lacI (Big Blue™) mice, we show here that BBN is a potent mutagen and it causes high-level of mutagenesis specifically in the epithelial cells (urothelial) of the urinary bladder. After a 2-6-week treatment of 0.05% BBN in the drinking water, mutagenesis in urothelial cells of male and female mice was about two orders of magnitude greater than the spontaneous mutation background. In contrast, mutagenesis in smooth muscle cells of the urinary bladder was about five times lower than in urothelial tissue. No appreciable increase in mutagenesis was observed in kidney, ureter, liver or forestomach. In lacI (Big Blue™) rats, BBN mutagenesis was also elevated in urothelial cells, albeit not nearly as profoundly as in mice. This provides a potential explanation as to why rats are less prone than mice to the formation of aggressive form of bladder cancer induced by BBN. Our results suggest that the propensity to BBN-triggered mutagenesis of urothelial cells underlies its heightened susceptibility to this carcinogen and that mutagenesis induced by BBN represents a novel model for initiation of bladder carcinogenesis. PMID:24445298

Scherr, Douglas S

2014-02-01

374

Role of TREM1-DAP12 in Renal Inflammation during Obstructive Nephropathy  

PubMed Central

Tubulo-interstitial damage is a common finding in the chronically diseased kidney and is characterized by ongoing inflammation and fibrosis leading to renal dysfunction and end-stage renal disease. Upon kidney injury, endogenous ligands can be released which are recognized by innate immune sensors to alarm innate immune system. A new family of innate sensors is the family of TREM (triggering receptor expressed on myeloid cell). TREM1 is an activating receptor and requires association with transmembrane adapter molecule DAP12 (DNAX-associated protein 12) for cell signaling. TREM1-DAP12 pathway has a cross-talk with intracellular signaling pathways of several Toll-like receptors (TLRs) and is able to amplify TLR signaling and thereby contributes to the magnitude of inflammation. So far, several studies have shown that TLRs play a role in obstructive nephropathy but the contribution of TREM1-DAP12 herein is unknown. Therefore, we studied TREM1 expression in human and murine progressive renal diseases and further investigated the role for TREM1-DAP12 by subjecting wild-type (WT), TREM1/3 double KO and DAP12 KO mice to murine unilateral ureter obstruction (UUO) model. In patients with hydronephrosis, TREM1 positive cells were observed in renal tissue. We showed that in kidneys from WT mice, DAP12 mRNA and TREM1 mRNA and protein levels were elevated upon UUO. Compared to WT mice, DAP12 KO mice displayed less renal MCP-1, KC and TGF-?1 levels and less influx of macrophages during progression of UUO, whereas TREM1/3 double KO mice displayed less renal MCP-1 level. Renal fibrosis was comparable in WT, TREM1/3 double KO and DAP12 KO mice. We conclude that DAP12, partly through TREM1/3, is involved in renal inflammation during progression of UUO. PMID:24358193

Rampanelli, Elena; Blank, Froilan; Butter, Loes M.; Claessen, Nike; Takai, Toshiyuki; Colonna, Marco; Leemans, Jaklien C.; Florquin, Sandrine; Dessing, Mark C.

2013-01-01

375

Renal response of euryhaline toad (Bufo viridis) to acute immersion in tap water, NaCl, or urea solutions.  

PubMed

Green toads (Bufo viridis) were acclimated to either tap water, 230 mOsmol NaCl kg-1 H2O (saline), 500 mOsmol NaCl kg-1 H2O (high saline), or 500 mmol L-1 urea. Renal functions for each acclimation group were studied on conscious animals that had one ureter chronically catheterized. Reciprocal immersion of tap-water- and saline-acclimated toads in the opposite solution did not stress the animals osmotically, and plasma osmolality increased or decreased by no more than 15%. However, urine osmolality and ionic composition changed immediately and profoundly on exposure to the other solution. Exposure of tap-water-acclimated toads to saline decreased urine flow by 30%, whereas the reciprocal immersion led to an increase of 30%. Immersion of tap-water-acclimated toads in high saline led to immediate cessation of urine flow, whereas immersion of 500 NaCl- or urea-acclimated toads in tap water led to a large increase in urine flow, with an overshoot that lasted 10 h (as a result of either salt or urea diuresis). Urine flow then stabilized at a level 5-6 times higher than the value attained at high-salt environment. On immersion of 500 urea-acclimated toads in 500 NaCl, urine flow doubled, accompanied by a change in ion composition, without change in the osmolality. In all experimental conditions, plasma potassium concentration was maintained within a narrow range. The results show that the toad's kidneys contributed efficiently both to osmo- and ionoregulation in a wide range of ambient solutions. PMID:10068626

Shpun, S; Katz, U

1999-01-01

376

Renal function at steady state in a toad (Bufo viridis) acclimated in hyperosmotic NaCl and urea solutions.  

PubMed

Kidney function of the euryhaline toad Bufo viridis was studied in animals acclimated to tap water and solutions of NaCl (230 and 500 mosmol.kg-1 H2O) and urea (500 mmol.l-1) in steady-state conditions. An ureter was catheterized for continuous urine collection and blood was sampled from an iliac artery. A single injection of 3H-inulin served for estimation of glomerular filtration rate: this was in the range of 15-27 ml.kg-1.h-1 and did not differ significantly in any of the acclimation conditions. Urine flow, on the other hand, varied considerably and was highest in tap water (18.2 +/- 3.2 ml.kg-1.h-1; urine/plasma inulin ratio = 0.88), lower in 230 mosmol.kg-1 H2O NaCl solution (13.5 +/- 3.9 ml.kg-1.h-1; u/p inulin ratio = 1.73) and lowest in 500 mosmol.kg-1 H2O NaCl or urea acclimation solutions (5-7 ml.kg-1.h-1; u/p inulin = 3.7-4.2). Clearance of free water was high in the tap water group, lower in 230 mosmol.kg-1 H2O NaCl solution, and much lower in the hyperosmotic acclimation conditions. Clearances of both Na+ and Cl- were similar under our experimental conditions, but changed independently in accordance to the composition of the acclimation solution. Potassium clearance was similar in all acclimation conditions, and a constant plasma K+ concentration was maintained. Urea clearance was high in tap water and 500 mmol.l-1 urea acclimation groups and low in the NaCl acclimations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7738233

Shpun, S; Katz, U

1995-01-01

377

Imaging the renal mass: a historical review.  

PubMed

A matter of months after Roentgen's landmark discovery in 1895, Roentgen's rays were focused on diseases and disorders of the urinary tract, specifically the kidney. At the dawn of the 20th century, urologists in the United States and around the world quickly recognized that by using a variety of metal stylets and radiopaque contrast agents, such as silver salts, the upper urinary tract, namely the ureter, pelvis, and calyces, could be depicted with radiography. Renal cysts and tumors were diagnosed on the basis of deformities in the kidney. Retrograde pyelography dominated the imaging evaluation of the kidney until the discovery of a safe intravenous method for urinary tract imaging (ie, intravenous pyelography). Pioneers and pathfinders in the field of contrast media development and radiologic procedures helped give radiologists the lead role in the work-up of renal masses, an area where urologists once held forth. The subspecialty of uroradiology was born in the middle of the 20th century. Intravenous urography, nephrotomography, and diagnostic angiography with pharmacologic manipulation followed by cyst or mass puncture and biopsy yielded unrivaled specificity for the diagnosis and staging of benign and malignant renal masses. The advent of cross-sectional and multiplanar imaging and the profound effects they had and continue to have on the discovery and characterization of renal masses has been detailed in the pages of Radiology since the 1920s. Ultrasonography, nuclear imaging, computed tomographic scanning, magnetic resonance imaging, and positron emission tomography each have made a claim to a part of the imaging algorithm of modern uroradiologic practice. © RSNA, 2014 Listen to a discussion of the history of radiology. PMID:25340433

McClennan, Bruce L

2014-11-01

378

The Effect of Tumor Location on Prognosis in Patients Treated with Radical Nephroureterectomy at Memorial Sloan-Kettering Cancer Center  

PubMed Central

Background The prognostic impact of primary tumor location on outcomes for patients with upper-tract urothelial carcinoma (UTUC) is still contentious. Objective To test the association between tumor location and disease recurrence and cancer-specific survival (CSS) in patients treated with radical nephroureterectomy (RNU) for UTUC. Design, setting, and participants Prospectively collected data were retrospectively reviewed from 324 consecutive patients treated with RNU between 1995 and 2008 at a single tertiary referral center. Patients who had previous radical cystectomy, preoperative chemotherapy, previous contralateral UTUC, or metastatic disease at presentation were excluded. This left 253 patients for analysis. Tumor location was categorized as renal pelvis or ureter based on the location of the dominant tumor. Recurrences in the bladder only, in nonbladder sites, and in any site were analyzed. Intervention All patients were treated with RNU. Measurements Recurrence-free survival and CSS probabilities were estimated using Kaplan-Meier and Cox regression analyses. Results and limitations Median follow-up for survivors was 48 mo. The 5-yr recurrence-free probability (including bladder recurrence) and CSS estimates were 32% and 78%, respectively. On multivariable analysis, pathologic stage was the only predictor for disease recurrence (p = 0.01). Tumor location was not an independent predictor for recurrence (hazard ratio: 1.19; p = 0.3), and there was no difference in the probability of disease recurrence between ureteral and renal pelvic tumors (p = 0.18). On survival analysis, we also found no differences between ureteral and renal pelvic tumors on probability of CSS (p = 0.2). On multivariate analysis, pathologic stage (p < 0.0001) and nodal status (p = 0.01) were associated with worse CSS. This study is limited by its retrospective nature. Conclusions Our study did not show any differences in recurrence and CSS rates between patients with ureteral and renal pelvic tumors treated with RNU. PMID:20637540

Favaretto, Ricardo L.; Shariat, Shahrokh F.; Chade, Daher C.; Godoy, Guilherme; Adamy, Ari; Kaag, Matthew; Bochner, Bernard H.; Coleman, Jonathan; Dalbagni, Guido

2014-01-01

379

Epidemiological urinalysis of children from kindergartens of Can Gio, Ho Chi Minh City - Vietnam  

PubMed Central

Background Recent studies on Vietnamese children have shown that kidney diseases are not detected early enough to prevent chronic renal failure. The dipstick test is a simple and useful tool for detecting urinary abnormalities, especially in isolated or remote areas of Vietnam, where children have limited access to health care. Methods This cross-sectional study was conducted in 2011 at seven kindergartens in Can Gio district, Ho Chi Minh City, Vietnam. Two thousand and twelve children, aged 3 to 5, were enrolled. Morning mid-stream urine samples were examined by dipstick. Children with abnormal findings were re-examined with a second dipstick and underwent further investigations. Results Urinalysis was available for 1,032 boys and 980 girls. Mean age was 4.4?±?0.8 years. Urinary abnormalities were detected in 108 (5.5%) of the subjects. Among them, nitrituria and leucocyturia accounted for more than 50%. Positive fractions of proteinuria, hematuria, nitrituria, leucocyturia, and combined nitrituria and leucocyturia after two dipsticks were 0.1%, 0.1%, 2%, 1% and 0.3%, respectively. Abnormal findings were more common in girls than boys (p?ureter. Conclusions The prevalence of urinary abnormalities in asymptomatic children in South Vietnam demonstrates the need for hygiene education among parents. Training for dipstick usage for all medical staff at health stations, especially in remote areas and in places with very low population density, is also clearly necessary. Routine urinalysis can be set up if a close control is conducted at locations. PMID:24206763

2013-01-01

380

Surgery-Related Complications and Sequelae in Management of Tuberculosis of Spine  

PubMed Central

Study Design Medical record-based survey. Purpose To survey the overall incidence of the intra- and postoperative complications and sequelae, and to propose the preventive measures to reduce complications in the spinal tuberculosis surgery. Overview of Literature There is no study focused on the surgery-related complications and sequelae, with some touching lightly on the clinical problems. Methods There were 901 patients in this study, including 92 paraplegics. One hundred eighty-six patients had no visible deformity, while those of 715 patients were visible. Six hundred fifty-nine patients had slight to moderate non-rigid kyphosis, and 56 had severe rigid kyphosis. Sixty-seven out of 92 paraplegics had slight to moderate non-rigid kyphosis, and 25 had severe kyphosis. There were 134 cervical and cervicodorsal lesions, 518 thoracic and thoracolumbar lesions, and 249 lumbar and lumbosacral lesions. Seven hundred sixty-four patients had primarily anterior surgeries, and 137 had posterior surgeries. Instrumentation surgery was combined in 174 patients. Results There were intra- and postoperative complications: direct large vessel and neurological injuries (cord, roots, nerves), late thrombophlebitis, various thoracic cavity problems, esophagus and ureter injuries, peritoneum perforation, ileus, wound infections, stabilization failure, increase of deformity and late adjacent joint and bone problems. Thrombophlebitis and sympatheticolysis symptoms and signs in the lower limbs were the most common complications related with anterior lumbar and lumbosacral surgeries. Kyphosis increased in 31.5% of the non-instrumented anterior surgery cases (42% in children and 21% in adults). Conclusions The safe, effective and most familiar surgical procedure should be adopted to minimize complications and sequelae. Cosmetic spinal surgery should be withheld if functional improvement could not be expected. PMID:25187860

Moon, Myung-Sang; Moon, Young-Wan; Moon, Hanlim; Kim, Sung-Sim

2014-01-01

381

Functional morphology of the light yellow cell and yellow cell (sodium influx-stimulating peptide) neuroendocrine systems of the pond snail Lymnaea stagnalis.  

PubMed

Neuroendocrine light yellow cells of the pond snail Lymnaea stagnalis express a neuropeptide gene encoding three different peptides. The morphology of the cell system has been studied by in situ hybridization, using two synthetic oligonucleotides encoding parts of light yellow cell peptides I and III, and by immunocytochemistry with antisera to synthetic light yellow cell peptide II and to two fragments of light yellow cell peptide I. One large cluster of light yellow cells was observed in the ventro-lateral protrusion of the right parietal ganglion, smaller clusters lying in the posterior dorsal part of this ganglion and in the visceral ganglion. The cells had an extended central neurohaemal area. Immunopositive axons projected into all nerves of the ganglia of the visceral complex, into the superior cervical and the nuchal nerves, and into the connective tissue surrounding the central nervous system. Axon tracts ramified between the muscle cells of the walls of the anterior aorta and of smaller blood vessels. Peripheral innervation by the light yellow cell system was only found in muscular tissue of the ureter papilla. The antisera to the two peptide fragments of light yellow cell peptide I not only stained the light yellow cells, but also the identified yellow cells, which have previously been shown to produce the sodium influx-stimulating neuropeptide. The latter cells were negative to the in situ hybridization probes and antisera specific to the light yellow cell system. It is therefore unlikely that the yellow cells express the light yellow cell neuropeptide gene. Nevertheless, the cells contain a neuropeptide sharing antigenic determinants with light yellow cell peptide I.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8111842

Boer, H H; Montagne-Wajer, C; Smith, F G; Parish, D C; Ramkema, M D; Hoek, R M; van Minnen, J; Benjamin, P R

1994-02-01

382

Pediatric urolithiasis: to cut or not to cut.  

PubMed

Urolithiasis is a major source of morbidity in children of the third world. Since its advent in 1982 and despite uncertainties about the long-term effects on the kidney, extracorporeal shock wave lithotripsy (ESWL) has rapidly replaced traditional surgery in the management of this condition. A retrospective study was conducted to compare the outcome of ESWL with that of open surgery in the management of paediatric urolithiasis in a single institution between November 1988 and December 1991. Emphasis was placed on the rate of stone clearance, complications, duration of follow-up, and cost of treatment of each modality. A total of 83 patients under 14 years of age underwent management of 101 stones; the stones were located in the kidneys (63), ureters (13), or bladder (25). Thirty-one patients who enrolled directly through the Lithotripsy Clinic underwent a total of 65 ESWL sessions for 44 calculi (mean, 2.1 sessions per patient). The overall stone clearance rate was 82%, with an 83% clearance rate for renal stones. There were three failures. Nine patients did not return after the first ESWL session, and by the end of 6 months, 93.5% were lost to follow-up. The cost of ESWL ranged from $600 to $1,000 (mean, $780). Fifty-two children were managed through the Pediatric Surgery Clinic and underwent open surgery (57 stones). The overall stone clearance rate was 96%, with a clearance of 88% for renal calculi. There were two wound infections and no deaths. All patients returned for the first follow-up visit, but by the end of 6 months, only 34.5% were available for follow-up. The total cost of treatment ranged from $520 to $900 (mean, $580). The authors believe that with the present level of knowledge, use of the lithotriptor should be restricted to children with small stones and/or those for whom long-term follow-up is possible. PMID:8078015

Moazam, F; Nazir, Z; Jafarey, A M

1994-06-01

383

Growth on demand: reviewing the mechanobiology of stretched skin.  

PubMed

Skin is a highly dynamic, autoregulated, living system that responds to mechanical stretch through a net gain in skin surface area. Tissue expansion uses the concept of controlled overstretch to grow extra skin for defect repair in situ. While the short-term mechanics of stretched skin have been studied intensely by testing explanted tissue samples ex vivo, we know very little about the long-term biomechanics and mechanobiology of living skin in vivo. Here we explore the long-term effects of mechanical stretch on the characteristics of living skin using a mathematical model for skin growth. We review the molecular mechanisms by which skin responds to mechanical loading and model their effects collectively in a single scalar-valued internal variable, the surface area growth. This allows us to adopt a continuum model for growing skin based on the multiplicative decomposition of the deformation gradient into a reversible elastic and an irreversible growth part. To demonstrate the inherent modularity of this approach, we implement growth as a user-defined constitutive subroutine into the general purpose implicit finite element program Abaqus/Standard. To illustrate the features of the model, we simulate the controlled area growth of skin in response to tissue expansion with multiple filling points in time. Our results demonstrate that the field theories of continuum mechanics can reliably predict the manipulation of thin biological membranes through mechanical overstretch. Our model could serve as a valuable tool to rationalize clinical process parameters such as expander geometry, expander size, filling volume, filling pressure, and inflation timing to minimize tissue necrosis and maximize patient comfort in plastic and reconstructive surgery. While initially developed for growing skin, our model can easily be generalized to arbitrary biological structures to explore the physiology and pathology of stretch-induced growth of other living systems such as hearts, arteries, bladders, intestines, ureters, muscles, and nerves. PMID:23623569

Zöllner, Alexander M; Holland, Maria A; Honda, Kord S; Gosain, Arun K; Kuhl, Ellen

2013-12-01

384

Clinical Application of High-pitch Excretory Phase Images during Dual-source CT Urography with Stellar Photon Detector.  

PubMed

Objective To retrospectively evaluate the clinical feasibility of high-pitch excretory phase images during dual-source CT urography with Stellar photon detector. Methods Totally 100 patients received dual-source CT high-pitch urinary excretory phase scanning with Stellar photon detector[80 kV,ref.92 mAs,CARE Dose 4D and CARE kV,pitch of 3.0,filter back projection reconstruction algorithm (FBP)](group A). Another 100 patients received dual-source CT high-pitch urinary excretory phase scanning with common detector(100 kV,ref.140 mAs,CARE Dose 4D,pitch of 3.0,FBP)(group B). Quantitative measurement of CT value of urinary segments(Hounsfield units),image noise(Hounsfield units),and effective radiation dose(millisievert)were compared using independent-samples t test between two groups. Urinary system subjective opacification scores were compared using Mann-Whitney U test between two groups. Results There was no significant difference in subjective opacification score of intrarenal collecting system and ureters between two groups(all P>0.05). The group A images yielded significantly higher CT values of all urinary segments(all P<0.01). There was no significant difference in image noise(P>0.05). The effective radiation dose of group A(1.1 mSv)was significantly lower than that of group B(3.79 mSv)(P<0.01). Conclusion High-pitch low-tube-voltage during excretory phase dual-source CT urography with Stellar photon detector is feasible,with acceptable image noise and lower radiation dose. PMID:25360650

Sun, Hao; Xue, Hua-Dan; Jin, Zheng-Yu; Wang, Xuan; Chen, Yu; He, Yong-Lan; Zhang, Da-Ming; Zhu, Liang; Wang, Yun; Qi, Bing; Xu, Kai; Wang, Ming

2014-10-31

385

Immunocytochemical localization of estrogen receptors in the normal male and female canine urinary tract and prostate  

SciTech Connect

We have used the monoclonal estrogen receptor (ER) antibody H222Sp gamma to localize ER by immunocytochemistry in frozen sections of the normal canine urinary tract of both sexes and of the normal prostate of the male. Striking regional heterogeneity of ER location was observed. In the urinary tract, specific ER staining was confined to nuclei of the transitional epithelium (mucosa) and subjacent stroma (submucosa) of the prostatic urethra in the male dog and of the proximal urethra in the female dog. In both sexes there was a gradient of ER staining intensity along these urethral segments. In the male, ER staining intensity was highest in the region of the verumontanum. The pattern and intensity of staining were similar in the male prostatic urethra and female proximal urethra, indicating a similar concentration of ER in these tissues, which have the same embryological origin. No specific staining was found in the kidney, ureter, bladder, or distal urethra of either sex. In the normal prostate, specific immunocytochemical ER staining was confined to nuclei of the prostatic stroma and prostatic ductal epithelium. Specific staining intensity appeared to be higher in the periurethral region of the prostate than in the periphery. No specific staining was found in the acinar epithelium of the prostate. Based on overall staining intensity there appeared to be a higher concentration of ER in the urethra than in the prostate. Scatchard analysis of (/sup 3/H)estradiol binding confirmed a similar ER content in the urethra of male and female dogs and a higher ER content in the prostatic urethra than in the prostate itself (P less than 0.001).

Schulze, H.; Barrack, E.R.

1987-11-01

386

Role of computed tomography (CT) scan in staging of cervical carcinoma  

PubMed Central

Background & objectives: Staging of cervical carcinoma is done clinically using International Federation of Obstetrics and Gynecology (FIGO) guidelines. It is based on physical examination findings and also includes results of biopsy, endoscopy and conventional radiological tests like chest radiograph, intravenous urography and barium enema. These conventional radiological investigations have largely been replaced by computed tomography (CT) and magnetic resonance imaging (MRI) at present. FIGO staging system does not consider CT and MRI mandatory; however, use of these modalities are encouraged. This prospective study was conducted to determine the role of CT in staging work up in women diagnosed with cervical carcinoma. Methods: Fifty three women diagnosed with cervical carcinoma were evaluated with contrast enhanced CT scan of abdomen and pelvis. CT scan images were especially evaluated to determine tumour size, invasion of parmetrium, pelvic walls, rectum, urinary bladder and ureters, pelvic or retroperitoneal lymphadenopathy and distant metastases. CT findings were associated with clinical findings and staging, including findings from cystoscopy and sigmoidoscopy. Results: There was a poor agreement between clinical and CT staging of cervical carcinoma. Primary tumour was demonstrated on CT in 36 (70%) of 53 patients. CT underestimated the parametrial, vaginal and pelvic wall invasion when compared with physical examination. CT overestimated the urinary bladder and rectal invasion when compared with cysto-sigmoidoscopy, however, CT had 100 per cent negative predictive value (NPV) to exclude bladder and rectal involvement. CT detection of lymph node enlargement and lung metastases influenced the management. Interpretation & conclusions: Our findings show that CT scan does not reliably correlate with clinical FIGO staging of cervical cancer. However, it can detect urinary obstruction as well as nodal or distant metastases and thus improves the clinical FIGO staging PMID:25027081

Prasad, T.V.; Thulkar, S.; Hari, S.; Sharma, D.N.; Kumar, S.

2014-01-01

387

Visual enhancement of fascial tissue in endoscopy  

NASA Astrophysics Data System (ADS)

A colon resection, necessary in case of colon cancer, can be performed minimally invasively by laparoscopy. Before the affected part of the colon can be removed, however, the colon must be mobilized. A good technique for mobilizing the colon is to use Gerota's fascia as a guiding structure, i. e. to dissect along this fascia, without harming it. The challenge of this technique is that Gerota's fascia is usually difficult to distinguish from other tissue. In this paper, we present an approach to enhance the visual contrast between fatty tissue covered by Gerota's fascia and uncovered fatty tissue, and the contrast of both structures to the remaining soft tissue in real time (50 fields per second). As fasciae are whitish transparent tissues, they cannot be identified by means of their color itself. Instead, we found that their most prominent feature to distinguish is the color saturation. To enhance their visible contrast, we applied a non-linear transformation to the saturation. An off-line evaluation was carried out consulting two specialists in laparoscopic colon resection. We presented them four scenes from two different interventions in which our enhancement was applied together with the original scenes. These scenes did not only contain situations where Gerota's fascia had to be found, but also situations where aerosol from ultrasonically activated scissors inhibited the clear vision, or situations where critical structures such as the ureter or nerves had to be identified under fascial tissue. The surgeons stated that our algorithm clearly offered an information gain in all of the presented scenes, and that it did not impair the clear vision in case of aerosol or the visibility of critical structures. So the colon mobilization could be carried out easier, faster, and safer. In the subsequent clinical on-line evaluation, the specialists confirmed the positive effect of the proposed algorithm on the visibility of Gerota's fascia.

Stehle, Thomas; Behrens, Alexander; Bolz, Matthias; Aach, Til

2008-03-01

388

Canonical Transforming Growth Factor-? Signaling Regulates Disintegrin Metalloprotease Expression in Experimental Renal Fibrosis via miR-29  

PubMed Central

Fibrosis pathophysiology is critically regulated by Smad 2– and Smad 3–mediated transforming growth factor-? (TGF-?) signaling. Disintegrin metalloproteases (Adam) can manipulate the signaling environment, however, the role and regulation of ADAMs in renal fibrosis remain unclear. TGF-? stimulation of renal cells results in a significant up-regulation of Adams 10, 17, 12, and 19. The selective Smad2/3 inhibitor SB 525334 reversed these TGF-?–induced changes. In vivo, using ureteral obstruction to model renal fibrosis, we observed increased Adams gene expression that was blocked by oral administration of SB 525334. Similar increases in Adam gene expression also occurred in preclinical models of hypertension-induced renal damage and glomerulonephritis. miRNAs are a recently discovered second level of regulation of gene expression. Analysis of 3? untranslated regions of Adam12 and Adam19 mRNAs showed multiple binding sites for miR-29a, miR-29b, and miR-29c. We show that miR-29 family expression is decreased after unilateral ureter obstruction and this significant decrease in miR-29 family expression was observed consistently in preclinical models of renal dysfunction and correlated with an increase in Adam12 and Adam19 expression. Exogenous overexpression of the miR-29 family blocked TGF-?–mediated up-regulation of Adam12 and Adam19 gene expression. This study shows that Adams are involved in renal fibrosis and are regulated by canonical TGF-? signaling and miR-29. Therefore, both Adams and the miR-29 family represent therapeutic targets for renal fibrosis. PMID:24103556

Ramdas, Vasudev; McBride, Martin; Denby, Laura; Baker, Andrew H.

2014-01-01

389

Knockout of the aryl hydrocarbon receptor results in distinct hepatic and renal phenotypes in rats and mice.  

PubMed

The aryl hydrocarbon receptor (AHR) is a ligand-activated transcription factor which plays a role in the development of multiple tissues and is activated by a large number of ligands, including 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). In order to examine the roles of the AHR in both normal biological development and response to environmental chemicals, an AHR knockout (AHR-KO) rat model was created and compared with an existing AHR-KO mouse. AHR-KO rats harboring either 2-bp or 29-bp deletion mutation in exon 2 of the AHR were created on the Sprague-Dawley genetic background using zinc-finger nuclease (ZFN) technology. Rats harboring either mutation type lacked expression of AHR protein in the liver. AHR-KO rats were also insensitive to thymic involution, increased hepatic weight and the induction of AHR-responsive genes (Cyp1a1, Cyp1a2, Cyp1b1, Ahrr) following acute exposure to 25 ?g/kg TCDD. AHR-KO rats had lower basal expression of transcripts for these genes and also accumulated ~30-45-fold less TCDD in the liver at 7 days post-exposure. In untreated animals, AHR-KO mice, but not AHR-KO rats, had alterations in serum analytes indicative of compromised hepatic function, patent ductus venosus of the liver and persistent hyaloid arteries in the eye. AHR-KO rats, but not AHR-KO mice, displayed pathological alterations to the urinary tract: bilateral renal dilation (hydronephrosis), secondary medullary tubular and uroepithelial degenerative changes and bilateral ureter dilation (hydroureter). The present data indicate that the AHR may play significantly different roles in tissue development and homeostasis and toxicity across rodent species. PMID:23859880

Harrill, Joshua A; Hukkanen, Renee R; Lawson, Marie; Martin, Greg; Gilger, Brian; Soldatow, Valerie; Lecluyse, Edward L; Budinsky, Robert A; Rowlands, J Craig; Thomas, Russell S

2013-10-15

390

A Novel CT-Guided Transpsoas Approach to Diagnostic Genitofemoral Nerve Block and Ablation  

PubMed Central

Background Inguinal hernia repair is associated with a high incidence of chronic postsurgical pain. This pain may be caused by injury to the iliohypogastric, ilioinguinal, or genitofemoral nerves. It is often difficult to identify the specific source of the pain, in part, because these nerves are derived from overlapping nerve roots and closely colocalize in the area of surgery. It is therefore technically difficult to selectively block these nerves individually proximal to the site of surgical injury. In particular, the genitofemoral nerve is retroperitoneal before entering the inguinal canal, a position that puts anterior approaches to the proximal nerve at risk of transgressing into the peritoneum. We report a computed tomography (CT)-guided transpsoas technique to selectively block the genitofemoral nerve for both diagnostic and therapeutic purposes while avoiding injury to the nearby ureter and intestines. Case A 39-year-old woman with chronic lancinating right groin pain after inguinal hernia repair underwent multiple pharmacologic interventions and invasive procedures without relief. Using CT and Stimuplex nerve stimulator guidance, the genitofemoral nerve was localized on the anterior surface of the psoas muscle and a diagnostic block with local anesthetic block was performed. The patient had immediate relief of her symptoms for 36 hours, confirming the diagnosis of genitofemoral neuralgia. She subsequently underwent CT-guided radiofrequency and phenol ablation of the genitofemoral nerve but has not achieved long-term analgesia. Conclusion CT-guided transpsoas genitofemoral nerve block is a viable option for safely and selectively blocking the genitofemoral nerve for diagnostic or therapeutic purposes proximal to injury caused by inguinal surgery. PMID:20546515

Parris, David; Fischbein, Nancy; Mackey, Sean; Carroll, Ian

2010-01-01

391

Vasohibin?1 deficiency enhances renal fibrosis and inflammation after unilateral ureteral obstruction  

PubMed Central

Abstract Tubulointerstitial injuries are known to predict the deterioration of renal function in chronic kidney disease (CKD). We recently reported the protective role of Vasohibin?1(VASH?1), a negative feedback regulator of angiogenesis, in diabetic nephropathy, but its impact on tubulointerstitial injuries remains to be elucidated. In the present study, we evaluated the role of endogenous VASH?1 in regulating the tubulointerstitial alterations induced by unilateral ureteral obstruction (UUO), and assessed its role on fibrogenesis and the activation of Smad3 signaling in renal fibroblasts. UUO was induced in female Vasohibin?1 heterozygous knockout mice (VASH?1+/?) or wild?type (WT) (VASH?1+/+) littermates. Mice were sacrificed on Day 7 after left ureter ligation, and the kidney tissue was obtained. Interstitial fibrosis, the accumulation of type I and type III collagen and monocytes/macrophages infiltration in the obstructed kidneys (OBK) were significantly exacerbated in VASH?1+/? mice compared with WT mice (Day 7). The increases in the renal levels of TGF??1, pSmad3, NF??B pp65, CCL2 mRNA, and the number of interstitial fibroblast?specific protein?1 (FSP?1)+ fibroblasts in the OBK were significantly aggravated in VASH?1+/? mice. In addition, treatment with VASH?1 siRNA enhanced the TGF??1?induced phosphorylation of Smad3, the transcriptional activation of the Smad3 pathway and the production of type I/type III collagen in fibroblasts, in vitro. Taken together, our findings demonstrate a protective role for endogenous VASH?1 on tubulointerstitial alterations via its regulation of inflammation and fibrosis and also show the direct anti?fibrotic effects of VASH?1 on renal fibroblasts through its modulation of TGF??1 signaling. PMID:24973329

Watatani, Hiroyuki; Maeshima, Yohei; Hinamoto, Norikazu; Yamasaki, Hiroko; Ujike, Haruyo; Tanabe, Katsuyuki; Sugiyama, Hitoshi; Otsuka, Fumio; Sato, Yasufumi; Makino, Hirofumi

2014-01-01

392

Uterine Artery Embolization for Ureteric Obstruction Secondary to Fibroids  

SciTech Connect

This case series examines the safety and efficacy of uterine artery embolization (UAE) in the treatment of obstructive nephropathy caused by large fibroids. Between 2004 and 2007, 10 patients referred with symptomatic uterine fibroids that were found to be causing either unilateral (7 patients) or bilateral (3 patients) hydronephrosis were treated by UAE. Presenting complaints included menorrhagia, dysmenorrhea, bulk symptoms, loin pain, postobstructive atrophy, and mild renal impairment. All had posterior intramural dominant fibroids >11 cm in maximum sagittal diameter and uterine volumes between 3776 and 15,625 ml. Outcome measures at between 12 and 36 months included procedural success, repeat intervention, relief of symptoms, resolution of hydronephrosis, stable renal function and size, and avoidance of hysterectomy. In all cases the cause of renal obstruction was confirmed to be a giant fibroid compressing the ureter at the pelvic brim. In all cases UAE was technically successful, though two patients required a repeat procedure. In eight patients hydronephrosis resolved and the obstruction was relieved, though two still had some bulk symptoms not requiring further treatment. Renal function improved or was stable in all cases. Renal size was stable in all cases. Where menorrhagia was part of the symptom complex it was relieved in all cases. Two patients diagnosed as having postobstructive atrophy of one kidney underwent retrograde ureteric stenting on the nonatrophied side prior to UAE. This was unsuccessful in one of the cases due to the distortion caused by the fibroid. Despite improvement in hydronephrosis this patient underwent hysterectomy at 7 months after a renogram demonstrated persistent obstruction at the pelvic brim. In the second patient a double pigtail stent was inserted with difficulty and eventually removed at 8 months. This patient has had stable renal function and size for 3 years post-UAE. We conclude that UAE is safe and effective in treating patients with obstructive hydronephrosis caused by large fibroids.

Mirsadraee, Saeed [Leeds Teaching Hospitals (United Kingdom); Tuite, David [Cork University Hospital (Ireland); Nicholson, Anthony, E-mail: Tony.Nicholson@leedsth.nhs.u [Leeds Teaching Hospitals (United Kingdom)

2008-11-15

393

Choice of surgical access for retroperitoneoscopic ureterolithotomy according to the results of 3D reconstruction of operational zone agreed with the patient: initial experience  

PubMed Central

Introduction For the procedure retroperitoneoscopic ureterolithotomy, the problems of access choice and thus visualization with utilizing minimally invasive surgical access (either with gasless single port method or gas insufflation) are solved. The decisions are based on the method of presurgery planning, grounded on matching the patient with a 3D model of the zone of surgical interest reconstructed according to the results of tomographic examination. Material and methods We used a hardware–software complex (HSC) for virtual modeling of the surgery zone and choosing the optimum points for minimally invasive surgical access. The HSC was recruited to choose optimum surgical access, realize presurgery planning, and estimation of the safety of the way of access chosen. The original method of matching the system of coordinates of a virtual model with the patient was offered. Results 12 patients with the calculus in the upper part of ureter averaging 11.5 (9–14) mm in size underwent gasless retroperitoneoscopic ureterolithotomy with use of the HSC. Mean age of the patients was 36.4 (25–49) years old. The surgeries lasted an average of 35.5 (25–40) minutes. Blood loss was averaged at 55.0 (30–90) ml. Healing by first intention was registered with all the patients. The mean hospitalization time was 6.0 (4–7) days. There were neither any complications nor difficulties, nor conversions from incorrectly chosen surgical access. Conclusions The choice of the optimum surgical access according to the results of a virtual 3D model of the operation zone, matching the system of coordinates of the model with patient concurrence, and presurgery planning, was effective in cases of gasless single port and with gas insufflation retroperitoneoscopic ureterolithotomy. PMID:24757541

Bashirov, Valerii I.; Furman, Yakov A.; Rozhentsov, Alexey A.; Yeruslanov, Ruslan V.; Kudryavtsev, Alexandr A.

2013-01-01

394

Sema4C-Plexin B2 signalling modulates ureteric branching in developing kidney.  

PubMed

Semaphorins, originally identified as axon guidance molecules, have also been implicated in angiogenesis, function of the immune system and cancerous growth. Here we show that deletion of Plexin B2 (Plxnb2), a semaphorin receptor that is expressed both in the pretubular aggregates and the ureteric epithelium in the developing kidney, results in renal hypoplasia and occasional double ureters. The rate of cell proliferation in the ureteric epithelium and consequently the number of ureteric tips are reduced in the kidneys lacking Plexin B2 (Plxnb2-/-). Semaphorin 4C, a ligand for Plexin B2, stimulates branching of the ureteric epithelium in wild type and Plxnb2+/- kidney explants, but not in Plxnb2-/- explants. As shown by co-immunoprecipitation Plexin B2 interacts with the Ret receptor tyrosine kinase, the receptor of Glial-cell-line-derived neurotrophic factor (Gdnf), in embryonic kidneys. Isolated Plxnb2-/- ureteric buds fail to respond to Gdnf by branching, but this response is rescued by Fibroblast growth factor 7 and Follistatin as well as by the metanephric mesenchyme. The differentiation of the nephrogenic mesenchyme, its morphology and the rate of apoptosis in the Plxnb2-/- kidneys are normal. Plexin B2 is co-expressed with Plexin B1 (Plxnb1) in the kidney. The double homozygous Plxnb1-Plxnb2-deficient mice show high embryonic lethality prior to onset of nephrogenesis. The only double homozygous embryo surviving to E12 showed hypoplastic kidneys with ureteric branches and differentiating mesenchyme. Taken together, our results show that Sema4C-Plexin B2 signalling regulates ureteric branching, possibly through modulation of Gdnf signalling by interaction with Ret, and suggest non-redundant roles for Plexin B1 and Plexin B2 in kidney development. PMID:21035938

Perälä, Nina; Jakobson, Madis; Ola, Roxana; Fazzari, Pietro; Penachioni, Junia Y; Nymark, Mariann; Tanninen, Tiina; Immonen, Tiina; Tamagnone, Luca; Sariola, Hannu

2011-02-01

395

Iodine-125 prostate seed brachytherapy in renal transplant recipients: an analysis of oncological outcomes and toxicity profile  

PubMed Central

Purpose Prostate cancer is among the most common non-cutaneous neoplasms affecting renal transplant recipients (RTRs). Available treatments including radical prostatectomy and external beam radiotherapy carry a risk of damage to the transplanted kidney, ureters, or bladder. We assessed the safety and efficacy of Iodine-125 (125I) prostate seed brachytherapy as an alternative to surgery and radiotherapy in these individuals. Material and methods We retrospectively reviewed our brachytherapy database to identify patients with a prior history of renal transplantation, who had undergone seed implantation for localized prostate cancer. Long term PSA control and treatment related toxicity, including graft dysfunction, urinary, rectal, and sexual complications, were assessed and compared with published outcomes for surgery and external beam radiotherapy. Results Of 1054 patients treated with permanent seed implantation from 2002-2012, we identified four who had a prior history of renal transplantation. Mean time from renal transplantation to prostate cancer diagnosis was 13 years. Mean follow-up after seed implantation was 44 months (range 12-60 months). All four patients remain free of PSA progression. No peri-operative complications were experienced following seed implantation, and all four patients continued to have normal graft function. Long term urinary and rectal function scores were comparable to reported outcomes for seed brachytherapy in the non-transplant population. Conclusions 125I prostate seed brachytherapy is associated with high rates of biochemical control and minimal toxicity to the renal graft in RTRs. This treatment should be considered as an alternative to surgery in managing RTRs with localized prostate cancer. PMID:24790617

Bucci, Joseph; Malouf, David

2014-01-01

396

Simultaneous laparoscopic management of ureteropelvic junction obstruction and renal lithiasis: the combined experience of two academic centers and review of the literature  

PubMed Central

Introduction Approximately one out of five patients with ureteropelvic junction obstruction (UPJO) present lithiasis in the same setting. We present our outcomes of simultaneous laparoscopic management of UPJO and pelvic or calyceal lithiasis and review the current literature. Methods Thirteen patients, with a mean age of 42.8±13.3 years were diagnosed with UPJO and pelvic or calyceal lithiasis. All patients were subjected to laparoscopic dismembered Hynes–Anderson pyeloplasty along with removal of single or multiple stones, using a combination of laparoscopic graspers, irrigation, and flexible nephroscopy with nitinol baskets. Results The mean operative time was 218.8±66 minutes. In two cases, transposition of the ureter due to crossing vessels was performed. The mean diameter of the largest stone was 0.87±0.25 cm and the mean number of stones retrieved was 8.2 (1–32). Eleven out of 13 patients (84.6%) were rendered stone-free. Complications included prolonged urine output from the drain in one case (Clavien grade I) and urinoma formation requiring drainage in another case (Clavien grade IIIa). The mean postoperative follow-up was 30.2 (7–51) months. No patient has experienced stone or UPJO recurrence. Conclusion Laparoscopy for the management of UPJO along with renal stone removal seems a very appealing treatment, with all the advantages of minimally invasive surgery. Concomitant renal stones do not affect the outcome of laparoscopic pyeloplasty, at least in the midterm. According to our results and the latest literature data, we advocate laparoscopic management as the treatment of choice for these cases. PMID:24892032

Stravodimos, Konstantinos G; Giannakopoulos, Stilianos; Tyritzis, Stavros I; Alevizopoulos, Aristeides; Papadoukakis, Stefanos; Touloupidis, Stavros; Constantinides, Constantinos A

2014-01-01

397

Immediate or delayed SWL in ureteric stones: a prospective and randomized study.  

PubMed

The objective is to compare immediate and delayed SWL as a treatment for ureter stones between 5 and 20 mm. Patients who applied to the emergency department with single, radio opaque ureteric stone of 5-20 mm size were included in the study. Patients were randomized into immediate and delayed SWL groups. SWL were carried out after pain relief in the delayed group. Maximum of three SWL sessions were applied to the patients with stones of 5 mm or bigger in diameter, leaving at least 3 days interval in-between. Stone-free rate after first session was similar in two groups. When CIRF was also considered as success, the success rate of SWL in the immediate SWL group was higher after first session (p = 0.02). Immediate SWL had a greater success rate in upper ureteric stones (p = 0.019). Overall average time required for elimination of stones was shorter in immediate SWL group than delayed SWL group (p = 0.033). The success rate after first SWL session (including CIRF) was 59 % for patients with chronic pain in the delayed group and 100 % for patients with acute pain in the immediate group. According to the hydronephrosis grade, success rates were 71 and 44.4 % for patients with grade 1 or no hydronephrosis in the immediate SWL group, and for patients with grade 2 or larger hydronephrosis in the delayed SWL group, respectively, after first SWL session. Immediate SWL insures stone-free status in a shorter time in cases with renal colicky pain and ureteral stones, particularly upper ureteral stones. PMID:22763796

Uguz, Sami; Senkul, Temucin; Soydan, Hasan; Ates, Ferhat; Akyol, Ilker; Malkoc, Ercan; Baykal, Kadir Vehbi

2012-12-01

398

Nephrogenic adenoma: a report of 3 unusual cases infiltrating into perinephric adipose tissue.  

PubMed

Nephrogenic adenoma of the urinary bladder, where they present most frequently, are typically confined to the lamina propria but can on occasion focally involve the superficial muscularis propria. Less commonly, nephrogenic adenoma involves the renal pelvis and ureter where again they almost always only involve the lamina propria. We identified 3 consult cases in which tubules of nephrogenic adenoma extensively involved the muscularis propria and focally infiltrated the perinephric adipose tissue, for which the contributing pathologists considered the diagnosis of adenocarcinoma. In 1 case, that of a 71-year-old man, the lesion was associated with a hemorrhagic renal cyst (3.0 cm) and a spontaneous retroperitoneal bleed (6.0 cm) of unknown origin. In the second case, that of a 73-year-old woman, 2 foci (2.2, 1.6 cm) were present in the renal pelvis. They developed after biopsy of a low-grade noninvasive papillary urothelial carcinoma in the same site complicated by perforation. The third case was that of a 20-year-old woman with ureteropelvic junction obstruction and severe hydronephrosis associated with renal calculi. In all cases, the lesions were positive for CK7 and PAX8. These 3 cases report the novel finding that nephrogenic adenoma can occasionally have a deep infiltrative pattern into perinephric adipose tissue, possibly as a result of either biopsy-associated perforation or extensive disruption due to hemorrhage or mechanical obstruction. Awareness of this worrisome infiltration pattern, although rare, can prevent a misdiagnosis of an infiltrating carcinoma. PMID:23426119

Diolombi, Mairo; Ross, Hillary M; Mercalli, Francesca; Sharma, Rajni; Epstein, Jonathan I

2013-04-01

399

Laparoscopic assisted resection of a ilio-sacral chondrosarcoma: A single case report  

PubMed Central

INTRODUCTION Sacral tumor often involves en bloc surgical resection with tumor-free margins and functional reconstruction challenges. Such a management is challenging because of difficulties in accessing the lesion, risks for damages of neighboring organs, and risks for massive blood loss. In posterior approach, because first elevation of the sacrum allows dissection of presacral structures, such risks for damages intrapelvic structures and hemorrhage are especially high. PRESENTATION OF CASE We report here about a laparoscopic assisted posterior resection of a ilio-sacral chondrosarcoma in a women, 6 weeks after vaginal delivery. Primary laparoscopic approach consisted in dissection of the ureter and of the colon with control to the pelvic vessels and nerves and determination of limits of the resection. The iliac osteotomy was performed from posterior approach with saw and osteotomes at the predetermined extralesional level. The defect was replaced with a structural fresh frozen femoral allograft and stabilization performed by lumbo-ischial screw/rod fixation. DISCUSSION Surgical time was about 360 min. No intra-postoperative complications occurred. Blood loss was estimated to about 1000 cm3. Histologic examination of the specimen showed tumor-free margins. At 8 months follow-up, the patient appears to be without recurrence. Because of the denervation of the nerve root L5 and below, she mostly uses two canes, but she has a functioning quadriceps. Continence and voiding functions for urine and stool have fully recovered. CONCLUSION Primary laparoscopic approach appeared to be a good way for preparation orthopedics sacroiliac resection to reduce postoperative morbidity, intraoperative blood loss and better assure macroscopic tumor-free margins. PMID:24862027

Possover, Marc; Uehlinger, Kurt; Ulrich Exner, G.

2014-01-01

400

Modifications to Facilitate Extraperitoneal Robot-Assisted Radical Prostatectomy Post Kidney Transplant  

PubMed Central

Introduction: Renal transplantation is the treatment of choice for patients with end-stage renal failure. With advances in immunosuppression, the short-term and long-term outcome has improved significantly. Subsequently, urologists are encountering more transplant recipients with genitourinary malignancies, and therefore urologists are becoming increasingly compelled to offer curative treatment options. Materials and Methods: We present modifications to facilitate E-RARP in these patients that include modified trocar arrangement, delayed bladder neck transection, utilizing the robotic Hem-o-lok applier, and posterior reconstruction of the anastomosis using a barbed V-loc suture. A 68-year-old male with a history of polycystic kidney disease, end-stage renal failure, and an allograft renal transplantation in the right iliac fossa, presented with T1c, Gleason 3+4 prostate cancer. He had a preoperative PSA of 6.93ng/mL, ASA score of 3, and a BMI of 26kg/m2. Follow-up for metastasis (MRI and bone scan) was negative. E-RARP was performed via the extraperitoneal approach using a 5-port 2-arm approach at an insufflation pressure of 10mm Hg. Results: The radical prostatectomy was successfully performed. Ureterovesical anastomosis was completed, and total console time was 130 minutes, with an estimated blood loss of 125mL. Final pathology was T2bNx, Gleason 3+4 with negative surgical margins. The patient was discharged with no change in serum creatinine or GFR. The catheter was removed on POD 10 with no intraoperative or immediate postoperative complications. Conclusion: E-RARP in the carefully selected renal allograft recipient is feasible and accomplished safely with technical modifications to avoid injuring the renal allograft, transplanted ureter, and ureteroneocystostomy. PMID:23477187

Erturk, Erdal; Joseph, Jean V.

2012-01-01

401

Vitamin A deficiency in quail  

USGS Publications Warehouse

Two experiments were conducted to determine the symptoms of avitaminosis A in growing and adolescent bobwhites. Chicks from parents that have received a diet rich in vitamin A may have enough stored to carry them a week or ten days on a growing diet deficient in vitamin A before symptoms of deficiency occur. The first sign is ruffled feathering, with the wing primaries standing out from the body and drooping. Ophthalmia in one or both eyes occurs and may close the eyes completely, but this condition is not severe in all cases and may not even be noticeable. Birds show poor growth, loss of appetite, and weakness before death. Under the conditions of the experiments discussed herein, death may occur in the fourth or fifth week, and mortality is high......Postmortem examination may reveal visceral gout with thick deposits of urates on the kidneys, in the ureters, on the heart, in the proventriculus, and occasionally covering all the viscera. There may also be hemorrhage of the heart and other organs....Adolescent quail reared on a diet rich in vitamin A may be able to live through the winter on a maintenance diet low in this vitamin without showing symptoms of avitaminosis, but some individuals whose storage of vitamin A in the liver is not as great as that of others may succumb to visceral gout.....A growing mash for quail which contains sufficient vitamin A when fresh may, after a period of storage, lose enough of the vitamin to cause the characteristic symptoms of avitaminosis A to appear.

Nestler, R.B.; Bailey, W.W.

1943-01-01

402

Frequency-doubled dual-pulse freddy lithrotripsy laser in the treatment of urinary tract calculi  

NASA Astrophysics Data System (ADS)

Background and Purpose: The Frequency-Doubled Dual-Pulse Nd:YAG FREDDY laser is a short-pulsed, solid-state laser with wavelengths of 532 and 1064 nm that was developed for intracorporeal lithothripsy. This clinical study is designed to test its fragmentation efficiency in the treatment of urinary tract calculi. Patients and Methods: 500 urinary tract calculi treated in 194 female and 306 male patients with a mean age of 46 years. All patients were assessed one week post-op with a plain film of the kidneys, ureters and bladder. Stone-free rate and final outcome have been evaluated. Final outcome is defined as stone-free or residual fragments. Analysis has been made according to stone size, location and number of stones. The analgesia requirements during each treatment and complications have also been analyzed. Results: The overall stone-free rate for patients was 92.4%. The success rate for upper ureteral was 85.1% (126/148), while the rate for mid/lower was 95.3% (307/322). Bladder stone success rate 96.6% (29/30). Of all 38 incomplete fragmentations, 20 cases (4%) were treated with ESWL and 18 cases (3.6%) had open surgery. Neither fever nor pyonephrosis was reported. The average laser treatment time was 3.3 minutes and the average post-op hospitalization was 2.5 days. Conclusions: The FREDDY laser is an extremely efficient and safe minimally invasive lithotripsy treatment for urinary stones. It should be considered as an alternative treatment for urolithiasis.

Huang, Xuyuan; Bo, Juanjie; Chen, Bin; Wang, Yi-Xin

2005-07-01

403

Impaired EphA4 signaling leads to congenital hydronephrosis, renal injury, and hypertension.  

PubMed

Experimental hydronephrosis induced by partial ureteral obstruction at 3 wk of age causes hypertension and renal impairment in adult rats and mice. Signaling by Ephrin receptors (Eph) and their ligands (ephrins) importantly regulates embryonic development. Genetically modified mice, where the cytoplasmic domain of the EphA4 receptor has been substituted by enhanced green fluorescent protein (EphA4gf/gf), develop spontaneous hydronephrosis and provide a model for further studies of the disorder. The present study aimed to determine if animals with congenital hydronephrosis develop hypertension and renal injuries, similar to that of experimental hydronephrosis. Ultrasound and Doppler techniques were used to visualize renal impairment in the adult mice. Telemetric blood pressure measurements were performed in EphA4gf/gf mice and littermate controls (EphA4+/+) during normal (0.7% NaCl)- and high (4% NaCl)-sodium conditions. Renal excretion, renal plasma flow, and glomerular filtration were studied, and histology and morphology of the kidneys and ureters were performed. EphA4gf/gf mice developed variable degrees of hydronephrosis that correlated with their blood pressure level. In contrast to EphA4+/+, the EphA4gf/gf mice displayed salt-sensitive hypertension, reduced urine concentrating ability, reduced renal plasma flow, and lower glomerular filtration rate. Kidneys from EphA4gf/gf mice showed increased renal injuries, as evidenced by fibrosis, inflammation, and glomerular and tubular changes. In conclusion, congenital hydronephrosis causes hypertension and renal damage, similar to that observed in experimentally induced hydronephrosis. This study further reinforces the supposed causal link between hydronephrosis and later development of hypertension in humans. PMID:23637205

Sällström, Johan; Peuckert, Christiane; Gao, Xiang; Larsson, Erik; Nilsson, Anders; Jensen, Boye L; Onozato, Maristela L; Persson, A Erik G; Kullander, Klas; Carlström, Mattias

2013-07-01

404

Nucleic acid-based tissue biomarkers of urologic malignancies.  

PubMed

Molecular biomarkers play an important role in the clinical management of cancer patients. Biomarkers allow estimation of the risk of developing cancer; help to diagnose a tumor, ideally at an early stage when cure is still possible; and aid in monitoring disease progression. Furthermore, they hold the potential to predict the outcome of the disease (prognostic biomarkers) and the response to therapy (predictive biomarkers). Altogether, biomarkers will help to avoid tumor-related deaths and reduce overtreatment, and will contribute to increased survival and quality of life in cancer patients due to personalized treatments. It is well established that the process of carcinogenesis is a complex interplay between genomic predisposition, acquired somatic mutations, epigenetic changes and genomic aberrations. Within this complex interplay, nucleic acids, i.e. RNA and DNA, play a fundamental role and therefore represent ideal candidates for biomarkers. They are particularly promising candidates because sequence-specific hybridization and amplification technologies allow highly accurate and sensitive assessment of these biomarker levels over a broad dynamic range. This article provides an overview of nucleic acid-based biomarkers in tissues for the management of urologic malignancies, i.e. tumors of the prostate, testis, kidney, penis, urinary bladder, renal pelvis, ureter and other urinary organs. Special emphasis is put on genomic, transcriptomic and epigenomic biomarkers (SNPs, mutations [genomic and mitochondrial], microsatellite instabilities, viral and bacterial DNA, DNA methylation and hydroxymethylation, mRNA expression, and non-coding RNAs [lncRNA, miRNA, siRNA, piRNA, snRNA, snoRNA]). Due to the multitude of published biomarker candidates, special focus is given to the general applicability of different molecular classes as biomarkers and some particularly promising nucleic acid biomarkers. Furthermore, specific challenges regarding the development and clinical implementation of nucleic acid-based biomarkers are discussed. PMID:24878394

Dietrich, Dimo; Meller, Sebastian; Uhl, Barbara; Ralla, Bernhard; Stephan, Carsten; Jung, Klaus; Ellinger, Jörg; Kristiansen, Glen

2014-08-01

405

Changes in gut and Malpighian tubule transport during seasonal acclimatization and freezing in the gall fly Eurosta solidaginis.  

PubMed

Since few studies have examined cold tolerance at the organ level in insects, our primary objective was to characterize the functional responses of the gut and Malpighian tubules (MT) to seasonal acclimatization, chilling and freezing in larvae of the goldenrod gall fly Eurosta solidaginis Fitch (Diptera, Tephritidae). From September to December, hemolymph osmolality (455-926 mOsmol kg l(-1)) and freezing tolerance increased markedly in field-collected larvae. Chlorophenol Red was readily transported into the lumen of the foregut, the posterior portion of the midgut, the ureter, the proximal region of the anterior pair of MT, and entire posterior pair of MT. Ouabain and KCN inhibited transport of Chlorophenol Red in the gut and MT. Transport was readily detected at 0 degrees C and the rate of transport was directly related to temperature. The rate of fluid transport by the MT decreased steadily from a monthly high in September (10.7+/-0.8 nl min(-1) for the anterior pair; 12.7+/-1.0 nl min(-1) for the posterior pair) until secretion was no longer detectable in December; this decrease parallels entry into diapause for this species. Even in larvae that died following freezing for 40 days at -20 degrees C, individual organ function was retained to a limited extent. Through the autumn, cholesterol concentrations in the hemolymph increased nearly fourfold. In contrast, the ratio of cholesterol to protein content (nmol mg l(-1)) in the MT membrane remained relatively constant (22 approximately 24 nmol mg l(-1) protein) during this period. Freezing of larvae for 20 days at -20 degrees C caused a significant decrease in cholesterol levels in the hemolymph and the MT membranes compared to unfrozen controls. These results suggest that cholesterol plays a role in seasonal cold hardening and freeze tolerance in insects. PMID:15879070

Yi, Shu-Xia; Lee, Richard E

2005-05-01

406

Noninvasive Biophotonic Imaging for Monitoring of Catheter-Associated Urinary Tract Infections and Therapy in Mice  

PubMed Central

Urinary tract infections (UTIs) are among the most common bacterial infections acquired by humans, particularly in catheterized patients. A major problem with catheterization is the formation of bacterial biofilms on catheter material and the risk of developing persistent UTIs that are difficult to monitor and eradicate. To better understand the course of UTIs and allow more accurate studies of in vivo antibiotic efficacy, we developed a catheter-based biofilm infection model with mice, using bioluminescently engineered bacteria. Two important urinary tract pathogens, Pseudomonas aeruginosa and Proteus mirabilis, were made bioluminescent by stable insertion of a complete lux operon. Segments of catheter material (precolonized or postimplant infected) with either pathogen were placed transurethrally in the lumen of the bladder by using a metal stylet without surgical manipulation. The bioluminescent strains were sufficiently bright to be readily monitored from the outside of infected animals, using a low-light optical imaging system, including the ability to trace the ascending pattern of light-emitting bacteria through ureters to the kidneys. Placement of the catheter in the bladder not only resulted in the development of strong cystitis that persisted significantly longer than in mice challenged with bacterial suspensions alone but also required prolonged antibiotic treatment to reduce the level of infection. Treatment of infected mice for 4 days with ciprofloxacin at 30 mg/kg of body weight twice a day cured cystitis and renal infection in noncatheterized mice. Similarly, ciprofloxacin reduced the bacterial burden to undetectable levels in catheterized mice but did not inhibit rebound of the infection upon cessation of antibiotic therapy. This methodology easily allows spatial information to be monitored sequentially throughout the entire disease process, including ascending UTI, treatment efficacy, and relapse, all without exogenous sampling, which is not possible with conventional methods. PMID:15972473

Kadurugamuwa, Jagath L.; Modi, Kshitij; Yu, Jun; Francis, Kevin P.; Purchio, Tony; Contag, Pamela R.

2005-01-01

407

Noninvasive biophotonic imaging for monitoring of catheter-associated urinary tract infections and therapy in mice.  

PubMed

Urinary tract infections (UTIs) are among the most common bacterial infections acquired by humans, particularly in catheterized patients. A major problem with catheterization is the formation of bacterial biofilms on catheter material and the risk of developing persistent UTIs that are difficult to monitor and eradicate. To better understand the course of UTIs and allow more accurate studies of in vivo antibiotic efficacy, we developed a catheter-based biofilm infection model with mice, using bioluminescently engineered bacteria. Two important urinary tract pathogens, Pseudomonas aeruginosa and Proteus mirabilis, were made bioluminescent by stable insertion of a complete lux operon. Segments of catheter material (precolonized or postimplant infected) with either pathogen were placed transurethrally in the lumen of the bladder by using a metal stylet without surgical manipulation. The bioluminescent strains were sufficiently bright to be readily monitored from the outside of infected animals, using a low-light optical imaging system, including the ability to trace the ascending pattern of light-emitting bacteria through ureters to the kidneys. Placement of the catheter in the bladder not only resulted in the development of strong cystitis that persisted significantly longer than in mice challenged with bacterial suspensions alone but also required prolonged antibiotic treatment to reduce the level of infection. Treatment of infected mice for 4 days with ciprofloxacin at 30 mg/kg of body weight twice a day cured cystitis and renal infection in noncatheterized mice. Similarly, ciprofloxacin reduced the bacterial burden to undetectable levels in catheterized mice but did not inhibit rebound of the infection upon cessation of antibiotic therapy. This methodology easily allows spatial information to be monitored sequentially throughout the entire disease process, including ascending UTI, treatment efficacy, and relapse, all without exogenous sampling, which is not possible with conventional methods. PMID:15972473

Kadurugamuwa, Jagath L; Modi, Kshitij; Yu, Jun; Francis, Kevin P; Purchio, Tony; Contag, Pamela R

2005-07-01

408

Role of TREM1-DAP12 in renal inflammation during obstructive nephropathy.  

PubMed

Tubulo-interstitial damage is a common finding in the chronically diseased kidney and is characterized by ongoing inflammation and fibrosis leading to renal dysfunction and end-stage renal disease. Upon kidney injury, endogenous ligands can be released which are recognized by innate immune sensors to alarm innate immune system. A new family of innate sensors is the family of TREM (triggering receptor expressed on myeloid cell). TREM1 is an activating receptor and requires association with transmembrane adapter molecule DAP12 (DNAX-associated protein 12) for cell signaling. TREM1-DAP12 pathway has a cross-talk with intracellular signaling pathways of several Toll-like receptors (TLRs) and is able to amplify TLR signaling and thereby contributes to the magnitude of inflammation. So far, several studies have shown that TLRs play a role in obstructive nephropathy but the contribution of TREM1-DAP12 herein is unknown. Therefore, we studied TREM1 expression in human and murine progressive renal diseases and further investigated the role for TREM1-DAP12 by subjecting wild-type (WT), TREM1/3 double KO and DAP12 KO mice to murine unilateral ureter obstruction (UUO) model. In patients with hydronephrosis, TREM1 positive cells were observed in renal tissue. We showed that in kidneys from WT mice, DAP12 mRNA and TREM1 mRNA and protein levels were elevated upon UUO. Compared to WT mice, DAP12 KO mice displayed less renal MCP-1, KC and TGF-?1 levels and less influx of macrophages during progression of UUO, whereas TREM1/3 double KO mice displayed less renal MCP-1 level. Renal fibrosis was comparable in WT, TREM1/3 double KO and DAP12 KO mice. We conclude that DAP12, partly through TREM1/3, is involved in renal inflammation during progression of UUO. PMID:24358193

Tammaro, Alessandra; Stroo, Ingrid; Rampanelli, Elena; Blank, Froilan; Butter, Loes M; Claessen, Nike; Takai, Toshiyuki; Colonna, Marco; Leemans, Jaklien C; Florquin, Sandrine; Dessing, Mark C

2013-01-01

409

Renal functional decline and glomerulotubular injury are arrested but not restored by release of unilateral ureteral obstruction (UUO).  

PubMed

Murine unilateral ureteral obstruction (UUO), a major model of progressive kidney disease, causes loss of proximal tubular mass and formation of atubular glomeruli. Adult C57BL/6 mice underwent a sham operation or reversible UUO under anesthesia. In group 1, kidneys were harvested after 7 days. In group 2, the obstruction was released after 7 days, and a physiological study of both kidneys was performed 30 days later. Renal blood flow (RBF), glomerular filtration rate (GFR), urine protein, and albumin excretion were measured after ligation of either the left or right ureter. Glomerular volume (periodic acid-Schiff), glomerulotubular integrity and proximal tubular mass (Lotus tetragonolobus lectin), and interstitial collagen (Sirius red) were measured by histomorphometry. Obstructed kidney weight was reduced by 15% at 7 days but was not different from sham after a 30-day recovery. Glomerular volume and proximal tubular area of the obstructed kidney were reduced by 55% at 7 days, but normalized after 30 days. Interstitial collagen deposition increased 2.4-fold after 7 days of UUO and normalized after release. However, GFR and RBF were reduced by 40% and urine albumin/protein ratio was increased 2.8-fold 30 days after release of UUO. This was associated with a 50% reduction in glomerulotubular integrity despite a 30-day recovery (P < 0.05 for all data). We conclude that release of 7-day UUO can arrest progression but does not restore normal function of the postobstructed kidney. Although the remaining intact nephrons have hypertrophied, glomerular injury is revealed by albuminuria. These results suggest that glomerulotubular injury should become the primary target of slowing progressive kidney disease. PMID:23220725

Chaabane, Wassim; Praddaude, Françoise; Buleon, Marie; Jaafar, Acil; Vallet, Marion; Rischmann, Pascal; Galarreta, Carolina I; Chevalier, Robert L; Tack, Ivan

2013-02-15

410

Vasohibin-1 deficiency enhances renal fibrosis and inflammation after unilateral ureteral obstruction.  

PubMed

Tubulointerstitial injuries are known to predict the deterioration of renal function in chronic kidney disease (CKD). We recently reported the protective role of Vasohibin-1(VASH-1), a negative feedback regulator of angiogenesis, in diabetic nephropathy, but its impact on tubulointerstitial injuries remains to be elucidated. In the present study, we evaluated the role of endogenous VASH-1 in regulating the tubulointerstitial alterations induced by unilateral ureteral obstruction (UUO), and assessed its role on fibrogenesis and the activation of Smad3 signaling in renal fibroblasts. UUO was induced in female Vasohibin-1 heterozygous knockout mice (VASH-1(+/-)) or wild-type (WT) (VASH-1(+/+)) littermates. Mice were sacrificed on Day 7 after left ureter ligation, and the kidney tissue was obtained. Interstitial fibrosis, the accumulation of type I and type III collagen and monocytes/macrophages infiltration in the obstructed kidneys (OBK) were significantly exacerbated in VASH-1(+/-) mice compared with WT mice (Day 7). The increases in the renal levels of TGF-?1, pSmad3, NF-?B pp65, CCL2 mRNA, and the number of interstitial fibroblast-specific protein-1 (FSP-1)(+) fibroblasts in the OBK were significantly aggravated in VASH-1(+/-) mice. In addition, treatment with VASH-1 siRNA enhanced the TGF-?1-induced phosphorylation of Smad3, the transcriptional activation of the Smad3 pathway and the production of type I/type III collagen in fibroblasts, in vitro. Taken together, our findings demonstrate a protective role for endogenous VASH-1 on tubulointerstitial alterations via its regulation of inflammation and fibrosis and also show the direct anti-fibrotic effects of VASH-1 on renal fibroblasts through its modulation of TGF-?1 signaling. PMID:24973329

Watatani, Hiroyuki; Maeshima, Yohei; Hinamoto, Norikazu; Yamasaki, Hiroko; Ujike, Haruyo; Tanabe, Katsuyuki; Sugiyama, Hitoshi; Otsuka, Fumio; Sato, Yasufumi; Makino, Hirofumi

2014-06-01

411

Extended lymph node dissection in robot-assisted radical prostatectomy: lymph node yield and distribution of metastases  

PubMed Central

In this study, we reported our experience performing robotic extended lymph node dissection (eLND) in patients with prostate cancer. A total of 147 patients with intermediate and high-risk prostate cancer who underwent robotic eLND from May 2008 to December 2011 were included in this analysis. The dissection template extended to the ureter crossing the iliac vessels. We assessed lymph node yield, lymph node positivity, and perioperative outcomes. Lymph node positivity was also evaluated according to the number of lymph nodes (LNs) removed (<22 vs ?22). The median number of LNs removed was 22 (11–51), and 97 positive LNs were found in 24 patients (16.3%). While the obturator fossa was the most common site for LN metastases (42.3%, 41/97), the internal iliac area was the most common area for a single positive LN packet (20.8%, 5/24). Eight patients (33.3%, 8/24) had positive LNs at the common iliac area. The incidence of positive LNs did not differ according to the number of LNs removed. Complications associated with eLND occurred in 21 patients (14.3%) and symptomatic lymphocele was found in five patients (3.4%). In conclusion, robotic eLND can be performed with minimal morbidity. Furthermore, LN yield and the node positive rate achieved using this robotic technique are comparable to those of open series. In addition, the extent of dissection is more important than the absolute number of LNs removed in eLND, and the robotic technique is not a prohibitive factor for performing eLND. PMID:25038184

Kim, Kwang Hyun; Lim, Sey Kiat; Koo, Kyo Chul; Han, Woong Kyu; Hong, Sung Joon; Rha, Koon Ho

2014-01-01

412

Evaluation of the Effect of Photoselective Vaporization of the Prostate on Sexual Function in a Prospective Study: A Single Center Experience of 150 Patients.  

PubMed

Abstract Background and Purpose: Photoselective vaporization of the prostate (PVP) has emerged as a minimally invasive alternative to transurethral resection of the prostate for treatment of benign prostate hyperplasia (BPH) with lower urinary tract symptoms (LUTS). Very few prospective studies have addressed the effect of PVP on sexual function. We performed this prospective study to assess the short-term effect of PVP on erectile function in patients who present with LUTS secondary to BPH. Patients and Methods: There were 150 consecutive patients who presented with LUTS secondary to BPH who underwent PVP and who were enrolled prospectively in this study. Patients were categorized in two groups: Group A, International Index of Erectile Function (IIEF) ?19; group B, IIEF <19. PVP was performed by using an 80?W GreenLight laser. Patients preoperative, perioperative, and follow-up data were recorded. Erectile function was assessed preoperatively and postoperatively at 1, 3, 6, and 12 months using IIEF-5. In follow-up, Ultrasonography of the kidneys, ureters, and bladder for residual prostate and postvoid residual urine, uroflowmetry, kidney function tests, and urine culture were performed at each visit. Cystoscopy was performed at 3 months. Data were analyzed statistically. Results: The two patient groups were comparable in their preoperative and perioperative data. Both groups showed improvement in International Prostate Symptom Score, maximum flow rate, quality of life, and decrease in postvoid residual urine at 1, 3, 6, and 12 months with no statistical significance. IIEF-5 scores in Group A, however, were 21.1, 19.2, 17.1, 16.2, and 16.1, respectively, at preoperative, postoperative month 1, 3, 6, and 12, respectively (P=0.02). IIEF-5 scores in Group B were 13.2, 12.1, 11.3, 11.2, and 10.9, respectively, at preoperative, postoperative month 1, 3, 6, and 12, respectively (P=0.45). Conclusions: In patients with normal preoperative erectile function, PVP resulted in significant decrease in EF up to follow-up of 1 year. In patients with preoperative ED, however, PVP did not significantly decrease EF. PMID:22849319

Kumar, Anup; Vasudeva, Pawan; Kumar, Niraj; Nanda, Biswajit; Mohanty, Nayan K

2012-10-01

413

Characterization of a unique technique for culturing primary adult human epithelial progenitor/“stem cells”  

PubMed Central

Background Primary keratinocytes derived from epidermis, oral mucosa, and urothelium are used in construction of cell based wound healing devices and in regenerative medicine. This study presents in vitro technology that rapidly expands keratinocytes in culture by growing monolayers under large volumes of serum-free, essential fatty acid free, low calcium medium that is replaced every 24?hrs. Methods Primary cell cultures were produced from epidermal skin, oral mucosa and ureter by trypsinization of tissue. Cells were grown using Epilife medium with growth factors under high medium volumes. Once densely confluent, the keratinocyte monolayer produced cells in suspension in the overlying medium that can be harvested every 24?hrs. over a 7–10?day period. The cell suspension (approximately 8 X 105 cells/ml) is poured into a new flask to form another confluent monolayer over 2–4?days. This new culture, in turn produced additional cell suspensions that when serially passed expand the cell strain over 2–3?months, without the use of enzymes to split the cultures. The cell suspension, called epithelial Pop Up Keratinocytes (ePUKs) were analyzed for culture expansion, cell size and glucose utilization, attachment to carrier beads, micro-spheroid formation, induction of keratinocyte differentiation, and characterized by immunohistochemistry. Results The ePUKs expanded greatly in culture, attached to carrier beads, did not form micro-spheroids, used approximately 50% of medium glucose over 24?hrs., contained a greater portion of smaller diameter cells (8–10 microns), reverted to classical appearing cultures when returned to routine feeding schedules (48?hrs. and 15?ml/T-75 flask) and can be differentiated by either adding 1.2?mM medium calcium, or essential fatty acids. The ePUK cells are identified as cycling (Ki67 expressing) basal cells (p63, K14 expressing). Conclusions Using this primary culture technique, large quantities of epithelial cells can be generated without the use of the enzyme trypsin to split the cultures. The cells are small in diameter and have basal cell progenitor/”stem” (P/SC) cell characteristics induced by daily feeding with larger than normal medium volumes. The ePUK epithelial cells have the potential to be used in regenerative medicine and for basic studies of epithelia P/SC phenotype. PMID:22726819

2012-01-01

414

Comparative evaluation of efficacy of use of naftopidil and/or celecoxib for medical treatment of distal ureteral stones.  

PubMed

We performed a randomized, prospective study to assess the possible role of combined a1D-receptor antagonist naftopidil and nonsteroidal anti-inflammatory hormones celecoxib for the spontaneous expulsion of distal ureteral stones. Patients were randomized to one of the three treatment groups. Treatment group 1 patients received naftopidil 50 mg/day, group 2 patients received naftopidil 50 mg/day plus celecoxib 200 mg (Take two capsules (400 mg) by mouth immediately, then take one capsule (200 mg) by mouth every 12 h), and group 3 patients received celecoxib 200 mg (Take two capsules (400 mg) by mouth immediately, then take one capsule (200 mg) by mouth every 12 h). All patients were instructed to drink at least 2 L of fluids daily. Pain descriptions were recorded by the patients using the visual analog scale. All patients were followed up for 2 weeks. A total of 105 patients provided consent and 103 patients completed the study. Stone expulsion was observed in 29 patients in group 1 (29 of 35, 82.86 %), 33 patients in group 2 (33 of 35, 94.29 %) and 20 patients in group 3 (20 of 33, 60.61 %). A statistically significant difference was noted with Chi-square testing for stone expulsion rate between groups 1 and 3, and groups 2 and 3 (P = 0.04 and P = 0.000, respectively). Kaplan-Meier curves were plotted to access the expulsion rate of each group over time. A significant difference was shown for the expulsion rate between the group 3 and the other two groups. (P < 0.001 by log-rank test).Average time to expulsion for groups 1, 2 and 3 was 8.00 ± 2.07, 7.70 ± 2.34 and 10.65 ± 2.92 days, respectively (P = 0.000). Treatment with naftopidil and celecoxib appears to be beneficial in distal ureter stone clearance, shortened the expulsion time, and could be used reliably and successfully to reduce the frequency and intensity of the pain episodes particularly. PMID:25139150

Lv, Jian Lin; Tang, Qing Lai

2014-12-01

415

A Novel Model of Urinary Tract Differentiation, Tissue Regeneration, and Disease: Reprogramming Human Prostate and Bladder Cells into Induced Pluripotent Stem Cells  

PubMed Central

Background Primary culture and animal and cell-line models of prostate and bladder development have limitations in describing human biology, and novel strategies that describe the full spectrum of differentiation from foetal through to ageing tissue are required. Recent advances in biology demonstrate that direct reprogramming of somatic cells into pluripotent embryonic stem cell (ESC)-like cells is possible. These cells, termed induced pluripotent stem cells (iPSCs), could theoretically generate adult prostate and bladder tissue, providing an alternative strategy to study differentiation. Objective To generate human iPSCs derived from normal, ageing, human prostate (Pro-iPSC), and urinary tract (UT-iPSC) tissue and to assess their capacity for lineage-directed differentiation. Design, setting, and participants Prostate and urinary tract stroma were transduced with POU class 5 homeobox 1 (POU5F1; formerly OCT4), SRY (sex determining region Y)-box 2 (SOX2), Kruppel-like factor 4 (gut) (KLF4), and v-myc myelocytomatosis viral oncogene homolog (avian) (MYC, formerly C-MYC) genes to generate iPSCs. Outcome measurements and statistical analysis The potential for differentiation into prostate and bladder lineages was compared with classical skin-derived iPSCs. The student t test was used. Results and limitations Successful reprogramming of prostate tissue into Pro-iPSCs and bladder and ureter into UT-iPSCs was demonstrated by characteristic ESC morphology, marker expression, and functional pluripotency in generating all three germ-layer lineages. In contrast to conventional skin-derived iPSCs, Pro-iPSCs showed a vastly increased ability to generate prostate epithelial-specific differentiation, as characterised by androgen receptor and prostate-specific antigen induction. Similarly, UT-iPSCs were shown to be more efficient than skin-derived iPSCs in undergoing bladder differentiation as demonstrated by expression of urothelial-specific markers: uroplakins, claudins, and cytokeratin; and stromal smooth muscle markers: ?-smooth-muscle actin, calponin, and desmin. These disparities are likely to represent epigenetic differences between individual iPSC lines and highlight the importance of organ-specific iPSCs for tissue-specific studies. Conclusions IPSCs provide an exciting new model to characterise mechanisms regulating prostate and bladder differentiation and to develop novel approaches to disease modelling. Regeneration of bladder cells also provides an exceptional opportunity for translational tissue engineering. PMID:23582880

Moad, Mohammad; Pal, Deepali; Hepburn, Anastasia C.; Williamson, Stuart C.; Wilson, Laura; Lako, Majlinda; Armstrong, Lyle; Hayward, Simon W.; Franco, Omar E.; Cates, Justin M.; Fordham, Sarah E.; Przyborski, Stefan; Carr-Wilkinson, Jane; Robson, Craig N.; Heer, Rakesh

2013-01-01

416

Pediatric transperitoneal laparoscopic partial nephrectomy: comparison with an age-matched group undergoing open surgery.  

PubMed

We have retrospectively evaluated the effectiveness of laparoscopic transperitoneal partial nephrectomy (LTPN) in children in comparison to an age-matched group of children who underwent open partial nephrectomy (OPN) in terms of safety, operative time, narcotic requirements and the length of hospitalization. All patients were divided into two groups. The first group of 10 children with a mean age of 3.6 +/- 1.3 years (mean +/- SEM) who underwent LTPN compared with an age and gender matched second group of 10 children with a mean age of 3.9 +/- 1.4 years who underwent OPN (P = 0.9119). In the first group, 5 upper poles and 5 lower poles partial nephrectomies were performed while in the second group 6 upper moieties and 4 lower moieties partial nephrectomies were performed, respectively. There was a single complication in each group. Intraoperative injury to the unaffected ureter was recognized during LTPN and required conversion to the open surgery in the beginning of learning curve and persistent urinary leakage from collecting system of the remnant pole in the OPN group, which resolved spontaneously. There was no difference in length of surgery and the intraoperative narcotic requirements (P = 0.8182, 0.7638, respectively). However, postoperative narcotic requirements were significantly lower in the first group 0.56 +/- 0.29 mg/kg compared to the second group 2.13 +/- 0.3 mg/kg, P = 0.0019. LTPN patients had significantly shorter hospitalization 2.7 +/- 0.29 days compared with the OPN group 5.1 +/- 0.64 days, P = 0.0039. Similar findings were also found in the subgroup of patients younger than 2 years. Median follow up in each group was 28 and 36 months, respectively. Our data show that LTPN is a safe and effective minimally invasive procedure at every age. It has an equivalent operative time, shorter hospitalization and lower postoperative narcotic requirements compared to the open approach. PMID:17899132

Chertin, Boris; Ben-Chaim, Jacob; Landau, Ezekiel H; Koulikov, Dmitry; Nadu, Andrei; Reissman, Petachia; Farkas, Amicur; Mor, Yoram

2007-12-01

417

[Testicular localization of extranodal multifocal non-Hodgkin lymphoma. Report of two cases, review of the literature and clinical considerations.  

PubMed

The aim of our study is to describe two cases of testicular localization of non- Hodgkin Lymphoma associated with the involvement of other extranodal organs, and to investigate the possible causes of this association according to the evidences found in literature. Non-Hodgkin Lymphoma is extranodal in 25% of cases. Most of the times the organs involved are stomach, bowel, skin, central nervous system. About urological localizations, the most common is testis. Very rare is to find lymphoma in kidney, prostate, urinary bladder, and ureter. Testicular lymphoma is about 5% of testis malignancies; it is more frequent in the 7th and in the 8th decade. Metastases of testicular non-Hodgkin lymphoma are described also many years later, and also in distant organs. Primary forms are usually "diffuse large B cell", a high-grade histotype; metastatic ones often show Burkitt cells. The standard therapy used for non-Hodgkin Lymphomas does not reach testis and central nervous system, so that these sites are called "Therapeutic Shrines". Therefore, in order to prevent testicular localization, it is necessary to use radiotherapy, and for nervous system prophylaxis it is necessary to administer intrathecal chemotherapy. More than one localization of non-Hodgkin lymphoma simultaneously found may indicate not only a metastatic spread, but also a multicentric origin. We describe two patients who had one testis removed because of a big mass that turned out to be a non-Hodgkin lymphoma. The first patient had been treated for a non-Hodgkin lymphoma of maxillary sinus 20 months before. The second patient showed contemporary involvement of other organs. In both cases the different localizations of non-Hodgkin lymphoma showed the same histological features and cellular immunophenotype. It is important to underline that in the former patient staging TC, repeated many times, had always been negative, but physical examination of testis had been omitted, so that sinonasal localization, assumed to be the first one, really might have been the spread of an undetected testis lymphoma. In conclusion, in case of extranodal non- Hodgkin lymphoma or any other malignancies, manual or ultrasound examination of testis should never be omitted, because standard techniques of staging (TC, RMN, PET) cannot explore this organ. PMID:21086316

Chierigo, P; Nicolardi, L; Rahmati, M; Lazzarotto, M; Brotza, D; Bassan, F; Franzolin, N

2009-01-01

418

Effect of Medullary Tonicity on Urinary Sodium Excretion in the Rat  

PubMed Central

In previous reports from this laboratory we have suggested that a reduction in medullary tonicity decreases the thin ascending loop of Henle sodium reabsorption and is in part responsible for the magnitude for the natriuresis accompanying 10% body weight Ringer loading. According to this postulate, one would expect that the medullary washout associated with water diuresis would also result in a natriuresis, but this does not occur. It is possible, however, that increased delivery from the proximal tubule is necessary to demonstrate an effect of medullary tonicity on urinary sodium excretion. Micropuncture studies were designed to test that possibility by increasing distal delivery by 2% Ringer loading in animals with and without reduced medullary tonicity. In an initial series of experiments the ?-adrenergic agonist clonidine was used to induce a water diuresis. When given alone, this agent caused a marked decrease in urine osmolality and an increase in urine flow rate but had no effect on proximal reabsorption in either superficial or juxtamedullary nephrons, and did not alter urinary sodium excretion. Volume expansion with 2% body weight Ringer solution resulted in a significant fall in proximal reabsorption and a trivial increment in sodium excretion. When this same degree of volume expansion was conferred on animals undergoing a water diuresis, a marked increase in absolute and fractional sodium excretion occurred. In a second group of studies medullary tonicity was reduced in the left kidney only by removal of the left ureter 1 h before micropuncture. When these animals were infused with 2% body weight Ringer solution, proximal reabsorption was decreased in juxtamedullary nephrons, and a marked increase in sodium excretion was observed only from the left kidney. Finally, the effect of water diuresis on fractional sodium delivery to the early and late distal tubule of superficial nephrons during 2% Ringer loading was evaluated. Delivery to both of these sites was comparable after 2% Ringer loading alone and during 2% Ringer loading plus water diuresis. From these data, we conclude that medullary tonicity does influence renal sodium handling but that this effect is manifest in the final urine only under conditions in which proximal reabsorption is decreased. The data also suggest that this effect is limited to juxtamedullary nephrons and is probably localized to the thin ascending limb of the loop of Henle. PMID:7076854

Reineck, H. John; Parma, Retta

1982-01-01

419

Comparison of scaffold-enhanced albumin and n-butyl-cyanoacrylate adhesives for joining of tissue in a porcine model  

NASA Astrophysics Data System (ADS)

An ex vivo study was conducted to compare the tensile strength of tissue samples repaired using three different techniques: (i) application of a scaffold-enhanced light-activated albumin protein solder, (ii) application of a scaffold-enhanced n-butyl-cyanoacrylate adhesive, and (iii) repair via conventional suture technique. Biodegradable polymer scaffolds of controlled porosity were fabricated with poly(L-lactic-co-glycolic acid) and salt particles using a solvent-casting and particulate-leaching technique. Group I porous scaffolds were doped with protein solder composed of 50%(w/v) bovine serum albumin solder and 0.5mg/ml indocyanine green dye mixed in deionized water, and activated with an 808-nm diode laser. Group II scaffolds were doped with n-butyl-cyanoacrylate, and required no light-activation. No stay sutures were required for Group I or II experiments. Group III repairs were performed using a single 4-0 suture. Thirteen organs were tested ranging from skin to liver to the small intestine, as well as the coronary, pulmonary, carotid, femoral and splenic arteries. Acute breaking strengths were measured and the data were analyzed by Student"s T-test. Using the protein solder of Group I, repairs formed on the ureter were most successful followed by small intestine, sciatic nerve, spleen, atrium, kidney, muscle, skin and ventricle. The strongest vascular repairs were achieved in the carotid artery and femoral artery. Overall, the tensile strength of Group III repairs performed via suture techniques were equivalent in magnitude to that of Group I repairs, however, a larger variance was observed in the suture repair group. Group II repairs utilizing the cyanoacrylate-doped scaffold all performed extremely well. Bonds formed using the Group II adhesive were approximately 30% stronger than Group I and III organ repairs and approximately 20% stronger than Group I and III vascular repairs. Application of the polymer scaffold assists in tissue alignment and reduces problems associated with adhesive runaway from the repair site. Scaffold-enhanced adhesives could possibly be used as a simple and effective method to join tissue together quickly and effectively in an emergency situation, or as a substitute to mechanical sutures or staples in many clinical applications.

McNally-Heintzelman, Karen M.; Riley, Jill N.; Heintzelman, Douglas L.

2003-06-01

420

Endoluminal pharmacologic stimulation of the upper urinary tract.  

PubMed

The experiments performed in this PhD thesis were conducted at the Institute of Experimental Surgery, Skejby Hospital, Aarhus, Denmark and at the Laboratory of Animal Science, Odense University Hospital, Denmark. The thesis is based on 3 peer review articles published in international journals and a review. Diagnostic or therapeutic endoscopic upper urinary tract procedures are usually characterised as minimal invasive procedures and associated with a low complication rate. Most often fever or pain are seen and sometimes septicaemia. However, mucosa lesion or even ureteric rupt