Sample records for ureter

  1. Giant ureters

    Microsoft Academic Search

    Subir K. Chatterjee; Ashoke K. Basu

    1987-01-01

    A variety of conditions give rise to an intra-abdominal cystic mass; a distended ureter is one of the least common of these. In 1964, one of us reported two hugely distended ureters. Subsequently three more have been encountered. All presented in boys and involved the left ureter, but had crossed over to the right in two. The structure and function

  2. [Ureter replacement operations].

    PubMed

    Melchior, H; Spehr, C

    1987-07-01

    Reviewing the recent literature and own clinical experiences, the possibilities of replacement of the ureter by isolated bowel segments, alloplastic prostheses and xenoplastic or autoplastic transplants are shown and evaluated. Although used only in single cases, the interposition of the appendix vermiformis into larger defects of the ureter seems to render the best results. The interposition of bowel segments in the urinary tract has been applied more often, the results, however, have been variable. Numerous modifications have been proposed. The use of alloplastic prostheses and free autologic transplants have--up to now--led to no satisfying long-term results. Only human deep frozen umbilical veins as xenotransplants seem to be suitable as ureter replacements. PMID:3307089

  3. Retrocaval Ureter: An Innocent Bystander

    PubMed Central

    NN, Hombalkar; PD, Dhandore; NB, Mody; SS, Bankar

    2014-01-01

    Retrocaval ureter is a rare congenital anomaly, with the ureter passing posterior to the inferior vena cava. Though it is a congenital anomaly, patients do not normally present with symptoms until the 3rd and 4th decades of life, which result from a hydronephrosis. We are presenting a case of 45-year-old lady who had right flank pain and dysuria, which were associated with right hydroureteronephrosis. Diagnosis was confirmed by doing Intravenous Pyelogram (IVP) and patient underwent an open surgical repair of the anomaly. PMID:24995212

  4. Effects by silodosin on the partially obstructed rat ureter in vivo and on human and rat isolated ureters

    PubMed Central

    Villa, L; Buono, R; Fossati, N; Rigatti, P; Montorsi, F; Benigni, F; Hedlund, P

    2013-01-01

    Background and Purpose ?1-adrenoceptor (-AR) antagonists may facilitate ureter stone passage in humans. We aimed to study effects by the ?1A-AR selective antagonist silodosin (compared to tamsulosin and prazosin) on ureter pressures in a rat model of ureter obstruction, and on contractions of human and rat isolated ureters. Experimental Approach After ethical approval, ureters of male rats were cannulated beneath the kidney pelvis for in vivo ureteral intraluminal recording of autonomous peristaltic pressure waves. A partial ureter obstruction was applied to the distal ureter. Mean arterial blood pressure (MAP) was recorded. Approximate clinical and triple clinical doses of the ?1-AR antagonists were given intravenously. Effects by the ?1-AR antagonists on isolated human and rat ureters were studied in organ baths. Key Results Intravenous silodosin (0.1–0.3 mg kg?1) or prazosin (0.03–0.1 mg kg?1) reduced obstruction-induced increases in intraluminal ureter pressures by 21–37% or 18–40% respectively. Corresponding effects by tamsulosin (0.01 or 0.03 mg kg?1) were 9–20%. Silodosin, prazosin and tamsulosin reduced MAP by 10–12%, 25–26% (P < 0.05), or 18–25% (P < 0.05) respectively. When effects by the ?1A-AR antagonists on obstruction-induced ureter pressures were expressed as a function of MAP, silodosin had six- to eightfold and 2.5- to eightfold better efficacy than tamsulosin or prazosin respectively. Silodosin effectively reduced contractions of both human and rat isolated ureters. Conclusions and Implications Silodosin inhibits contractions of the rat and human isolated ureters and has excellent functional selectivity in vivo to relieve pressure-load of the rat obstructed ureter. Silodosin as pharmacological ureter stone expulsive therapy should be clinically further explored. PMID:23373675

  5. CT Urography for Evaluation of the Ureter.

    PubMed

    Potenta, Scott E; D'Agostino, Robert; Sternberg, Kevan M; Tatsumi, Kanayo; Perusse, Karina

    2015-01-01

    Over the past decade, computed tomographic (CT) urography has emerged as the primary imaging modality for evaluating the urinary tract in various clinical settings, including the initial workup of hematuria. With the widespread implementation of CT urography, it is critical for radiologists to understand normal ureteral anatomy and the varied appearance of pathologic ureteral conditions at CT urography. Pathologic findings at CT urography include congenital abnormalities, filling defects, dilatation, narrowing, and deviations in course. These abnormalities are reviewed, along with the indications for CT urography, current imaging protocols with specific techniques for optimal evaluation of the ureter, and dose reduction strategies. PMID:25815907

  6. Differential gene expression in the developing mouse ureter

    Microsoft Academic Search

    Eleanor K. L. Mitchell; Darrin F. Taylor; Kyra Woods; Melissa J. Davis; Amy L. Nelson; Rohan D. Teasdale; Sean M. Grimmond; Melissa H. Little; John F. Bertram; Georgina Caruana

    2006-01-01

    In many instances, kidney dysgenesis results as a secondary consequence to defects in the development of the ureter. Through the use of mouse genetics a number of genes associated with such malformations have been identified, however, the cause of many other abnormalities remain unknown. In order to identify novel genes involved in ureter development we compared gene expression in embryonic

  7. Ureter Regeneration–The Proper Scaffold Has to Be Defined

    PubMed Central

    Kowalczyk, Tomasz; Nowacki, Maciej; Bodnar, Magdalena; Marsza?ek, Andrzej; Pokrywczy?ska, Marta; Frontczak-Baniewicz, Ma?gorzata; Kowalewski, Tomasz A.; Ch?osta, Piotr; Drewa, Tomasz

    2014-01-01

    The aim of this study was to compare two different acellular scaffolds: natural and synthetic, for urinary conduit construction and ureter segment reconstruction. Acellular aortic arch (AAM) and poly(L-lactide-co-caprolactone) (PLCL) were used in 24 rats for ureter reconstruction in both tested groups. Follow-up period was 4 weeks. Intravenous pyelography, histological and immunohistochemical analysis were performed. All animals survived surgical procedures. Patent uretero-conduit junction was observed only in one case using PLCL. In case of ureter segment reconstruction ureters were patent in one case using AAM and in four cases using PLCL scaffolds. Regeneration of urothelium layer and focal regeneration of smooth muscle layer was observed on both tested scaffolds. Obtained results indicates that synthetic acellular PLCL scaffolds showed better properties for ureter reconstruction than naturally derived acellular aortic arch. PMID:25162415

  8. Ureter Smooth Muscle Cell Orientation in Rat Is Predominantly Longitudinal

    PubMed Central

    Reesink, Koen D.; Kroon, Wilco; Delhaas, Tammo

    2014-01-01

    In ureter peristalsis, the orientation of the contracting smooth muscle cells is essential, yet current descriptions of orientation and composition of the smooth muscle layer in human as well as in rat ureter are inconsistent. The present study aims to improve quantification of smooth muscle orientation in rat ureters as a basis for mechanistic understanding of peristalsis. A crucial step in our approach is to use two-photon laser scanning microscopy and image analysis providing objective, quantitative data on smooth muscle cell orientation in intact ureters, avoiding the usual sectioning artifacts. In 36 rat ureter segments, originating from a proximal, middle or distal site and from a left or right ureter, we found close to the adventitia a well-defined longitudinal smooth muscle orientation. Towards the lamina propria, the orientation gradually became slightly more disperse, yet the main orientation remained longitudinal. We conclude that smooth muscle cell orientation in rat ureter is predominantly longitudinal, though the orientation gradually becomes more disperse towards the proprial side. These findings do not support identification of separate layers. The observed longitudinal orientation suggests that smooth muscle contraction would rather cause local shortening of the ureter, than cause luminal constriction. However, the net-like connective tissue of the ureter wall may translate local longitudinal shortening into co-local luminal constriction, facilitating peristalsis. Our quantitative, minimally invasive approach is a crucial step towards more mechanistic insight into ureter peristalsis, and may also be used to study smooth muscle cell orientation in other tube-like structures like gut and blood vessels. PMID:24465961

  9. Autonomy of spontaneous rhythmogenesis of perivesicular area of cat ureter

    Microsoft Academic Search

    K. V. Kazaryan; V. Ts. Vantsyan; A. S. Tirayan; R. R. Akopyan; N. N. Melkonyan; L. G. Simonyan

    2008-01-01

    The work presents data indicating no dependence of the pacemaker activity located in the zone of junction of cat ureter with\\u000a urinary bladder on genesis of the main perirenal pacemaker. Data are presented on effect of clamping the renal artery supplying\\u000a with blood flow the renal area on rhythmogenesis of the ureter perivesicular area. An inhibition of the pacemaker activity

  10. Peripelvic extravasation, urinoma formation and tumor obstruction of the ureter.

    PubMed

    Twersky, J; Twersky, N; Phillips, G; Coppersmith, H

    1976-09-01

    We report 4 cases of peripelvic extravasation caused by tumor obstruction of the ureter. A urinoma developed in 3 of the 4 cases. Review of the literature reveals only 5 previously reported cases of peripelvic extravasation secondary to tumor obstruction of the urinary tract. We discuss the mechanics of peripelvic extravasation and urinoma formation, and conclude that tumor obstruction of the ureter must be considered in all cases of peripelvic extravasation. PMID:957493

  11. Peristomal Pagetoid Spread of Urothelial Carcinoma of the Ureter

    PubMed Central

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

    2013-01-01

    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

  12. General Information about Transitional Cell Cancer of the Renal Pelvis and Ureter

    MedlinePLUS

    ... Cancer of the Renal Pelvis and Ureter Key Points Transitional cell cancer of the renal pelvis and ... Cancer of the Renal Pelvis and Ureter Key Points After transitional cell cancer of the renal pelvis ...

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

    PubMed Central

    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

    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

  14. Bericht über zwei Fälle von retrokavalem Ureter (davon ein Fall bei Situs inversus totalis und Nierenaplasie rechts)

    Microsoft Academic Search

    J. Moncada; H. Wenderoth

    1974-01-01

    The first case of left retrocaval ureter connected with situs inversus and unilateral renal agenesis and, in addition, one case of retrocaval ureter in normal situs are reported. In the first case, the renal pelvis was transsected, the retrocaval part of the ureter was dissected free and resected. The continuity was re-established by ureter-pelviplasty ventral of the vena cava inferior.

  15. Radiological findings of primary localized amyloidosis of the ureter.

    PubMed

    Tsujioka, Yuko; Jinzaki, Masahiro; Tanimoto, Akihiro; Nakagawa, Ken; Akita, Hirotaka; Kikuchi, Eiji; Okuda, Shigeo; Mikami, Shuji; Oya, Mototsugu; Kuribayashi, Sachio

    2012-02-01

    Localized amyloidosis is a rare condition, especially that involving the ureter. Because of its rarity and the difficulty in differentiating this condition from urothelial carcinoma by intravenous urography and computed tomography, nephroureterectomy has often been performed unnecessarily for this disease. The authors encountered two cases of this disease, both of which showed a negative urine cytology, no obvious mass effect, and a hypointensity on T2-weighted imaging. Because these findings are very rare in urothelial carcinoma, ureteroscopy-guided biopsy was performed, which yielded the diagnosis of amyloidosis. The patients were then treated and followed up at our institute. Primary localized amyloidosis of the ureter should be considered when evaluating ureteric lesions visualized as hypointensities on T2-weighted images that do not show an obvious mass effect, which could help in the avoidance of unnecessary surgery. PMID:22020852

  16. Functional muscarinic cholinoceptors in the isolated canine ureter

    Microsoft Academic Search

    Yoshitaka Tomiyama; Isao Wanajo; Yoshinobu Yamazaki; Makoto Murakami; Masami Kojima; Nobuo Shibata

    2003-01-01

    The purpose of present study was to characterize the functional muscarinic cholinoceptor (mAChR) subtypes in the isolated canine ureter. Carbachol (CCh), a non-selective mAChR agonist, concentration-dependently increased the frequency of the rhythmic contractions in isolated spiral ureteral preparations, the pD2 value being 5.78ǂ.12. We then evaluated the effects of subtype-selective mAChR antagonists on the CCh-induced rhythmic contractions. The rank order

  17. The lithotrity of stones in the ureter under visual control.

    PubMed

    Matouschek, E

    1984-01-01

    The successful lithotrity of stones in the ureter under vision using electrohydraulic pressure waves is described. A 1.6-mm probe is guided, under visual control, to the concrement, which is then destroyed by a pressure wave released at the tip of the probe by a spark discharge. The apparatus itself has an impulse voltage of 1,800-2,000 V. The discharge energy is up to 5 W s. The impulse frequency can be adjusted between 10 and 80 Hz. PMID:6698090

  18. Fibroepithelial polyp of distal ureter with periodic prolapse into bladder.

    PubMed

    Baltogiannis, Dimitrios; Kafetsoulis, Apostolos; Kafetzoulis, Apostolos; Giannakis, Dimitrios; Saito, Motoaki; Miyagawa, Ikuo; Sofikitis, Nikolaos

    2008-01-01

    Ureteric fibroepithelial polyp is a rare disease; it is of mesodermal origin and exhibits benign characteristics. Hydronephrosis occurs in rare cases, and it is generally accepted that it may result in an obstruction without causing alterations of renal function. In many cases it is difficult to differentiate from transitional cell carcinomas. Nowadays, endoscopic evaluation is the means of treatment and management. In our case study we report a patient with a long fibroepithelial polyp of the distal ureter prolapsing into the bladder in a periodic pattern. Cystoscopy revealed that movement of the polyp was moving forward and backward in the right ureteric orifice. Cold-cut biopsy established the diagnosis. The patient underwent ureteroscopic excision and remains asymptomatic a year later. PMID:18480645

  19. ORIGINAL ARTICLE ATP release from the human ureter on distension and P2X3

    E-print Network

    Burnstock, Geoffrey

    . Sections of ureter were stained using antibodies against P2X3 and capsaicin receptors (TRPV1). [ATP] rose TRPV1 transient receptor potential vanilloid 1 Introduction Pain due to a calculus causing an acute

  20. Ectopic ureter in the horse: Three cases and a review of the literature

    PubMed Central

    Pringle, John K.; Ducharme, Normand G.; Baird, John D.

    1990-01-01

    Ureterovesicular anastomosis resulted in resolution of the clinical signs of urinary incontinence in three horses with unilateral ectopic ureter. Follow-up of two of the horses ten months and three years later indicated no further urinary tract problems; the third horse died four days after surgery from intestinal infarction. Diagnosis can be readily confirmed by antegrade or retrograde ureterography, or endoscopic visualization of the ectopic ureteral openings. Nephrectomy appears indicated in cases of unilateral ectopic ureter with associated ipsilateral urinary tract infection or hydronephrosis, providing the contralateral kidney has normal function. Ureterovesicular anastomosis appears to be indicated in the management of unilateral ectopic ureters in the absence of ascending urinary tract infection or hydronephrosis, and in cases of bilateral ectopic ureters. ImagesFigure 1. PMID:17423490

  1. The impact of method of distal ureter management during radical nephroureterectomy on tumour recurrence

    PubMed Central

    Kapoor, Anil; Dason, Shawn; Allard, Christopher B.; Shayegan, Bobby; Lacombe, Louis; Rendon, Ricardo; Jacobsen, Niels-Erik; Fairey, Adrian; Izawa, Jonathan; Black, Peter; Tanguay, Simon; Chin, Joseph; So, Alan; Lattouf, Jean-Baptiste; Bell, David; Saad, Fred; Drachenberg, Darrell; Cagiannos, Ilias; Fradet, Yves; Alamri, Abdulaziz; Kassouf, Wassim

    2014-01-01

    Introducton: Radical nephroureterectomy for upper tract urothelial carcinoma (UTUC) must include some form of distal ureter management to avoid high rates of tumour recurrence. It is uncertain which distal ureter management technique has the best oncologic outcomes. To determine which distal ureter management technique resulted in the lowest tumour recurrence rate, we analyzed a multi-institutional Canadian radical nephroureterectomy database. Methods: We retrospectively analyzed patients who underwent radical nephroureterectomy with distal ureter management for UTUC between January 1990 and June 2010 at 10 Canadian tertiary hospitals. Distal ureter management approaches were divided into 3 categories: (1) extravesical tenting for ureteric excision without cystotomy (EXTRAVESICAL); (2) open cystotomy with intravesical bladder cuff excision (INTRAVESICAL); and (3) extravesical excision with endoscopic management of ureteric orifice (ENDOSCOPIC). Data available for each patient included demographic details, distal ureter management approach, pathology and operative details, as well as the presence and location of local or distant recurrence. Clinical outcomes included overall recurrence-free survival and intravesical recurrence-free survival. Survival analysis was performed with the Kaplan-Meier method. Multivariable Cox regression analysis was also performed. Results: A total of 820 patients underwent radical nephroureterectomy with a specified distal ureter management approach at 10 Canadian academic institutions. The mean patient age was 69.6 years and the median follow-up was 24.6 months. Of the 820 patients, 406 (49.5%) underwent INTRAVESICAL, 316 (38.5%) underwent EXTRAVESICAL, and 98 (11.9%) underwent ENDOSOPIC distal ureter management. Groups differed significantly in their proportion of females, proportion of laparoscopic cases, presence of carcinoma in situ and pathological tumour stage (p < 0.05). Recurrence-free survival at 5 years was 46.3%, 35.6%, and 30.1% for INTRAVESICAL, EXTRAVESICAL and ENDOSCOPIC, respectively (p < 0.05). Multivariable Cox regression analysis confirmed that INTRAVESICAL resulted in a lower hazard of recurrence compared to EXTRAVESICAL and ENDOSCOPIC. When looking only at intravesical recurrence-free survival (iRFS), a similar trend held up with INTRAVESICAL having the highest iRFS, followed by ENDOSCOPIC and then EXTRAVESICAL management (p < 0.05). At last follow-up, 406 (49.5%) patients were alive and free of disease. Conclusion: Open intravesical excision of the distal ureter (INTRAVESICAL) during radical nephroureterectomy was associated with improved overall and intravesical recurrence-free survival compared with extravesical and endoscopic approaches. These findings suggest that INTRAVESICAL should be considered the gold standard oncologic approach to distal ureter management during radical nephroureterectomy. Limitations of this study include its retrospective design, heterogeneous cohort, and limited follow-up. PMID:25485014

  2. Laparoscopic Nephroureterectomy and Management of the Distal Ureter: A Review of Current Techniques and Outcomes

    PubMed Central

    Viprakasit, Davis P.; Macejko, Amanda M.; Nadler, Robert B.

    2009-01-01

    Laparoscopic nephroureterectomy (LNU) is becoming an increasingly common alternative treatment for transitional cell carcinoma (TCC) of the renal pelvis and ureter due to decreased perioperative morbidity, shorter hospitalization, and comparable oncologic control with open nephroureterectomy (ONU). Mobilization of the kidney and proximal ureter may be performed through a transperitoneal, retroperitoneal, or hand-assisted approach. Each technique is associated with its own benefits and limitations, and the optimal approach is often dictated by surgeon preference. Our analysis of the literature reflects equivalent cancer control between LPN and OPN at intermediate follow-up with significantly improved perioperative morbidity following LPN. Several methods for bladder cuff excision have been advocated, however, no individual technique for management of the distal ureter proved superior. Overall, complete en-bloc resection with minimal disruption of the urinary tract should be optimized to maintain oncologic outcomes. Longer follow-up and prospective studies are needed to fully evaluate these techniques. PMID:19148293

  3. Does the surgical technique for management of the distal ureter influence the outcome after nephroureterectomy?

    PubMed

    Phé, Véronique; Cussenot, Olivier; Bitker, Marc-Olivier; Rouprêt, Morgan

    2011-07-01

    Study Type - Therapy (case series) Level of Evidence?4 What's known on the subject? and What does the study add? The resection of the distal ureter and its orifice is an oncological principle during radical nephroureterectomy which is based on the fact that it represents a part of the urinary tract exposed to a considerable risk of recurrence. After removal of the proximal part it is hardly possible to image or approach it by endoscopy during follow-up. Recent publications on survival after nephroureterectomy do not allow the conclusion that removal of distal ureter and bladder cuff are useless. Several techniques of distal ureter removal have been described but they are not equivalent in term of oncological safety. •?The standard treatment of upper urinary tract urothelial carcinomas (UUT-UCs) must obey oncological principles, which consist of a complete en bloc resection of the kidney and the ureter, as well as excision of a bladder cuff to avoid tumour seeding. •?The open technique is the 'gold standard' of treatment to which all other techniques developed are necessarily compared, and various surgical procedures have been described. •?The laparoscopic stapling technique maintains a closed system but risks leaving behind the ureteric and bladder cuff segments. •?Transvesical laparoscopic detachment and ligation is a valid approach from an oncological stance but is technically difficult. The major inconvenience of the transurethral resection of the ureteric orifice and intussusception techniques is the potential for tumour seeding. •?Management of the distal ureter via the robot-assisted laparoscopic method is technically feasible, but outcomes from these procedures are still preliminary. •?Therefore, prospective comparative studies with more thorough explorations of these techniques are needed to solve the dilemma of the management of the distal ureter during nephroureterectomy. However, bladder cuff excision should remain the standard of care irrespective of the stage of the disease. PMID:21070580

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

    SciTech Connect

    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

    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.

  5. A Quantitative Histological Evaluation of the Dilated Ureter of Childhood. II: Ectopia, Posterior Urethral Valves and the Prune Belly Syndrome

    Microsoft Academic Search

    John P. Gearhart; Benjamin R. Lee; Alan W. Partin; Jonathan I. Epstein; John A. Gosling; Barry A. Kogan

    1995-01-01

    A quantitative histological study was performed on specimens of 33 ureters obtained from 14 male and 19 female patients 5 days to 14 years old (mean age 1.2 years). A high resolution color image video analysis system was used to quantify and compare collagen and smooth muscle components of the muscularis layers to normal control ureters from patients of similar

  6. An artificial model for studying fluid dynamics in the obstructed and stented ureter.

    PubMed

    Carugo, D; Elmahdy, M; Zhao, X; Drake, M J; Zhang, X; Clavica, F

    2013-01-01

    Fluid dynamics in the obstructed and stented ureter represents a non-trivial subject of investigation since, after stent placement, the urine can flow either through the stent lumen or in the extra-luminal space located between the stent wall and the ureteric inner wall. Fluid dynamic investigations can help understanding the phenomena behind stent failure (e.g. stent occlusions due to bacterial colonization and encrustations), which may cause kidney damage due to the associated high pressures generated in the renal pelvis. In this work a microfluidic-based transparent device (ureter model, UM) has been developed to simulate the fluid dynamic environment in a stented ureter. UM geometry has been designed from measurements on pig ureters. Pressure in the renal pelvis compartment has been measured against three variables: fluid viscosity (?), volumetric flow rate (Q) and level of obstruction (OB%). The measurements allowed a quantification of the critical combination of ?, Q and OB% values which may lead to critical pressure levels in the kidney. Moreover, an example showing the possibility of applying particle image velocimetry (PIV) technology to the developed microfluidic device is provided. PMID:24110941

  7. Laparoscopic Transvesical Resection of an En Bloc Bladder Cuff and Distal Ureter during Nephroureterectomy

    PubMed Central

    Giannakopoulos, Stilianos; Toufas, George; Dimitriadis, Charalampos; Giannopoulos, Stavros; Kalaitzis, Christos; Bantis, Athanasios; Patris, Emmanuel; Touloupidis, Stavros

    2012-01-01

    Objective. The most appropriate technique for excising the distal ureter and bladder cuff during laparoscopic nephroureterectomy is still debated. We report our experience with a pure laparoscopic transvesical method that duplicates the long-standing open transvesical approach. Materials and Methods. Seven men and three women diagnosed with upper tract transitional cell carcinoma were treated with this procedure. Three intravesical ports were inserted, and pneumovesicum was established at 12?mmHg. Transvesical laparoscopic circumferential detachment of the bladder cuff and en bloc mobilization of the last centimeters of the distal ureter were performed, followed by the closure of the bladder defect. Subsequently, a nephrectomy was performed either laparoscopically or using an open flank approach. Results. The median age was 68.5 years. The procedure was completed uneventfully in all cases. The median operating time for distal ureter excision was 82.5 minutes (range 55–120). No complications directly related to the pneumovesicum method were recorded. The median follow-up period was 31 months (range 12–55). During the follow-up period, two patients (20%) died from the disease, and a bladder tumor developed in three cases (30%). Conclusion. The laparoscopic transvesical resection of the en bloc bladder cuff and distal ureter is a reliable, effective, and oncologically safe technique, at least in the midterm. PMID:23049475

  8. Laparoscopic Nephroureterectomy: Oncologic Outcomes and Management of Distal Ureter; Review of the Literature

    PubMed Central

    Berger, Andre; Fergany, Amr

    2009-01-01

    Introduction. Laparoscopic radical nephroureterectomy (LNU) is being increasingly performed at several centers across the world. We review oncologic outcomes after LNU procedure and the techniques for the management of distal ureter. Materials and Methods. A comprehensive review of the literature was performed on the oncological outcomes and management of distal ureter associated with LNU for upper tract transitional cell carcinoma (TCC). Results and Discussion. LNU for upper tract TCC is performed pure laparoscopically (LNU) or hand-assisted (HALNU). The management of the distal ureter is still debated. LNU appears to have superior perioperative outcomes when compared to open surgery. Intermediate term oncologic outcomes after LNU are comparable to open nephroureterectomy (ONU). Conclusions. Excision of the distal ureter and bladder cuff during nephroureterectomy remains controversial. Intermediate term oncologic outcomes for LNU compare well with ONU. Initial long-term oncologic outcomes are encouraging. Prospective randomized comparison between LNU and open surgery is needed to define the role of these modalities in the current context. PMID:19020656

  9. Normal functioning single system ectopic ureter draining into a Gartner’s cyst: laparoscopic management

    PubMed Central

    Prakash, Jai; Singh, Bhupendra Pal; Sankhwar, Satyanarayan; Goel, Apul

    2013-01-01

    Association of single system ectopic ureter with normal functioning bilateral kidney and absence of congenital anomalies is very rarely reported in the literature. We are reporting for the first time a case of this type of anomaly in which uretral ectopia was draining into a Gartner's cyst and was managed by laparoscopy. A 16?year girl presented with normal voiding with continuous dribbling since birth. Voiding cystourethrogram, intravenous urogram, cystovaginoscopy and retrograde contrast study confirmed the diagnosis. Ultrasound of the whole abdomen and physical examination ruled out any associated congenital anomalies. Transperitoneal laparoscopic ureteric reimplantation was performed and distal stump was ligated. On follow-up at 3?months she was completely dry; her vaginoscopy showed disappearance of cystic bulge and her voiding cystourethrogram showed normal study without any reflux. When single system ectopic ureter opens into small-to-moderate size wide opened mouth vaginal Gartner's cyst, laparoscopic ureteric reimplantation and ligation of distal stump is an appropriate procedure. PMID:23737579

  10. Long-term results of treatment of single-system ectopic ureters

    Microsoft Academic Search

    L. Wünsch; U. Hübner; H. Halsband

    2000-01-01

    Single-system ureteral ectopia (UE) encompasses a spectrum of malformations involving the bladder trigone, ureter, and kidney.\\u000a The clinical presentation is variable, and both diagnostic and therapeutic problems are common. Reduced renal function in\\u000a these patients may result from primary dysplasia, obstruction, vesicoureteral reflux, or recurrent infection. Based on our\\u000a experience of seven patients, suggestions for diagnostic procedures and criteria for

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

    PubMed Central

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

    2014-01-01

    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

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

    PubMed Central

    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

    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

  13. The significance of Pax2 expression in the ureter epithelium of children with vesicoureteric reflux.

    PubMed

    Zheng, Yibing; Xu, Jing; Guo, Wei; Xu, Hong; Chen, Jing; Shen, Qian; Zhang, Xin; Zhai, Yihui

    2015-07-01

    Vesicoureteral reflux (VUR) is the retrograde passage of urine from the bladder to the urinary tract; this leads to renal scarring and end-stage renal disease in children. Pax2 is a nuclear transcription factor that is involved in urinary system development. We measured the expression of Pax2 in the ureters of 47 patients with VUR. The messenger RNA expression and the protein level of Pax2 were significantly increased in patients with VUR, suggesting a correlation with VUR. Further studies demonstrated that Pax2 was hypomethylated, and Dnmt3a messenger RNA expression was significantly lower than in the control group. We speculate that the low level of Dnmt2a might decrease PAX2 gene methylation and up-regulate the Pax2 protein. The high level of Pax2 might be related to cellular apoptosis and functional lesions in ureters. In conclusion, our results revealed that the level of Pax2 is correlated with VUR; thus, Pax2 represents a possible target for VUR therapy. PMID:25912758

  14. Regional differences of energetics, mechanics, and kinetics of myosin cross-bridge in human ureter smooth muscle

    PubMed Central

    Vargiu, Romina; Perinu, Anna; Tintrup, Frank; Broccia, Francesca; Lisa, Antonello De

    2015-01-01

    This study provides information about baseline mechanical properties of the entire muscle and the molecular contractile mechanism in human ureter smooth muscle and proposed to investigate if changes in mechanical motor performance in different regions of isolated human ureter are attributable to differences in myosin crossbridge interactions. Classic mechanical, contraction and energetic parameters derived from the tension-velocity relationship were studied in ureteral smooth muscle strips oriented longitudinally and circularly from abdominal and pelvic human ureter parts. By applying of Huxley’s mathematical model we calculated the total working crossbridge number per mm2 (?), elementary force per single crossbridge (?0), duration of maximum rate constant of crossbridge attachment 1/f1 and detachment 1/g2 and peak mechanical efficiency (Eff.max). Abdominal longitudinal smooth muscle strips exhibited significantly higher maximum isometric tension and faster maximum unloaded shortening velocity compared to pelvic ones. Contractile differences were associated with significantly higher crossbridge number per mm2. Abdominal longitudinal muscle strips showed a lower duration of maximum rate constant of crossbridge attachment and detachment and higher peak mechanical efficiency than pelvic ones. Such data suggest that the abdominal human ureter showed better mechanical motor performance mainly related to a higher crossbridge number and crossbridge kinetics differences. Such results were more evident in the longitudinal rather than in the circular layer.

  15. Bipolar plasma vaporization – an innovative intramural ureter detachment method during nephroureterectomy

    PubMed Central

    Geavlete, P; Multescu, R; Geavlete, B; Georgescu, D; Moldoveanu, C

    2012-01-01

    Introduction:Nephroureterectomy with perimeatal cystectomy is still the gold standard in the treatment of urothelial upper urinary-tract carcinoma (UUTC). Ureteral endoscopic surgery was proposed as a complementary first step in nephroureterectomy, in order to obviate the low abdominal incision. Our goal was to establish the value of a novel method of endoscopic distal ureteral management in on step nephroureterectomy for UUTC: pluck technique by using bipolar plasma vaporization. Materials and Methods:During the last two years, we performed nephroureterectomy with pluck transurethral detachment of the intramural ureter by using bipolar plasma vaporization in 42 cases with UUTC (pTa in 16 cases, pT1 in 10 cases, pT2 in 9 cases, pT3 in 7 cases). The tumor was pyelocaliceal in 34 cases, ureteral in 7 cases, and both ureteral and pyelocaliceal in 1 case. The follow-up was performed by cystoscopy with urinary cytology, ultrasonography, intravenous urography and CT. The mean follow-up was of 14 months (range 8 to 26 months). Results:All procedures were completed successfully. The complications rate was of 4.8%: 2 cases of hematuria, one imposing an endoscopic approach and another one treated conservatively. During follow-up, 6 patients had bladder recurrences, 1 had renal fossa tumors and 1 had secondary lymph-node invasion. The disease-specific mortality rate was of 4.8%. Conclusions:The endoscopic approach of the terminal ureter with bipolar plasma vaporization as part of one-step nephroureterectomy is a safe, facile and effective method offering good oncological results. PMID:22802881

  16. Antagonism of BMP4 Signaling Disrupts Smooth Muscle Investment of the Ureter and Ureteropelvic Junction

    PubMed Central

    Wang, Gerald J.; Brenner-Anantharam, Andrea; Vaughan, E. Darracott; Herzlinger, Doris

    2015-01-01

    Purpose Congenital ureteropelvic junction obstruction has been associated with aberrant ureteral smooth muscle organization. Recent evidence has shown that BMP4 may be involved in ureteral morphogenesis. We determined whether the disruption of BMP4 signaling results in abnormal smooth muscle investment of the ureter and ureteropelvic junction. Materials and Methods We used a Cre mediated Bmp4 knockout system to conditionally excise the Bmp4 gene in developing mouse embryos. Kidney rudiments were isolated from embryos at varying gestational ages from WT and conditional knockout mice. Metanephric kidney explants were cultured in the presence or absence of the BMP antagonist Noggin. Agarose beads pre-incubated with Gremlin, another BMP antagonist, were used for localized disruption of BMP signaling. Frozen sections and whole metanephric explants were then analyzed by immunofluorescence. Results Bmp4 gene excision resulted in a dose dependent loss of ureteral smooth muscle. Antagonism of BMP signaling inhibited ureteral smooth muscle investment in a dose dependent manner and was paralleled by a dose dependent decrease in the immediate downstream targets of BMP signaling, phosphorylated Smad1, 5 and 8. Localized antagonism of BMP resulted in the focal disruption of ureteral smooth muscle investment. Conclusions We report that decreased BMP signaling, whether by the loss of BMP4 in vivo or direct antagonism in vitro, results in a gradual reduction of the normal, well organized coat of smooth muscle surrounding the ureter. Our results also suggest that this occurs via a direct Smad dependent pathway. This raises the possibility that abnormalities in BMP4 signaling may have a role in the development of congenital ureteropelvic junction obstruction. PMID:19010499

  17. Carcinosarcoma of the Ureter with a Small Cell Component: Report of a Rare Pathologic Entity and Potential for Diagnostic Error on Biopsy

    PubMed Central

    Newsom, Kent; Tojuola, Bayo; Al-Quran, Samer; Parekattil, Sijo; Hamilton, William; Vila Duckworth, Lizette

    2014-01-01

    Carcinosarcomas of the ureter are rare biphasic neoplasms, composed of both malignant epithelial (carcinomatous) and malignant mesenchymal (sarcomatous) components. Carcinosarcomas of the urinary tract are exceedingly rare. We report a unique case of a carcinosarcoma of the ureter with a chondrosarcoma and small cell tumor component arising in a 68-year-old male who presented with microscopic hematuria. CT intravenous pyelogram revealed right-sided hydroureter and hydronephrosis with thickening and narrowing of the right ureter. The patient underwent robot-assisted ureterectomy with bladder cuff excision and subsequent adjuvant chemotherapy. The patient is disease-free at 32 months after treatment. We provide a brief synoptic review of carcinosarcoma of the ureter and bladder with utilization of immunohistochemical (IHC) stains and potential diagnostic pitfalls. PMID:25587477

  18. Suprapubic transvesical single-port technique for control of lower end of ureter during laparoscopic nephroureterectomy for upper tract transitional cell carcinoma

    PubMed Central

    Ahlawat, Rajesh K.; Gautam, Gagan

    2011-01-01

    Context: Various minimally invasive techniques – laparoscopic, endoscopic or combinations of both - have been described to handle the lower ureter during laparoscopic nephroureterectomy but none has received wide acceptance. Aims: We describe an endoscopic technique for the management of lower end of ureter during laparoscopic nephroureterectomy using a single suprapubic laparoscopic port. Materials and Methods: Transurethral resectoscope is used to make a full thickness incision in the bladder cuff around the ureteric orifice from 1 o’clock to 11 o’clock. A grasper inserted through the transvesical suprapubic port is used to retract the ureter to complete the incision in the bladder cuff overlying the anterior aspect of the ureteric orifice. The lower end of ureter is subsequently sealed with a clip applied through the port. This is followed by a laparoscopic nephrectomy and the specimen is removed by extending the suprapubic port incision. Our technique enables dissection and control of lower end of ureter under direct vision. Moreover, surgical occlusion of the lower end of the ureter prior to dissection of the kidney may decrease cell spillage. The clip also serves as a marker for complete removal of the specimen. Results: Three patients have undergone this procedure with an average follow up of 19 months. Operative time for the management of lower ureter has been 35, 55 and 40 minutes respectively. A single recurrence was detected on the opposite bladder wall after 9 months via a surveillance cystoscopy. There has been no residual disease or any other locoregional recurrence. Conclusions: The described technique for management of lower end of ureter during laparoscopic nephroureterectomy adheres to strict oncologic principles while providing the benefit of a minimally invasive approach. PMID:21814308

  19. Endoscopic Versus Open Approach of Bladder Cuff and Distal Ureter in the Management of Upper Urinary Tract Transitional Cell Carcinoma

    PubMed Central

    Yapanoglu, Turgut; Kocaturk, Huseyin; Polat, Ozkan; Demirel, Azam; Okyar, Guray

    2008-01-01

    Objective: Nephroureterectomy with the removal of the ipsilateral ureteral orifice and bladder cuff en bloc remains the gold standard treatment for upper urinary tract urothelial cancer. The distal ureter can be removed with the open surgical technique or endoscopic approach. We compared the outcomes of the endoscopic approach with those of conventional open surgery on the distal ureter. Materials and Methods: We collected data from the charts of 30 patients who underwent radical nephroureterectomy at our clinic from January 1997 to January 2007 for upper urinary tract urothelial carcinoma. The patients were divided into two groups according to procedure performed on the distal ureter. Group I (n:12) was comprised of patients who underwent an open surgical procedure, and group II (n:18), was comprised of patients who underwent an endoscopic approach. Both groups were compared in terms of operative time, blood loss, transurethral catheter duration and duration of hospital stay. Results: Patient age and tumor location showed no significant differences between the two groups. The operative time was significantly longer in group I than group II (181 versus 128 minutes; p<0.05). On the other hand, the estimated blood loss, transurethral catheter duration and duration of hospital stay were significantly lower in group II (205 mL versus 435 mL, 5 versus 8.5 days and 5.6 versus 9.2 days, respectively; p <0.05). Conclusion: The results of our study show that the endoscopic approach is less invasive than open surgery on the distal ureter. This procedure can easily be performed in the management of upper urinary tract urothelial carcinoma. PMID:25610045

  20. Particle motion in unsteady two-dimensional peristaltic flow with application to the ureter

    NASA Astrophysics Data System (ADS)

    Jiménez-Lozano, Joel; Sen, Mihir; Dunn, Patrick F.

    2009-04-01

    Particle motion in an unsteady peristaltic fluid flow is analyzed. The fluid is incompressible and Newtonian in a two-dimensional planar geometry. A perturbation method based on a small ratio of wave height to wavelength is used to obtain a closed-form solution for the fluid velocity field. This analytical solution is used in conjunction with an equation of motion for a small rigid sphere in nonuniform flow taking Stokes drag, virtual mass, Faxén, Basset, and gravity forces into account. Fluid streamlines and velocity profiles are calculated. Theoretical values for pumping rates are compared with available experimental data. An application to ureteral peristaltic flow is considered since fluid flow in the ureter is sometimes accompanied by particles such as stones or bacteriuria. Particle trajectories for parameters that correspond to calcium oxalates for calculosis and Escherichia coli type for bacteria are analyzed. The findings show that retrograde or reflux motion of the particles is possible and bacterial transport can occur in the upper urinary tract when there is a partial occlusion of the wave. Dilute particle mixing is also investigated, and it is found that some of the particles participate in the formation of a recirculating bolus, and some of them are delayed in transit and eventually reach the walls. This can explain the failure of clearing residuals from the upper urinary tract calculi after successful extracorporeal shock wave lithotripsy. The results may also be relevant to the transport of other physiological fluids and industrial applications in which peristaltic pumping is used.

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

    PubMed Central

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

    2014-01-01

    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

  2. Partial substitution of the ureter using a double short segments of the ileum following the monti procedure

    PubMed Central

    Lahyani, Mounir; Jakhlal, Nabil; Bakloul, Fouad; Karmouni, Tarik; Elkhader, Khalid; Koutani, Abdellatif; Andaloussi, Ahmed Ibn Attya; Bezza, Ismail; Elouazni, Mohamed; Ifrine, Lhssan; Belkouchi, Abdelkader

    2015-01-01

    The partial substitution of the ureter using a pediculated double short segments of the ileum is a technique used to re-establish ureteral transit and preserve the renal unit, following the resection of extensive ureteral lesions. Standard surgical procedure for an ileoureteroplasty consists of isolating an ileal duct of equal or greater length than the ureteral defect and interposing it in the urinary tract in an isoperistaltic direction. Monti described a surgical technique that allows for the creation of catheterizable stomas in continent urinary diversions, using the Mitrofanoff principle. These passageways were created from one or several 2.5 cm long ileal sections by means of their detubulization and transverse retubulization.

  3. Excitatory motor and electrical effects produced by tachykinins in the human and guinea-pig isolated ureter and guinea-pig renal pelvis

    PubMed Central

    Patacchini, Riccardo; Santicioli, Paolo; Zagorodnyuk, Vladimir; Lazzeri, Massimo; Turini, Damiano; Alberto Maggi, Carlo

    1998-01-01

    In isolated tissue experiments, neurokinin?A (NKA) produced concentration-dependent contraction of human and guinea-pig ureter (pD2=6.7 and 7.2, respectively); an effect greatly reduced (>80% inhibition) by the tachykinin NK2 receptor-selective antagonist MEN?11420 (0.1??M). The tachykinin NK1 and NK3 receptor agonists septide and senktide, respectively, were ineffective.Electrical field stimulation (EFS) of the guinea-pig isolated renal pelvis produced an inotropic response blocked by MEN?11420 (0.01–1??M). In the same preparation MEN?11420 (0.1??M) blocked (apparent pKB=8.2) the potentiation of spontaneous motor activity produced by the NK2 receptor-selective agonist [?Ala8]NKA(4–10).In sucrose-gap experiments, EFS evoked action potentials (APs) accompanied by phasic contractions of human and guinea-pig ureter, which were unaffected by tetrodotoxin or MEN?11420 (3??M), but were blocked by nifedipine (1–10??M). NKA (1–3??M) produced a slow membrane depolarization with superimposed APs and a tonic contraction with superimposed phasic contractions. NKA prolonged the duration of EFS-evoked APs and potentiated the accompanying contractions. MEN?11420 completely prevented the responses to NKA in both the human and guinea-pig ureter.Nifedipine (1–10??M) suppressed the NKA-evoked APs and phasic contractions in both human and guinea-pig ureter, and slightly reduced the membrane depolarization induced by NKA. A tonic-type contraction of the human ureter in response to NKA persisted in the presence of nifedipine.In conclusion, tachykinins produce smooth muscle excitation in both human and guinea-pig ureter by stimulating receptors of the NK2 type only. NK2 receptor activation depolarizes the membrane to trigger the firing of APs from latent pacemakers. PMID:9846636

  4. DLG1 influences distal ureter maturation via a non-epithelial cell autonomous mechanism involving reduced retinoic acid signaling, Ret expression, and apoptosis.

    PubMed

    Kim, Sung Tae; Ahn, Sun-Young; Swat, Wojciech; Miner, Jeffrey H

    2014-06-15

    The absence of Discs-large 1 (DLG1), the mouse ortholog of the Drosophila discs-large tumor suppressor, results in congenital hydronephrosis characterized by urinary tract abnormalities, reduced ureteric bud branching, and delayed disconnection of the ureter from the common nephric duct (CND). To define the specific cellular requirements for Dlg1 expression during urogenital development, we used a floxed Dlg1 allele and Pax2-Cre, Pax3-Cre, Six2-Cre, and HoxB7-Cre transgenes to generate cell type-restricted Dlg1 mutants. In addition, we used Ret(GFP) knockin and retinoic acid response element-lacZ transgenic mice to determine the effects of Dlg1 mutation on the respective morphogenetic signaling pathways. Mutation of Dlg1 in urothelium and collecting ducts (via HoxB7-Cre or Pax2-Cre) and in nephron precursors (via Pax2-Cre and Six2-Cre) resulted in no apparent abnormalities in ureteric bud branching or in distal ureter maturation, and no hydronephrosis. Mutation in nephrons, ureteric smooth muscle, and mesenchyme surrounding the lower urinary tract (via the Pax3-Cre transgene) resulted in congenital hydronephrosis accompanied by reduced branching, abnormal distal ureter maturation and insertion, and smooth muscle orientation defects, phenotypes very similar to those in Dlg1 null mice. Dlg1 null mice showed reduced Ret expression and apoptosis during ureter maturation and evidence of reduced retinoic acid signaling in the kidney. Taken together, these results suggest that Dlg1 expression in ureter and CND-associated mesenchymal cells is essential for ensuring distal ureter maturation by facilitating retinoic acid signaling, Ret expression, and apoptosis of the urothelium. PMID:24699546

  5. [The cell composition and cytoarchitectonic characteristics of the lymphoid formations in the kidney pelvis and ureter of adults].

    PubMed

    Sapin, M R; Bakhmet, A A

    1995-01-01

    Quantitative characteristics, cell composition and cytoarchitectonics are characterized for lymph nodules in the walls of renal pelvis and ureter according to the findings in 14 total autopsied specimens of the pelvis and ureter obtained from 7 females and males aged 22-60. All of them had been killed in accidents and were free of urogenital, hematological, immune and lymphatic diseases. As indicated by histological sections, lymph nodules in the pelvic and ureteral mucosa of the examinees did not contain clear reproduction centers. The cells of the above lymph nodules comprised primarily small and medium-sized lymphocytes as well as reticular cells. Blast cells and macrophages were not numerous and averaged 2.6% of the total cell population. The count of cells undergoing destruction remained stable and made up from 1.57 +/- 1.6 to 3.52 +/- 2.06%. As for cytoarchitectonics, typical for the nodules was the existence of pairs, groups and chains of small and medium-sized lymphocytes. PMID:7732624

  6. TSHZ3 and SOX9 Regulate the Timing of Smooth Muscle Cell Differentiation in the Ureter by Reducing Myocardin Activity

    PubMed Central

    Martin, Elise; Caubit, Xavier; Airik, Rannar; Vola, Christine; Fatmi, Ahmed; Kispert, Andreas; Fasano, Laurent

    2013-01-01

    Smooth muscle cells are of key importance for the proper functioning of different visceral organs including those of the urogenital system. In the mouse ureter, the two transcriptional regulators TSHZ3 and SOX9 are independently required for initiation of smooth muscle differentiation from uncommitted mesenchymal precursor cells. However, it has remained unclear whether TSHZ3 and SOX9 act independently or as part of a larger regulatory network. Here, we set out to characterize the molecular function of TSHZ3 in the differentiation of the ureteric mesenchyme. Using a yeast-two-hybrid screen, we identified SOX9 as an interacting protein. We show that TSHZ3 also binds to the master regulator of the smooth muscle program, MYOCD, and displaces it from the coregulator SRF, thereby disrupting the activation of smooth muscle specific genes. We found that the initiation of the expression of smooth muscle specific genes in MYOCD-positive ureteric mesenchyme coincides with the down regulation of Sox9 expression, identifying SOX9 as a possible negative regulator of smooth muscle cell differentiation. To test this hypothesis, we prolonged the expression of Sox9 in the ureteric mesenchyme in vivo. We found that Sox9 does not affect Myocd expression but significantly reduces the expression of MYOCD/SRF-dependent smooth muscle genes, suggesting that down-regulation of Sox9 is a prerequisite for MYOCD activity. We propose that the dynamic expression of Sox9 and the interaction between TSHZ3, SOX9 and MYOCD provide a mechanism that regulates the pace of progression of the myogenic program in the ureter. PMID:23671695

  7. Laparoscopic nephroureterectomy with transvesical single-port distal ureter and bladder cuff dissection: points of technique and initial surgical outcomes with five patients

    PubMed Central

    Markuszewski, Marcin; K??cz, Jakub; Sieczkowski, Marcin; Po?om, Wojciech; Piaskowski, Wojciech; Krajka, Kazimierz; Matuszewski, Marcin

    2014-01-01

    Although a variety of techniques have been used to manage the distal ureter during laparoscopic radical nephroureterectomy (LNU), a consensus has not yet been established. Recently, some authors have used a single-port transvesical approach to excise the distal ureter and bladder cuff following LNU. The aim of the study was to present our initial experience in „en bloc” dissection of the distal ureter and bladder cuff during LNU, using a transvesical single-port approach (T-LESS) and standard laparoscopic instruments. From April to October 2012, 5 patients aged 45 to 73 years with upper urinary tract urothelial tumors were subjected to LNU/T-LESS. After a standard LNU was performed, a TriPort+® device was introduced into the bladder and the pneumovesicum was established. A bladder cuff with a distal ureter was dissected and put in the paravesical tissue. The bladder wall defect was closed with the V-loc® 3/0 suture. The LNU was then completed in the flank position. All procedures were completed successfully. No significant blood loss or complications were observed. The mean operative time was 250 min (range: 200–370) for a total procedure and 59 min (range: 42–80) for the T-LESS stage. The postoperative hospital stay was 5.2 days (range: 4–9). Pathologic examination revealed no positive margin in any of the cases. The LNU/T-LESS approach is an efficient and safe procedure. A well-visualized dissection of the distal ureter, closing the defect of the bladder, the use of standard laparoscopic instruments and a good cosmesis are advantages of the method. PMID:25097698

  8. A novel ureter dilatation method for replacing hydromantic perfusion pump during ureteroscopic lithotripsy in patients with ureteral calculi and ibroepithelial polyps.

    PubMed

    Li, Tengcheng; Fang, Youqiang; Wu, Jieying; Zhou, Xiangfu

    2014-01-01

    This study aimed to evaluate the clinical value of a novel ureter dilatation method during ureteroscopic pneumatic lithotripsy in patients with ureteral calculi and polyps. Clinical information of 86 patients with ureter calculi and polyps who underwent ureteroscopic pneumatic lithotripsy was reviewed. A cavity-distention machine was used in 44 cases to inject normal saline for keeping clear operation view (cavity-distention machine-assisted group). A high handled water bag with artificial water injection (traditional pneumatic lithotripsy group) was used in 42 cases. The total operation time, time of stone removal, stone clearance rate and surgery complications were compared between two groups. All operations were successful with no patients transferred to open surgery. No ureter breakage or avulsion occurred in two groups. Two patients in traditional pneumatic lithotripsy group suffered from ureter perforation. In cavity-distention machine-assisted group and traditional pneumatic lithotripsy group, the total operation time was 30.1±4.8 min and 36.2±6.0 min, respectively (t=-5.22, P<0.01); the time of stone removal was 6.4±1.3 min and 9.3±1.5 min, respectively (t=-9.59, P<0.01); the stone clearance rate was 100% (44/44) and 95.2% (40/42; upper ureter stone immigrated to the renal pelvis in 2, and extraorgan shock wave lithotripsy was performed), respectively. Thus, intraoperative infusion of saline with a cavity-distention machine may replace the hydromantic perfusion pump to maintain a clear operation view and favor the stone removal in lesser time. This method has important clinical value in the treatment of ureteral calculi and polyps. PMID:24753755

  9. Metabolic and cellular alterations underlying the exaggerated renal prostaglandin and thromboxane synthesis in ureter obstruction in rabbits. Inflammatory response involving fibroblasts and mononuclear cells.

    PubMed Central

    Okegawa, T; Jonas, P E; DeSchryver, K; Kawasaki, A; Needleman, P

    1983-01-01

    Unilateral ureter obstruction in rabbits produced profound changes in endogenous and exogenous renal arachidonic acid metabolism. Isolated perfused hydronephrotic kidneys (removed after 3 or 10 d of ureter obstruction) responded to bradykinin stimulation with a markedly enhanced release of prostaglandin E2 and thromboxane A2. Reversal (3 or 10 d) of the ureter obstruction resulted in a reduction in the vasoactive peptide-induced release of prostaglandin E2 and thromboxane A2 from the perfused hydronephrotic kidney. However, postobstruction reversal of prostaglandin production by the agonist-stimulated perfused kidney was not reflected in the cortical microsomal cyclooxygenase activity, which is greatly enhanced during ureter obstruction and does not decrease after removal of the obstruction. Histological analysis of the renal cortex in rabbits with ureteral obstruction revealed a proliferation of fibroblast-like cells and the presence of mononuclear cells; removal of the obstruction did not result in a disappearance of cortical fibroblasts but did result in a decrease of monocytes. The critical involvement of mononuclear cells in the exaggerated arachidonate metabolism that occurs during hydronephrosis was exhibited by the demonstration that: (a) only the perfused hydronephrotic rabbit kidney responded to administration of endotoxin with a sustained release of prostaglandin E2 and thromboxane A2; (b) the contralateral rabbit kidney, which is devoid of mononuclear cells, did not respond to endotoxin; and (c) the hydronephrotic cat kidney, which exhibits a fibroblast proliferation with a low number of mononuclear cells, did not respond to endotoxin. Thus, proliferation of fibroblast-like cells and the presence of mononuclear cells appear to be involved in the exaggerated prostaglandin and thromboxane production underlying hydronephrosis. The increase in microsomal cyclooxygenase activity is apparently most closely correlated with the increased fibroblastic activation and cellularity, whereas mononuclear cells (possibly via monokines) seem to be critical for the markedly enhanced prostaglandin and thromboxane release induced by endotoxin and bradykinin. Images PMID:6848562

  10. [Histology and histochemistry of the kidney and ureters of the Caiman crocodilus yacare (Daudin, 1802)--Crocodilia Reptilia)].

    PubMed

    Jin, S M; Rodrigues, A M; de Souza, A C

    1995-02-01

    The elongated kidneys of Caiman crocodilus yacare are found in pairs and have two lobes. Each lobe is crossed lengthwise down the middle by the renal vein and artery along which there are the renal corpuscules in groups of two or four which delimit the medullar renal region. These corpuscules are generally poorly developed and there is a center of connective tissue with few capillary loops. The Bowman capsule is of pavement or cubic epithelium and leads into a narrow, short, non-secretory neck segment composed of cubical cells followed by tubulus contortus with brush borders against the lumen and the distal tubule with cubic epithelium brush borders. In the renal cortical region are the median tubulus with cylindrical and granular epithelium and the smaller collecting canals which flow into larger collecting canals which flow along the renal border. Among the various tubular parenchyma segments there is a network of blood vessels which lead into the renal vein and into a renal afferent vein. Abundant fat granular bodies and lipid droplets are observed in the proximal and median tubules. The collecting canals and ureters show PAS positive granules in their cells. PMID:7569146

  11. Correlation of Traditional Point a With Anatomic Location of Uterine Artery and Ureter in Cancer of the Uterine Cervix

    SciTech Connect

    Wang, K.-L. [Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan (China); Department of Health Care Management, National Taipei College of Nursing, Taipei, Taiwan (China); Department of Early Childhood Care and Education, Mackay Medicine, Nursing, and Management College, Taipei, Taiwan (China); Yang, Y.-C. [Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan (China); Department of Obstetrics and Gynecology, Taipei Medical University, Taipei, Taiwan (China); Department of Early Childhood Care and Education, Mackay Medicine, Nursing, and Management College, Taipei, Taiwan (China); Chao, K. S. Clifford [Department of Radiation Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, TX (United States)], E-mail: cchao@mdanderson.org; Wu, M.-H.; Tai, H.-C. [Department of Radiation Oncology, Mackay Memorial Hospital, Taipei, Taiwan (China); Chen, T.-C.; Huang, M.-C.; Chen, J.-R. [Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan (China); Su, T.-H. [Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan (China); Department of Early Childhood Care and Education, Mackay Medicine, Nursing, and Management College, Taipei, Taiwan (China); Chen, Y.-J. [Department of Radiation Oncology, Mackay Memorial Hospital, Taipei, Taiwan (China); Graduate Institute of Sport Coaching Science, Chinese Culture University, Taipei, Taiwan (China)], E-mail: chenmdphd@yahoo.com

    2007-10-01

    Purpose: Point A, used for dose specification for intracavitary brachytherapy for cervical cancer, is the point at which the uterine artery and ureter cross. This study assessed compatibility of commonly used traditional point A (TPA) and actual anatomic point A (APA). Methods and Materials: We visualized and placed radiopaque clips at the APA during pelvic and paraaortic lymphadenectomy in 11 patients with cervical carcinoma. Orthogonal and oblique radiographs were obtained after insertion of brachytherapy applicators. We measured the distance between the TPA and APA and estimated the brachytherapy dose to each of the two points. Results: A total of 64 brachytherapy treatments were performed. The mean distances between the TPA and APA were 5.2 {+-} 1.0 cm on the right and 5.4 {+-} 1.1 cm on the left. The estimated brachytherapy doses delivered to the APA as a percentage of the presumed 500-cGy fraction size to the TPA were 35.2% (176.6 {+-} 59.0 cGy) on the right and 30.0% (150.2 {+-} 42.9 cGy) on the left. The marked discrepancy in the position of the two points was not related to individual kinetic variations during brachytherapy treatment, tumor size, or bladder filling. Conclusions: The conventional TPA does not provide an accurate estimate of the APA determined during lymphadenectomy, indicating a need to reevaluate the current practice for determining the brachytherapy prescription for cervical cancer. ( (ClinicalTrials.gov) Identifier, NCT00319462)

  12. Right sided double inferior vena cava with obstructed retrocaval ureter: Managed with single incision multiple port laparoscopic technique using "Santosh Postgraduate Institute tacking ureteric fixation technique"

    PubMed Central

    Singh, Shivanshu; Garg, Nitin

    2015-01-01

    Right double inferior vena cava with obstructed retrocaval ureter is an extremely rare anomaly with only a few reported cases in the literature. To the best of our knowledge, this is the first case report describing ureteric repair by use of a single-incision laparoscopic technique. In addition, this report addresses the underlying surgical challenges of this repair and provides a brief review of the embryology of this anomaly. The "Santosh Postgraduate Institute ureteric tacking fixation technique" provides ease of end-to-end uretero-ureteric anastomosis in a single-incision laparoscopic surgery. PMID:25874048

  13. Effect of Na+,K+,2Cl- cotransport inhibitor bumetanide on electrical and contractile activity of smooth muscle cells in guinea pig ureter.

    PubMed

    Kovalev, I V; Baskakov, M B; Anfinogenova, Ya D; Borodin, Yu L; Kilin, A A; Minochenko, I L; Popov, A G; Kapilevich, L V; Medvedev, M A; Orlov, S N

    2003-08-01

    The effect of Na(+),K(+),2Cl(-) cotransport inhibitor bumetanide on action potentials and contractions of smooth muscle cells in the ureter of guinea pigs evoked by electrical stimulation was studied by the method of double sucrose bridge. Bumetanide (10-100 microM) dose-dependently suppressed action potential and contractions of smooth muscle cells induced by 1-10 microM histamine, 10 microM mesatone, 5 mM tetraethylammonium, and 100 microM sodium nitroprusside. Our findings suggest that test substances modulate Na(+),K(+),2Cl(-) cotransport in smooth muscle cells. PMID:14631495

  14. Injury - kidney and ureter

    MedlinePLUS

    ... such as uric acid (which can occur with gout or treatment of bone marrow, lymph node, or ... lower uric acid in the blood due to gout) Pain medicines Eliminating medicines or exposure to substances ...

  15. Transcatheter Arterial Embolization Therapy for a Hypoplastic Pelvic Kidney with a Single Vaginal Ectopic Ureter to Control Incontinence: The Usefulness of Three-Dimensional CT Angiography Using Multidetector-Row Helical CT

    SciTech Connect

    Kudoh, Kouichi, E-mail: cdk70770@par.odn.ne.jp; Kadota, Masataka; Nakayama, Yoshiharu; Imuta, Masanori; Yasuda, Tsuyoshi; Yamashita, Yasuyuki [Kumamoto University School of Medicine, Kumamoto, Department of Radiology (Japan); Inadome, Akito; Yoshida, Masaki; Ueda, Shouichi [Kumamoto University School of Medicine, Kumamoto, Department of Urology (Japan)

    2003-09-15

    A girl with continuous urinary incontinence was successfully treated by angiographic embolization of a hypoplastic pelvic kidney with a single unilateral vaginal ectopic opening of the ureter. For this intervention, CT angiography was useful for detecting the corresponding renal artery of the hypoplastic kidney.

  16. NK2 tachykinin receptors mediate contraction of the pig intravesical ureter: tachykinin-induced enhancement of non-adrenergic non-cholinergic excitatory neurotransmission.

    PubMed

    Bustamante, S; Orensanz, L M; Barahona, M V; García-Sacristán, A; Hernández, M

    2001-01-01

    The current study was designed to characterize the functionally active tachykinin receptors involved in tachykinin-elicited contractions in the pig intravesical ureter, and to investigate the possible modulation exerted by the natural tachykinins substance P (SP) and neurokinin A (NKA) on the non-adrenergic non-cholinergic (NANC) excitatory ureteral neurotransmission. In pig intravesical ureteral strips pretreated with phosphoramidon (10(-5) mol/L) to block the endopeptidase activities, isometric force recordings showed that SP, NKA, and the NK2 receptor selective agonist [beta-Ala(8)]-NKA (4-10), all three induced contractions, with the following potency order: NKA > [beta-Ala(8) ]-NKA (4-10) > SP. [Sar(9), Met(O(2))(11)]-SP and senktide, selective agonists of the NK1 and NK3 receptors, respectively, failed to modify the ureteral tone. Urothelium removal and incubation with tetrodotoxin (10(-6) mol/L), phentolamine (10(-7) mol/L), propranolol (3 x 10(-6) mol/L), atropine (10(-7) mol/L) and indomethacin (3 x 10(-6) mol/L), did not alter the contraction induced by a submaximal (10(-7) mol/L) dose of [beta-Ala(8)]-NKA (4-10). MEN 10,376 (10(-8)-10(-7) mol/L), a NK2 receptor antagonist, reduced the contraction to 3 x 10(-8) mol/L NKA. GR 82334 (10(-6) -10(-5) mol/L) and SR 142801 (10(-8)-10(-7) mol/L), selective antagonists of the NK1 and NK3 receptors, respectively, did not modify that contraction. In pig intravesical ureteral strips in NANC conditions, SP and NKA induced a potentiation of the contractions to electrical field stimulation (EFS) and to exogenous ATP. The results suggest that the tachykinins evoke a direct contraction of pig intravesical ureteral strips through NK2 receptors located in the smooth muscle. SP and NKA exert an enhancement of the NANC excitatory neurotransmission of the pig intravesical ureter. PMID:11385696

  17. Rare cause of adult female incontinence: complete duplication of the collecting system and ectopic ureter of the kidney draining into the vagina treated by laparoscopic upper pole heminephrectomy and ureterectomy.

    PubMed

    Alkan, Ilter; Özveri, Hakan; Ta?, Selim; Ipekçi, Tümay; Y?lmaz, Serdar

    2014-08-01

    A 38-year-old woman presented with a lifelong history of involuntary urinary leakage. The patient reported that she had been operated for her urinary leakage with the diagnosis of stress incontinence with transobturator tape two times at two different institutions. Preoperative computed tomography scan showed complete duplication of the left kidney with poorly functioning upper pole and a tortuous left dilated ureter running down and opening into the vagina. Laparoscopic left upper pole heminephrectomy and ureterectomy were performed uneventfully. Her incontinence improved immediately after surgery. PMID:24682863

  18. Extrinsic Obstruction of the Ureter

    MedlinePLUS

    ... in both print and download format. View Products Urology Care Foundation 1000 Corporate Boulevard Linthicum, MD 21090 ... Conditions Financials & Annual Report Leadership Privacy Statement © 2015 Urology Care Foundation | All Rights Reserved.

  19. [Na+,K+,2Cl(-)-cotransport and chloride permeability of the cell membrane in mezaton and histamine regulation of electrical and contractile activity in smooth muscle cells from the guinea pig ureter].

    PubMed

    Kovalev, I V; Baskakov, M B; Medvedev, M A; Minochenko, I L; Kilin, A A; Anfinogenova, Ia D; Borodin, Iu V; Gusakova, S V; Popov, A G; Kapilevich, L V; Orlov, S N

    2007-03-01

    Influence of Na+,K+,2Cl(-)-cotransport and chloride permeability of the cell membrane on electrically-induced action potential and contraction of smooth muscle cells from guinea pig ureter was examined with the methods of the double sucrose gap junction. Mesatone (10 microM) and histamine (10 microM) induced prolongation of the action potential and elevation of smooth muscle cell contraction, whereas hyperosmic medium (+150 mM sucrose), and recovery of solution osmolality in hyposmic condition (70 mM NaCl) after a single contraction. Inhibitor Na+,K+,2Cl(-)-cotransport bumetanide (10 microM) and chloride permeability blockers niflumic acid (10-100 microM) and SITS (10-500 microM) attenuated stimulating effects of mesatone, histamine and hyperosmic medium. In opposite to adenylate cyclase activation with forskolin (1 microM), guanylate cyclase activation with sodium nitroprusside (SN, 100 microM) decreased both inhibitory action of bumetanide, niflumic acid and activating effects of mesatone, histamine on action potential and elevation contraction of smooth muscle cells. Influence of forskolin rather and not SN on AP and SMC C was inhibited with tetraethylammonium (5 mM). These results suggest that influence of Na+,K+,2Cl(-)-cotransport on electrical and contractil properties of ureter smooth muscle cells is mediated by stimulation of Ca(2+)-activated chloride permeability of the cell membrane and modulated by intracellular cGMP, but not triggered by Ca2+ release from sarcoplasmic reticulum. PMID:17598474

  20. Use of computed tomography scout film and Hounsfield unit of computed tomography scan in predicting the radio-opacity of urinary calculi in plain kidney, ureter and bladder radiographs

    PubMed Central

    Chua, Michael E.; Gomez, Odina R.; Sapno, Lorelei D.; Lim, Steve L.; Morales, Marcelino L.

    2014-01-01

    Objective: The objective of this study is to determine the diagnostic utility of computed tomography (CT)- scout film with an optimal non-contrast helical CT scan Hounsfield unit (HU) in predicting the appearance of urinary calculus in the plain kidneys, ureter, urinary bladder (KUB)-radiograph. Methods: A prospective cross-sectional study was executed and data were collected from June 2007 to June 2012 at a tertiary hospital. The included subjects were diagnosed to have <10mm urolithiasis with non-contrast helical CT scan and KUB X-ray, which were carried out on the same day. Both KUB radiographs and CT-scout film were read by two qualified radiologists with inter-observer standardization prior to the study. Urolithiasis characteristics such as stone location, CT attenuation value, CT-scout film and KUB radiograph appearance were recorded independently by two observers. Univariate logistic analysis with receiver operating characteristic curve was generated to determine the best cut-off HU value of urolithiases not identified in CT-scout film, but determined radio-opaque in KUB X-ray. Subsequently, its sensitivity, specificity, predictive values and likelihood ratios were calculated. Statistical significance was set at P value of 0.05 or less. Results: Two hundred and three valid cases were included. 73 out of 75 CT-scout film detected urolithiasis were identified on plain radiograph and determined as radio-opaque. The determined best cut off value of HU utilized for prediction of radiographic characteristics was 630HU at which urinary calculi were not seen at CT-scout film and were KUB X-ray radio-opaque. The set HU cut-off was established of ideal accuracy with an overall sensitivity of 82.2%, specificity of 96.9% and a positive predictive value of 96.5% and negative predictive value of 83.5%. Conclusion: Urolithiases identified on the CT-scout film were also seen as radiopaque on the KUB radiograph while those stones not visible on the CT-scout film, but above the optimal HU cut-off value of 630 are also likely to be radiopaque. PMID:25125894

  1. Scrotal Extraperitoneal Hernia of the Ureter: Case Report and Literature Review

    Microsoft Academic Search

    Matteo Giglio; Mauro Medica; Francesco Germinale; Matteo Raggio; Fabio Campodonico; Robert Stubinski; Giorgio Carmignani

    2001-01-01

    Ureteral herniation is a rare, often misdiagnosed event and serious surgical complications are possible. Until 1992, 128 cases of ureteral herniation were reported and in 54 (42%) the inguino-scrotal region was involved. From an anatomical and pathogenic standpoint, two types of uretero-inguinal hernias can be identified: paraperitoneal (more frequent, acquired, always presenting a peritoneal hernia sac, frequently associated with other

  2. In vitro analysis of the effect of hyperbilirubinemia on rabbit ureter and bladder

    Microsoft Academic Search

    Nergis Murat; Belde Kasap; Salih Kavukcu; Alper Soylu; Mehmet Türkmen; Sedef Gidener

    2006-01-01

    Spontaneous resolution of intrauterine pelvic dilatations after birth is an expected outcome. In nonobstructive pelvic dilatations, changes in ureteral and bladder physiology may also play a part. We aimed to demonstrate the effect of increased concentrations of bilirubin on ureteral and bladder muscles in vitro. Normal and pathologic concentrations of bilirubin (3.5×10-7–10-5M and 10-4–4×10-4M, respectively) caused no change in the

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

    PubMed

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

    2012-01-01

    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

  4. Urine Blockage in Newborns

    MedlinePLUS

    ... the ureter joins the kidney, only the kidney swells. The ureter remains a normal size. UPJ obstruction ... urine backs up and causes the ureters to swell, called hydroureter, and hydronephrosis. Swelling in the kidney ...

  5. Analysis of factors affecting spontaneous expulsion of ureteral stones that may predict unfavorable outcomes during watchful waiting periods: What is the influence of diabetes mellitus on the ureter?

    PubMed Central

    Choi, Taesoo; Choi, Seung-Kwon; Kim, Dong Soo; Lee, Dong-Gi; Min, Gyeong Eun; Jeon, Seung Hyun; Lee, Hyung-Lae; Jeong, In-Kyung

    2015-01-01

    Purpose The aim of our study was to evaluate the association of several factors with spontaneous stone expulsion, including ureteral stone characteristics (size, location, hydronephrosis, perinephric stranding), types of medications prescribed (?-blocker, low-dose steroid), and other possible demographic and health-history factors (gender, age, serum creatinine, underlying diabetes mellitus [DM], and hypertension). Materials and Methods A total of 366 patients with ureteral stones were enrolled. All patients underwent watchful waiting without any invasive procedures. Initial diagnoses of ureteral stones were confirmed by computed tomography scans, which were taken at approximately 1-month intervals to check for stone expulsion. Univariate and multivariate analyses were conducted to identify significant factors that contributed to stone expulsion. Results Among 366 patients, 335 patients (91.5%) experienced spontaneous stone passage during a mean follow-up period of 2.95±2.62 weeks. The patients were divided into two groups depending on the success of spontaneous stone passage. Univariate analyses revealed that stone location (p=0.003), stone size (p=0.021), and underlying DM (p<0.001) were significant predictors of stone passage. Multivariate analyses confirmed that stone size (p=0.010), stone location (p=0.008), and underlying DM (p=0.003) were independent predictive factors affecting stone passage. Conclusions Stone size, location, and underlying DM were confirmed to be significant predictive factors for spontaneous passage of ureteral stones. Urologists should consider active procedures, such as shock wave lithotripsy or ureteroscopy, rather than conservative management in patients presenting with proximally located stones, large ureteral stones, or underlying DM.

  6. The value of ureterocolostomy in the male Felis domestica 

    E-print Network

    Beamer, Russell James

    1958-01-01

    of surgical incision . . . . . . . . . . Figure 2 ? Isolation of urinary bladder and ureters 32 33 Figure 3 - Transection of ureters at entrance to urinary bladder iv PAGE Figure 4 - Pixation of suture in terminal end ot right ureter 35 Pigure 5... - Pixation of suture in terminal end of left ureter . . . . . . Figure 6 - Transplantation and fixation of right ureter in lumen of colon . 37 Pigure 7 - Transplantation snd fixation of left ureter in lumen o! colon . . Figure 8 - Completed fixation...

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

    ClinicalTrials.gov

    2013-01-11

    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

  8. 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

    2015-05-06

    Adult Solid Neoplasm; Bladder Carcinoma; Breast Carcinoma; Endometrial Carcinoma; Esophageal Carcinoma; Lung Carcinoma; Malignant Head and Neck Neoplasm; Melanoma; Ovarian Neoplasm; Renal Pelvis and Ureter Urothelial Carcinoma; Testicular Lymphoma; Ureter Carcinoma; Urethral Carcinoma

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

    ClinicalTrials.gov

    2015-07-16

    Bladder Urothelial Carcinoma; Distal Urethral Carcinoma; Infiltrating Bladder Urothelial Carcinoma Associated With Urethral Carcinoma; Metastatic Urothelial Carcinoma of the Renal Pelvis and Ureter; Proximal Urethral Carcinoma; Recurrent Bladder Carcinoma; Recurrent Prostate Carcinoma; Recurrent Urethra Carcinoma; Recurrent Urothelial Carcinoma of the Renal Pelvis and Ureter; Regional Urothelial Carcinoma of the Renal Pelvis and Ureter; Stage IV Bladder Cancer; Stage IV Prostate Cancer; Stage IV Urethral Cancer; Ureter Carcinoma

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

    ClinicalTrials.gov

    2015-05-22

    Distal Urethral Carcinoma; Infiltrating Bladder Urothelial Carcinoma Associated With Urethral Carcinoma; Metastatic Urothelial Carcinoma of the Renal Pelvis and Ureter; Proximal Urethral Carcinoma; Recurrent Bladder Carcinoma; Recurrent Urethra Carcinoma; Recurrent Urothelial Carcinoma of the Renal Pelvis and Ureter; Regional Urothelial Carcinoma of the Renal Pelvis and Ureter; Stage III Bladder Cancer; Stage III Urethral Cancer; Stage IV Bladder Cancer; Stage IV Urethral Cancer; Ureter Carcinoma

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

    ClinicalTrials.gov

    2015-06-01

    Distal Urethral Carcinoma; Infiltrating Bladder Urothelial Carcinoma Associated With Urethral Carcinoma; Metastatic Urothelial Carcinoma of the Renal Pelvis and Ureter; Proximal Urethral Carcinoma; Recurrent Bladder Carcinoma; Recurrent Urethra Carcinoma; Recurrent Urothelial Carcinoma of the Renal Pelvis and Ureter; Regional Urothelial Carcinoma of the Renal Pelvis and Ureter; Stage III Bladder Cancer; Stage III Urethral Cancer; Stage IV Bladder Cancer; Stage IV Urethral Cancer; Ureter Carcinoma

  12. Pembrolizumab and Docetaxel or Gemcitabine Hydrochloride in Treating Patients Urothelial Cancer

    ClinicalTrials.gov

    2015-05-05

    Metastatic Urothelial Carcinoma of the Renal Pelvis and Ureter; Recurrent Bladder Carcinoma; Recurrent Urothelial Carcinoma of the Renal Pelvis and Ureter; Regional Urothelial Carcinoma of the Renal Pelvis and Ureter; Stage III Bladder Urothelial Carcinoma; Stage III Urethral Cancer; Stage IV Bladder Urothelial Carcinoma; Stage IV Urethral Cancer; Urethral Urothelial Carcinoma

  13. Gemcitabine, Paclitaxel, Doxorubicin in Metastatic or Unresectable Bladder Cancer With Decreased Kidney Function

    ClinicalTrials.gov

    2015-06-19

    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 IV Bladder Cancer; Transitional Cell Carcinoma of the Bladder; Urethral Cancer Associated With Invasive Bladder Cancer

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

    ClinicalTrials.gov

    2014-01-27

    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

  15. Sorafenib in Treating Patients With Regional or Metastatic Cancer of the Urothelium

    ClinicalTrials.gov

    2014-05-20

    Adenocarcinoma of the Bladder; 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; Squamous Cell Carcinoma of the Bladder; Stage III Bladder Cancer; Stage IV Bladder Cancer; Transitional Cell Carcinoma of the Bladder; Urethral Cancer Associated With Invasive Bladder Cancer

  16. Study of Genes and Environment in Patients With Cancer in East Anglia, Trent, or West Midlands Regions of the United Kingdom

    ClinicalTrials.gov

    2013-08-23

    Bladder Cancer; Brain and Central Nervous System Tumors; Esophageal Cancer; Intraocular Melanoma; Kidney Cancer; Lymphoma; Melanoma (Skin); Pancreatic Cancer; Transitional Cell Cancer of the Renal Pelvis and Ureter

  17. Vesico-ureteric reflux and urinary tract development in the Pax21Neu+\\/ mouse

    Microsoft Academic Search

    Inga J. Murawski; David B. Myburgh; Jack Favor; Indra R. Gupta

    2007-01-01

    that a mouse model with an identical mutation, the Pax21Neu\\/ mouse, has a 30% incidence of VUR. In VUR, urine flows retro- gradely from the bladder to the ureter and is associated with urinary tract infections, hypertension, and renal failure. The propensity to reflux in the Pax21Neu\\/ mouse is correlated with a shortened intravesical ureter that has lost its oblique

  18. Urinoma formation in posterior urethral valves: Relationship to later renal function

    Microsoft Academic Search

    S. K. Fernbach; K. A. Feinstein; M. R. Zaontz

    1990-01-01

    A retrospective analysis of radiologically determined individual renal function was performed in five boys who presented in the neonatal period with posterior urethral valves, vesicoureteral reflux and documented urinoma formation. Renal function was evaluated with scintigraphy. There was reflux in eight of ten ureters. Six of these ureters had an associated urinoma and compromised renal function in the neonatal period.

  19. Trastuzumab in Treating Patients With Previously Treated, Locally Advanced, or Metastatic Cancer of the Urothelium

    ClinicalTrials.gov

    2013-05-01

    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; Stage IV Bladder Cancer; Transitional Cell Carcinoma of the Bladder; Urethral Cancer Associated With Invasive Bladder Cancer

  20. Distal ureterectomy techniques in laparoscopic and robot-assisted nephroureterectomy: Updated review

    PubMed Central

    Stravodimos, Konstantinos G.; Komninos, Christos; Kural, Ali Riza; Constantinides, Constantinos

    2015-01-01

    Controversies exist about the best method for managing the distal ureter during the laparoscopic (LNU) and robot-assisted nephroureterectomy (RANU). Therefore, PubMed, Scopus and Web of Science databases were searched in order to identify articles describing the management of distal ureter during LNU or RANU in patients suffering from upper urinary tract urothelial cell carcinoma. Forty seven articles were selected for their relevance to the subject of this review. The approaches that are usually performed regarding the distal ureter management are open excision, transurethral resection of ureteral orifice (Pluck Technique), ureteric intussusception and pure LNU or pure RANU. Pure LNU and RANU with complete laparoscopic dissection and suture reconstruction of ureter and bladder cuff seems to be better tolerated than open nephroureterectomy providing equal efficacy, without deteriorating the oncological outcome, however evidence is poor. Transurethral resection of the ureteric orifice and the bladder cuff after occlusion of the ureter with a balloon catheter seems to be an attractive alternative option for low stage, low grade tumors of the renal pelvis and the proximal ureter, while stapling technique is correlated with the increased risk of positive surgical margins. The open resection of the distal ureter in continuity with the bladder cuff is considered the most reliable approach, preferred in our practice as well, however the existing data are based on retrospective and non-randomized studies. PMID:25657536

  1. Pazopanib in Treating Patients With Metastatic Urothelial Cancer

    ClinicalTrials.gov

    2014-05-22

    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

  2. Math. Model. Nat. Phenom. Vol. ?, No. ?, 20??, pp. ?-?

    E-print Network

    Chrispell, John

    with the fluid, such as ovum transport in the oviduct or kidney stones in the ureter. In some of these biological contractions in the oviduct and uterus contribute to ovum transport and embryo implantation in the uterus [4

  3. [Early results of endoscopic treatment of vesico-ureteral reflux in children].

    PubMed

    Borówka, A; Hanecki, R; Kuzaka, B; Olpinski, M; Krzeski, T

    1991-07-01

    Endoscopic treatment of vesicoureteral reflux (VUR) is based on transurethral injection of Teflon paste or collagen gel into the submucosa of the bladder wall beneath the distal ureter, resulting in support of the intramural part. This endoscopic procedure was performed in 75 children with VUR of varying severity. Altogether 111 ureters were treated, 94 with injections of Teflon paste and 17 with collagen gel. Improvement of VUR in the early postoperative period was achieved in 91.5% of the ureters treated with Teflon and in 82.4% of the ureters treated with collagen. No complications were observed. Endoscopic treatment of VUR seems to be an worthwhile alternative to open surgery. However, since long-term follow-up has not been completed, the efficacy of the method cannot yet be finally assessed. PMID:1926675

  4. Laser lithotripsy with a Q-switched alexandrite laser system

    NASA Astrophysics Data System (ADS)

    Uebelacker, Walter

    1992-06-01

    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.

  5. Your Kidneys

    MedlinePLUS

    ... filters that take the waste out of the blood and make urine the ureters: tubes that carry the urine from each kidney to the bladder the bladder: a bag that collects the urine the urethra: a tube ...

  6. Ureteral Disorders

    MedlinePLUS

    ... rays, and examination of the ureter with a scope called a cystoscope. Treatment depends on the cause of the problem. It may include medicines and, in severe cases, surgery. NIH: National Institute of Diabetes and Digestive and Kidney Diseases

  7. 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

  8. A life of pelvic pain Karen J. Berkley *

    E-print Network

    Berkley, Karen J.

    on the uterus. (b) Colon inflammation produces signs of inflammation in the otherwise healthy bladder and uterus crosstalk; Endometriosis; Uterus; Vagina; Bladder; Colon; Ureter; Spinal cord; Pain mechanisms 1

  9. Simulation of the upper urinary system.

    PubMed

    Hosseini, Ghazaleh; Williams, John J R; Avital, Eldad J; Munjiza, A; Dong, Xu; Green, James S A

    2013-01-01

    The ureter and its peristalsis motions have long been of significant interest in biomechanics. In this article we review experimental, theoretical, and numerical studies of the behavior of the ureter together with its mechanical properties, emphasizing studies that contain information of importance in building a virtual simulation tool of the complete ureter that includes its complex geometry, nonlinear material properties, and interaction with urine flow. A new technique to model the contraction of a ureter, which directly applies wall forces to model pacemaker activities, is presented. The required further steps to capture the full complex movement of the peristalsis are discussed, aiming to construct a computational platform that will provide a reliable tool to assist in the investigation and design of material devices (stents) for the renal system. PMID:24579647

  10. 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

  11. 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 ...

  12. Long-Term Results of Ileum Interposition for Ureteral Obstruction

    Microsoft Academic Search

    Frank J. H Verduyckt; John P. F. A Heesakkers; Frans M. J Debruyne

    2002-01-01

    Objective: To present the long-term results of ileum interposition in the ureter for uni- or bilateral ureteral obstruction.Patients and Methods: Between 1981 and 2000, a total of 22 patients received an ileal segment interposition as a substitution for the ureter, of whom 18 were available for analysis. The mean age was 54 years (range 29–73). Patients were followed for a

  13. VEGF Trap in Treating Patients With Recurrent, Locally Advanced, or Metastatic Cancer of the Urothelium

    ClinicalTrials.gov

    2014-10-10

    Adenocarcinoma of the Bladder; 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; Squamous Cell Carcinoma of the Bladder; Stage III Bladder Cancer; Stage III Urethral Cancer; Stage IV Bladder Cancer; Transitional Cell Carcinoma of the Bladder; Urethral Cancer Associated With Invasive Bladder Cancer

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

    PubMed Central

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

    2012-01-01

    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

  15. [Multifocal urothelial tumors and renal autotransplantation].

    PubMed

    Boutemy, Frédéric; Demailly, Manuel; Petit, Jacques

    2002-12-01

    The authors report the case of a patient with multiple urothelial tumours only sparing the superior left ureter and the urethra. The complex treatment consisted of a combination of resection of the entire urinary tract, except for the left kidney and its proximal ureter that was transplanted into the right iliac fossa, after ex vivo partial pyelectomy. This complex treatment regimen avoided the need for dialysis with a good functional and oncological result, three years later. PMID:12545643

  16. Laparoscopic ipsilateral ureteroureterostomy for the management of children with duplication anomalies

    PubMed Central

    Chandrasekharam, VVS; Jayaram, Harish

    2015-01-01

    Aim: Ipsilateral ureteroureterostomy is an established method for the treatment of duplication anomalies in children. With the advent of pediatric laparoscopy, many urologic procedures in children are being performed using minimal access techniques. We present our experience with laparoscopic ipsilateral ureteroureterostomy (LIUU) for duplex anomalies. Patients and Methods: The data of children who underwent LIUU was reviewed for demographic parameters, clinical and operative details, follow-up and results. Results: Over 3 years period, LIUU was performed in eight children (age 6-60 months). Five children had complete ipsilateral duplication with ectopic upper moiety ureter, one child each had ipsilateral incomplete duplication and bilateral duplex systems (with ipsilateral ectopic upper moiety ureter). One child had ipsilateral complete duplex with Grade V vesicoureteric reflux into the lower moiety ureter. Four children had antenatal diagnosis of hydronephrosis; three children had a urinary infection and two children presented with urinary incontinence. The surgical procedure consisted of cystoscopy, retrograde studies and cannulation of the recipient ureter. Then, LIUU was performed using three ports. The ectopic (donor) ureter was divided at the pelvic brim; the recipient ureter was opened and end-to-side LIUU was performed with 5/0 vicryl stitches over a double J (DJ) stent placed in the recipient ureter. Bladder catheter was removed after 2 days, and DJ stent was removed after 4 weeks. At a mean follow-up of 19 months (3-36), all children are asymptomatic and continent, with a significant reduction in hydroureteronephrosis on ultrasound. The cosmetic results were excellent. Conclusion: LIUU is a safe and effective technique in the management of duplication anomalies in children. It could be performed with minimal blood loss, minimal postoperative pain, excellent cosmesis and good success. PMID:25552828

  17. Exaggerated prostaglandin biosynthesis and its influence on renal resistance in the isolated hydronephrotic rabbit kidney.

    PubMed Central

    Nishikawa, K; Morrison, A; Needleman, P

    1977-01-01

    Basal and hormone-stimulated prostaglandin biosynthesis was compared in isolated perfused rabbit kidneys with and without ureteral obstruction. At 72 h there was enhanced responsiveness to bradykinin in the ureter-obstructed hydronephrotic kidney. The amount of prostaglandin-like substance released from the perfused kidneys by 25 ng of bradykinin was 533+/-163 ng from the ureter-obstructed, 28+/-4 ng from the contralateral, and 26+/-3 ng from the normal kidney. The enhanced response was also noted with angiotensin II and with norepinephrine. This exaggerated responsiveness by the ureter-obstructed kidney could not be explained by decreased prostaglandin (PG) destruction or by decreased renal peptide inactivation (bradykinin or angiotensin). There was no enhanced PG biosynthesis with exogenous arachidonate, suggesting there was no increase in cyclo-oxygenase activity in the ureter-obstructed kidney. Renal tubular transport of PG from medulla to cortex was apparently not essential for the enhanced PG biosynthesis to hormone stimulation since the same exaggerated responses were noted during perfusion with the ureter ligated. The cyclo-oxygenase inhibitor, indomethacin, increased basal perfusion pressure in the obstructed kidney and enhanced the magnitude and duration of the renal vasoconstriction produced by angiotensin II in the hydronephrotic kidney. These results suggest that the local exaggerated biosynthesis of PG may be occurring in the cortical resistance vessels and may be important to the alteration in blood flow and excretory function that occur in ureteral obstruction. PMID:864006

  18. Spontaneous Forniceal Rupture in Pregnancy

    PubMed Central

    Upputalla, Roshni; Moore, Robert M.; Jim, Belinda

    2015-01-01

    Forniceal rupture is a rare event in pregnancy. We report a case of a 26-year-old primigravid woman who experienced a forniceal rupture at 23 weeks of gestation with no inciting cause except for pregnancy. Pregnancy is associated with ureteral compression due to increase in pelvic vasculature with the right ureter more dilated due to anatomic reasons. Hormones such as prostaglandins and progesterone render the ureter more distensible to allow for pressure build-up and an obstructive picture at the collecting system. We will discuss physiologic changes in pregnancies that predispose to this uncommon phenomenon and the most up-to-date management strategies. PMID:25648411

  19. Experience with endoluminal ultrasonography in the urinary tract.

    PubMed

    Lee, D I; Bagley, D H; Liu, J B

    2001-02-01

    Ultrasonography has been an invaluable tool in the field of urology for its noninvasiveness, safety, and relatively low cost. However, examination of the ureter with ultrasound is difficult because of the distance of the transducer from the ureter and because of intervening structures such as nonconductive bowel gas. As smaller probes have become available, attempts have been made to apply them to endoluminal use. Endoluminal ultrasonography has been employed in urology to examine the proper placement of injected collagen, diagnose urethral diverticula, diagnose and stage upper tract transitional-cell carcinoma, locate crossing vessels to guide endopyelotomy, diagnose submucosal calculi, and examine the severity and length of ureteral strictures. PMID:11248923

  20. Ureteral carcinoma presenting as a complex pelvic mass in a post menopausal patient.

    PubMed

    Farley, J H; Douglas, T H; Mcleod, D G; Harrison, C R

    1998-07-01

    This is a report of a low-grade ureteral carcinoma presenting as a pelvic mass in a postmenopausal woman with a prolonged history of lower back pain. A right complex adnexal mass and right hydroureter and hydronephrosis in an atrophic nonfunctioning right kidney was found during evaluation for the back pain. Operative evaluation revealed a normal uterus and ovaries; however, a 2 x 3-cm mass in the right ureter was found at the level of the uterine arteries. A total abdominal hysterectomy, bilateral salpingo-oophorectomy, and right nephroureterectomy were performed with pathology returning grade I papillary transitional cell carcinoma of the ureter. PMID:9698491

  1. Intraureteral and intravenous indocyanine green to facilitate robotic partial nephroureterectomy in a patient with complete ureteral triplication

    PubMed Central

    Lee, Matthew; Lee, Ziho

    2015-01-01

    A patient with a complete right ureteral triplication presented with recurrent pyelonephritis and flank pain that was refractory to medical management. Evaluation showed that the atrophic upper-most renal moiety had been chronically obstructed and was associated with a dilated ureter. Intraureteral and intravenous indocyanine green (ICG) were used as real-time contrast agents intraoperatively to facilitate right robotic partial nephroureterectomy of the diseased system. Intraureteral ICG was used to accurately distinguish the pathologic ureter and associated renal pelvis from its normal counterparts. Intravenous ICG was used to assess perfusion in the right kidney and delineate the margins of diseased renal parenchyma.

  2. Mesenteric Fibromatosis Causing Ureteral Stenosis

    PubMed Central

    Choi, Jae Young; Kang, Kyung Mo; Kim, Bum Soo

    2010-01-01

    Mesenteric fibromatosis is a rare benign disease characterized by proliferating fibrous tissue in the bowel mesentery. We report a case of aggressive mesenteric fibromatosis with ureteral stenosis arising in a 46-year-old woman who suffered from intermittent right abdominal pain. Computed tomography revealed a right retroperitoneal mass with right ureteral stenosis at the level of the right common iliac vessel. The mass was excised with resection of the affected segment of the ileum, ascending colon, and ureter, and end-to-end ureter anastomosis was performed. Pathological examination confirmed mesenteric fibromatosis. PMID:20664786

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

    PubMed

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

    2014-01-01

    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

  4. Parapelvic solitary neurofibroma of the kidney.

    PubMed

    Singh, Bhupendra Pal; Krishnaswamy, Srinivas Arakalagud; Singhai, Atin; Sankhwar, Satyanarayan

    2015-01-01

    A middle-aged man presented with intermittent gross haematuria and dull aching left flank pain for 1?month. He was a chronic smoker for 15?years. Contrast-enhanced CT scan of the abdomen detected a 4.5×3.0×2.5?cm, heterogeneous and poorly contrast-enhancing mass in the left renal sinus and upper ureteric region causing narrowing of the pelviureteric junction and upper ureter. Considering it to be a transitional cell carcinoma of upper urinary tract, the patient underwent laparoscopic radical nephroureterectomy. Histopathology revealed the mass to be a neurofibroma in the renal sinus extending around the upper ureter. PMID:26063112

  5. Horseshoe kidney transplantation

    PubMed Central

    Kanyári, Zsolt; Zádori, Gergely; Zsom, Lajos; Berhés, Mariann; Hamar, Mátyás; Kóbor, Krisztina; Péter, Antal

    2015-01-01

    Horseshoe kidney is a fusion anomaly found in approximately one in 400–600 people. Due to vascular and ureteral variations, transplantation with a horseshoe kidney presents a technical challenge. In our case, the isthmus connected the upper poles and contained parenchyma. It consisted of three renal arteries, five veins collected to the inferior vena cava, and two ureters and pyelons. It was implanted en bloc to the left side retroperitoneally. During the early period, cellular and humoral rejection was confirmed and treated. For a urine leak, double J catheters were implanted into both ureters. Later, the first catheter was removed. Subsequently, urinary sepsis developed, necessitating graftectomy. The uncommon anatomy of ureters and antibody-mediated rejection (AMR) may both be factors for a ureter tip necrosis led to an infected urinoma. After other Hungarian authors, we also report a horseshoe kidney transplantation that was technically successful. However, after an adequately treated but severe acute humoral rejection, the patient developed sepsis, and the kidney had to be removed. We conclude that transplantation with horseshoe kidney is technically feasible but may increase the risk for urinary complications and resultant infections. Careful consideration of risk and benefit is advised when a transplant professional is faced with this option. PMID:26120481

  6. Sonographic evaluation of the normal ureteral submucosal tunnel in infancy and childhood

    Microsoft Academic Search

    G. J. Marchal; A. L. Baert; R. Eeckels; W. Proesmans

    1983-01-01

    Sonography was used to evaluate in vivo the length of the submucosal segment of the intravesical ureter in 35 normal infants, children and adults. Age varied between 3 and 30 years. Sonographic measurements were plotted against, age, height and weight. Analysis of the statistical data shows an almost linear growth profile in this age group. The dimensions obtained in vivo

  7. Congenital segmental giant megaureter

    Microsoft Academic Search

    S Ramaswamy; V Bhatnagar; D. K Mitra; A. K Gupta

    1995-01-01

    A case of congenital segmental giant megaureter is reported. The patient presented with an asymptomatic abdominal mass resulting from the megaureter. A mildly hydronephrotic ipsilateral kidney was palpable as a separate mass. The ureter proximal and distal to the dilated segment showed normal peristaltic activity. Treatment consisted of excision of the dilated segment, with end-to-end ureteric anastomosis.

  8. Congenital cyst of the seminal vesicle.

    PubMed

    Lucon, A M; Nahas, W C; Wroclawski, E R; Borrelli, M; de Goes, P M; de Goes, G M

    1983-01-01

    A case of congenital cyst of the seminal vesicle in association with an ectopic ureter is presented. The clinical, diagnostic and therapeutic aspects are discussed with special emphasis on the role played by ultrasound and computerized tomography in the evaluation of pelvic pain and painful ejaculation. PMID:6653627

  9. EGF AND TGF ALPHA EXPRESSION INFLUENCE THE DEVELOPMENTAL TOXICITY OF TCDD: DOSE RESPONSE AND AHR PHENOTYPE IN EGF, TGF ALPHA AND EGF+TGF ALPHA KNOCKOUT MICE

    EPA Science Inventory

    Abstract The environmental toxicant 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) produces cleft palate (CP) and hydronephrosis (HN) in mice. The etiology of these defects involves hyperproliferation of epithelial cells of the secondary palatal shelf and ureter, respectively. ...

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

    Microsoft Academic Search

    Avelino Hernandez Osti; Georg Hofmockel; Hubert Frohmüller

    1997-01-01

    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

  11. Telocytes in the urinary system

    PubMed Central

    2012-01-01

    Background Telocytes, a new type of interstitial cells, have been identified in many organs in mammals. The present studies aimed at investigating the ultrastructure, distribution and interactions of telocytes with surrounding cells in the urinary system of rats, to confirm the existence of telocytes in kidneys, ureter and urinary bladder. Methods Samples of kidney, ureter, or urinary bladder were harvested for the ultrastructure by the electron microscope. The primary culture of telocytes was performed to investigate the dynamic alterations. Results Telocytes mainly located in the sub-capsular space of kidney, or between smooth muscle bundles and in the lamina propria of ureter and urinary bladder. Telocytes established numerous contacts with macrophages in the sub-capsular space of kidney, or with smooth muscle cells, nerve endings as well as blood capillaries in the ureter and urinary bladder. The complete morphology of telocytes with telopodes was observed clearly through the primary cell culture from the kidney tissues of rats. Conclusions Our data evidenced the existence of telocytes in the urinary system, which may contribute to the tissue reparation and regeneration. PMID:22963412

  12. Unenhanced CT for the evaluation of acute ureteric colic: the essential pictorial guide

    Microsoft Academic Search

    Steven J Kennish; Tze M Wah; Henry C Irving

    2010-01-01

    Acute ureteric colic is a common emergency, often dealt with by the emergency physician or general practitioner and referred on to the urologist. Unenhanced CT of the kidneys, ureters and bladder (CTKUB) is the ‘gold standard’ imaging investigation for establishing a diagnosis and guiding management. An appreciation of the CTKUB signs, which support or refute a diagnosis of ureteric colic,

  13. Renal excretory sectors

    Microsoft Academic Search

    M. Burykh

    2002-01-01

    One thousand and ninety-four normal human kidneys and 18 abnormal (with duplication of the ureter) were studied by the corrosion method and pyelography followed by topometric and mathematics analyses. It was found that the renal pelvis is a calicopelvic complex built up of renal calices, urine ducts and renal pelvis. Before opening into the renal pelvis, renal calices join together

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

    PubMed

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

    2014-10-01

    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

  15. Urothelial lesions in Chinese-herb nephropathy

    Microsoft Academic Search

    Jean-Pierre Cosyns; Michel Jadoul; Jean-Paul Squifflet; François-Xavier Wese; Charles van Ypersele de Strihou

    1999-01-01

    Rapidly progressive renal fibrosis after a slimming regimen including Chinese herbs containing aristolochic acid (AA) has been identified as Chinese-herb nephropathy (CHN). We reported urothelial atypia in three patients with CHN, with the subsequent development in one patient of overt transitional cell carcinoma (TCC). Therefore, it was decided to remove the native kidneys, as well as the ureters, in all

  16. Urological Complications in Renal Transplantation from Cadaveric Donor Grafts: A Retrospective Analysis of 20 Years

    Microsoft Academic Search

    V. Praz; H.-J. Leisinger; M. Pascual; P. Jichlinski

    2005-01-01

    Introduction: This study is a retrospective analysis of ureteral complications and their management from a monocenter series of 277 consecutive renal transplantations. Materials and Methods: From September 1979 to June 1999, 277 renal transplantations (cadaveric origin) were performed in 241 patients. The ureter from the kidney graft was inserted into the bladder according to the technique of extravesical implantation described

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

    Microsoft Academic Search

    ANTHONY MASALONIS; RAJA PARASURAMAN

    2003-01-01

    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).

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

    NASA Astrophysics Data System (ADS)

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

    1994-05-01

    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.

  19. Combined percutaneous antegrade and cystoscopic retrograde ureteral stent placement: an alternative technique in cases of ureteral discontinuity

    Microsoft Academic Search

    Darren Postoak; Jonathan M. Simon; anoj Monga; Hector Ferral; Raju Thomas

    1997-01-01

    We describe an alternative method of double J stent placement for ureteral transection following the failure of traditional antegrade and retrograde approaches. Cystoscopically, a guidewire was placed across the distal ureteral segment and was advanced into a urinoma cavity at the level of the transected ureter. Subsequently, an antegrade approach was used to place a gooseneck snare through the proximal

  20. [Intraureteral lithrotripsy (author's transl)].

    PubMed

    Teichmann, H H

    1980-07-01

    In some cases it is possible to enter the ureter and inspect its lower part up to 4 inches using a 13,5 charr. sized childrens cystoscop. By use of a 5 charr. foreign body forceps small stones can be extracted and larger ones removed by lithotripsy. Own cases are reported. PMID:7414769

  1. Combined percutaneous antegrade and cystoscopic retrograde approach in the treatment of distal ureteric fistulae

    Microsoft Academic Search

    Thierry de Baere; Alain Roche; Christine Lagrange; Alban Denys; Bernard Court; Joël Isapoff; Paris Pappas

    1995-01-01

    Purpose: To determine the efficacy of a cystoscopic approach, as definitive treatment of ureteral fistulae, after failure of antegrade ureteral stent insertion. Methods: Of 43 ureter fistulae encountered over 4 years, 10 postoperative and\\/or postradiotherapy fistulae could not be stented via an antegrade approach alone. A cystoscopic approach was used, with the antegrade approach available as back-up, if necessary. Results:

  2. Large spectrum of complete urinary collecting system duplication exemplified by cases. Pictorial essay.

    PubMed

    Fufezan, Otilia; T?tar, Simona; Dee, Ana Maria; Cramariuc, Radu; As?voaie, Carmen; Co?arc?, Mihaela

    2013-12-01

    Urinary collecting system duplication is a congenital anomaly and can associate various types of urinary tract pathologies. Authors will illustrate by cases some of associated anomalies such as ureterocele, extravesical ectopic ureter, vesicoureteral reflux or reflux nephropathy; one case presented an association between posterior urethral valve and bilateral collecting system duplication. PMID:24286096

  3. Acute perirenal extravasation of urine in an infant with non-refluxing megaureter

    Microsoft Academic Search

    Rolf Beetz; Raimund Stein; Petra Rohatsch; Rita Brzezinska; Jochen W. Thüroff

    2004-01-01

    Perirenal extravasation of urine is a rare event in congenital uropathies, mostly observed perinatally in the case of infravesical obstruction. We describe a male infant with a primary non-refluxing obstructive left megaureter who developed an acute perirenal extravasation and ascites at the age of 4 weeks. After temporary upper urinary diversion, ureterocystoneostomy was successfully performed. Intraoperatively, the distal ureter showed an

  4. Obstructive ureterocele—an ongoing challenge

    Microsoft Academic Search

    E. Merlini; P. Lelli Chiesa

    2004-01-01

    Ureterocele is a cystic dilatation of the intravesical ureter that is most commonly observed in females and children, and usually affects the upper moiety of a complete pyeloureteral duplication. According to their position, ureteroceles are divided into intravesical, when the ureterocele is completely contained inside the bladder, and extravesical when part of the cyst extends to the urethra or bladder

  5. Multiple Biomarkers for the Prediction of First Major Cardiovascular Events and Death

    Microsoft Academic Search

    Thomas J. Wang; Philimon Gona; Martin G. Larson; Geoffrey H. Tofler; Daniel Levy; Christopher Newton-Cheh; Paul F. Jacques; Nader Rifai; Jacob Selhub; Sander J. Robins; Emelia J. Benjamin; Ralph B. D'Agostino; Ramachandran S. Vasan

    2010-01-01

    Methods We measured 10 biomarkers in 3209 participants attending a routine examination cycle of the Framingham Heart Study: the levels of C-reactive protein, B-type natri- uretic peptide, N-terminal pro-atrial natriuretic peptide, aldosterone, renin, fibrino- gen, D-dimer, plasminogen-activator inhibitor type 1, and homocysteine; and the uri- nary albumin-to-creatinine ratio. Results

  6. Organ and Species Specificity in the Stimulation of Transitional Epithelial Cell Growth by Fibroblasts

    Microsoft Academic Search

    Andrea Staack; Terri Alexander; Paul Merguerian; Martha K. Terris

    2001-01-01

    Objectives: Culture of transitional epithelium for urinary tract reconstruction has been problematic due, in part, to the dependence of urothelial cells on a basal layer of bladder fibroblasts for growth. In vitro studies on the effect of bladder, ureter, and intestinal fibroblast cocultures and conditioned media upon urothelial cell growth were conducted to better characterize the dependence of urothelial cells

  7. Ultrafiltration Versus Intravenous Diuretics for Patients Hospitalized for Acute Decompensated Heart Failure

    Microsoft Academic Search

    Maria Rosa Costanzo; Maya E. Guglin; Mitchell T. Saltzberg; Mariell L. Jessup; Bradley A. Bart; John R. Teerlink; Brian E. Jaski; James C. Fang; Erika D. Feller; Garrie J. Haas; Allen S. Anderson; Michael P. Schollmeyer; Paul A. Sobotka

    2007-01-01

    Background Early ultrafiltration may be an alternative to intravenous diuretics in patients with decompensated HF and volume overload. Methods Patients hospitalized for HF with ! 2 signs of hypervolemia were randomized to ultrafiltration or intravenous di- uretics. Primary end points were weight loss and dyspnea assessment at 48 h after randomization. Secondary end points included net fluid loss at 48

  8. Tbx18 regulates the development of the ureteral mesenchyme

    PubMed Central

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

    2006-01-01

    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

  9. [Characteristics and results of retroperitoneoscopic operations in urology].

    PubMed

    Teodorovich, O V; Lutsevich, O E; Galliamov, E A; Zabrodina, N B; Presnov, K S; Glukharev, A M

    2006-01-01

    The aim of the study was analysis of retroparietoscopic operations made in patients with renal cysts, anomalies of the kidneys, uretero-pelvic strictures, concrements of the upper third of the ureter to optimize treatment policy. A total of 29 patients were treated in the urological department (17 males, 12 females, age 23-70 years, mean age--49.7 years). Of them, 18--for renal cysts, 4--for ureteropelvic stricture (postoperative structure--1, ureterovasal conflict--2, high position of the ureter--1), postoperative stricture of the lower third of the left ureter--1, urolithiasis--5 (located in the upper third of the ureter--4, located in the pelvis and lower calyces of the dystopic left kidney--1), hydroureteronephrosis of the upper half of the double right kidney--1. Ultrasound scanning was followed by multispiral computed tomography. Retroparietoscopic method is characterized by limited positions of the instrumental trochar, absence of definite anatomic marks and difficulties in maintenance of necessary pressure in the cavity. Valid position of the trochars in the retroperitoneoscopic operation is a necessary condition of successful operation. In retroparietoscopic interventions the operative approach includes creation of the primary cavity, placement of trochars and creation of working cavity. Duration of retroperitoneoscopic operations ranged from 1 hour to 4 hours 30 min. Only short-term fever was a complication. Postoperative hospital stay was 1 to 7 days. Thus, retroperitoneoscopic operations are a good alternative to conventional surgery. PMID:17058676

  10. Increased fluid intake and adequate dietary modification may be enough for the successful treatment of uric acid stone.

    PubMed

    Chae, Ji Yun; Kim, Jong Wook; Kim, Jin Wook; Yoon, Cheol Yong; Park, Hong Seok; Moon, Du Geon; Oh, Mi Mi

    2013-04-01

    Uric acid stones are the most readily dissolvable of all types of urinary stones. The present paper describes two patients with uric acid stones in kidney and ureter, whom we have treated successfully only by a combination of increased fluid intake and adequate dietary modification. PMID:23503881

  11. Left-sided renal colic as a symptom of advanced stomach cancer – a case report

    PubMed Central

    Kuciel-Lisieska, Gra?yna; Licznerska, Gra?yna; Tenderenda, Micha?

    2012-01-01

    The typical symptoms of advanced cancer of the stomach are well known in clinical practice. The presented case concerns a patient with symptoms of left-sided renal colic, caused by a malignant tumour involving the ureter, which was diagnosed with a CT scan. The multifocal process, involving the stomach, two parts of the colon, the left ovary and the side of the pelvis, was confirmed only during surgery. The resection or partial resection of the above-mentioned organs involved by the malignant process and reconstruction of the alimentary tract as well as the ureter were performed at time of this operation. The patient's recovery was without any complications. The histopathological findings support the diagnosis of this malignant process as disseminated stomach cancer. In the available literature only two cases of stomach cancer metastasis to the ureter have been described. In both cited examples resection of the ureter with nephrectomy was performed. The review of the literature supports the value of stomach palliative resection in prolonging life and improving quality of life. PMID:23788876

  12. Vesicoureteral Reflux

    MedlinePLUS

    ... tract is the body’s drainage system for removing wastes and extra water. The urinary tract includes two kidneys, two ureters, ... through the kidneys, and the kidneys filter out wastes and extra water, making urine. The urine travels down two narrow ...

  13. What I Need to Know about My Child's Urinary Tract Infection

    MedlinePLUS

    ... tract is the body’s drainage system for removing wastes and extra water. The urinary tract includes two kidneys , two ureters , ... kidneys process about 3 ounces of blood, removing wastes and extra water. The wastes and extra water make up the ...

  14. Hematuria (Blood in the Urine)

    MedlinePLUS

    ... tract is the body’s drainage system for removing wastes and extra water. The urinary tract includes two kidneys, two ureters, ... 1 to 2 quarts of urine, composed of wastes and extra water. The urine flows from the kidneys to the ...

  15. Urodynamic Testing

    MedlinePLUS

    ... tract is the body’s drainage system for removing wastes and extra water. The urinary tract includes two kidneys, two ureters, ... through the kidneys, and the kidneys filter out wastes and extra water, making urine. The urine travels down two narrow ...

  16. Biomimetic propulsion for a swimming surgical micro-robot

    Microsoft Academic Search

    Jon Edd; Sébastien Payen; Boris Rubinsky; Marshall L. Stoller; Metin Sitti

    2003-01-01

    A surgical micro-robot that swims inside the human ureter is proposed to provide a novel and minimally invasive method of kidney stone destruction. Inspired by the swimming mechanisms of bacteria such as E. coli, the robot utilizes biomimetic synthetic flagella composed of multiwalled carbon nanotubes that are driven into a rotating helical shape by a micro motor. Design aspects are

  17. Ureteric foreign body following previous aorto-iliac graft

    PubMed Central

    da Silva, Vitor; Taylor, Jonathan

    2015-01-01

    Foreign bodies in the ureter are extremely rare. We report a case of an 82-year-old man who, after an incidental presentation with asymptomatic hydroureteronephrosis, had an intraureteric foreign body. The patient was managed with atraumatic endoscopic extraction of the specimen.

  18. [Seminal vesicle cyst and ipsilateral kidney failure. Report of 2 cases and review of the literature].

    PubMed

    Zurkirchen, M A; Sulser, T; Schmucki, O; Hauri, D

    1996-11-01

    The seminal vesicle cyst is a congenital malformation of the male urogenital tract, which seems to be more frequent than originally presumed. It is usually combined with an ipsilateral renal agenesis and an ectopic ureter. Two relevant cases are reported and embryology, major presenting symptoms, diagnostic procedures, differential diagnosis and therapy are extensively discussed. PMID:9064889

  19. Pathology of Tangier disease

    Microsoft Academic Search

    Patricia M. Bale; P. Clifton-Bligh; B. N. P. Benjamin; H. M. Whyte

    1971-01-01

    Two cases of Tangier disease are described in children from families unrelated to each other. Necropsy in one case, the first to be reported in this condition, showed large collections of cholesterol-laden macrophages in tonsils, thymus, lymph nodes, and colon, and moderate numbers in pyelonephritic scars and ureter. As the storage cells may be scanty in marrow, jejunum, and liver,

  20. [Transureteroureterostomy. Results in a series of 42 children and young adults].

    PubMed

    Villers, A; Cohen, L; Melin, Y; Cendron, J

    1988-01-01

    Forty two TUU have been performed from 1974 to 1986 in children and young adults: the youngest was 10 years, the oldest 26. The mean follow-up has been more than 5 years: 23 bladder exstrophies, 12 neurogenic bladders, 5 mega-ureters and 2 retroperitoneal tumors. TUU were performed after failure of uretero-cysto-neostomies (8/42) ou uretero-sigmoid reimplantation (19/42). The technique with details about drainage (16/42) is described. In 5 cases, complications appeared early: 3 fistulae, 2 sweelings of the anastomosis. tests done 3 months after the operation did not show any other complication in relation with the TUU. Nevertheless one reflux and 3 stenoses of the end of the recipient ureter caused dilatation of two upper urinary tracts. During the long term follow-up, it was necessary to perform 2 nephrectomies of the donor ureter and 5 operations on the end of the recipient ureter. These complications were independant of the TUU. The final result of TUU was excellent. PMID:3369842

  1. Impact of Ureteral Length on Urological Complications and Patient Survival After Kidney Transplantation

    PubMed Central

    Ali-Asgari, Majid; Dadkhah, Farid; Ghadian, Alireza; Nourbala, Mohammad Hossein

    2013-01-01

    Background Urologic complications are of the most important complications after kidney transplantation which increases mortality and morbidity significantly. Objectives We designed this study to evaluate the association between ureteral length and postoperative complications. Patients and Methods We recorded the length of the transplanted ureter during the operation. Ureter-to-bladder anastomosis was performed using modified Lich-Gregoir method on the ureteral stent. Complications like urine leakage and increased creatinine were evaluated. We used both univariate and multivariate analyses and survival analysis according lengths of ureter. It means that the main variable is ureteral length and other variables are studied based on it. Result A total of 395 patients with the mean age of 37 years (range, 18 to 68 years) were enrolled in the study, twenty six graft lost during the follow-up period. The Mean age of recipients was 37 ± 13 years. Urinary stenosis was seen in 6 patients (1.5%) and urinary leakage in 4 (1%) patients. The complication rate was not significantly different between these groups (P = 0.67). We found that there were no significant difference among complication (P = 0.25), hospitalization (P = 0.31) and survival (P = 0.84) at 5.5 cm length cut off. Conclusions The length of transplanted ureter does not affect the postoperative urologic complications (including urinary fistula and ureter-to-bladder anastomosis stricture), and it seems that decreased rate of complication frequency during the recent years is due to technical improvement, surgeon’s skillfulness and development in use of immunosuppressant’s postoperatively. PMID:24350086

  2. Complete laparoscopic nephroureterectomy with intravesical lockable clip

    PubMed Central

    Eret, Viktor; Ürge, Tomáš; Kle?ka, Ji?í; Trávní?ek, Ivan; Hes, Ond?ej; Petersson, Fredrik; Stránský, Petr

    2012-01-01

    Introduction We present a cohort of patients with low-stage pelviureteric neoplastic disease who underwent complete laparoscopic nephroureterectomy (CLNUE) with intravesical lockable clip (IVLC). Due to the absence of a standard technique of NUE, the study was not randomized. Materials From 1/2010 to 1/2012, 21 patients were subjected to CLNUE-IVLC. The first step was transurethral excision of the ureterovesical junction with Collin's knife deep into the paravesical adipose tissue. The ureter was grasped with biopsy forceps and the distal end of the ureter was occluded with lockable clip. The applicator was introduced through a 5 mm port inserted as an epicystostomy. The patients were rotated to flank position and CLNUE followed. The endoscopically introduced clip on the distal ureter is proof of completion of the total ureterectomy. Results The mean operation time was 161 (115-200) min. In four (19.0%), the application of the clip failed and CLNUE was completed with non-occluded ureter. In three cases, subsequent laparoscopic nephrectomy was converted to open surgery. In two cases, the distal ureterectomy was completed with pluck technique through a lower abdominal incision that was also used for extraction of the specimen. There were four complications (Clavien II 2x, IIIb, V). Follow-up was available for all – mean 10.6 (range: 0-25) months. One died of disease generalization within 11 months. Conclusion CLNUE-IVLC is fast and safe. If needed, the endoscopic phase can be switched to open NUE. Disadvantages include: the need to change the position of the patient, the risk of inability to apply the clip on the distal ureter, and the risk of an unclosed defect of the urinary bladder. PMID:24578933

  3. Cascade bioassay evidence for the existence of urothelium-derived inhibitory factor in Guinea pig urinary bladder.

    PubMed

    Guan, Na N; Thor, Anna; Hallén, Katarina; Wiklund, N Peter; Gustafsson, Lars E

    2014-01-01

    Our aim was to investigate whether guinea pig urothelium-derived bioactivities compatible with the existence of urothelium-derived inhibitory factor could be demonstrated by in vitro serial bioassay and whether purinergic P1 receptor agonists, nitric oxide, nitrite or prostaglandins might explain observed activities. In a cascade superfusion system, urothelium-denuded guinea pig ureters were used as bioassay tissues, recording their spontaneous rhythmic contractions in presence of scopolamine. Urothelium-intact or -denuded guinea pig urinary bladders were used as donor tissues, stimulated by intermittent application of carbachol before or during the nitric oxide synthase inhibitor NG-nitro-L-arginine methyl ester (L-NAME), the adenosine/P1 nucleoside receptor antagonist 8-(p-sulfophenyl)theophylline (8-PST) or the cyclo-oxygenase inhibitor diclofenac infused to bath donor and bioassay tissues. The spontaneous contractions of bioassay ureters were unaltered by application of carbachol 1-5 µM in the presence of scopolamine 5-30 µM. When carbachol was applied over the urothelium-denuded bladder, the assay ureter contraction rate was unaltered. Introducing carbachol over the everted urothelium-intact bladder significantly inhibited the contraction frequency of the assay ureter, suggesting the transfer of an inhibitory activity from the bladder to the assay ureter. The transmissible inhibitory activity was not markedly antagonized by L-NAME, 8-PST or diclofenac, while L-NAME nearly abolished nitrite release from the urothelium-intact bladder preparations. We suggest that urothelium-derived inhibitory factor is a transmissible entity over a significant distance as demonstrated in this novel cascade superfusion assay and seems less likely to be nitric oxide, nitrite, an adenosine receptor agonist or subject to inhibition by administration of a cyclo-oxygenase inhibitor. PMID:25084114

  4. Cascade Bioassay Evidence for the Existence of Urothelium-Derived Inhibitory Factor in Guinea Pig Urinary Bladder

    PubMed Central

    Guan, Na N.; Thor, Anna; Hallén, Katarina; Wiklund, N. Peter; Gustafsson, Lars E.

    2014-01-01

    Our aim was to investigate whether guinea pig urothelium-derived bioactivities compatible with the existence of urothelium-derived inhibitory factor could be demonstrated by in vitro serial bioassay and whether purinergic P1 receptor agonists, nitric oxide, nitrite or prostaglandins might explain observed activities. In a cascade superfusion system, urothelium-denuded guinea pig ureters were used as bioassay tissues, recording their spontaneous rhythmic contractions in presence of scopolamine. Urothelium-intact or -denuded guinea pig urinary bladders were used as donor tissues, stimulated by intermittent application of carbachol before or during the nitric oxide synthase inhibitor NG-nitro-L-arginine methyl ester (L-NAME), the adenosine/P1 nucleoside receptor antagonist 8-(p-sulfophenyl)theophylline (8-PST) or the cyclo-oxygenase inhibitor diclofenac infused to bath donor and bioassay tissues. The spontaneous contractions of bioassay ureters were unaltered by application of carbachol 1–5 µM in the presence of scopolamine 5–30 µM. When carbachol was applied over the urothelium-denuded bladder, the assay ureter contraction rate was unaltered. Introducing carbachol over the everted urothelium-intact bladder significantly inhibited the contraction frequency of the assay ureter, suggesting the transfer of an inhibitory activity from the bladder to the assay ureter. The transmissible inhibitory activity was not markedly antagonized by L-NAME, 8-PST or diclofenac, while L-NAME nearly abolished nitrite release from the urothelium-intact bladder preparations. We suggest that urothelium-derived inhibitory factor is a transmissible entity over a significant distance as demonstrated in this novel cascade superfusion assay and seems less likely to be nitric oxide, nitrite, an adenosine receptor agonist or subject to inhibition by administration of a cyclo-oxygenase inhibitor. PMID:25084114

  5. Comprehensive Management of Upper Tract Urothelial Carcinoma

    PubMed Central

    Koukourakis, Georgios; Zacharias, Georgios; Koukourakis, Michael; Pistevou-Gobaki, Kiriaki; Papaloukas, Christos; Kostakopoulos, Athanasios; Kouloulias, Vassilios

    2009-01-01

    Urothelial carcinoma of the upper urinary tract represents only 5% of all urothelial cancers. The 5-year cancer-specific survival in the United States is roughly 75% with grade and stage being the most powerful predictors of survival. Nephroureterectomy with excision of the ipsilateral ureteral orifice and bladder cuff en bloc remains the gold standard treatment of the upper urinary tract urothelial cancers, while endoscopic and laparoscopic approaches are rapidly evolving as reasonable alternatives of care depending on grade and stage of disease. Several controversies remain in their management, including a selection of endoscopic versus laparoscopic approaches, management strategies on the distal ureter, the role of lymphadenectomy, and the value of chemotherapy in upper tract disease. Aims of this paper are to critically review the management of such tumors, including endoscopic management, laparoscopic nephroureterectomy and management of the distal ureter, the role of lymphadenectomy, and the emerging role of chemotherapy in their treatment. PMID:19096525

  6. Computed tomography of the abdomen of calves during the first 105 days of life: III. Urinary tract and adrenal glands.

    PubMed

    Braun, U; Schnetzler, C; Augsburger, H; Bettschart, R; Ohlerth, S

    2014-05-01

    Computed tomographic (CT) findings of the urinary tract and adrenal glands of five healthy male calves in the first 105 days of life were compared with corresponding cadaver slices. The structures seen on CT images were identified using the corresponding cadaver slices. CT produced exact images of the kidneys, urinary bladder, urethra and adrenal glands, but reliable images of the ureters were only obtained near the renal hilus. There was excellent agreement between the structures on the CT images and the tissue slices. The structure and vessels of the kidneys, the origin of the ureters, the location, size and content of the urinary bladder and the course of the urethra in the pelvis and penis were evident on images. The size and volume of the kidneys and the length and width of the adrenal glands increased significantly during the study, but the ureteral and urethral diameters changed little. PMID:24794237

  7. Chronic obstructive uropathy due to uretero-inguinal hernia: A case report

    PubMed Central

    Won, Andy Chuk Moon; Testa, Gerard

    2012-01-01

    INTRODUCTION Inguinal hernia in men is common but uretero-inguinal hernia is very rare. PRESENTATION OF CASE A 85-year-old obese man presented with chronic obstructive uropathy with previous renal ultrasound showing bilateral enlarged kidneys and hydronephrosis. The medical history revealed a 3-year history of a noticeable bilateral partial reducible inguinoscrotal herniae associated with urinary symptoms. Progress CT scan showed very large inguinal herniae, which were predominantly fat-containing with the ureters herniated, and both kidneys were displaced inferiorly. DISCUSSION Uretero-inguinal hernia in patients with native kidneys is rare, but cases of renal failure secondary to uretero-inguinal hernia have also been reported previously in the literature with two anatomical variations have been reported – paraperitoneal and extraperitoneal types. Endourological and surgical procedures are rarely straight-forward because of tortuosity of the herniated ureter. CONCLUSION Although uretero-inguinal hernia is rare, it can be the cause of chronic renal impairment. PMID:22609811

  8. Diffuse Calcification of the Urinary System and Miliary Tuberculosis Due To Delayed Diagnosis of Genitourinary Tuberculosis: A Case Report

    PubMed Central

    CHEN, Hairong; LIU, Yubo; WU, Dawei

    2015-01-01

    Genitourinary tuberculosis (GUTB) is difficult to diagnose in the earlier stage owing to the non-specific symptoms. Usually, renal tuberculous involvement is unilateral and the imaging finding is renal calcification, but associated calcifications of bilateral ureter and bladder are rare. We report a 66-year-old man who presented with diffuse calcification of the urinary system (including bilateral pelvicalyceal system, both ureters and bladder) and disseminated miliary tuberculosis due to GUTB. He had been misdiagnosed with urinary tract infection and urinary lithiasis for two years before the diagnosis of GUTB was confirmed by microbiological examination of the urine. This case highlights the importance of maintaining a high index of clinical suspicion for GUTB. PMID:25905063

  9. Simultaneous Colonic Obstruction and Hydroureteronephrosis due to Mesenteric Fibromatosis.

    PubMed

    Jung, Sung Hoon; Paik, Chang Nyol; Jung, Ji Han; Lee, Kang-Moon; Chung, Woo Chul; Yang, Jin-Mo

    2009-09-01

    Mesenteric fibromatosis (MF) is a rare benign mesenchymal lesion that can occur throughout the gastrointestinal tract, especially small bowel. Its biological behavior is intermediate between benign fibrous tissue proliferation and malignant fibrosarcoma. In previously reported cases of MF, we could find colonic obstruction or ureter obstruction, but simultaneous involvement of colon and ureter was not able to be seen. We described a patient that presented with colonic obstruction and hydroureteronephrosis due to MF at sigmoid colon which mimicked submucosal tumor such as gastrointestinal tumor. This case resulted in a positive positron emission tomography scan suggesting malignant neoplasm, but beta-catenin positivity on immunohistochemical staining separated MF from gastrointestinal stromal tumor and sclerosing mesenteritis. The clinical course of the patient was improved after surgical resection. PMID:20431749

  10. Simultaneous Colonic Obstruction and Hydroureteronephrosis due to Mesenteric Fibromatosis

    PubMed Central

    Jung, Sung Hoon; Jung, Ji Han; Lee, Kang-Moon; Chung, Woo Chul; Yang, Jin-Mo

    2009-01-01

    Mesenteric fibromatosis (MF) is a rare benign mesenchymal lesion that can occur throughout the gastrointestinal tract, especially small bowel. Its biological behavior is intermediate between benign fibrous tissue proliferation and malignant fibrosarcoma. In previously reported cases of MF, we could find colonic obstruction or ureter obstruction, but simultaneous involvement of colon and ureter was not able to be seen. We described a patient that presented with colonic obstruction and hydroureteronephrosis due to MF at sigmoid colon which mimicked submucosal tumor such as gastrointestinal tumor. This case resulted in a positive positron emission tomography scan suggesting malignant neoplasm, but ?-catenin positivity on immunohistochemical staining separated MF from gastrointestinal stromal tumor and sclerosing mesenteritis. The clinical course of the patient was improved after surgical resection. PMID:20431749

  11. Skinny needle pyelography. An advance in uroradiology.

    PubMed

    Hare, W S; McOmish, D

    1981-08-01

    Diagnostic puncture of the renal pelvis with a fine-gauge needle inserted under radiological and ultrasound control, has been performed in more than 100 cases. The method is safe, easy to perform for those trained in imaging modalities, and causes little discomfort. Pyelography and pressure flow studies can be made and urine specimens obtained from the upper urinary tract. Skinny needle pyelography is indicated in unilateral non-visualization of the ureter on intravenous pyelography, in acute oliguric renal failure when ultrasound reveals dilated ureters, and when retrograde pyelography is not feasible. The method is cost-effective, as it can be performed on outpatients as a follow-on procedure after intravenous pyelography or renal ultrasound scanning. PMID:7026995

  12. Altered Regulation of Renin-Angiotensin, Endothelin and Natriuretic Peptide Systems in Rat Kidney with Chronic Unilateral Ureteral Obstruction

    Microsoft Academic Search

    Eun Hui Bae; In Jin Kim; Jeong Woo Park; Seong Kwon Ma; Ki Chul Choi; Jong Un Lee; Soo Wan Kim

    2007-01-01

    Background: The present study was designed to investigate the role of the local renin-angiotensin-aldosterone system (RAAS), endothelin (ET) and the natriuretic peptide system (NPS) for the development of renal fibrosis and progressive renal disease in experimental unilateral ureteral obstructed (UUO) rats. Methods: Male Sprague-Dawley rats (180–200 g) were unilaterally obstructed by ligation of the proximal ureters for 14 days. Control

  13. Diminished Expression of Sodium Transporters in the Ureteral Obstructed Kidney in Rats

    Microsoft Academic Search

    Soo Wan Kim; JongUn Lee; Kwon Jung; Seong Kwon Ma; YoonWha Oh; Wan-Young Kim; Ki Chul Choi; Jin Kim

    2004-01-01

    Background\\/Aims: Whether the postobstructive natriuresis and diuresis is related with an altered regulation of sodium transporters in the kidney was examined. Methods: Male Sprague-Dawley rats underwent either bilateral (BUO) or unilateral obstruction (UUO) of the proximal ureters for 24 h. The expression of Na,K-ATPase, type-3 sodium-hydrogen exchanger (NHE3), type-1 bumetanide-sensitive sodium cotransporter (BSC1), and thiazide-sensitive sodium cotransporter (TSC) proteins was

  14. Increased expression of atrial natriuretic peptide in the kidney of rats with bilateral ureteral obstruction

    Microsoft Academic Search

    Soo Wan Kim; Jongun Lee; Jong Wook Park; Jung Hee Hong; Hyun Kook; Chan Choi; Ki Chul Choi

    2001-01-01

    Increased expression of atrial natriuretic peptide in the kidney of rats with bilateral ureteral obstruction.BackgroundWhether the postobstructive diuresis can be related to an altered regulation of local atrial natriuretic peptide (ANP) in the kidney was investigated.MethodsThree groups of rats had both of their ureters obstructed for 48 hours. The kidneys were taken without releasing the obstruction in one group [bilateral

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

    Microsoft Academic Search

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

    2003-01-01

    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

  16. Sulfasalazine reduces inflammatory renal injury in unilateral ureteral obstruction

    Microsoft Academic Search

    Savas Demirbilek; Memet Hanefi Emre; Engin Nasuhi Ayd?n; Mehmet Naci Edali; Rauf Tu?rul Aksoy; Melih Ak?n; Kubilay Gürünlüo?lu; Erkan Tas; Selma Ay; Zümrüt Yilmaz

    2007-01-01

    The purpose of this study was to test whether sulfasalazine has a protective action against interstitial inflammation and\\u000a the development of renal fibrosis in obstructive nephropathy. Female rats were subjected to a sham (n?=?10) or unilateral ureteral obstruction (UUO, n?=?30). UUO was induced in rats by ligating the left ureter. Three days after operation, rats subjected to UUO were randomized

  17. Deletion (11)(q14.1q21)

    SciTech Connect

    Stratton, R.F.; Lazarus, K.H.; Ritchie, E.J.L. [Southwest Texas Methodist Hospital, San Antonio, TX (United States); Bell, A.M. [Nichols Institute, Los Angeles, CA (United States)

    1994-02-01

    The authors report on a 4-year-old girl with moderate development delay, horseshoe kidney, bilateral duplication of the ureters with right upper pole obstruction, hydronephrosis and nonfunction, and subsequent Wilms tumor of the right lower pole. She had an interstitial deletion of the long arm of chromosome 11 involving the region 11(q14.1q21). 22 refs., 2 figs., 1 tab.

  18. Prosthetic Sphincter Controls Urination

    NASA Technical Reports Server (NTRS)

    Tenny, John B., Jr

    1986-01-01

    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.

  19. [The choice of the type of operation in hydronephrosis in children].

    PubMed

    Pugachev, A G; Kudriavtsev, Iu V; Larionov, I N; Chumakov, A M

    1996-01-01

    113 hydronephrosis children underwent Andersen-Hynes operation, 62 Calp de Werd operation. The ureteropelvic segment was examined morphologically. 3 macroscopic variants of ureteral structure and 5 variants of leiomyocyte presence in the muscular lining of the ureter are defined. Long-term follow-up results (1-10 years) are available. Resection gave positive results in 80%, graft plastic repair was effective in 92% of cases. PMID:8928328

  20. Danazol in the management of ureteral obstruction secondary to endometriosis

    SciTech Connect

    Rivlin, M.E.; Krueger, R.P.; Wiser, W.L.

    1985-08-01

    A case is reported in which a woman was diagnosed with ureteral obstruction secondary to endometriosis after cystourethrogram, retrograde pyelogram and a renal scan. After unsuccessful treatment with danazol, a retroperitoneal ureteroneocystotomy was performed. The ureter was found to be obstructed by dense fibrous tissue that contained endometrial glands. It was concluded that danazol is unlikely to relieve endometriotic ureteric obstruction once dense fibrosis has occurred. 8 references, 2 figures.

  1. Creation of the digital three-dimensional model of the prostate and its adjacent structures based on Chinese visible human

    Microsoft Academic Search

    Yi WuShao-Xiang; Shao-Xiang Zhang; Na Luo; Ming-Guo Qiu; Li-Wen Tan; Qi-Yu Li; Guang-Jiu Liu; Kai Li

    2010-01-01

    We managed to provide three-dimensional digitized visible model of the prostate and its adjacent structures and to provide\\u000a morphological data for imaging diagnosis and male urological surgery. With 3D-DOCTOR software, the contour line of prostate\\u000a and its adjacent structures including rectum, bladder, male urethra, ureter, seminal vesicle, ductus deferens, ejaculatory\\u000a ducts, obturator internus, levator ani, coccygeus, male pelvis, femur, prostatic

  2. SPECT/CT imaging of retroperitoneal extraskeletal osteosarcoma.

    PubMed

    Hu, Bin; Liu, Yan; Cheng, Lixia; Li, Wei; Cao, Xiaozheng

    2014-02-01

    The condition of a 52-year-old man was diagnosed with unresectable retroperitoneal extraskeletal osteosarcoma. SPECT/CT demonstrated a retroperitoneal extraskeletal osteosarcoma adjacent to the right upper ureter with large calcifications and increased Tc-MDP accumulation. Multiple hepatic capsular, renal fascial, and peritoneal metastases were noted. Four months later, multiple peritoneal metastases were noted at the second-look surgery. A histopathologic examination confirmed osteosarcoma. PMID:24300353

  3. Cystoscopic Confirmation of Inadvertent Ureteral Catheterization during Cystometry

    Microsoft Academic Search

    E. J. Gill; C. M. Nichols

    2002-01-01

    :   A patient in whom the right ureter was inadvertently catheterized at the time of cystometry is described. Upon filling, the\\u000a patient immediately developed severe colicky right flank pain and the vesical pressure of 150 cmH2O triggered the pump’s automatic shut-off mechanism. Cystoscopy was performed and confirmed the inadvertent placement of the\\u000a microtip catheter in the right ureteral orifice. After

  4. Aspects concerning posterior urethral valves

    Microsoft Academic Search

    M. D. Melekos; H. W. Asbach; S. Giannoulis; P. Perimenis; G. Barbalias

    1989-01-01

    Twenty-six boys were evaluated and treated for posterior urethral valves. At the time the valves were diagnosed unilateral\\u000a or bilateral vesicoureteral reflux was present in 58% of the ureters and 69% of the children, while dilatation of the upper\\u000a urinary tract was present in 88% and 92%, respectively. There was a variety of symptoms and signs, but the most prominent

  5. The effects of dietary phenylalanine supplementation on ochratoxicosis in normal and partially nephrectomized rats 

    E-print Network

    Parker, Roger William

    1983-01-01

    molecular weight of 403. 59 g and is a colorless, crystalline compound obtained by crystallization from benzene or xylene. With acid or enzymatic hydrolysis, OA yields L-beta-phenyl alanine and a 1actone acid, ochratoxin alpha (7-carboxy- 5-chloro-3, 4... impair- ments, glucosuria, proteinuria, reduced PAH clearance, and decreased GFR About one-third of dying patients have papillomas and/or carcinomas of renal pelvis, ureters, or bladder. Control Harvest cereal grains under proper climatic conditions...

  6. Cancer Research Repository for Individuals With Cancer Diagnosis and High Risk Individuals.

    ClinicalTrials.gov

    2014-12-12

    Pancreatic Cancer; Thyroid Cancer; Lung Cancer; Esophageal Cancer; Thymus Cancer; Colon Cancer; Rectal Cancer; GIST; Anal Cancer; Bile Duct Cancer; Duodenal Cancer; Gallbladder Cancer; Gastric Cancer; Liver Cancer; Small Intestine Cancer; Peritoneal Surface Malignancies; Familial Adenomatous Polyposis; Lynch Syndrome; Bladder Cancer; Kidney Cancer; Penile Cancer; Prostate Cancer; Testicular Cancer; Ureter Cancer; Urethral Cancer; Hypopharyngeal Cancer; Laryngeal Cancer; Lip Cancer; Oral Cavity Cancer; Nasopharyngeal Cancer; Oropharyngeal Cancer; Paranasal Sinus Cancer; Nasal Cavity Cancer; Salivary Gland Cancer; Skin Cancer; CNS Tumor; CNS Cancer; Mesothelioma

  7. Chronic renal failure in a patient with bilateral ureterocele

    PubMed Central

    Dada, Samuel A.; Rafiu, Mojeed O.; Olanrewaju, Timothy O.

    2015-01-01

    Ureterocele is a congenital anomaly, in which there is mal-development of the caudal segments of the ureter. There is a female preponderance with most cases seen in Caucasians. Among the reported complications of this condition, chronic renal failure occurring in the setting of ureterocele has not been well documented. We report a case of a young girl with bilateral ureterocele presenting with chronic renal failure, whose management presented a diagnostic failure and inadequate treatment. PMID:26108593

  8. Acute renal failure due to obstruction in Burkitt lymphoma

    Microsoft Academic Search

    Elpis Mantadakis; Victor M. Aquino; William R. Strand; R. Quigley

    1999-01-01

    Acute renal failure in Burkitt lymphoma is commonly the result of tumor lysis syndrome. We present a 15-year-old boy who\\u000a developed hypertension, seizures, and acute renal failure due to extrinsic compression of the bladder and ureters by a large\\u000a retrovesical Burkitt lymphoma. The causes of acute renal failure in Burkitt lymphoma and the incidence of acute urinary obstruction\\u000a in this

  9. Endoscopic excision of an eroding calcified mesh sling, 10 years after primary surgery

    Microsoft Academic Search

    Bassem S. Wadie

    2009-01-01

    Management of urethral erosion typically entails two options: sling incision (in the early postoperative period) or excision\\u000a of the suburethral part of the sling (urethrolysis). This paper describes a different endoscopic technique. A forty-year-old\\u000a woman with a synthetic sling implanted 10 years prior presented with persistent lower urinary tract symptoms. A kidney ureter\\u000a bladder X-ray showed a stone at the level

  10. Excising multiple ureteral cysts endoscopically utilizing the OmniPlus-Max 80 W holmium laser

    PubMed Central

    Blewniewski, Mariusz; Ró?a?ski, Waldemar

    2015-01-01

    We present a rare case of ureteral cysts in the left ureter treated by an endoscopic holmium laser. These cysts caused asymptomatic hydronephrosis in the left kidney. Complete cyst removal was performed by a ureteroscopically applied holmium laser. Six months post-procedure, the patient had no recurrence, which suggests that endoscopic excision is an optimal treatment for this disorder. Periodic ureteroscopic examination is indicated for further observation. PMID:25624968

  11. Gonadoblastoid Testicular Dysplasia in Walker-Warburg Syndrome

    Microsoft Academic Search

    Noelyn A. Hung; Meredith M. Silver; David Chitayat; John Provias; A. Toi; Venita Jay; Laurence E. Becker

    1998-01-01

    Two male fetuses (18 and 22 weeks gestation) and a 3-month-old male infant (full sibling of the younger fetus) who were diagnosed\\u000a with Walker-Warburg syndrome (WWS) on the basis of neuropathologic autopsy findings in brain, eyes, and muscle also had micro-orchia\\u000a and, microscopically, diffuse gonadoblastoid dysplasia in the testes. Both fetuses also had a miniature left ureter and cystic\\u000a dysplastic

  12. Elucidating the Life History and Ecological Aspects of Allodero hylae (Annelida: Clitellata: Naididae), A Parasitic Oligochaete of Invasive Cuban Tree Frogs in Florida.

    PubMed

    Andrews, Jessee M; Childress, Jasmine N; Iakovidis, Triantafilos J; Langford, Gabriel J

    2015-06-01

    Given their ubiquitous nature, it is surprising that more oligochaete annelid worms (Annelida: Clitellata) have not adopted an endoparasitic lifestyle. Exceptions, however, are the understudied members of the genus Dero (Allodero) that parasitize the ureters of tree frogs and toads. This study experimentally explores the life cycle and host specificity of Allodero hylae, the worm's use of chemical cues in host searching, and its seasonal prevalence and abundance over a year-long collection period on the Florida Southern College campus. A total of 2,005 A. hylae was collected from the ureter, urinary bladder, or expressed urine of wild Osteopilus septentrionalis ; a significant positive correlation was found between host snout-vent length and parasite intensity for female but not male hosts. Monthly prevalence of A. hylae reached a peak of 58% in April, but never dropped below 20% in any month; mean abundance peaked March-May, whereas few worms were recovered in December and January. Confirming a parasitic lifestyle, wild-collected hosts with intense infections, typically >40 worms, showed obvious dilatation of the ureter wall, and some young-of-the-year O. septentrionalis exposed to A. hylae in the laboratory were killed by the apparent rupture of the host's ureter. The worm has a direct life cycle: worms expelled in the host's urine are capable of locating and re-infecting other hosts within aquatic microhabitats such as bromeliad tanks, and worms can survive for weeks in a free-living environment, even undergoing a morphological change. Further, chemotaxis assays found a positive response to a tree frog attractant for worms recently removed from hosts. Overall, this study provides the first multifaceted investigation on the life history and ecology of any Allodero spp., which offers new insights into an understudied endoparasitic oligochaete. PMID:25730299

  13. Robot-Assisted Radical Nephroureterectomy

    Microsoft Academic Search

    Daniel Willis; Joseph Pugh; Sijo J. Parekattil; Hany Atalah; Li-Ming Su

    \\u000a Radical nephroureterectomy with formal bladder cuff excision was first proposed in 1933 by Kimball and Ferris (J Urol 31:\\u000a 257, 1933) for the treatment of papillomatous tumors of the renal pelvis and ureter. This approach has become standard of\\u000a care for upper urinary tract neoplasms as many of these tumors are characterized by multifocality, high ipsilateral recurrence\\u000a rates after partial

  14. Excretory System Activity

    NSDL National Science Digital Library

    2012-06-12

    This activity from Darcy Hartley-Pinard will help elementary school teachers demonstrate the structures and process of the excretory system. The class will use a diagram of a human body and everyday items including straws, uncooked spaghetti, yarn and kidney beans to recreate the veins, arteries, kidneys, ureters, bladder and urethra. This activity is useful for younger students to visualize and connect with the processes that take place in their own bodies.

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

    PubMed Central

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

    2011-01-01

    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

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

    USGS Publications Warehouse

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

    2003-01-01

    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.

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

    PubMed

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

    2003-10-01

    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

  18. Urinary tract pacemaker cells: current knowledge and insights from nonrenal pacemaker cells provide a basis for future discovery.

    PubMed

    Feeney, Meghan M; Rosenblum, Norman D

    2014-04-01

    Coordinated ureteric peristalsis propels urine from the kidney to the bladder. Cells in the renal pelvis and ureter spontaneously generate and propagate electrical activity to control this process. Recently, c-kit tyrosine kinase and hyperpolarization-activated cyclic nucleotide-gated channel 3 (HCN3) were identified in the upper urinary tract. Both of these proteins are required for coordinated proximal to distal contractions in the ureter. Alterations in pacemaker cell expression are present in multiple congenital kidney diseases, suggesting a functional contribution by these cells to pathologic states. In contrast to gut and heart pacemaker cells, the developmental biology of ureteric pacemaker cells, including cell lineage and signaling mechanisms, is undefined. Here, we review pacemaker cell identify and function in the urinary pelvis and ureter and the control of pacemaker function by Hedgehog-GLI signaling. Next, we highlight current knowledge of gut and heart pacemaker cells that is likely to provide insight into developmental mechanisms that could control urinary pacemaker cells. PMID:24129851

  19. Usefulness of lower-dose computed tomography urography with iterative reconstruction technique in diagnosis of congenital anomalies in urinary tract in children.

    PubMed

    Krzemie?, Gra?yna; Szmigielska, Agnieszka; Bombi?ski, Przemys?aw; Brzewski, Micha?; Warcho?, Stanis?aw; Dudek-Warcho?, Teresa

    2014-01-01

    Introduction of iterative reconstruction technique in modern computed tomography allowed to reduce the radiation dose and to extend indications for computed tomography urography in children. We describe the case of boy with congenital anomalies in urinary tract including bilateral double collecting system, dilatation of double collecting system in the right kidney and dilatation of lower pelvis in left kidney and bilateral dilatation of ureters. Anomalies were detected in prenatal and then confirmed in postnatal ultrasonography. Voiding cystourethrograhy, which was performed on the 4th day of life revealed grade IV vesicoureteral reflux to the lower part of double collecting system in the right kidney and grade V vesicoureteral reflux to the left kidney. In cystoscopy posterior urethral valves were excluded and presence of double ureters was confirmed. Dynamic scintigraphy (99mTc-EC) detected impaired parenchymal secretory function in the lower pole of left kidney. The patient was qualified for surgical treatment including left lower heminephoureterectomy. Before surgery procedure computed tomography urography was performed and revealed congenital anomalies in urinary tract: bilateral double collecting system, bilateral hydronephrosis of the lower part of kidneys, dilatation of ureters associated with high grade of vesicoureteral refluxes, narrow cortex of left kidney. Computed tomography urography with iterative reconstruction techniques enables precise visualization of urinary tracts with reduced radiation dose. It replaces conventional X-ray urography because of much better visualization of urinary tracts with comparable or even lower radiation dose. PMID:25874784

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

    NASA Astrophysics Data System (ADS)

    Ogiela, Marek R.; Tadeusiewicz, Ryszard

    2000-02-01

    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.

  1. Treatment of Ureteroarterial Fistulae with Covered Vascular Endoprostheses and Ureteral Occlusion

    SciTech Connect

    Bilbao, Jose I., E-mail: jibilbao@unav.es; Cosin, Octavio; Bastarrika, Gorka [Clinica Universitaria de Navarra, Universidad de Navarra, Department of Radiology (Spain); Rosell, David; Zudaire, Javier [Clinica Universitaria de Navarra, Universidad de Navarra, Department of Urology (Spain); Martinez-Cuesta, Antonio [Clinica Universitaria de Navarra, Universidad de Navarra, Department of Radiology (Spain)

    2005-04-15

    Background. Ureteroarterial fistulae (UAFs) are a rare entity, often difficult to identify, and associated with a high mortality rate. This fact has been attributed to a delay in diagnosis and treatment. Five conditions that can predispose to the development of this uncommon entity have been described: prior pelvic surgery, prolonged ureteral stenting, radiation therapy, previous vascular surgery and vascular pathology. Methods. We present 4 patients with UAFs and at least three of the above-mentioned conditions. Ureteral ischemia and subsequent necrosis promote the formation of these fistulae. The constant pulsation of the iliac artery is transmitted to an already compromised ureter containing a stiff intraluminal foreign body, resulting in pressure necrosis, most likely where the ureter crosses the iliac artery. Results and Conclusion. Cases were managed percutaneously with a combination of the deployment of a covered prosthesis and, when needed, with mechanical occlusion of the ureter. Hematuria stopped in all the patients with no evidence of immediate rebleeding. One patient presented a new episode of vaginal bleeding 13 months after endograft placement and ureteral embolization. Arteriography showed the presence of a hypogastric artery pseudoaneurysm that was occluded using coils. No new bleeding has occurred in this patient 12 months after the second embolization. At present all 4 patients are alive with follow-up periods of 5, 9, 11 and 25 months since the first procedure.

  2. Pyelolymphatic backflow demonstrated by an abdominal CT: A case report

    PubMed Central

    Durhan, Gamze; Ayy?ld?z, Veysel Atilla; Çiftçi, Türkmen Turan; Akata, Deniz; Özmen, Mustafa Nasuh

    2014-01-01

    Summary Background Pyelolymphatic backflow phenomenon, which is a subtype of pyelorenal backflow, is a rare condition that occurs during the acute phase of urinary obstruction. Pyelorenal backflow has already been described in humans with retrograde pyelography. Our report presents a rare case of pyelolyphatic backflow demonstrated by a computed tomography. Case Report A 67-year-old man with a history of bladder carcinoma was admitted to the emergency department due to right-sided flank pain and hematuria. Hematuria resolved after insertion of a 3-way urinary catheter, but flank pain persisted. As a result, an abdominopelvic CT was performed. CT revealed numerous tiny, serpiginous tubular structures connected with each other and filled with urine. They began intrarenally and extended caudally surrounding the ureter in the retroperitoneum. Subsequently, the patient underwent an ultrasound-guided nephrostomy to decompress the collecting system of the right kidney. Antegrade pyelography revealed minimal hydroneprosis. However, no leakage from the ureter to the retroperitoneum was observed, proving that the changes demonstrated by a CT were due to pyelolymphatic reflux caused by increased pressure in the collecting tubules filling the lymphatics with opaque urine. Conclusions This report presents a very rare case of pyelolymphatic reflux demonstrated by a CT. We present this case report as a reminder that although rare, pyelolymphatic reflux can occur as a result of obstruction without manifestations of hydronephrosis and it can be confused with leakage from the ureter. PMID:24478814

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

    PubMed Central

    Adeyemo, Bamidele; Makovitch, Steven; Foo, Dominic

    2013-01-01

    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

  4. Ureteral stricture formation after ureteroscope treatment of impacted calculi: A prospective study

    PubMed Central

    Singam, Praveen; Ho, Christopher Chee Kong; Sridharan, Radhika; Hod, Rozita; Bahadzor, Badrulhisham; Goh, Eng Hong; Tan, Guan Hee; Zainuddin, Zulkifli

    2015-01-01

    Purpose Urinary calculi is a familiar disease. A well-known complication of endourological treatment for impacted ureteral stones is the formation of ureteral strictures, which has been reported to occur in 14.2% to 24% of cases. Materials and Methods This was a prospective study. Ureterotripsy treatment was used on patients with impacted ureteral stones. Then, after 3 months and 6 months, the condition of these patients was assessed by means of a kidney-ureter-bladder (KUB) ultrasound. If the KUB ultrasound indicated moderate to serious hydronephrosis, the patient was further assessed by means of a computed tomography intravenous urogram or retrograde pyelogram to confirm the occurrence of ureteral strictures. Results Of the 77 patients who participated in the study, 5 developed ureteral strictures. Thus, the stricture rate was 7.8%. An analysis of the intraoperative risk factors including perforation of the ureter, damage to the mucous membrane, and residual stone impacted within the ureter mucosa revealed that none of these factors contributed significantly to the formation of the ureteric strictures. The stone-related risk factors that were taken into consideration were stone size, stone impaction site, and duration of impaction. These stone factors also did not contribute significantly to the formation of the ureteral strictures. Conclusions This prospective study failed to identify any predictable factors for ureteral stricture formation. It is proposed that all patients undergo a simple postoperative KUB ultrasound screening 3 months after undergoing endoscopic treatment for impacted ureteral stones. PMID:25598938

  5. Endoscopic holmium laser treatment for ureterolithiasis

    PubMed Central

    Sosnowski, Marek

    2012-01-01

    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

  6. Location of the ureteral openings in the cloacas of tinamous, some ratite birds, and crocodilians: a primitive character.

    PubMed

    Oliveira, Cleida Aparecida; Silva, Renata Mageste; Santos, Marcileida Maria; Mahecha, Germán Arturo Bohórquez

    2004-05-01

    Cloacas of 67 avian species, of both sexes, from various habitats and differing dietary habits, were examined macro- and microscopically to investigate possible variation in the location of the ureteral openings. Differing from most birds studied, in adult male Rhea americana and several tinamous species the ureters were found to open into the coprodeum. In these species the urodeum receives only the vas deferens or oviduct. Similarly, in crocodiles Caiman crocodilus yacare, but not in lizards Tropidurus montanus and snakes Crotalus durissus terrificus, the ureters empty into the coprodeum. This similarity between ancient birds (ratites and tinamous) and crocodiles may indicate a primitive character linking reptiles and birds. This unusual position of the ureteral orifice can represent an adaptation to facilitate urine collection into the coprodeum and large intestine. Another possibility is that this variation in ureter position is a male reproductive strategy to avoid the mixture of urine and semen in the cloaca. There were no evident correlations between the location of the ureteral openings and the birds' habitat, diet, or histology of the coprodeal mucosa. The occurrence of a phallus in eight species of birds was detected, as well as a peculiar vascularization related to the coprodeal epithelium of anseriformes. Together, these data add to the scarce information about the morphophysiology of the avian cloaca, and also contribute to clarify avian phylogenetic linkages. PMID:15108162

  7. Possible Complications of Ureteroscopy in Modern Endourological Era: Two-Point or “Scabbard” Avulsion

    PubMed Central

    Gaizauskas, Sergejus; Zelvys, Arunas

    2014-01-01

    Indication has led ureteroscopy to be a worldwide technique, with the expected appearance of multiple types of complications. Severe complications are possible including ureteral perforation or avulsion. Ureteral avulsion has been described as an upper urinary tract injury related to the action of blunt trauma, especially from traffic accidents, being the mechanism of injury, the result of an acute deceleration/acceleration movement. With the advent of endourology, that term is also applied to the extensive degloving injury resulting from a mechanism of stretching of the ureter that eventually breaks at the most weakened site, or ureteral avulsion is referred to as a discontinuation of the full thickness of the ureter. The paper presents a case report and literature review of the two-point or “scabbard” avulsion. The loss of long segment of the upper ureter, when end-to-end anastomosis is not technically feasible, presents a challenge to the urological surgeon. In the era of small calibre ureteroscopes these complications, due to growing incidence of renal stones will become more and more actual. Our message to other urologists is to know such a complication, to know the ways of treatment, and to analyse ureteroscopic signs, when to stop or pay attention. PMID:25610699

  8. Bricker versus Wallace anastomosis: A meta-analysis of ureteroenteric stricture rates after ileal conduit urinary diversion

    PubMed Central

    Davis, Niall F.; Burke, John P.; McDermott, TED; Flynn, Robert; Manecksha, Rustom P.; Thornhill, John A.

    2015-01-01

    Introduction: Data comparing the incidence of ureteroenteric strictures for Bricker and Wallace anastomoses are limited. This study compares both anastomotic techniques in terms of ureteroenteric stricture rates after radical cystectomy and ileal conduit urinary diversion. Methods: Electronic databases (Medline, EMBASE, and Cochrane database) were searched for studies comparing Bricker and Wallace ureteroeneteric anastomoses for ileal conduit urinary diversion after radical cystectomy. Meta-analyses were performed using the random effects method. The primary outcome measure was to determine differences in postoperative ureteroenteric stricture rates for both surgical techniques. Four studies describing 658 patients met the inclusion criteria. The total number of ureters used for ureteroeneteric anastomoses was 1217 (545 in the Bricker group and 672 in the Wallace group). Results: There were no significant differences in age (p = 0.472), gender (p = 0.897), duration of follow-up (p = 0.168), and duration to stricture development between groups (p = 0.439). The overall stricture rate was 29 of 1217 (2.4%); 16 of 545 ureters (2.9%) in the Bricker group and 13 of 672 ureters (1.9%) in the Wallace group. The Bricker anastomosis was not associated with a significantly higher overall stricture rate compared to the Wallace ureteroenteric anastomosis (odds ratio: 1.393, 95% confidence interval: 0.441–4.394, p = 0.572). Conclusion: Accepting limitations in the available data, we found no significant difference in the incidence of ureteroenteric stricture for Bricker and Wallace anastomoses.

  9. Case-control study of arsenic in drinking water and kidney cancer in uniquely exposed Northern Chile.

    PubMed

    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

    2013-09-01

    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

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

    PubMed Central

    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

    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

  11. Cutaneous tube ureterostomy: a fast and effective method of urinary diversion in emergency situations

    PubMed Central

    Abdin, Tamer; Zamir, Gideon; Pikarsky, Alon; Katz, Ran; Landau, Ezekiel H; Gofrit, Ofer N

    2015-01-01

    Aim To report on a simple and rapid method of urinary diversion. This method was applied successfully in different clinical scenarios when primary reconstruction of the ureters was not possible. Materials and methods The disconnected ureter is catheterized by a feeding tube. The tube is secured with sutures and brought out to the lateral abdominal wall as cutaneous tube ureterostomy (CTU). Results This method was applied in three different clinical scenarios: a 40-year-old man who sustained multiple high-velocity gunshots to the pelvis with combined rectal and bladder trigone injuries and massive bleeding from a comminuted pubic fracture. Damage control included colostomy and bilateral CTUs. A 26-year-old woman had transection of the right lower ureter during abdominal hysterectomy. Diagnosis was delayed for 3 weeks when the patient developed sepsis. The right kidney was diverted with a CTU. A 37-year-old male suffered from bladder perforation and hemorrhagic shock. Emergency cystectomy was done and urinary diversion was accomplished with bilateral CTUs. In all cases, effective drainage of the urinary system was achieved with normalization of kidney function. Conclusion When local or systemic conditions preclude definitive repair and damage control surgery is needed, CTU provides fast and effective urinary diversion.

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

    ClinicalTrials.gov

    2015-05-06

    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

  13. Intramuscular nerve distribution in bladder and the relationship between intramuscular ganglia and bladder function in man and dog

    PubMed Central

    Zhao, Zeju; Xu, Qian; Lu, Li; Luo, Xu; Fu, Xiaoyun

    2014-01-01

    In clinical, the relationship between bladder intramuscular nerve and function is also elusive. This study aims to compare the bladder intramuscular nerve distribution and its characteristics and significance in human and dog. Eleven dogs’ bladders were stained by Sihler’s and HE techniques. Fifteen human bladders were adopted by Sihler’s staining, using 10% formaldehyde to fix 12 weeks, 7 by HE dyeing fixes 24 hours. Results indicated that man’s bladder was triangularpyramid-shaped. While dog’s bladder was spherical-shaped and its muscle fibers arrange were irregularly shaped. Longitudinal muscle of the outer layer is fleshy, the terminal is at the bladder neck without exception, and vesical trigone has relatively obvious three layers of structure. After dyeing dog’s bladder was transparent jelly, the nerve was purple color, enter bladder at the ureter-bladder junction with different forms. Man’s bladder nerves, no ganglion, were more trivial than that of dogs, and with smaller branches, the large nerve ganglion. The links with the nerve fibers and forms the network on the dog’s bladder wall, and the nerve fibers crosses comparatively little on both the left and right sides in the midline. The right nerve branch gains advantage on the man’s bladder wall, the situations is opposite on the dog’s. In conclusion, bladder nerves which scatter to the bladder wall have branches to lower ureter at the ureter-bladder junction, the structure and distribution of intramuscular nerves are different, the existence of intramuscular ganglia is relating to the bladder function both in man and dog. PMID:25664008

  14. Evaluation of Extracorporeal Shock Wave Lithotripsy (ESWL): Efficacy in Treatment of Urinary System Stones

    PubMed Central

    Junuzovic, Dzelaludin; Prstojevic, Jelena Kovacevic; Hasanbegovic, Munira; Lepara, Zahid

    2014-01-01

    ABSTRACT Introduction: Elimination of stone is determined by size and its localization. Stone from the ureter in 80% of cases can be eliminated spontaneously. If the stone by its characteristics is not spontaneously eliminated, taken are further steps and therapeutic protocols to solve this problem. Material and methods: The study was prospective, open and comparative. It was conducted at the Urology Clinic Clinical Center of Sarajevo University in the period from 2007 to 2013. The study included 404 patients with urinary tract lithiasis treated by ESWL. ESWL treatment is performed on the machine Siemens Model Lithostar Multiline, which has a combined ultrasonographic and fluoroscopic display, large energy density in order to obtain optimum focus (without damaging surrounding tissue) and minimal pain that on rare occasions requires for mild sedation-sedation. Results: From a total of 404 patients included in the study there were 234 (57.92%) male and 170 (42.08%) female patients. The most common type of stone both in female and male patients was calcium type. From a total of 262 calcium stones, 105 of them (40.07%) was present in female patients and 157 (59.92%) in male. Share of infectious type of stone in female patients was 63 (49.60%) and 64 among males (50.39%). Other stones were less abundant in both the gender groups and their total number was only 17. In women their frequency was 2 (13.33%) and 13 among males (86.67%). There was a significant difference in the frequency of different types of stones by gender (x2 = 11.47, p = 0.009). Conclusion: There was no statistically significant correlation between the number of treatments and localization of stones in the ureter, as well as a statistically significant correlation between the size of the stone and the localization of calculus in the ureter. PMID:25568579

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

    NASA Astrophysics Data System (ADS)

    Ogiela, Marek R.; Tadeusiewicz, Ryszard

    2000-04-01

    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.

  16. The Use of a Sheathless Basket via Miniature Ureteroscopes

    PubMed Central

    1995-01-01

    The conventional use of a basket involves a metallic wire section that is contained within a polythene sheath. The wire basket can be withdrawn or protruded from the sheath using a handle. The advantage of this system is that the basket can be kept shut or open at will within the ureter. Thus one can keep the basket closed in order to maneuver the basket past a stone before opening it above the stone. With the development of efficient and safe lithotripsy modalities becoming widely available and with miniaturization of these and the ureteroscopes, it is becoming less common to dilate the ureter. Therefore it is not frequently possible to extract a stone intact. Baskets still can be used secondarily to extract the fragments. It is possible to use the basket wire without its sheath. The ureteroscope channel effectively becomes the sheath, and the basket opens immediately on protruding it beyond the ureteroscope. This has the following advantages: (a) A larger-diameter basket wire can be introduced. The very small baskets of 2F and 3F used via miniature ureteroscopes are very flimsy. When the sheath is removed, it becomes possible to use an otherwise 3F basket via a 2F channel. (b)The operator can work the basket usingjust two fingers close to the instrument channel port. This is more ergonomic than working an opening mechanism at the end of the basket, because this latter system takes the operator's hand away from the instrument. (c) The basket can be detached more readily from the ureteroscope, should it become, impacted together with a stone within the ureter. This makes it possible to reinsert the ureteroscope alongside the basket and fragment the stone within the basket, provided that there is no reinforced section to the inner wire at the handle. PMID:18493362

  17. Postoperative ureteral obstruction after endoscopic treatment for vesicoureteral reflux

    PubMed Central

    Chung, Jae Min; Park, Chang Soo

    2015-01-01

    Purpose We undertook this study to evaluate the incidence, risk factors, management, and outcome of postoperative ureteral obstruction after endoscopic treatment for vesicoureteral reflux (VUR). Materials and Methods Ninety patients undergoing endoscopic treatment for VUR were retrospectively reviewed and classified into two groups according to ureteral obstruction: the nonobstruction group (83 cases, 122 ureters; mean age, 7.0±2.8 years) and the obstruction group (7 cases, 10 ureters; mean age, 6.2±8.1 years). We analyzed the following factors: age, sex, injection material, laterality, voiding dysfunction, constipation, renal scarring, preoperative and postoperative ultrasound findings, endoscopic findings, injection number, and injection volume. Additionally, we reviewed the clinical manifestations, natural course, management, and outcome of ureteral obstruction after endoscopic treatment. Results The incidence of ureteral obstruction after endoscopic treatment was 7.6% (10/132 ureters). The type of bulking agent used and injection volume tended to be associated with ureteral obstruction. However, no significant risk factors for obstruction were identified between the two groups. Three patients showed no symptoms or signs after the onset of ureteral obstruction. Most of the patients with ureteral obstruction experienced spontaneous resolution within 1 month with conservative therapy. Two patients required temporary ureteral stents to release the ureteral obstruction. Conclusions In our experience, the incidence of ureteral obstruction was slightly higher than in previous reports. Our study identified no predictive risk factors for developing ureteral obstruction after endoscopic treatment. Although most of the ureteral obstructions resolved spontaneously within 1 month, some cases required drainage to relieve symptoms or to prevent renal function deterioration. PMID:26175873

  18. Holmium Laser Lithotripsy with Semi-Rigid Ureteroscopy: A First-Choice Treatment for Impacted Ureteral Stones in Children?

    PubMed Central

    Adanur, Senol; Aydin, Hasan Riza; Ozkaya, Fatih; Ziypak, Tevfik; Polat, Ozkan

    2014-01-01

    Background We aimed to assess the effectiveness of semi-rigid ureteroscopy and holmium laser lithotripsy in the treatment of impacted ureteral stones in children. Material/Methods We evaluated a total of 32 children under the age of 18 years treated with ureteroscopic holmium laser lithotripsy for impacted ureteral stones between January 2005 and July 2013. Their stone-free state was defined as the absence of any residual stone on radiologic evaluation performed 4 weeks postoperatively. Complications were evaluated according to the modified Clavien classification. Result The mean patient age was 9.5±5.1 years (range 1–18 years). Seven (21.8%) of the stones were located in the proximal ureter, 9 (28.2%) were in the mid-ureter, and 16 (50%) were in the distal ureter. The mean stone size was calculated as being 10.46±3.8 mm2 (range 5–20). The stone-free rate was 93.75% (30/32 patients) following primary URS. Additional treatment was required for only 2 (6.25%) of the patients. After the procedure, a D-J stent was placed in all the patients. The total complication rate was 15.6% (5 patients). The 10 total complications in these 5 patients were 5 (15.6%) Grade I, 1 (3.1%) Grade II, 2 (6.25%) Grade IIIa, and 2 (6.25%) Grade IIIb. The mean follow-up period was 16.5 months (range 3–55). Conclusions For the treatment of impacted ureteral stones in children, holmium laser lithotripsy with semi-rigid ureteroscopy, with its low retreatment requirement and acceptable complication rates, is an effective and reliable method in experienced and skilled hands as a first-choice treatment approach. PMID:25415256

  19. Characteristics of Calculi in the Urinary Tract

    PubMed Central

    Prstojevic, Jelena Kovacevic; Junuzovic, Dzelaludin; Hasanbegovic, Munira; Lepara, Zahid; Selimovic, Mirsad

    2014-01-01

    Introduction: Elimination of stone is determined by size and its localization. Stone from the ureter in 80% of cases can be eliminated spontaneously. If the stone by its characteristics is not spontaneously eliminated, taken are further steps and therapeutic protocols to solve this problem. Material and methods: The study was prospective, open and comparative. It was conducted at the Urology Clinic Clinical Center of Sarajevo University in the period from 2007 to 2013. The study included 404 patients with urinary tract lithiasis treated by ESWL. ESWL treatment is performed on the machine Siemens Model Lithostar Multiline, which has a combined ultrasonographic and fluoroscopic display, large energy density in order to obtain optimum focus (without damaging surrounding tissue) and minimal pain that on rare occasions requires for mild sedation-sedation. Results: From a total of 404 patients included in the study there were 234 (57.92%) male and 170 (42.08%) female patients. The most common type of stone both in female and male patients was calcium type. From a total of 262 calcium stones, 105 of them (40.07%) was present in female patients and 157 (59.92%) in male. Share of infectious type of stone in female patients was 63 (49.60%) and 64 among males (50.39%). Other stones were less abundant in both the gender groups and their total number was only 17. In women their frequency was 2 (13.33%) and 13 among males (86.67%). There was a significant difference in the frequency of different types of stones by gender (?2 = 11.47, p = 0.009). Conclusion: There was no statistically significant correlation between the number of treatments and localization of stones in the ureter, as well as a statistically significant correlation between the size of the stone and the localization of calculus in the ureter. PMID:25568625

  20. Tissue Engineering of Ureteral Grafts: Preparation of Biocompatible Crosslinked Ureteral Scaffolds of Porcine Origin

    PubMed Central

    Koch, Holger; Hammer, Niels; Ossmann, Susann; Schierle, Katrin; Sack, Ulrich; Hofmann, Jörg; Wecks, Mike; Boldt, Andreas

    2015-01-01

    The surgical reconstruction of ureteric defects is often associated with post-operative complications and requires additional medical care. Decellularized ureters originating from porcine donors could represent an alternative therapy. Our aim was to investigate the possibility of manufacturing decellularized ureters, the characteristics of the extracellular matrix (ECM) and the biocompatibility of these grafts in vitro/in vivo after treatment with different crosslinking agents. To achieve these goals, native ureters were obtained from pigs and were decellularized. The success of decellularization and the ECM composition were characterized by (immuno)histological staining methods and a DNA-assay. In vitro: scaffolds were crosslinked either with carbodiimide (CDI), genipin (GP), glutaraldehyde, left chemically untreated or were lyophilized. Scaffolds in each group were reseeded with Caco2, LS48, 3T3 cells, or native rat smooth muscle cells (SMC). After 2?weeks, the number of ingrown cells was quantified. In vivo: crosslinked scaffolds were implanted subcutaneously into rats and the type of infiltrating cells were determined after 1, 9, and 30?days. After decellularization, scaffold morphology and composition of ECM were maintained, all cellular components were removed, DNA destroyed and strongly reduced. In vitro: GP and CDI scaffolds revealed a higher number of ingrown 3T3 and SMC cells as compared to untreated scaffolds. In vivo: at day 30, implants were predominantly infiltrated by fibroblasts and M2 anti-inflammatory macrophages. A maximum of MMP3 was observed in the CDI group at day 30. TIMP1 was below the detection limit. In this study, we demonstrated the potential of decellularization to create biocompatible porcine ureteric grafts, whereas a CDI-crosslink may facilitate the remodeling process. The use of decellularized ureteric grafts may represent a novel therapeutic method in reconstruction of ureteric defects.

  1. A Rare Case of Nephrocolic Fistula Resulting from Radio Frequency Ablation (RFA) of Renal Cell Carcinoma

    PubMed Central

    Patel, Bhavesh J.; Puri, Nishant; Jackson, Christian S.

    2014-01-01

    Nephrocolic fistula is a rare, abnormal fistulous connection between the urinary system (kidney/ureters) and colon. Different benign and malignant etiologies are implicated in the formation of a nephrocolic fistula. Even though conservative treatment options have been tried recently (especially for benign etiologies), surgical resection has been the treatment of choice and should be pursued if conservative management fails. We report the first case of a nephrocolic fistula after a radiofrequency ablation of a renal cell carcinoma, which required surgical resection after conservative management failed.

  2. Neonatal sacrococcygeal teratoma with acute renal failure

    PubMed Central

    Ahmad, Mehtab; Arora, Mudit; Ullah, Ekram; Malik, Azharuddin Mohammed

    2013-01-01

    Teratomas are germ cell tumours composed of multiple types of cells derived from more than a single germ cell layer. The most common site of an extragonadal teratoma is the sacrococcygeal region. We report a case of a 16-day-old female child with a large swelling in the sacrococcygeal region extending laterally into the buttocks with severely deranged renal functions. Ultrasonography and CT helped in making the diagnosis and, more importantly, to delineate the extent of the tumour and the involvement of adjacent organs and tissues: in our case, lower bilateral ureters. Imaging findings and clinical presentation led to the diagnosis of sacrococcygeal teratoma with renal failure. PMID:23704437

  3. [Sonography of the lower urinary tract].

    PubMed

    Egender, G; Helweg, G; Frommhold, H

    1983-03-01

    According to literature and to our experiences sonography should be the first investigation of the lower urinary tract in children, if there is suspicion of obstruction or malformation. In many cases the localisation of obstruction or the diagnosis of malformation can be found. Furthermore by sonographic follow-up studies of ureter obstructions by tumors, by concrements or after surgery, the normal radiographic investigations like urography or retrograde pyelography can be reduced. Sonography is a valuable enrichment for investigations of functional and morphological changes of the urinary bladder, especially for the classification of bladder tumors: whereas the diagnosis of urethral diseases still is found by clinical investigations and conventional radiological procedures. PMID:6844597

  4. Ureteral Hernia Mimicking Retrocrural Lymphadenopathy in 18F-FDG PET/CT.

    PubMed

    Almeida, Lanamar; Carvalhaes, Felipe; Bitencourt, Almir; Moreira, Fernando

    2015-08-01

    An 82-year-old woman was submitted to F-FDG PET/CT to evaluate an indeterminate solitary lung nodule identified on chest CT. At the examination, there was a hypermetabolic area at the topography of the right retrocrural region, mimicking a lymphadenopathy on axial images. After careful analysis of multiplanar CT images, it was better characterized as a loop of the ureter insinuating itself by a small diaphragmatic hernia. Ureteral hernia is a rare entity with few cases reported in the literature. This case demonstrates the importance of conducting careful evaluation of multiplanar CT images to avoid false-positive results on PET/CT. PMID:26125547

  5. [Flexible ureterorenoscopy: a method for minimally invasive diagnosis and therapy in the upper urinary tract].

    PubMed

    Fuchs, G J

    1995-01-01

    Retrograde intrarenal surgery (RIRS) utilizing flexible, actively deflectable instruments has become a valuable asset in the diagnosis of upper urinary tract pathology and treatment of stone disease. Flexible endoscopic surgery of the proximal ureter and in the intrarenal collecting system constitutes the natural extension of rigid instrumentation in the upper urinary tract. At the UCLA Stone Center, retrograde ureteral and intrarenal surgery has become an integral part of our diagnostic and therapeutic armamentarium. This is documented by over 500 treatments and diagnostic procedures performed in the upper urinary tract during the past 5 years. PMID:7571649

  6. [Prolit in combined treatment of urolithiasis].

    PubMed

    Gorlenko, V N; Gorlenko, O V; Lezhnin, S I; Velichko, D N; Sizov, K A

    2007-01-01

    The study of dietary supplement (biologically active additive) Prolit in 20 patients and 20 controls (mean age 44.0 +/- 13.8 years) hospitalized for urolithiasis, uncomplicated renal colic proved that Prolit use in combined therapy of urolithiasis effectively relieves pain syndrome (renal colic) and prevents its recurrence. Prolit has a pronounced anti-inflammatory and spasmolytic effects which prevent attacks of acute (chronic) pyelonephritis. Combined treatment of urolithiasis with Prolit addition has one more advantage over conventional therapy in evacuation of the concrements and elimination of urostasis, especially in small concrements (up to 1 cm) in the ureter. PMID:17471998

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

    SciTech Connect

    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

    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.

  8. Hollow waveguide for urology treatment

    NASA Astrophysics Data System (ADS)

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

    2010-02-01

    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.

  9. Obturator Hernia with Ureteral Entrapment

    PubMed Central

    Izzo, Matteo; Regusci, Luca; Fasolini, Fabrizio

    2014-01-01

    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

  10. Postoperative Ureteral Leak Treated Using a Silicone-Covered Nitinol Stent

    PubMed Central

    Park, Hyo Jung; Shin, Ji Hoon; Kim, Jong Woo; Hong, Bum Sik

    2015-01-01

    Ureteral fistula is a serious complication of abdomino-pelvic surgeries, often resulting in poor outcomes owing to lack of proper treatment. We report the case of a 49-year-old woman who underwent placement of a silicone-covered ureteral occlusion stent in her right ureter for the management of ureteral leakage after pelvic surgery. A ureterogram obtained 18 months following the stent placement confirmed that there was no stent migration or additional urine leakage. We propose that the silicone-covered ureteral occlusion stent is practical, fast, and safe for the management of ureteral leakage. PMID:25833481

  11. Retroperitoneal fibrosis due to malignancy: a case report.

    PubMed

    Erton, M L; Ilker, Y N; Ceyhan, N; Akda?, A

    1995-01-01

    Retroperitoneal fibrosis is idiopathic in two thirds of cases and is found most commonly as an isolated fibrotic plaque centered over the lumbar spine and entrapping one or both ureters. It has been postulated that fibrosis in the idiopathic cases results from a hypersensitivity reaction to antigens leaking into the retroperitoneum from atheromatous plaques in the aorta or common iliac arteries. In the remaining one third of cases, causes include ergot-derivative drugs, retroperitoneal haemorrhage or urine extravasation, and a desmoplastic response to a variety of tumours. PMID:7591570

  12. The clinical efficacy of extracorporeal shock wave lithotripsy in pediatric urolithiasis: a systematic review and meta-analysis.

    PubMed

    Lu, Pei; Wang, Zijie; Song, Rijin; Wang, Xiaolan; Qi, Kai; Dai, Qiying; Zhang, Wei; Gu, Min

    2015-06-01

    The aim was to investigate the clinical efficacy and safety of extracorporeal shock wave lithotripsy (ESWL) in pediatric urolithiasis. A comprehensive systematic review and meta-analysis were performed. PubMed, Embase, and the Cochrane central register of controlled trials (CENTRAL) were searched, and the stone-free rates (SFRs) of various stone sizes and stone positions were extracted from the eligible articles. The quality of the original articles was assessed according to the McHarm Scale. The risk ratios (RRs) and 95% confidential intervals (CIs) were pooled, and the sensitive analysis was performed to evaluate the heterogeneity among all eligible studies. In total, 14 studies with 1842 patients were identified. The pooled RR for the SFR of stones less than 10 mm and greater than 10 mm was 1.14 (95% CI: 1.07, 1.21, P < 0.001); the RR for the SFR of stones in the renal pole calix (PC) and the renal pelvis was 0.95 (95% CI: 0.893, 1.009, P < 0.01); the RR for the SFR of stones in the upper/middle PC and the lower PC was 1.07 (95% CI: 0.997, 1.156, P < 0.061); and the RR for the SFR of stones in the proximal ureter and middle/distal ureter was 1.077 (95% CI: 1.005, 1.154, P = 0.036). Heterogeneity was low in all the analyses. Major complications in ESWL of pediatric urolithiasis were steinstrasse and abdominal colic, the incidences of which were 6.00 and 6.29 %, respectively. The SFR of stones <10 mm was significantly higher than stones >10 mm, and the SFR of stones located in proximal ureter was statistically greater than stones in middle or distal ureter in pediatric urolithiasis, leaving no significant between stones in renal PC and renal pelvis, or between upper/middle PC and lower PC. The use of ESWL in children is highly efficient, with negligible complications; ESWL therapy could be considered the first-line treatment for pediatric urolithiasis. PMID:25721456

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

    NSDL National Science Digital Library

    Hakam, Ardeshir

    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.

  14. Postoperative ureteral leak treated using a silicone-covered nitinol stent.

    PubMed

    Park, Hyo Jung; Shin, Ji Hoon; Kim, Jong Woo; Hong, Bum Sik

    2015-03-01

    Ureteral fistula is a serious complication of abdomino-pelvic surgeries, often resulting in poor outcomes owing to lack of proper treatment. We report the case of a 49-year-old woman who underwent placement of a silicone-covered ureteral occlusion stent in her right ureter for the management of ureteral leakage after pelvic surgery. A ureterogram obtained 18 months following the stent placement confirmed that there was no stent migration or additional urine leakage. We propose that the silicone-covered ureteral occlusion stent is practical, fast, and safe for the management of ureteral leakage. PMID:25833481

  15. Stereoselective synthesis of a novel 2-aza-7-oxabicyclo[3.3.0]octane as neurokinin-1 receptor antagonist

    Microsoft Academic Search

    Yuji Shishido; Fumitaka Ito; Hiromasa Morita; Masaya Ikunaka

    2007-01-01

    A novel neurokinin-1 receptor antagonist, (±)-(1R?,3S?,4S?,5S?)-4-[(N-(2-methoxy-5-trifluoromethoxybenzyl)amino]-3-phenyl-2-aza-7-oxabicyclo[3.3.0]octane (1), was synthesized stereoselectively using Padwa’s intramolecular 1,3-dipolar cycloaddition methodology as the key step. Compound (±)-1 showed high affinity for the NK-1 receptors in human IM-9 cells with an IC50 value of 0.22nM. This new structural scaffold demonstrated significant in vivo antagonistic activity in the guinea pig ureter capsaicin-induced plasma extravasation model with an

  16. [Clinical significance of profilometry of the pyeloureteral segment in congenital hydronephrosis in children].

    PubMed

    Rostovskaia, V V; Kazanskaia, I V; Babanin, I L; Orlikovski?, O V

    2003-01-01

    Examination of hydrodynamic condition of the upper urinary tracts with step-by-step pyelomanometry and profilometry of the pyeloureteral segment in 26 children at the age of 6 to 14 years with hydronephrosis provided topical diagnosis of the obstruction level. The priority role of the pelvis in development of obstructive urodynamic disorders was ascertained in 9 children. In the rest 17 children urodynamic disorders were determined by a different degree of obstruction in the prepelvic ureter. This urodynamic study may be essential for design of new approaches to choice of treatment method in the context of pathogenesis of hydronephrosis development. PMID:12811926

  17. [Classification and natural history of bladder tumors].

    PubMed

    Allory, Yves

    2014-12-01

    Urinary bladder tumors are mainly of urothelial type. Classifications include stage and grade to provide with the required prognostic factors and help to select the most adequate treatment. Though somatic mutations in bladder tumors are known, their used for targeted therapy are restricted to clinical trials. Upper urinary tract tumors are classified as urinary bladder tumor at histological level, but tumor staging is specified according to calyx, renal pelvis or ureter location; in young patients with upper urinary tract tumor, a Lynch syndrome should be eliminated. PMID:25668829

  18. Brucella abortus ure2 region contains an acid-activated urea transporter and a nickel transport system

    PubMed Central

    2010-01-01

    Background Urease is a virulence factor that plays a role in the resistance of Brucella to low pH conditions, both in vivo and in vitro. Brucella contains two separate urease gene clusters, ure1 and ure2. Although only ure1 codes for an active urease, ure2 is also transcribed, but its contribution to Brucella biology is unknown. Results Re-examination of the ure2 locus showed that the operon includes five genes downstream of ureABCEFGDT that are orthologs to a nikKMLQO cluster encoding an ECF-type transport system for nickel. ureT and nikO mutants were constructed and analyzed for urease activity and acid resistance. A non-polar ureT mutant was unaffected in urease activity at neutral pH but showed a significantly decreased activity at acidic pH. It also showed a decreased survival rate to pH 2 at low concentration of urea when compared to the wild type. The nikO mutant had decreased urease activity and acid resistance at all urea concentrations tested, and this phenotype could be reverted by the addition of nickel to the growth medium. Conclusions Based on these results, we concluded that the operon ure2 codes for an acid-activated urea transporter and a nickel transporter necessary for the maximal activity of the urease whose structural subunits are encoded exclusively by the genes in the ure1 operon. PMID:20380737

  19. Biological consequences of fiber fragmentation with pulsed laser lithotripsy

    NASA Astrophysics Data System (ADS)

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

    1990-06-01

    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.

  20. Escherichia coli–Mediated Impairment of Ureteric Contractility Is Uropathogenic E. coli Specific

    PubMed Central

    Floyd, Rachel V.; Upton, Mathew; Hultgren, Scott J.; Wray, Susan; Burdyga, Theodor V.; Winstanley, Craig

    2012-01-01

    Background.?Ureters are fundamental for keeping kidneys free from uropathogenic Escherichia coli (UPEC), but we have shown that 2 strains (J96 and 536) can subvert this role and reduce ureteric contractility. To determine whether this is (1) a widespread feature of UPEC, (2) exhibited only by UPEC, and (3) dependent upon type 1 fimbriae, we analyzed strains representing epidemiologically important multilocus sequence types ST131, ST73, and ST95 and non-UPEC E. coli. Methods.?Contractility and calcium transients in intact rat ureters were compared between strains. Mannose and fim mutants were used to investigate the role of type 1 fimbriae. Results.?Non-UPEC had no significant effect on contractility, with a mean decrease after 8 hours of 8.8%, compared with 8.8% in controls. UPEC effects on contractility were strain specific, with decreases from 9.47% to 96.7%. Mannose inhibited the effects of the most potent strains (CFT073 and UTI89) but had variable effects among other UPEC strains. Mutation and complementation studies showed that the effects of the UTI89 cystitis isolate were fimH dependent. Conclusions.?We find that (1) non-UPEC do not affect ureteric contractility, (2) impairment of contractility is a common feature of UPEC, and (3) the mechanism varies between strains, but for the most potent UPEC type 1 fimbriae are involved. PMID:23002447

  1. Retrograde Positive Contrast Urethrocystography of the Fish Urogenital System

    PubMed Central

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

    2014-01-01

    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

  2. Anodized 20 nm diameter nanotubular titanium for improved bladder stent applications

    PubMed Central

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

    2011-01-01

    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

  3. Primary carcinoid tumor of the kidney with estrogen and progesterone receptor expression

    PubMed Central

    LIN, CHUNHUA; WU, JITAO; GAO, ZHENLI; QU, GUIMEI; WANG, WEI; YU, GUOHUA

    2015-01-01

    Primary carcinoid tumors are uncommon neoplasms in the kidney. The current study presents a case of primary carcinoid tumor of the kidney in a 49-year-old female who suffered from painless gross hematuria for half a month. Left hydronephrosis, a horseshoe kidney and a space-occupying lesion of the left ureter were found by abdominal computed tomography scans and ultrasonic testing. Surgery was performed and an oval tumor was found under the left ureter; the tumor and left kidney were excised completely. The neoplasm was composed of solid nests of cells, trabeculae, adenoid structures and anastomosing cords in a loose and myxoid background. The tumor cells, which were consistent in volume, exhibited centrally oval nuclei with inconspicuous nucleoli, and eosinophilic finely granular cytoplasm. Upon immunohistochemical staining, the neoplastic cells were positive for AE1/AE3, vimentin, synaptophysin, chromogranin A, estrogen receptor and progesterone receptor, while being negative for epithelial membrane antigen, inhibin A, cluster of differentiation (CD)99, S-100 and CD10. Based on the histological characteristics, a diagnosis of primary carcinoid tumor of the left kidney was formed. The patient did not receive further treatment. The total follow-up period was 18 months after the surgery and repeated imaging examinations every 6 months revealed no recurrence. PMID:26171049

  4. Renal excretory sectors.

    PubMed

    Burykh, M P

    2002-01-01

    One thousand and ninety-four normal human kidneys and 18 abnormal (with duplication of the ureter) were studied by the corrosion method and pyelography followed by topometric and mathematics analyses. It was found that the renal pelvis is a calicopelvic complex built up of renal calices, urine ducts and renal pelvis. Before opening into the renal pelvis, renal calices join together forming urine ducts (superior and inferior; or superior, middle and inferior; or superior, middle anterior, middle posterior and inferior) which transport urine to the container, the renal pelvis. It can be seen that groups of renal calices with pyramids and their surrounding cortical substance form the renal excretory sectors of the kidneys where the processes of uropoiesis and transportation of urine through elements of the nephron and calicopelvic complex take place. These are two (superior and inferior), three (superior, middle and inferior) or four (superior, middle anterior, middle posterior and inferior) renal excretory sectors. The existence of renal excretory sectors is proved by congenital anomalies of the calicopelvic complex such as duplication of the ureter, where urine ducts of the superior and inferior renal excretory sectors do not form a renal pelvis but run separately to the urinary bladder. On the basis of anatomical data obtained, renal excretory sectors may be distinguished, analogous to bronchopulmonary segments in lungs. These data about renal excretory sectors will contribute to further improvement in the operative technique of renal partial resections as well as to anatomical nomenclature. PMID:12375073

  5. Characterization of nanostructured ureteral stent with gradient degradation in a porcine model

    PubMed Central

    Wang, Xiaoqing; Shan, Hongli; Wang, Jixue; Hou, Yuchuan; Ding, Jianxun; Chen, Qihui; Guan, Jingjing; Wang, Chunxi; Chen, Xuesi

    2015-01-01

    A tubular poly(?-caprolactone) (PCL)/poly(lactide-co-glycolide) (PLGA) ureteral stent composed of nanofibers with micropores was fabricated by double-needle electrospinning. The stent was ureteroscopically inserted into six Changbai pigs, and the commercial polyurethane Shagong® stent was inserted into four pigs as control. Intravenous pyelography revealed that the PCL/PLGA stent gradually degraded from the distal end to proximal terminal, and all stents were completely degraded at 10 weeks post-insertion. No significant difference was observed in hydronephrosis severity between the two groups. The levels of serum creatinine and urine pH remained similar throughout the study in the two groups, but the number of white blood cells in the urine was significantly higher in the Shagong® stent group. On Day 70, histological evaluation indicated equivalent histological severity scores in the middle and distal ureter sections and bladder in the two groups. However, the PCL/PLGA stent-implanted pigs had significantly lower mean severity scores in the kidney and proximal ureter sites. These data revealed that the PCL/PLGA stent degraded in a controlled manner, did not induce obstruction, and had a lower urothelial impact in comparison to the Shagong® stent, indicating that the stent exhibited great potential for clinical application. PMID:25945051

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

    PubMed

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

    2014-01-01

    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. PMID:25105843

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

    PubMed

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

    2014-11-01

    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

  8. Ultrasonography of the urinary tract in 29 female Saanen goats.

    PubMed

    Steininger, K; Braun, U

    2012-02-01

    The left and right kidneys, ureters, urinary bladder and urethra of 29 female clinically healthy Saanen goats were examined via transcutaneous and transrectal ultrasonography. In order to establish reference values the examinations were performed using a 5.0 MHz linear transducer to scan the right caudal costal part of the abdominal wall, right and left dorsal flanks and right and left inguinal regions of standing goats. A 5.0 MHz intracavity probe was used for transrectal ultrasonographic examination of the urinary bladder and urethra. The kidneys were examined in longitudinal and cross section and assessed subjectively. They could usually be seen from the 12th intercostal space on the right side and dorsal right flank. The right kidney was 8.0 ± 0.67 cm long and the left was 8.4 ± 0.64 cm long. The ureters could not be visualized in any of the goats. The length of the urinary bladder was 5.1 ± 1.38 cm, and its largest cross-sectional diameter was 2.6 ± 1.01 cm. The urethra was seen in 23 goats and appeared as echogenic lines with no visible lumen. The transition from the neck of the bladder to the internal urethral orifice extended beyond the brim of the pelvis in only one goat. PMID:22287138

  9. Ureteral extracorporeal shock wave lithotripsy utilizing Dornier MFL 5000.

    PubMed

    Ilker, N Y; Alican, Y; Sim?ek, F; Türkeri, L N; Akda?, A

    1994-02-01

    Early reports indicated that stones in the upper ureter that have been manipulated back into the kidney have a higher success rate with SWL than those treated in situ. Difficulties in detecting stones in the mid and lower ureter with lithotripters using ultrasonographic localization also limit in situ SWL of ureteral calculi. We treated 254 patients with ureteral calculi (85 upper, 72 mid, and 97 lower) using in situ SWL on the Dornier MFL 5000. The mean stone volume was 1.4 cm2. Approximately one third of the patients required more than one session. The mean number of shock waves was 2010 (range 1400-3000) with a mean voltage of 20 kV (range 14-30 kV). Fragmentation was achieved in 92.6% of the patients. Only 0.4% of the sessions involved general anesthesia. At 3-month follow-up, available in 75% of the patients, the stone-free rate was 82.6%. Ureteral calculi can be treated effectively in situ by means of SWL. PMID:8186776

  10. Ureteral complications after renal transplant in children: timing of presentation, and their open and endoscopic management.

    PubMed

    Castagnetti, Marco; Angelini, Lorenzo; Ghirardo, Giulia; Zucchetta, Pietro; Gamba, Piergiorgio; Zanon, GiovanniFranco; Murer, Luisa; Rigamonti, Waifro

    2014-03-01

    We retrospectively reviewed the records of 24 consecutive patients undergoing treatment for ureteral complications after RTx in the period 2001-2012 to determine the timing of presentation of the complications, and their open or endoscopic management. Three patients (12%) had a necrosis of the transplanted ureter soon after RTx. All required open urinary diversion in a native ureter. Ten cases (42%) developed ureteral obstruction. Time of presentation was variable mainly in relation to the underlying cause. Endoscopic treatment was successful in two cases with urinary stones and open surgery in two with mid-ureteral obstruction. Six patients had VUJ stenosis, three underwent open reimplantation, whereas temporary double-J stent placement was successfully performed in the remainder. Eleven patients (46%) had VUR. It seldom presented in the first year after RTx. Endoscopic treatment was attempted in all and was successful in all the six cases without vs. only one of the five with lower urinary tract pathology (p = 0.01). Endoscopic treatment is an option in patients with VUR in the absence of lower urinary tract pathology. It is an option also for the treatment of stones and can be attempted in case of VUJ stenosis. Ureteral necrosis always requires open treatment. PMID:24373057

  11. The Role of Ureteral Relaxation in the Promotion of Stone Passage

    NASA Astrophysics Data System (ADS)

    Davenport, Kim; Timoney, Anthony G.; Keeley, Francis X.

    2007-04-01

    In order to promote stone passage in renal colic, we must first understand normal ureteral activity and how this is affected by the presence of a stone. Measuring normal ureteral activity in humans is difficult without the use of invasive methods or techniques which in themselves may affect peristalsis. Monitoring the activity during confirmed renal colic is even more difficult and virtually impossible. Both animal and human studies have therefore been used in an attempt to understand the physiology of the ureter and how this is affected by the presence of a stone. Using this knowledge, drugs can be used to alter the behavior of the ureter in an attempt to promote stone passage. Peristalsis has always been thought to be essential to allow stone passage and therefore it has been necessary to determine whether stone passage occurs by promotion of ureteral activity or by smooth muscle relaxation. Research indicates that drugs which allow continued peristalsis whilst preventing the increased uncoordinated activity seen in renal colic would be the most advantageous. The alpha-1A-adrenoceptor antagonists are the most effective drugs to date.

  12. Proximity injury by the ultrasonically activated scalpel during dissection.

    PubMed

    Kadesky, K M; Schopf, B; Magee, J F; Blair, G K

    1997-06-01

    The ultrasonically activated scalpel is a high-frequency oscillating instrument that is reported to have a decreased dispersion of energy to surrounding tissues during use. To determine if this effect is beneficial and safe to surrounding tissue, it was used on anesthetized adolescent swine to dissect the portal vein from the pancreas, the renal artery and vein from the renal hilum, the ureter from the retroperitoneum, the aorta from the inferior vena cava and the common bile duct from surrounding tissue. Three-second contact to intestine and nerve roots was also performed. Wedge biopsy specimens of liver and spleen were performed. Dissection technique used was as described by the company. Structures were dissected with electrocautery using similar techniques for comparison. Tissues were harvested and placed in formalin for histological analysis. Dissection with the ultrasonically activated scalpel was simple, achieved excellent hemostasis, and did not appear to damage adjacent tissue. Microscopic analysis showed adventicial and media injury to vascular structures. The ureter and common bile duct demonstrated marked injury with regions of transmural coagulation. Nerve and small bowel did not appear to have much injury from the 3-second contact with the instrument. This study indicated that although the ultrasonically activated scalpel can ease dissection with good hemostasis, care must be taken to avoid injury to adjacent structures. Although its lateral energy dispersion may be less than that of cautery, it can still cause transmural necrosis to major structures. PMID:9200091

  13. Gentics of urogenital abnormalities in ACI inbread rats.

    PubMed

    Cramer, D V; Gill, T J

    1975-08-01

    The frequency of urogenital abnormalities in adult ACI rats was 18.8%. These abnormalities consisted of a spectrum of defects ranging from focal aplasia of the ureter to the complete absence of the ureter, kidney, and tubular genital tract on the affected side. When ACI rats with normal urogenital tracts tracts were crossed with F344 rats the frequency of the defects decreased to a constant level in the F1, F2, and F3 generations. There was no clearly significant decrease in the frequency of the defects in the backcross offspring of (ACI times F344)F1 times ACI matings, but there was a significant and dramatic decrease in the backcross to F344 rats. Attempts to select against these defects by brother-sister matings among normal ACI rats were not successful: 5 generations of inbreeding did not alter the frequency of the urogenital abnormalities. The frequency of the abnormalities was the same in the offspring of affected parents as in the offspring of normal parents, indicating homozygosity of the factors responsible for the defects. The results suggest that the transmission of these defects is polygenic. PMID:1162622

  14. Study of antireflux nipple valves of Kock ileal urinary reservoir. Experimental investigation in dogs.

    PubMed

    Boyd, S D; Skinner, D G; Lieskovsky, G; Kawachi, M H; Ahlering, T E

    1991-01-01

    To better assess the construction, maintenance, and function of the Kock ileal urinary reservoir with its continent antirefluxing nipple valves, laboratory investigations in dogs were done simultaneously with clinical trials in humans in 1983. Fifteen dogs underwent creation of hemi-Kock ileal reservoirs (without the efferent valve and limb) that were anastomosed to their bladders as enterocystoplasties. The afferent antirefluxing nipple valves were intussuscepted after 7 cm of underlying mesentery had been removed. The nipples were further stabilized with metal and absorbable (Polysorb) staples and Marlex collars. The right ureters were anastomosed to the afferent limb of the reservoirs with the contralateral systems left intact as controls. Ten dogs were able to be followed at the vivaria for twelve to thirty-six months and then studied. All nipple valves remained intact, viable, and nonrefluxing without revision. All kidneys remained histologically normal except those in dogs with dilated ureters secondary to ureteroileal stenosis with concurrent calculi formation. Calculi formed on exposed metal staples and Marlex. The absorbable staples were found to promote appropriate healing and were never the nidus for stone formation. It appears that the intussuscepted nipple valve (with its mesentery removed) is reproducible and functionally reliable in preventing reflux. It also appears these valves can histologically preserve diverted kidneys if the upper urinary tract drainage is normal and calculi are minimized. The proper placement of staples and the elimination of Marlex-anchoring collars are indicated to minimize calculi. PMID:1986481

  15. Ureteric reconstruction for the management of transplant ureteric stricture: a decade of experience from a single centre.

    PubMed

    Pike, Thomas W; Pandanaboyana, Sanjay; Hope-Johnson, Thea; Hostert, Lutz; Ahmad, Niaz

    2015-05-01

    This study was conducted to review the outcomes of patients who had undergone surgical repair of a ureteric stricture following renal transplantation. All patients who developed a ureteric stricture and underwent ureteric reconstruction following renal transplantation, between December 2003 and November 2013, were reviewed. One thousand five hundred and sixty renal transplants were performed during the study period. Forty patients required surgical repair of a ureteric stricture (2.5%, 25 male, median age 48 [14-78]). The median time to stricture was 3 [1-149] months. 19 patients were reconstructed by reimplantation to the bladder, 18 utilized a Boari flap, two were a pre-existing ileal conduit and one was an anastomosis to a native ureter. In one patient, reconstruction was impossible and consequently an extra-anatomic stent was used. Two patients required re-operation for restricture and kinking. Median serum creatinine at 12 months following surgery was 148 [84-508] ?mol/l. There was no 90-day mortality. Eleven grafts were lost at the time of this study, a median time of 11 [1-103] months after reconstruction. The incidence of ureteric stricture following renal transplant is low. Surgical reconstruction of the transplant ureter is the optimal treatment and is successful in the majority of patients. PMID:25557065

  16. Treatment of ureteral calculi with an 8.3F disposable shaft rigid ureteroscope.

    PubMed

    D'amico, F C; Belis, J A

    1993-10-01

    Seventy-one adult patients underwent ureteroscopy for treatment of ureteral calculi using the disposable shaft semirigid mini-ureteroscope. The ureteroscope has an 8.3F outer diameter with a fiber optic core that allows some flexibility of the shaft. It has a 4.0F working channel that allows simultaneous use of 3F instruments and irrigation. Twenty-three patients had upper ureteral calculi and 48 patients had lower ureteral calculi. Thirty-six patients did not require ureteral dilation and the remainder had minimal dilation to 10-12F. Fifty-one patients underwent laser lithotripsy, 14 patients underwent basket extraction, and six patients had both. Five patients required use of a second flexible ureteroscope. Seventy-seven percent of the patients went home the day of the procedure, 16% stayed one night in the hospital, and the remaining 7% had longer hospital stays. No major complications or infections were noted. Only 11% of the patients required IV or IM narcotics for pain management post-operatively. The stone-free results at 1 month were 96% for lower ureteral calculi and 91% for upper ureteral calculi. We have found this ureteroscope to be similar to other rigid mini-ureteroscopes with some additional advantages. A larger working channel, increased flexibility/steerability, and improved optics make it useful for treating ureteral calculi in the lower ureter in men and the entire ureter in women. PMID:10146424

  17. Options in the management of tuberculous ureteric stricture

    PubMed Central

    Goel, Apul; Dalela, D.

    2008-01-01

    Ureteric stricture is a feared manifestation of genitourinary tuberculosis (TB) with the commonest site being the lower ureter. The purpose of this review is to discuss the management options for this condition. Literature search was done using PubMed and all articles on TB and ureteric stricture were reviewed published between 1990 till September 2007. The exact site and length of stricture must be defined with radioimaging (intravenous urography, retrograde, or antegrade pyelography) and renal function be quantified. The treatment of stricture mostly requires some kind of intervention after a brief period of antituberculous medicines with or without steroids. For uncomplicated/simple strictures (short segment, passable, with renal function >25%, good bladder capacity) endourologic option should be used which usually means double-J stenting with or without balloon dilatation. For complicated/complex strictures (long segment, dense fibrosis, with renal function <20%, small bladder capacity) regular surgical options should be considered which usually means ureteroureterostomy or ureteropyelostomy for upper ureteric strictures, intubated ureterostomy, or transureteroureterostomy for midureteric strictures, psoas hitch/Boari flap for lower ureteric strictures or ileal ureter/autotransplantation for whole length/multiple strictures. PMID:19468472

  18. Anterior pelvic reconstruction with ileum after cancer treatment.

    PubMed

    Hendry, W F; Christmas, T J; Shepherd, J H

    1991-12-01

    Ileum has been used to reconstruct the lower urinary tract in 15 patients (10 women, five men) after treatment for bladder or gynaecological cancer. Seven patients had previously received radical pelvic irradiation. Four methods were used: group 1 (five patients): bladder patch after partial cystectomy or bladder augmentation after clam cystotomy for bladder contracture; group 2 (four patients): bladder replacement after subtotal (supratrigonal) cystectomy; group 3 (two patients): ureteric replacement for lower ureteric obstruction or fistula, and group 4 (four patients): complete replacement of bladder and lower ureters after anterior pelvic exenteration, with creation of neovagina from caecum in the two female patients. Review of the results indicates that ileum provides a versatile and safe material for anterior pelvic reconstruction in cancer patients even after previous pelvic irradiation. PMID:1774743

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

    PubMed Central

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

    2013-01-01

    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

  20. Intestinal type villous adenoma of the renal pelvis.

    PubMed

    Hudson, Jill; Arnason, Thomas; Merrimen, Jennifer L O; Lawen, Joseph

    2013-01-01

    Intestinal type villous adenomas are uncommon in the genitourinary tract. Most reported cases have been located in the urinary bladder or urachus. Villous adenoma arising in the renal pelvis or ureter is very rare. We present a case of an 81-year-old female who presented with difficulty voiding and mucosuria. A computed tomography scan identified right-sided hydronephrosis, renal parenchymal atrophy, nonobstructing calculi and a lower pole renal mass. She underwent open right nephrectomy. Histopathologic examination of the kidney revealed an intestinal type villous adenoma of the renal pelvis with high-grade dysplasia and focal areas suspicious for invasive adenocarcinoma. We review the four previously reported cases of intestinal type villous adenoma in the renal pelvis and discuss diagnosis and management of this unusual neoplasm. PMID:23671505

  1. Laparoscopic resection of a functional paraganglioma in the organ of Zuckerkandl.

    PubMed

    Tagaya, N; Suzuki, N; Furihata, T; Kubota, K

    2002-01-01

    We describe the successful laparoscopic resection of a functional paraganglioma in the organ of Zuckerkandl. A 47-year-old man with hypertension and diabetes mellitus was found to have an abdominal mass beside the aorta. The tumor was diagnosed as a functional paraganglioma by diagnostic imaging and biochemical tests. We then performed a transperitoneal laparoscopic resection for removal. After freeing the left ureter, resecting the inferior mesenteric artery, and dividing the small blood vessels, the tumor was isolated and found to be preserved in its capsule. It was retrieved in a bag through an enlarged incision. The operation time was 450 min and blood loss was 410 ml. The postoperative course was uneventful and there has been no local recurrence or distant metastasis during the 18-month follow-up period. Laparoscopic resection of functional extraadrenal paragangliomas is technically feasible and safe if adequate pre- and intraoperative medical management and a careful, steady surgical technique are used. PMID:11961657

  2. Radiation disease of the urinary tract: histological features of 18 cases.

    PubMed Central

    Suresh, U R; Smith, V J; Lupton, E W; Haboubi, N Y

    1993-01-01

    AIMS: To study the spectrum of histological changes in the urinary tract caused by pelvic irradiation. METHODS: Biopsy specimens of ureter and bladder and cystectomy specimens from 18 patients who had received pelvic irradiation were studied and the histological features were arbitrarily grouped into early and late changes. RESULTS: A wide range of histological changes were noted of which submucosal inflammation, fibrosis, and epithelial damage were the commonest. Other less common features were interstitial haemorrhage, ureteritis and cystitis cystica, squamous metaplasia of vaginal type and perineural inflammation. CONCLUSIONS: Although epithelial changes were most prominent in early cases and stromal changes in the late cases, there was a continuing spectrum of epithelial damage which persisted many years after initial radiation. Similarly, submucosal fibrosis was equally prominent in early and late phases. Images PMID:8463415

  3. Laparoscopic Nephroureterectomy: The Distal Ureteral Dilemma

    PubMed Central

    Srirangam, Shalom J.; van Cleynenbreugel, Ben; van Poppel, Hein

    2009-01-01

    Transitional cell carcinoma affecting the upper urinary tract, though uncommon, constitutes a serious urologic disease. Radical nephroureterectomy remains the treatment of choice but has undergone numerous modifications over the years. Although the standard technique has not been defined, the laparoscopic approach has gained in popularity in the last two decades. The most appropriate oncological management of the distal ureteral and bladder cuff has been a subject of much debate. The aim of the nephroureterectomy procedure is to remove the entire ipsilateral upper tract in continuity while avoiding extravesical transfer of tumor-containing urine during bladder surgery. A myriad of technical modifications have been described. In this article, we review the literature and present an overview of the options for dealing with the lower ureter during radical nephroureterectomy. PMID:19020654

  4. [Fetal uropathies and pulmonary hypoplasia].

    PubMed

    Jakobovits, Akos

    2003-05-11

    The author discusses the role of fetal uropathies in the development of pulmonary hypoplasia. The predisposing abnormalities may occur at various locations, including the kidneys and the efferent urinary ducts (ureters, urocyst, urethra). Following a brief general overview of the normal development of the urinary system, the developmental abnormalities are discussed. These anomalies interfere with the secretion of urine or, alternatively, may hinder or obstruct its elimination through the urinary ducts, thus leading to oligohydramnios. Inadequate production of amniotic fluid hinders the respiratory movements and unfavourable affects or even arrests pulmonary development. The stage of lung maturity at the time of birth offers a key to the determination of the time of initial occurrence of pulmonary hypoplasia. Regretfully, the therapeutic options are rather limited, due to the substantial maternal and fetal risks of in utero fetal surgery. In case of valvula urethrae posterior, a vesico-amniotic shunt offers a realistic chance for success. PMID:12809071

  5. Peristaltic pumping of solid particles immersed in a viscoelastic fluid

    NASA Astrophysics Data System (ADS)

    Chrispell, John; Fauci, Lisa

    2010-11-01

    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.

  6. Metastatic tumors to the urinary tract. Review a propos of two cases.

    PubMed

    Sarlis, N I; Sarlis, J N; Kehayas, P

    1990-01-01

    The problems of clinical diagnosis and treatment of metastatic tumors of the urinary tract remain very important, despite the relative rarity of these tumors and the development of new imaging techniques. We report two such cases. The first one refers to a 63-year-old man, who presented with a tumor of the right kidney. Postoperatively, the lesion proved to be a metastasis of a small-cell lung carcinoma. In the second case, a 59-year-old man was admitted with acute anuria and a history of infiltrating ductal carcinoma of the breast. His anuria was resolved by passage of ureteral stents, but relapsed soon after their removal. Thus, a ureterostomy was performed. Intraoperatively, an extensive metastatic infiltration of the ureters by the mammary tumor was discovered. Reviewing the world literature, we discuss the diagnostic and therapeutic clues of these tumors. PMID:1964541

  7. 45,X/47,XXX Mosaicism and Short Stature.

    PubMed

    Everest, Erica; Tsilianidis, Laurie A; Haider, Anzar; Rogers, Douglas G; Raissouni, Nouhad; Schweiger, Bahareh

    2015-01-01

    We describe the case of a ten-year-old girl with short stature and 45,X/47,XXX genotype. She also suffered from vesicoureteric reflux and kidney dysfunction prior to having surgery on her ureters. Otherwise, she does not have any of the characteristics of Turner nor Triple X syndrome. It has been shown that this mosaic condition as well as other varieties creates a milder phenotype than typical Turner syndrome, which is what we mostly see in our patient. However, this patient is a special case, because she is exceptionally short. Overall, one cannot predict the resultant phenotype in these mosaic conditions. This creates difficulty in counseling parents whose children or fetuses have these karyotypes. PMID:26137340

  8. Engineering Better Lithotripters.

    PubMed

    Chaussy, Christian G; Tiselius, Hans-Göran

    2015-08-01

    Although shock wave lithotripsy (SWL) remains an excellent non-invasive method for active removal of stones from the ureter and kidney, its popularity has decreased during recent years and the arguments for choosing endoscopic procedures rather than the only non-invasive surgical procedure are usually based on the opinion that SWL results are inferior to those obtained with endoscopic methods. It is considered that slow technical progress has not sufficiently met the requirements of disintegration, reduced need of repeated treatments, shorter treatment duration and less negative effects on tissues. This article summarises some recently published articles that address these problems and have the aim of improving the function of lithotripters. Modification of the shock wave geometry, elimination or control of cavitation bubbles, and different techniques of disintegration studied in in vitro and in animal experiments suggest several possible future directions that might provide a basis for development of a new "gold standard" lithotripter. PMID:26077353

  9. Morphology and SSU rDNA sequences of Ortholinea orientalis (Shul'man and Shul'man-Albova, 1953) (Myxozoa, Ortholineidae) from Clupea harengus and Sprattus sprattus (Clupeidae) from Denmark.

    PubMed

    Karlsbakk, Egil; Køie, Marianne

    2011-07-01

    Ortholinea orientalis (Shul'man and Shul'man-Albova 1953) Shul'man 1956 is redescribed from Clupea harengus L. and Sprattus sprattus (L.) (Teleostei, Clupeidae) from the northern Øresund, Denmark. S. sprattus is a new host record. Polysporic plasmodia and most myxospores were found in the ureters of both hosts. The myxospores have external valvular ridges, which were not observed in the original description. The presence of this character causes us to consider Ortholinea clupeidae Aseeva 2000 as a likely synonym of O. orientalis. Ortholinea antipae Moshu and Trombitsky, 2006 from a Black Sea clupeid is also similar and represent a possible synonym. Sequence comparisons and phylogenetic analysis of partial SSU rDNA sequences of O. orientalis reveal closest affinity (82-86% identity) to members of the 'Freshwater Urinary Bladder Clade' sensu Fiala (2006), a clade among the Platysporina containing members of the myxosporean genera Myxobilatus, Hoferellus, Myxidium, Zschokkella and Chloromyxum from freshwater fishes. PMID:21301876

  10. Bladder Neck Rupture Following Perineal Bull Horn Injury: A Surgical Challenge

    PubMed Central

    Padilla-Fernandez, B.; Diaz-Alferez, F.J.; Garcia-Garcia, M.A.; Herrero-Polo, M.; Velasquez-Saldarriaga, J.F.; Lorenzo-Gomez, M.F.

    2012-01-01

    Pelvic-abdominal injuries caused by goring are serious lesions which require rapid diagnosis and urgent treatment in the context of a polytraumatized patient. The simultaneous rupture of both the bladder and the prostatic-membranous urethra occurs in 10%–29% of males with pelvic fractures but bladder neck injuries in adults are rarer. Unstable pelvic fractures, bilateral fractures of the ischiopubic branches (also referred to as fractures from falling astride) and the diastasis of the pubic symphysis are those that have the greatest likelihood of injuring both the posterior urethra and the bladder. We present a case of perineal bull horn injury with muscle laceration, bone fractures, scrotal avulsion and rupture of the bladder neck involving the right ureter which required two operations to be repaired. PMID:23066348

  11. The role of ureteroscopy as a diagnostic and therapeutic tool in various indications.

    PubMed

    Ilker, Y; Dillio?lugil, O; Tarcan, T; Türkeri, L; Akda?, A

    1994-01-01

    Ureteroscopy is now in routine use for the diagnosis and treatment of various pathologies in the upper urinary tract. We report here on our experience in diagnostic and therapeutic applications of the 11.5 F rigid ureteroscope in 85 patients and 88 ureters. An overall success rate of 68.18% (60/88) was achieved when therapeutic and diagnostic interventions were evaluated together. Success rate was 66.65% in the treatment of ureteral stones (all locations), 100% in the removal of retained catheters, and 81.82% in diagnostic interventions. Frequencies of complications like postoperative fever, stone migration, and various degrees of ureteral perforation were 5.68%, 5.68%, and 7.95%, respectively, consistent with current literature. We conclude that rigid ureteroscopy can be safely applied for appropriate indications in the hands of competent urologists. PMID:7759200

  12. [A case of combination with proliferative cystitis and pelvic lipomatosis causing bilateral hydronephrosis].

    PubMed

    Nakata, Seiji; Ohtsuka, Yasuhiro; Koya, Tomoko; Nakano, Katsuya; Takahashi, Hirotomo

    2007-01-01

    A 70-year-old man consulted our hospital complaining of gross hematuria and bilateral hydronephrosis. Cystoscopic findings suggested non-papillary sessile tumor at the bladder neck. CT findings revealed bilateral hydronephrosis caused by the stricture of lower ureters. Tumorous structure existed between bladder and prostate. Abundant fatty tissue was observed around bladder and rectum, the shape of the bladder was distorted to inverted tear-drop and the bladder was transferred anteriorly, showing findings of pelvic lipomatosis. Urethrocystography revealed elongation of prostatic urethra and anterior displacement of the bladder. Transurethral tumor resection was performed under spinal anesthesia. Pathological diagnosis was proliferative cystitis and no malignant cells were observed. Transperineal tumor biopsy also revealed no malignant cells. The patient was followed under administration of "Saireitou" (chinese medicine) and cetirizine hydrochloride, followed by antibiotics and anti-inflammatory enzyme preparations. PMID:17302294

  13. [Augmentation ileocystoplasty as a treatment of vesicoureteral injury following rectal amputation: a case report].

    PubMed

    Kinebuchi, Y; Okaneya, T; Murata, Y; Yoneyama, Y

    1999-05-01

    A 65-year-old man underwent transperineal drainage of pelvic abscess after rectal amputation for rectal cancer. The bladder wall and right ureter were injured during this operation, which led to vesicoperineal fistula and contracted bladder. We performed partial resection of the bladder (fistulectomy), augmentation ileocystoplasty (Cup-patch technique), and bilateral ureteral reimplantation (LeDuc-Camey technique). After surgery, the patient was able to void without any residual urine or incontinence. There was no hydronephrosis or resicoureteral reflux postoperatively. Augmentation cystoplasty is usually performed to treat a contracted bladder, but it can also be applied for the reconstruction of complicated lower urinary tract injury, and may improve the quality of life (QOL) dramatically. PMID:10410322

  14. Endoscopic excision of an eroding calcified mesh sling, 10 years after primary surgery.

    PubMed

    Wadie, Bassem S

    2009-02-01

    Management of urethral erosion typically entails two options: sling incision (in the early postoperative period) or excision of the suburethral part of the sling (urethrolysis). This paper describes a different endoscopic technique. A forty-year-old woman with a synthetic sling implanted 10 years prior presented with persistent lower urinary tract symptoms. A kidney ureter bladder X-ray showed a stone at the level of the bladder neck. Disintegration of the stone revealed eroding mesh embedded in the urethral wall. Complete resection of the mesh using an electrocautery knife was performed. Two months since the procedure, the patient has had an uneventful course. Both vaginal and urethral walls are intact, and she is capable of normal voiding with some stress incontinence. Although it is unusual, a sling eroding the urethra is a diagnosis that needs to be considered even 10 years after surgery. Endoscopic management is feasible and can be successful. PMID:18758681

  15. Hormonal Treatment for Severe Hydronephrosis Caused by Bladder Endometriosis

    PubMed Central

    Efe, Erkan; Serin, Salih; Kolus, Eyüp; Ercan, Önder; Resim, Sefa

    2014-01-01

    The incidence of endometriosis cases involving the urinary system has recently increased, and the bladder is a specific zone where endometriosis is most commonly seen in the urinary system. In the case presented here, a patient presented to the emergency department with the complaint of side pain and was examined and diagnosed with severe hydronephrosis and bladder endometriosis was determined in the etiology. After the patient was pathologically diagnosed, Levonorgestrel-Releasing Intrauterine System (LNG-IUS) was administered to the uterine cavity. At the 12-month follow-up, endometriosis was not observed in the cystoscopy and symptoms had completely regressed. Hydronephrosis may be observed after exposure of the ureter, and silent renal function loss may develop in patients suffering from endometriosis with bladder involvement. For patients with moderate or severe hydronephrosis associated with bladder endometriosis, LNG-IUS application may be separately and successfully used after conservative surgery. PMID:25506035

  16. Xanthine urolithiasis causing bilateral ureteral obstruction in a 10-month-old cat.

    PubMed

    Mestrinho, Lisa A; Gonçalves, Tiago; Parreira, Pedro B; Niza, Maria M R E; Hamaide, Annick J

    2013-10-01

    Xanthine urolithiasis was diagnosed in a 10-month-old intact female domestic shorthair cat presented with acute renal failure due to bilateral ureteral obstruction. Ultrasonography revealed the presence of multiple uroliths in both kidneys and ureters that were not detectable on previous survey radiographs. Medical management failed and ureteral obstruction persisted with no evidence of stone migration into the bladder. Bilateral ureterotomy with urolith removal was performed in order to relieve the obstruction. The cat recovered from surgery, and blood urea nitrogen and creatinine values decreased within normal limits 6 days postoperatively. Urolith analysis by infrared spectrometry determined xanthine composition, and a higher blood and urine concentration of hypoxanthine and xanthine was also found. At 1-year follow-up, the cat was free of clinical signs. However, ultrasonography of the abdomen revealed small-size calculi in both kidneys, despite the low protein diet intake. The very young age of the animal suggests a possible congenital xanthinuria. PMID:23413269

  17. Retroperitoneal malignant peripheral nerve sheath tumor replacing an absent kidney in a child.

    PubMed

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

    2013-01-01

    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

  18. [Application of rowatinex in the perioperative period in the extracorporeal shock wave lithotripsy].

    PubMed

    Popkov, V M; Bliumberg, B I; Osnovin, O V; Shatylko, T V

    2014-01-01

    Despite the high efficacy and safety of ESWL used to disintegrate stones in pyelocaliceal system and upper ureter, the issue of further reduction of the risk of complications of this procedure remains unresolved. The inclusion ofphytopreparations with anti-inflammatory and lithokinetic properties in the scheme of perioperative treatment is one of the ways for prevent complications of ESWL. The effect of the drug Rowatinex on the process of discharge of calculi fragments after ESWL is evaluated. The frequency and intensity of qualitative changes of urine after appointment this drug were assessed. It is concluded that Rowatinex has positive impact on the final result of ESWL in the case of its inclusion in the complex medical treatment, which manifests in terms of reducing the time of discharge of fragments, mitigation of subjective symptoms, as well as reducing the frequency of subclinical bacteriuria and severe complications. PMID:24956667

  19. Simplified laparoscopic technique for the treatment of long distal ureteral stenosis.

    PubMed

    Golab, Adam; Slojewski, Marcin; Sikorski, Andrzej

    2013-12-01

    Laparoscopic interventions with the application of vesico-psoas hitch and Boari flap methods for the reconstruction of pronounced ureter defects require considerable physical skill and competence. This case series aims to present our experience in the treatment of long, distal ureteral stenoses via simplified laparoscopic ureteroneocystostomy in 3 male patients in whom the stenoses ranged from 5 cm to 6 cm. Prior to each laparoscopic intervention, intravenous urography and pyelography via a nephrostomy tube were performed. The mean operation time was 157 min (120-180 min), and blood loss averaged 33 ml (20-50 ml). No intra-operative or post-operative complications were recorded. The post-operative hospital stay was ? 6 days. Follow-up imaging examinations revealed normal kidney-urinary bladder urine flow in all cases. In conclusion, we consider that simplified ureteral replantation facilitates laparoscopic treatment of long, distal ureteral stenoses. PMID:24501606

  20. Simplified laparoscopic technique for the treatment of long distal ureteral stenosis

    PubMed Central

    Slojewski, Marcin; Sikorski, Andrzej

    2013-01-01

    Laparoscopic interventions with the application of vesico-psoas hitch and Boari flap methods for the reconstruction of pronounced ureter defects require considerable physical skill and competence. This case series aims to present our experience in the treatment of long, distal ureteral stenoses via simplified laparoscopic ureteroneocystostomy in 3 male patients in whom the stenoses ranged from 5 cm to 6 cm. Prior to each laparoscopic intervention, intravenous urography and pyelography via a nephrostomy tube were performed. The mean operation time was 157 min (120–180 min), and blood loss averaged 33 ml (20–50 ml). No intra-operative or post-operative complications were recorded. The post-operative hospital stay was ? 6 days. Follow-up imaging examinations revealed normal kidney-urinary bladder urine flow in all cases. In conclusion, we consider that simplified ureteral replantation facilitates laparoscopic treatment of long, distal ureteral stenoses. PMID:24501606

  1. Extra-adrenal paraganglioma of the prostate.

    PubMed

    Wang, Hong-Hau; Chen, Yen-Lin; Kao, Hao-Lun; Lin, Shih-Chung; Lee, Chiao-Hua; Huang, Guo-Shu; Chang, Wei-Chou

    2013-01-01

    Extra-adrenal pheochromocytomas, or paragangliomas, are rare tumours that may develop from extra-adrenal chromaffin cells, and most occur in the organ of Zuckerkandl. Extra-adrenal paraganglioma of the prostate is extremely rare. We report a 53-year-old man with hypertension and lower urinary tract symptoms, who was initially diagnosed with benign prostate hyperplasia. Computed tomography (CT) showed a large heterogenously enhancing mass in the prostate, imprinting the right distal ureter and urinary bladder. Before surgical intervention, CT-guided biopsy of the prostatic mass was performed and the result of histologic examination confirmed extra-adrenal paraganglioma. He underwent radical prostatectomy, partial cystectomy and right ureteroneocystostomy. The patient recovered and his blood pressure returned within normal range after surgical removal of the prostate tumour. In this article, we stress that the rarity of prostatic paraganglioma, preoperative localization and imaging-guided biopsy were useful in determining the surgical strategy. PMID:23766843

  2. [Report of 2 cases of arterio-ureteral fistula].

    PubMed

    Demailly, M; Gastaud, O; Hakami, F; Petit, J

    2001-06-01

    Uretero-arterial fistulas are exceptional complications: only about forty cases have been reported in the literature. The authors report new two cases of fistula between the common iliac artery and the ureter. One fistula occurred in a context of prolonged ureteric stenting after radiotherapy and pelvic surgery for cancer of the uterus, and the other occurred after an aorto-bifemoral allograft. These fistulas generally occur in a particular clinical context, associating several aetiological factors. The clinical presentation is dominated by often massive and intermittent haematuria. The most useful diagnostic examinations are retrograde ureteropyelography and arteriography. The proposed treatment options (nephrectomy, vascular bypass graft and even embolization) depend on the urgency of the situation and involve both the blood vessel and the urinary tract. The prognosis depends on early diagnosis, but preventive measures can be envisaged to decrease the risk of appearance of these fistulas in high-risk patients. PMID:11512471

  3. 45,X/47,XXX Mosaicism and Short Stature

    PubMed Central

    Everest, Erica; Tsilianidis, Laurie A.; Haider, Anzar; Rogers, Douglas G.; Raissouni, Nouhad; Schweiger, Bahareh

    2015-01-01

    We describe the case of a ten-year-old girl with short stature and 45,X/47,XXX genotype. She also suffered from vesicoureteric reflux and kidney dysfunction prior to having surgery on her ureters. Otherwise, she does not have any of the characteristics of Turner nor Triple X syndrome. It has been shown that this mosaic condition as well as other varieties creates a milder phenotype than typical Turner syndrome, which is what we mostly see in our patient. However, this patient is a special case, because she is exceptionally short. Overall, one cannot predict the resultant phenotype in these mosaic conditions. This creates difficulty in counseling parents whose children or fetuses have these karyotypes. PMID:26137340

  4. Quantitative autoradiography of angiotensin II receptors in brain and kidney: focus on cardiovascular implications

    SciTech Connect

    Gehlert, D.R.; Speth, R.C.; Wamsley, J.K.

    1985-01-01

    Quantitative techniques of receptor autoradiography have been applied to localize (/sup 125/I)-angiotensin II binding sites in brain and kidney. High densities of autoradiographic grains, indicating the presence of angiotensin II receptors, have been localized to several rat brain nuclei including the dorsal motor nucleus of the vagus, nucleus of the solitary tract, anterior pituitary, locus coeruleus and several hypothalamic nuclei. Cat thoracic spinal cord exhibited a high density of sites over the intermedio-lateral cell column. In sections of rat kidney, angiotensin II receptors were detected in the glomerulus, vasa recta and ureter. The cardiovascular implications of these results are apparent and relate angiotensin II to hypertensive mechanisms. Thus, angiotensin II represents an endocoid which is involved in control of blood pressure through its effects on peripheral organs as well as the central nervous system.

  5. Primary angiosarcoma of the bladder in a young female.

    PubMed

    Warne, Richard R; Ong, Jeremy S L; Snowball, Bret; Vivian, Justin B

    2011-01-01

    Our case report pertains to a 32-year-old woman initially presenting with left flank pain and gross haematuria throughout her urinary stream. CT of her kidney/ureter/bladder (CT KUB) revealed ureteric dilatation to the level of the bladder without evidence of renal calculus and subsequently a stent was inserted. She represented a month later with contralateral flank pain, and a transuretheral resection of bladder tumour was performed. Histopathological diagnosis was epithelioid angiosarcoma. Further imaging (MRI pelvis) revealed that the tumour arose from the posterior bladder wall with local invasion and regional lymph node metastasis. Ifosfamide and epirubicin chemotherapy with single-fraction radiotherapy induced significant reduction in tumour bulk, although this initial response was followed by the development of symptoms suggestive of disease progression. She died 19 months after initial diagnosis with persistent pulmonary and vertebral metastases although no autopsy was performed. PMID:22700613

  6. Primary angiosarcoma of the bladder in a young female

    PubMed Central

    Warne, Richard R; Ong, Jeremy S L; Snowball, Bret; Vivian, Justin B

    2011-01-01

    Our case report pertains to a 32-year-old woman initially presenting with left flank pain and gross haematuria throughout her urinary stream. CT of her kidney/ureter/bladder (CT KUB) revealed ureteric dilatation to the level of the bladder without evidence of renal calculus and subsequently a stent was inserted. She represented a month later with contralateral flank pain, and a transuretheral resection of bladder tumour was performed. Histopathological diagnosis was epithelioid angiosarcoma. Further imaging (MRI pelvis) revealed that the tumour arose from the posterior bladder wall with local invasion and regional lymph node metastasis. Ifosfamide and epirubicin chemotherapy with single-fraction radiotherapy induced significant reduction in tumour bulk, although this initial response was followed by the development of symptoms suggestive of disease progression. She died 19 months after initial diagnosis with persistent pulmonary and vertebral metastases although no autopsy was performed. PMID:22700613

  7. Pelvic complications after definitive treatment of prostate cancer by interstitial or external beam radiation

    SciTech Connect

    Schellhammer, P.F.; El-Mahdi, A.M.

    1983-05-01

    Radiation complications, after definitive treatment of localized prostatic carcinoma by either external beam or interstitial implantation with Iodine-125 seeds, are reviewed. Late serious complications to immediately adjacent structures of the anterior rectal wall, prostatic urethra, bladder neck, and external sphincter occurred with similar frequency in both treatment groups. However, late serious complications of the remotely adjacent structures of the bladder, urethra, distal ureters, and circumferential rectal wall occurred more frequently in the external beam treatment series, a reflection of the fact that larger tissue volumes were irradiated. Rectal ulceration, while occurring in both treatment groups, was amenable to surgical correction or underwent spontaneous healing only in the 125I group. At this point in our experience, morbidity from late radiation complications has been less among those patients having interstitial implantation for definitive treatment of localized prostatic carcinoma.

  8. [Bladder substitution with continent ileum pouch experimental study on dogs (author's transl)].

    PubMed

    Sulmoni, A; Leisinger, H J; Hauri, D; Schmucki, O

    1975-01-01

    Ileum conduit is a good method for supravesical diversion of urine. The disadvantage is, however, that it does not have a reservoir function. For the first time, in 1969 Kock had shown good results with a continent intra-abdominal ileum pouch for feces, and this gave us the idea to try a similar pouch for urine on 15 dogs. To make reservoirs of the small intestine was technically not simple and often led to complications. Urine continency could be attained by invagination of the small intestine. Primary and secondary reflux as well as stenoses of the ureter implantations led in 50% of the cases to ascending infections. Complications of urine reabsorption did not occur. Further studies of the continency, reflux and reabsorption problems indicate that a continent, intra-abdominal ileum pouch for urine will be possible. PMID:1189125

  9. [The Laferma reflux family, a case of multiple familial reflux].

    PubMed

    Vonbank, F; Schmucki, O

    1981-08-01

    We substantiate that five of total seven examined members of a family including the mother showed a reflux disease. Two of them had a monolateral, three a bilateral, two a vesicoureteral and three a vesicorenal reflux. Three of the examined members suffered from enuresis nocturna. All of the reflux-positive members of the family endoscopically showed gaping ostia of the ureter at the reflux-positive side. We found no criteria for an intravesical obstruction. All reflux-positive members showed a low-pressure reflux. Interestingly, only the female members exhibited a reflux. We don't know whether this case of an increased incidence of reflux disease within one family will represent a known hereditary pattern. PMID:7287463

  10. In-Vitro Assessment of a New Portable Ballistic Lithotripter with Percutaneous and Ureteroscopic Models

    PubMed Central

    Wang, Agnes J.; Baldwin, Gregory T.; Gabriel, James C.; Cocks, F. Hadley; Goldsmith, Zachariah G.; Iqbal, Muhammad W.; Astroza, Gaston M.; Simmons, W. Neal; Zhong, Pei; Preminger, Glenn M.

    2012-01-01

    Abstract Background and Purpose The EMS Swiss LithoBreaker is a new, portable, electrokinetic lithotripter. We compared its tip velocity and displacement characteristics with a handheld, pneumatic lithotripter LMA StoneBreaker.™ We also evaluated fragmentation efficiency using in vitro models of percutaneous and ureteroscopic stone fragmentation. Materials and Methods Displacement and velocity profiles were measured for 1-mm and 2-mm probes using a laser beam aimed at a photo detector. For the percutaneous model, 2-mm probes fragmented 10-mm spherical BegoStone phantoms until the fragments passed through a 4-mm mesh sieve. The ureteroscopic model used 1-mm probes and compared the pneumatic and electrokinetic devices to a 200-?m holmium laser fiber. Cylindrical (4-mm diameter, 4-mm length) BegoStone phantoms were placed into silicone tubing to simulate the ureter; fragmented stones passed through a narrowing in the tubing. Results For both 1-mm and 2-mm probes, the electrokinetic device had significantly higher tip displacement and slower tip velocity, P<0.01. In the percutaneous model, the electrokinetic device needed an average of 484 impulses over 430 seconds to fragment one BegoStone, while the pneumatic device needed 29 impulses over 122 seconds to fragment one stone. Both clearance times and number of impulses needed for percutaneous stone clearance were significantly different at P<0.01. Ureteroscopically, the mean clearance time was 97 seconds for the electrokinetic lithotripter, 145 seconds for the pneumatic lithotripter, and 304 seconds for the laser. Comparing the pneumatic device with the electrokinetic device ureteroscopically, there was no significant difference in clearance time, P=0.55. Both the pneumatic and electrokinetic lithotripters, however, demonstrated decreased clearance times compared with the laser, P=0.027. Conclusions The portable electrokinetic lithotripter may be better suited for ureteroscopy instead of percutaneous nephrolithotomy. It appears to be comparable to the portable pneumatic device in the ureter. Further clinical studies are needed to confirm these findings in vivo. PMID:22873666

  11. Acoustic performance and clinical use of a fibreoptic hydrophone.

    PubMed

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

    1998-01-01

    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

  12. Ureteroscope-assisted double-J stenting following laparoscopic ureterolithotomy.

    PubMed

    Chen, I-Hsuan; Tsai, Jeng-Yu; Yu, Chia-Cheng; Wu, Tony; Huang, Jong-Khing; Lin, Jen-Tai

    2014-05-01

    The aim of this study was to examine the feasibility of ureteroscope-assisted double-J stenting following laparoscopic ureterolithotomy and to evaluate the effects of retrograde ureteroscopic access exerted on the sutured ureterotomy site. From January 2002 to December 2011, 30 patients with proximal ureteral stone underwent ureteroscopic double-J stenting of the ureter following retroperitoneal laparoscopic ureterolithotomy. Patient demographics and perioperative parameters, including the degree of hydronephrosis, urine leakage, and drainage time, were retrospectively reviewed. These data were compared with those of 30 consecutive patients who received open ureterolithotomy and intracorporeal ureteral double-J stenting. In addition, a PubMed search was conducted and the related literature on the placement of a ureteral stent was reviewed. Twenty-eight patients successfully underwent ureteral double-J stenting with ureteroscopic access. No malposition of the ureteral stent was identified in the ureteroscopic group, but two patients in the intracorporeal group required postoperative adjustment of the stent. Residual stone fragments were found during stent placement in three patients in the ureteroscopic group and holmium:yttrium-aluminum-garnet laser lithotripsy was immediately performed. There was no significant difference in postoperative outcomes or complication rates between the two groups. Ureteroscope-assisted ureteral double-J stenting is a simple and safe alternative allowing intraluminal navigation along the entire ureter, correct stent placement, and prompt treatment of residual stone fragments, without radiation exposure. In addition, ureteral disruption and urinary extravasation may not be concerns for ureteroscopic access with continuous normal saline irrigation. PMID:24751387

  13. Optimization of dosimetry and safety using the holmium laser for urology

    NASA Astrophysics Data System (ADS)

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

    1998-07-01

    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.

  14. The feasibility of ureteral tissue engineering using autologous veins: an orthotopic animal model with long term results

    PubMed Central

    2014-01-01

    Background In an earlier study we demonstrated the feasibility to create tissue engineered venous scaffolds in vitro and in vivo. In this study we investigated the use of tissue engineered constructs for ureteral replacement in a long term orthotopic minipig model. In many different projects well functional ureretal tissue was established using tissue engineering in animals with short-time follow up (12 weeks). Therefore urothelial cells were harvested from the bladder, cultured, expanded in vitro, labelled with fluorescence and seeded onto the autologous veins, which were harvested from animals during a second surgery. Three days after cell seeding the right ureter was replaced with the cell-seeded matrices in six animals, while further 6 animals received an unseeded vein for ureteral replacement. The animals were sacrificed 12, 24, and 48 weeks after implantation. Gross examination, intravenous pyelogram (IVP), H&E staining, Trichrome Masson’s Staining, and immunohistochemistry with pancytokeratin AE1/AE3, smooth muscle alpha actin, and von Willebrand factor were performed in retrieved specimens. Results The IVP and gross examination demonstrated that no animals with tissue engineered ureters and all animals of the control group presented with hydronephrosis after 12 weeks. In the 24-week group, one tissue engineered and one unseeded vein revealed hydronephrosis. After 48 weeks all tissue engineered animals and none of the control group showed hydronephrosis on the treated side. Histochemistry and immunohistochemistry revealed a multilayer of urothelial cells attached to the seeded venous grafts. Conclusions Venous grafts may be a potential source for ureteral reconstruction. The results of so far published ureteral tissue engineering projects reveal data up to 12 weeks after implantation. Even if the animal numbers of this study are small, there is an increasing rate of hydronephrosis revealing failure of ureteral tissue engineering with autologous matrices in time points longer than 3 months after implantation. Further investigations have to prove adequate clinical outcome and appropriate functional long-term results. PMID:25381044

  15. Morphology and putative function of the colon and cloaca of marine and freshwater snakes.

    PubMed

    Babonis, Leslie S; Womack, Molly C; Evans, David H

    2012-01-01

    Among tetrapods, evidence for postrenal modification of the urine by the distal digestive tract (including the colon and cloaca) is highly variable. Birds and bladderless reptiles are of interest because the colon and cloaca represent the only sites from which water and ions can be reclaimed from the urine secreted by the kidney. For animals occupying desiccating environments (e.g., deserts and marine environments), postrenal modification of the urine may directly contribute to the maintenance of hypo-osmotic body fluids. We compared the morphology and distribution of key proteins in the colon, cloaca, and urogenital ducts of watersnakes from marine (Nerodia clarkii clarkii) and freshwater (Nerodia fasciata) habitats. Specifically, we examined the epithelia of each tissue for evidence of mucus production by examining the distribution of mucopolysaccharides, and for evidence of water/ion regulation by examining the distribution of Na(+) /K(+) -ATPase (NKA), Na(+) /K(+) /Cl(-) cotransporter (NKCC), and aquaporin 3 (AQP3). NKCC localized to the basolateral epithelium of the colon, urodeal sphincter, and proctodeum, consistent with a role in secretion of Na(+), Cl(-) , and K(+) from the tissue, but NKA was not detected in the colon or any compartment of the cloaca. Interestingly, NKA was detected in the basolateral epithelium of the ureters, suggesting the urothelium may play a role in active ion transport. AQP3 was detected in the ureters and coprodeal complex, consistent with a role in urinary and fecal dehydration or, potentially, in the production of the watery component of the mucus secreted by the coprodeal complex. Since no differences in general cloacal morphology, production of mucus, or the distribution of ion transporters/water channels were detected between the two species, cloacal osmoregulation may either be regulated by proteins not examined in this study or may not be responsible for the differential success of N. c. clarkii and N. fasciata in marine habitats. PMID:21935975

  16. The ROMK potassium channel is present in mammalian urinary tract epithelia and muscle

    PubMed Central

    Spector, David A.; Yang, Qing; Klopouh, Leonid; Deng, Jie; Weinman, Edward J.; Steplock, Deborah A.; Biswas, Rajatsubhra; Brazie, Marc F.; Liu, Jie; Wade, James B.

    2008-01-01

    There is increasing evidence that mammalian urinary tract epithelial cells utilize membrane channels and transporters to transport solutes across their apical (luminal) and basalateral membranes to modify solute concentrations in both cell and urine. This study investigates the expression, localization, and regulation of the ROMK (Kir 1.1) potassium channels in rat and dog ureter and bladder tissues. Immunoblots of homogenates of whole ureter, whole bladder, bladder epithelial cells, and bladder smooth muscle tissues in both rat and dog identified ?45- to 50-kDa bands characteristic of ROMK in all tissues. RT-PCR identified ROMK mRNA in these same tissues in both animal species. ROMK protein localized by immunocytochemistry was strongly expressed in the apical membranes of the large umbrella cells lining the bladder lumen and to a lesser extent in the cytoplasm of epithelial cells and smooth muscle cells in the rat bladder. ROMK protein and mRNA were also discovered in cardiac, striated, and smooth muscle in diverse organs. There was no difference in immunoblot expression of ROMK abundance in bladder homogenates (whole bladder, epithelial cell, or muscle cell) or ureteral homogenates between groups of rats fed high- or low-potassium diets. Although the functional role of ROMK in urinary tract epithelia and smooth muscle is unknown, ROMK may participate in the regulation of epithelial and smooth muscle cell volume and osmolality, in the dissipation of potassium leaked or diffused from urine across the epithelial cell apical membranes or tight junctions, and in net or bidirectional potassium transport across urinary tract epithelia. PMID:18799551

  17. Absence of Canonical Smad Signaling in Ureteral and Bladder Mesenchyme Causes Ureteropelvic Junction Obstruction

    PubMed Central

    Tripathi, Piyush; Wang, Yinqiu; Casey, Adam M.

    2012-01-01

    Obstruction of the ureteropelvic junction (UPJ) is a common congenital anomaly frequently associated with ureteral defects. To study the molecular mechanisms that modulate ureteral development, we inactivated Smad4, the common Smad critical for transcriptional responses to TGF-? and Bmp signaling, in the ureteral and bladder mesenchyme during embryogenesis. Loss of canonical Smad signaling in these tissues caused bilateral UPJ obstruction and severe hydronephrosis beginning at embryonic day 17.5. Despite a reduction in quantity of ureteral smooth muscle, differentiation proceeded without Smad4, producing a less severe phenotype than Bmp4 mutants; this finding suggests that at least some Bmp4 functions in ureteral smooth muscle may be Smad-independent. The absence of canonical Smad signaling in the ureteral mesenchyme, but not in the urothelium itself, led to urothelial disorganization, highlighting the importance of mesenchymal support for epithelial development. Transcript profiling revealed altered expression in known Bmp targets, smooth muscle-specific genes, and extracellular matrix-related genes in mutant ureters before the onset of hydronephrosis. Expression of the Bmp target Id2 was significantly lower in Smad4 mutants, consistent with the observation that Id2 mutants develop UPJ obstruction. In summary, Smad4 deficiency reduces the number and contractility of ureteral smooth muscle cells, leading to abnormal pyeloureteral peristalsis and functional obstruction. The subsequent bending and luminal constriction of the ureter at the UPJ marks the transition from a functional obstruction to a more intractable physical obstruction, suggesting that early intervention for this disease may prevent more irreversible damage to the urinary tract. PMID:22282597

  18. Uroplakins in Urothelial Biology, Function and Disease

    PubMed Central

    Wu, Xue-Ru; Kong, Xiang-Peng; Pellicer, Angel; Kreibich, Gert; Sun, Tung-Tien

    2013-01-01

    Urothelium covers the inner surfaces of the renal pelvis, ureter, bladder and prostatic urethra. Although morphologically indistinguishable, the urothelia in these anatomic locations differ in their embryonic origin and lineages of cellular differentiation, as reflected in their different uroplakin content, expandability during micturition and susceptibility to chemical carcinogens. Previously thought to be an inert tissue forming a passive barrier between the urine and blood, urothelia have recently been shown to have a secretory activity that actively modifies the urine composition. Urothelial cells express a number of ion channels, receptors and ligands, enabling them to receive and send signals and communicate with adjoining cells and their broader environment. The urothelial surface bears specific receptors that not only allow uropathogenic E. coli to attach to and invade into the bladder mucosa, but also provide a route by which the bacteria ascend via the ureters to the kidney to cause pyelonephritis. Genetic ablation of one or more uroplakin genes in mice causes severe retrograde vesicoureteral reflux, hydronephrosis and renal failure, conditions that mirror certain human congenital diseases. Clearly, abnormalities of the lower urinary tract can impact on the upper tract, and vice versa, through the urothelial connection. In this review, we highlight recent advances in the field of urothelial biology by focusing on the uroplakins, a group of urothelium-specific and differentiation-dependent integral membrane proteins. We discuss these proteins’ biochemistry, structure, assembly, intracellular trafficking and their emerging roles in urothelial biology, function and pathological processes. We also call attention to important areas where greater investigative efforts are warranted. PMID:19340092

  19. Urothelial Defects from Targeted Inactivation of Exocyst Sec10 in Mice Cause Ureteropelvic Junction Obstructions

    PubMed Central

    Fogelgren, Ben; Polgar, Noemi; Lui, Vanessa H.; Lee, Amanda J.; Tamashiro, Kadee-Kalia A.; Napoli, Josephine Andrea; Walton, Chad B.; Zuo, Xiaofeng; Lipschutz, Joshua H.

    2015-01-01

    Most cases of congenital obstructive nephropathy are the result of ureteropelvic junction obstructions, and despite their high prevalence, we have a poor understanding of their etiology and scarcity of genetic models. The eight-protein exocyst complex regulates polarized exocytosis of intracellular vesicles in a large variety of cell types. Here we report generation of a conditional knockout mouse for Sec10, a central component of the exocyst, which is the first conditional allele for any exocyst gene. Inactivation of Sec10 in ureteric bud-derived cells using Ksp1.3-Cre mice resulted in severe bilateral hydronephrosis and complete anuria in newborns, with death occurring 6–14 hours after birth. Sec10FL/FL;Ksp-Cre embryos developed ureteropelvic junction obstructions between E17.5 and E18.5 as a result of degeneration of the urothelium and subsequent overgrowth by surrounding mesenchymal cells. The urothelial cell layer that lines the urinary tract must maintain a hydrophobic luminal barrier again urine while remaining highly stretchable. This barrier is largely established by production of uroplakin proteins that are transported to the apical surface to establish large plaques. By E16.5, Sec10FL/FL;Ksp-Cre ureter and pelvic urothelium showed decreased uroplakin-3 protein at the luminal surface, and complete absence of uroplakin-3 by E17.5. Affected urothelium at the UPJ showed irregular barriers that exposed the smooth muscle layer to urine, suggesting this may trigger the surrounding mesenchymal cells to overgrow the lumen. Findings from this novel mouse model show Sec10 is critical for the development of the urothelium in ureters, and provides experimental evidence that failure of this urothelial barrier may contribute to human congenital urinary tract obstructions. PMID:26046524

  20. [A case of recurrent colon cancer with improvement in prognosis and cancer pain after surgical intervention].

    PubMed

    Fujisaki, Shigeru; Takashina, Motoi; Tomita, Ryouichi; Sakurai, Kenichi; Takayama, Tadatoshi

    2014-11-01

    We report a case of recurrent colon cancer with improvement in prognosis and cancer pain after surgical intervention. A 47-year-old man underwent an emergency Hartmann procedure for colon obstruction from descending colon cancer. Histopathological findings confirmed adenocarcinoma (moderate to poor), pT4apN0cM0, pStage II, and Cur A. In October 2009, abdominal computed tomography examination detected a solitary intraperitoneal recurrent lesion. Multi-agent chemotherapy ( mFOLFOX6)was administered. A fentanyl patch was also placed for relieving cancer pain, but was removed 4 months later because the pain disappeared. From June 2010, multi-agent chemotherapy with FOLFIRI was replaced with bevacizumab because of the increase in recurrent lesion size. In August 2011, the recurrent lesion involving the abdominal wall, left side of the colon, iliopsoas muscle, and left side of the ureter was resected and the left ureter was reconstructed. No fentanyl patch was prescribed at this time. In October 2012, tumor relapse was detected along with lung metastasis, and multi-agent chemotherapy ( FOLFIRI+bevacizumab) was resumed. In January 2013, the cancer pain recurred, and a fentanyl patch was placed again. Since then, the fentanyl dosage has been gradually increased. In August 2013, the tumor in the abdominal wall was resected to manage the patients' pain in the left lower side of the abdomen. Histopathology revealed a tumor in the lymph nodes. In November 2013, multi-agent chemotherapy with FOLFIRI+cetuximab was initiated, but was ineffective. In January 2014, regorafenib was prescribed. The patient has survived for more than 6 years after the primary surgery. We conclude that a therapeutic strategy that combines surgical interventions and multi-agent chemotherapy needs to be considered for improving prognosis and cancer pain in recurrent colon cancer. PMID:25731330

  1. [Renal handling of 3,5,3'-triiodothyronine (T3) in the dog studied by stopflow analysis].

    PubMed

    Kitaoka, H; Yoshida, K; Sakurada, T; Fukazawa, H; Kaise, N; Kaise, K; Suzuki, M; Yamamoto, M; Saito, S; Yoshinaga, K

    1982-10-20

    In order to investigate the renal handling of 3,5,3'-triiodothyronine (T3), we studied the clearance of T3 (CT3) in dogs and the site of tubular secretion and reabsorption of T3 in dog kidney using the stopflow technique (Malvin et al.). Four female dogs, weighing between 12.2 and 17.8 kg, were used for CT3 measurement. Fourteen anesthetized dogs, weighing between 7.8 and 17.5 kg, were used for the stopflow study. After the catheter was inserted into the left ureter, 15% mannitol solution and isotonic saline containing both 0.2% PSP and 0.5% creatinine or 0.1% inulin, were infused and then 10-30 micrograms/kg of T3 or 100 micrograms/kg of T4 was injected as a bolus. When the urine flow reached a stable state of at least 5 ml/min about one-hr after T3 or T4 injection, the ureteral catheter was clamped shut for 10 min. After the release of the clamp, 20 fractions of urine, 1 ml each, were collected sequentially. The changes in pH and PSP concentrations were used as indices of urine from the distal and proximal tubules, respectively. Urinary T3 was determined by RIA. CT3 was obtained by calculating the ratio of the 24-hr urinary T3 excretion to the serum free T3 concentration. CT3, 51.9 +/- 12.3 ml/min, was greater than the clearance of creatinine (Ccr), 23.8 +/- 4.7 ml/min, suggesting that T3 is secreted at the tubules in dogs. Almost immediately after the release of the clamped ureter, the concentration of urinary T3, corrected with excreted urinary creatinine or inulin, was increased, reaching the maximum value at No. 2 or 3 fraction. This maximum urinary T3 value was followed by decreased concentrations of urinary T3, reaching the minimum around No. 13--15 fraction. The fraction with the highest urinary T3 concentration was close to the one with the lowest pH, and the fraction with the lowest urinary T3 concentration was close to the one with the highest PSP concentration. These data suggest that T3 might be reabsorbed or metabolized at the level of the proximal tubules and secreted into the urine at the level of the distal tubules. PMID:7185575

  2. Use of drug therapy in the management of symptomatic ureteric stones in hospitalized adults (SUSPEND), a multicentre, placebo-controlled, randomized trial of a calcium-channel blocker (nifedipine) and an ?-blocker (tamsulosin): study protocol for a randomized controlled trial

    PubMed Central

    2014-01-01

    Background Urinary stone disease is common, with an estimated prevalence among the general population of 2% to 3%. Ureteric stones can cause severe pain and have a significant impact on quality of life, accounting for over 15,000 hospital admissions in England annually. Uncomplicated cases of smaller stones in the lower ureter are traditionally treated expectantly. Those who fail standard care or develop complications undergo active treatment, such as extracorporeal shock wave lithotripsy or ureteroscopy with stone retrieval. Such interventions are expensive, require urological expertise and carry a risk of complications. Growing understanding of ureteric function and pathophysiology has led to the hypothesis that drugs causing relaxation of ureteric smooth muscle, such as the selective ?-blocker tamsulosin and the calcium-channel blocker nifedipine, can enhance the spontaneous passage of ureteric stones. The use of drugs in augmenting stone passage, reducing the morbidity and costs associated with ureteric stone disease, is promising. However, the majority of clinical trials conducted to date have been small, poor to moderate quality and lacking in comprehensive economic evaluation. This trial aims to determine the clinical and cost-effectiveness of tamsulosin and nifedipine in the management of symptomatic urinary stones. Methods/design The SUSPEND (Spontaneous Urinary Stone Passage ENabled by Drugs) trial is a multicentre, double-blind, randomized controlled trial evaluating two medical expulsive therapy strategies (nifedipine or tamsulosin) versus placebo. Patients aged 18 to 65 with a ureteric stone confirmed by non-contrast computed tomography of the kidney, ureter and bladder will be randomized to receive nifedipine, tamsulosin or placebo (400 participants per arm) for a maximum of 28 days. The primary clinical outcome is spontaneous passage of ureteric stones at 4 weeks (defined as no further intervention required to facilitate stone passage). The primary economic outcome is a reduction in the incremental cost per quality-adjusted life years, determined at 12 weeks. The analysis will be based on all participants as randomized (intention to treat). The trial has 90% power with a type I error rate of 5% to detect a 10% increase in primary outcome between the tamsulosin and nifedipine treatment groups. Trial registration ISRCTN69423238; EudraCT number: 2010-019469-26 PMID:24947817

  3. Light microscopic morphometry of the kidneys of fourteen avian species.

    PubMed Central

    Warui, C N

    1989-01-01

    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

  4. Myocardin is required for maintenance of vascular and visceral smooth muscle homeostasis during postnatal development.

    PubMed

    Huang, Jianhe; Wang, Tao; Wright, Alexander C; Yang, Jifu; Zhou, Su; Li, Li; Yang, Jisheng; Small, Aeron; Parmacek, Michael S

    2015-04-01

    Myocardin is a muscle-restricted transcriptional coactivator that activates a serum response factor (SRF)-dependent gene program required for cardiogenesis and embryonic survival. To identify myocardin-dependent functions in smooth muscle cells (SMCs) during postnatal development, mice harboring a SMC-restricted conditional, inducible Myocd null mutation were generated and characterized. Tamoxifen-treated SMMHC-Cre(ERT2)/Myocd(F/F) conditional mutant mice die within 6 mo of Myocd gene deletion, exhibiting profound derangements in the structure of great arteries as well as the gastrointestinal and genitourinary tracts. Conditional mutant mice develop arterial aneurysms, dissection, and rupture, recapitulating pathology observed in heritable forms of thoracic aortic aneurysm and dissection (TAAD). SMCs populating arteries of Myocd conditional mutant mice modulate their phenotype by down-regulation of SMC contractile genes and up-regulation of extracellular matrix proteins. Surprisingly, this is accompanied by SMC autonomous activation of endoplasmic reticulum (ER) stress and autophagy, which over time progress to programmed cell death. Consistent with these observations, Myocd conditional mutant mice develop remarkable dilation of the stomach, small intestine, bladder, and ureters attributable to the loss of visceral SMCs disrupting the muscularis mucosa. Taken together, these data demonstrate that during postnatal development, myocardin plays a unique, and important, role required for maintenance and homeostasis of the vasculature, gastrointestinal, and genitourinary tracts. The loss of myocardin in SMCs triggers ER stress and autophagy, which transitions to apoptosis, revealing evolutionary conservation of myocardin function in SMCs and cardiomyocytes. PMID:25805819

  5. Left renal cyst – Left duplex kidney with compromised superior renal unit and ectopic ureteral orifice in the prostatic urethra

    PubMed Central

    Spinu, D; Bratu, O; Madan, V; Farcas, C; Radulescu, A; Popescu, R; Mischianu, D

    2013-01-01

    The urinary abnormalities are an important health problem. If they are not recognized in due time, they usually lead to the loss of the renal unit function. In many cases, the diagnosis is late and incidental. Case presentation. We present the case of M.I., a 74-year-old male admitted in our surgical unit with diffuse left lumbar pain, low urinary tract symptoms and slow increase in abdomen volume in the past 4 years. Computer tomography scan and ecography showed a large left lumbar cyst like mass with a dilated supernumerary ureter with ectopic ureteral orifice in the prostatic urethra and apparently normal anatomic inferior renal unit. The goal was the excision of the “cyst like” mass (superior left renal unit) but because of the anatomical particularities (extensive fibrosis and local topographical changes) total nephrectomy was performed. Conclusions. Given a normal contralateral kidney, the discovery of a urinary abnormality can be a real challenge, their evolution being a silent one. This type of disease can be suspected only with the development of clinical symptoms. The anatomic particularities (duplex kidney) together with the long evolution of the disease changed the local topography making the preservation of the inferior left renal unit a difficult, almost impossible task for the surgeon. PMID:23904879

  6. The C5a receptor is expressed by human renal proximal tubular epithelial cells

    PubMed Central

    Zahedi, R; Braun, M; Wetsel, R A; Ault, B H; Khan, A; Welch, T R; Frenzke, M; Davis, A E

    2000-01-01

    The C5a receptor is expressed by a variety of cell types. These studies demonstrate by immunohistochemistry that the receptor is present on the surface of proximal and distal tubular epithelial cells from normal kidney. In addition, the receptor was detected on transitional epithelial cells of the ureter and bladder. Primary proximal tubular cultures and a proximal tubular cell line both also expressed the C5a receptor, as demonstrated by immunofluorescence and by FACS analysis. The presence of mRNA encoding the receptor was confirmed by reverse transcriptase-polymerase chain reaction analysis. As opposed to its effect on glomerular mesangial cells, the receptor did not mediate a proliferative response by the proximal tubular cells. C5a also did not enhance the synthesis/secretion of transforming growth factor-beta 1, monocyte chemoattractant protein-1, platelet-derived growth factor-AB or tumour necrosis factor-alpha by cultured proximal tubular cells. Therefore, although the C5a receptor clearly is expressed by proximal tubular cells, clarification of its functional relevance on this cell type awaits further studies. PMID:10931135

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

    PubMed

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

    2005-05-01

    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

  8. Modified simultaneous integrated boost radiotherapy for large retroperitoneal malignant tumor: A case report

    PubMed Central

    NOMIYA, TAKUMA; AKAMATSU, HIROKO; HARADA, MAYUMI; OTA, IBUKI; HAGIWARA, YASUHITO; ICHIKAWA, MAYUMI; MIWA, MISAKO; MIZUTANI, MASAOMI; KATO, TOMOYUKI; NAGAOKA, AKIRA; TOMITA, YOSHIHIKO; NEMOTO, KENJI

    2015-01-01

    The current study reports the case of a large retroperitoneal tumor treated with modified simultaneous integrated boost (SIB) radiotherapy. A 45-year-old female presented to the emergency department complaining of left abdominal pain and fever. A computed tomography scan detected a retroperitoneal tumor of 12×16×16 cm, and a biopsy revealed a poorly-differentiated adenocarcinoma. The patient was diagnosed with a large adenocarcinoma originating from the left ureter, with no distant metastasis. Due to the patient's poor physical condition, surgery was not recommended, and the patient was referred to the Department of Radiation Oncology (Yamagata University Hospital, Yamagata, Japan). Modified SIB radiotherapy was administered following the acquisition of written consent from the patient. The total irradiation dose to the center of the tumor and to the surrounding healthy tissue was ?96 Gy/33 fractions and <60 Gy/33 fractions, respectively. At the end of the radiotherapeutic course, the tumor volume was reduced by ?80%, and the residual tumor was surgically resected. As a result of the resection, a complete pathological response was confirmed; the patient has been recurrence-free for >3 years with no complications. Modified SIB radiotherapy may be safely administered, with favorable outcomes. Complete recovery can be achieved with this technique, even in a patient with a large radioresistant tumor. PMID:26137100

  9. Multidetector CT urography of renal fusion anomalies.

    PubMed

    Türkvatan, Aysel; Olçer, Tülay; Cumhur, Turhan

    2009-06-01

    Renal fusion anomalies, in which both kidneys are fused togeher in early embyronic life, are rarely encountered. Once a fused kidney is diagnosed or suspected, further laboratory and imaging evaluation should be performed to assess the status of the kidneys and to look for treatable causes of renal pathology. The early dignosis of potential complications that can accompany this anomaly must be made in order to prevent permanent renal damage. The advantage of multidetector computed tomographic (MDCT) urography is its ability to depict the normal urinary tract anatomy, including both the renal parenchyma, and collecting structures and ureters. MDCT urography is helpful to screen for the presence of stones, hydronephrosis or masses. Additionally, it provides information about the vascular supply of the fused kidneys. Therefore, MDCT urography enables a comprehensive evaluation of patients with renal fusion anomalies in a single examination. Especially three-dimensional reformatted images can provide good delineation of congenital fusion anomalies of the kidney. In this study we report our experience with MDCT urography for the anatomic demonstration of renal fusion anomalies. PMID:19517383

  10. GPs have key role in early diagnosis of endometriosis.

    PubMed

    Coleman, Laura; Overton, Caroline

    2015-03-01

    Endometriosis is defined as the presence of endometrial-like tissue outside the uterus. Deposits are commonly distributed on the ovaries, uterosacral ligaments, pouch of Douglas, rectum and sigmoid colon, bladder and ureter. Endometriosis is common, affecting 10% of the female adult population and up to 50% of women with infertility. Risk factors include early menarche, late menopause, delayed childbearing, vaginal outflow obstruction and a first-degree relative affected. Women commonly present to their GP with pelvic pain, painful intercourse or subfertility. Classically the pain starts several days before the period which is extremely painful. After the period, symptoms tend to improve until mid-cycle when the pattern repeats again. Patients also complain of fatigue. Abdominal palpation, bimanual and speculum examination are important to identify signs of endometriosis, but also to exclude alternative diagnoses such as fibroid uterus, infection or pregnancy. However, a normal examination does not exclude a diagnosis of endometriosis. Serum CA125 can be raised in endometriosis but is not specific or sensitive for the condition and is therefore not recommended as a screening test. A normal pelvic ultrasound scan does not exclude a diagnosis of endometriosis. The gold standard investigation for endometriosis is laparoscopy and biopsy with histological confirmation. Referral should be considered if pain is not controlled with simple analgesia or the diagnosis is suspected in a woman who is actively trying to conceive. Early referral should be considered in women with abnormal examination findings, or an abnormal ultrasound result. PMID:26062268

  11. Pelvic kidney: associated diseases and treatment.

    PubMed

    Cinman, Nadya M; Okeke, Zeph; Smith, Arthur D

    2007-08-01

    The incidence of pelvic kidney has been approximated at between 1 in 2200 and 1 in 3000. The ectopic kidney is thought to be no more susceptible to disease than the normally positioned kidney, except for the development of calculi and hydronephrosis. Because of the greater risk of injuring aberrant vessels or overlying abdominal viscera and nerves, the pelvic kidney presents special treatment challenges. Alternative approaches to treating nephrolithiasis may yield better outcomes. The tortuous ureter often associated with a pelvic kidney hinders deflection of the flexible ureteroscope, potentially limiting access. Laparoscopy-guided intervention permits visual exposure of the kidney, enhancing safe puncture and tract placement integral to percutaneous nephrolithotomy. Laparoscopy-assisted anterior retrograde percutaneous nephroscopy involves percutaneous access using a Hunter-Hawkins retrograde nephrostomy needle with adjunctive laparoscopy to permit viewing and manipulation of overlying bowel. Ureteropelvic junction (UPJ) obstruction has been reported to occur in 22% to 37% of ectopic kidneys. Endoscopic incision presents difficulties beyond those of anatomically normal kidneys. The laparoscopic approach provides good surgical exposure, and operative times are comparable to those of laparoscopic pyeloplasty in anatomically normal kidneys. To date, only a handful of cases of malignancy in a pelvic kidney have been described. Like a nonfunctioning anatomically normal kidney, a nonfunctional pelvic kidney may require primary removal. There are a few reports of laparoscopic pelvic nephrectomy. Additional studies are needed to compare the various treatments for disease of the pelvic kidney in order to decide which options have the most beneficial outcomes. PMID:17867938

  12. Dose audit for patients undergoing two common radiography examinations with digital radiology systems

    PubMed Central

    ?nal, Tolga; Ataç, Gökçe

    2014-01-01

    PURPOSE We aimed to determine the radiation doses delivered to patients undergoing general examinations using computed or digital radiography systems in Turkey. MATERIALS AND METHODS Radiographs of 20 patients undergoing posteroanterior chest X-ray and of 20 patients undergoing anteroposterior kidney-ureter-bladder radiography were evaluated in five X-ray rooms at four local hospitals in the Ankara region. Currently, almost all radiology departments in Turkey have switched from conventional radiography systems to computed radiography or digital radiography systems. Patient dose was measured for both systems. The results were compared with published diagnostic reference levels (DRLs) from the European Union and International Atomic Energy Agency. RESULTS The average entrance surface doses (ESDs) for chest examinations exceeded established international DRLs at two of the X-ray rooms in a hospital with computed radiography. All of the other ESD measurements were approximately equal to or below the DRLs for both examinations in all of the remaining hospitals. Improper adjustment of the exposure parameters, uncalibrated automatic exposure control systems, and failure of the technologists to choose exposure parameters properly were problems we noticed during the study. CONCLUSION This study is an initial attempt at establishing local DRL values for digital radiography systems, and will provide a benchmark so that the authorities can establish reference dose levels for diagnostic radiology in Turkey. PMID:24317331

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

    PubMed Central

    2013-01-01

    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

  14. Calculus-related ureteral intussusception: A case report and literature review

    PubMed Central

    Sewell, James; Blecher, Gideon; Tsai, Ken; Bishop, Conrad

    2015-01-01

    Introduction Ureteral intussusception is a rarely reported condition, primarily as a complication of ureteric tumours. Fewer than 30 case reports have been made. This case represents the first reported case, to our knowledge, of ureteral intussusception caused by a ureteric calculus. Presentation of case We present the case of a 70 year old man with a history of conservatively managed renal calculi, in whom obstructive ureterolithiasis was incidentally detected. Retrograde pyelography and ureteroscopy revealed intussusception of the ureter around a calculus. Extensive biopsies revealed no evidence of tumour, and the intussusception resolved following stone clearance. Discussion Literature review of previously reported cases of ureteral intussusception revealed 26 cases, of which 22 were secondary to tumour and 4 were secondary to surgical procedures. We propose a mechanism by which calculus-related ureteral intussusception may occur, and suggest treatment for this condition. Conclusion Calculus-related ureteral intussusception is a rare condition, of which this represents the only case report. Management of the condition should involve excluding the presence of tumour, and then clearing the stone, avoiding the use of a basket for retrieval of fragments. PMID:26011803

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

    PubMed

    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

    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

  16. Radiation-induced endometriosis in Macaca mulatta

    SciTech Connect

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

    1991-05-01

    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.

  17. Bifunctional irrigation liquid as an ideal energy converter for laser lithotripsy with nanosecond laser pulses

    NASA Astrophysics Data System (ADS)

    Reichel, Erich; Schmidt-Kloiber, Heinz; Paltauf, Guenther; Groke, Karl

    1991-07-01

    The intracorporal lithotripsy of ureter stones using laser pulses with a duration of 8 to 20 ns is carried out by means of energy converters. These devices have the purpose to transform the optical energy of the laserlight into mechanical energy of shockwaves, which cause the intended stone fragmentation. Therefore this method is independent of any optical property of the stone. For the endoscopic lithotripsy a continuous flow of irrigation liquid must be supplied to ensure a clear field of view and to transport the small stone fragments out of the body. In the case of the method developed by us, a second function is appointed to this liquid: the energy conversion. In transparent liquids, conversion of the optical energy is done by the laser-induced breakdown (LIB), which produces mechanical shockwaves. To release such a LIB, the laserpulse intensity must exceed a certain threshold. To achieve a LIB in the liquid at the fiber exit there are two possibilities. First, the fiber exit is spherically shaped, which leads to a kind of focus between fiber and stone. Second, the threshold intensity of the liquid is lowered. This is performed by addition of minimal amounts of Fe+++-ions. To obtain a stable and physiologically applicable irrigation solution the Fe+++-ions were added to isotonic saline solution in form of a dextran complex.

  18. Hand-Assisted Retroperitoneoscopic Nephroureterectomy With Bladder Cuffing After Preperitoneal and Retroperitoneal Perivesical Ballooning

    PubMed Central

    Kim, Chang Hee; Kim, Kwang Taek; Kim, Khae Hawn

    2014-01-01

    Purpose We aimed to describe the surgical technique of hand-assisted retroperitoneoscopic nephroureterectomy (HARNU) with bladder cuffing after preperitoneal and retroperitoneal perivesical ballooning. Materials and Methods From March 2008 to September 2012, we performed HARNU and open bladder cuffing in 28 consecutive series of patients with upper urinary tract urothelial carcinoma. We performed HARNU according to the following procedure: (1) a camera port incision was made on the posterior axillary line; (2) multiple, repeated, preperitoneal and retroperitoneal ballooning was performed on both the posterior axillary line and in the umbilicus; (3) a 7.0 cm skin incision was made from the suprapubic to the lower inguinal with the balloon present in the extraperitoneal area; (4) hand-assisted laparoscopic retroperitoneal nephroureterectomy; (5) cessation of gas insufflation; and (6) extravesical cuffing as an open surgical procedure. Results The mean estimated blood loss was 250 mL. The mean operation time was 240 minutes. The mean time to oral intake and ambulation was 1.0 day and two days, respectively. As for postoperative complications due to the hand-assisted device, one patient developed febrile urinary tract infection within three weeks postoperatively and was hospitalized again to receive parenteral antibiotics. Conclusions We made a low Gibson incision for a route for the hand-assisted procedure as well as a window for open surgery in dissecting the distal ureter and extracting the surgical specimens. Thus, our results indicate that the HARNU might be a feasible surgical modality. PMID:24466394

  19. Upper urinary tract urothelial carcinoma: what have we learned in the last 4 years?

    PubMed Central

    Remzi, Mesut; Shariat, Shahrokh; Huebner, Wilhelm; Fajkovic, Harun; Seitz, Christian

    2011-01-01

    In the last 4 years many studies have been published on the topic of upper urinary tract urothelial carcinoma (UTUC). This is a recent review of the available literature of the last 3 years. A systematic Medline/PubMed search on UTUC including limits for clinical trials and randomized, controlled trials was performed for English-language articles using the keywords ‘upper urinary tract carcinoma’, ‘nephroureterectomy’, ‘laparoscopic’, ‘ureteroscopy’, ‘percutaneous’, ‘renal pelvis’, ‘ureter’ and their combinations from January 2008 to December 2010. Additional selected reports from 2007 were included. Case reports and non-English literature were excluded. Publications were mostly retrospective, including some large, multicentre studies from the Upper Tract Urothelial Carcinoma Collaboration (UTUCC). The authors of this article are members of the UTUCC. Altogether, 92 original articles dealing with UTUC were identified and summarized. The vast majority of the available literature has a low level of evidence (level IV), although many multicentre studies tried to overcome the problem of low numbers by pooling data. It was concluded that in the last 3 years our knowledge regarding UTUC has increased dramatically, although new study concepts allowing us to increase the level of evidence are needed. PMID:21869907

  20. [Fetal urology].

    PubMed

    Jakobovits, Akos; Jakobovits, Antal

    2009-06-14

    Although it becomes vitally important only after birth, renal function already plays significant role in maintaining fetal metabolic equilibrium. The kidneys significantly contribute to production of amniotic fluid. Adequate amount of amniotic fluid is needed to stimulate the intrauterine fetal respiratory activity. Intrauterine breathing is essential for lung development. As a result, oligohydramnion is conducive to pulmonary hypoplasia. The latter may lead to neonatal demise soon after birth. In extrauterine life kidneys eliminate nitrogen containing metabolic byproducts. Inadequate renal function results therefore lethal uremia. Integrity of ureters and the urethra is essential for the maintenance of renal function. Retention of urine causes degeneration of the functional units of the kidneys and ensuing deterioration of renal function. Intrauterine kidney puncture or shunt procedure may delay this process in some cases. On the other hand, once renal function has been damaged, no therapy can restart it. Certain anomalies of renal excretory pathways may also be associated with other congenital abnormalities, making the therapeutic efforts pointless. Presence of these associated intrauterine defects makes early pregnancy termination a management alternative, as well as it affects favorably perinatal mortality rates. PMID:19739276

  1. [Ureterovaginal fistulae].

    PubMed

    Muzzonigro, Giovanni; Tombolini, Flavia

    2015-01-01

    Ureterovaginal fistulae are pathological communications between the ureter and the vagina; it commonly occur as a rare but serious sequela of unrecognized distal ureteral injuries during pelvic operations. Patients may present symptoms as leakage of urine from the vagina, flank pain and fever; in some cases it could be possible also the loss of renal function. The purpose of this study is to review the articles from 1991 to 2014 to evaluate the most correct diagnostic procedures and endourological and surgical techniques used in the management of ureterovaginal fistula. Nowadays computered tomography and retrograde pielography are the most commonly diagnostic modalities used to identify fistulous tract and to describe its anatomical position. The major of ureterovaginal fistulae can be successfully managed by conservative methods. Modern endourological treatment will result in resolution of a ureterovaginal fistula if retrograde or anterograde passage of a suitable internal stent is feasible. When stenting failed or in complicated cases, ureteral reimplantation is necessary. Ureteroneocystostomy, psoas hitch and Boari flap are three different possible surgical techniques used to realized an ureteral reimplantation. Both open and mini invasive (laparoscopy and robot assisted) surgical approach have proved successful. PMID:25754410

  2. Constitutive TL1A expression under colitogenic conditions modulates the severity and location of gut mucosal inflammation and induces fibrostenosis.

    PubMed

    Barrett, Robert; Zhang, Xiaolan; Koon, Hon Wai; Vu, Michelle; Chang, Jyh-Yau; Yeager, Nicole; Nguyen, Mary Ann; Michelsen, Kathrin S; Berel, Dror; Pothoulakis, Charalabos; Targan, Stephan R; Shih, David Q

    2012-02-01

    Intestinal fibrostenosis is a hallmark of severe Crohn's disease and can lead to multiple surgeries. Patients with certain TNFSF15 variants overexpress TL1A. The aim of this study was to determine the effect of TL1A overexpression on intestinal inflammation and the development of fibrostenosis. We assessed the in vivo consequences of constitutive TL1A expression on gut mucosal inflammation and fibrostenosis using two murine models of chronic colitis. In the dextran sodium sulfate (DSS) and adoptive T-cell transfer models, there was proximal migration of colonic inflammation, worsened patchy intestinal inflammation, and long gross intestinal strictures in Tl1a transgenic compared to wild-type littermates. In the DSS model, myeloid- and T-cell-expressing Tl1a transgenic mice had increased T-cell activation markers and interleukin-17 expression compared to wild-type mice. In the T-cell transfer model, Rag1(-/-) mice receiving Tl1a transgenic T cells had increased interferon-? expression but reduced T-helper 17 cells and IL-17 production. Narrowed ureters with hydronephrosis were found only in the Tl1a transgenic mice in all chronic colitis models. In human translational studies, Crohn's disease patients with higher peripheral TL1A expression also exhibited intestinal fibrostenosis and worsened ileocecal inflammation with relative sparing of rectosigmoid inflammation. These data show that TL1A is an important cytokine that not only modulates the location and severity of mucosal inflammation, but also induces fibrostenosis. PMID:22138299

  3. Origin of Parietal Podocytes in Atubular Glomeruli Mapped by Lineage Tracing

    PubMed Central

    Schulte, Kevin; Berger, Katja; Boor, Peter; Jirak, Peggy; Gelman, Irwin H.; Arkill, Kenton P.; Neal, Christopher R.; Kriz, Wilhelm; Floege, Jürgen; Smeets, Bart

    2014-01-01

    Parietal podocytes are fully differentiated podocytes lining Bowman’s capsule where normally only parietal epithelial cells (PECs) are found. Parietal podocytes form throughout life and are regularly observed in human biopsies, particularly in atubular glomeruli of diseased kidneys; however, the origin of parietal podocytes is unresolved. To assess the capacity of PECs to transdifferentiate into parietal podocytes, we developed and characterized a novel method for creating atubular glomeruli by electrocoagulation of the renal cortex in mice. Electrocoagulation produced multiple atubular glomeruli containing PECs as well as parietal podocytes that projected from the vascular pole and lined Bowman’s capsule. Notably, induction of cell death was evident in some PECs. In contrast, Bowman’s capsules of control animals and normal glomeruli of electrocoagulated kidneys rarely contained podocytes. PECs and podocytes were traced by inducible and irreversible genetic tagging using triple transgenic mice (PEC- or Pod-rtTA/LC1/R26R). Examination of serial cryosections indicated that visceral podocytes migrated onto Bowman’s capsule via the vascular stalk; direct transdifferentiation from PECs to podocytes was not observed. Similar results were obtained in a unilateral ureter obstruction model and in human diseased kidney biopsies, in which overlap of PEC- or podocyte-specific antibody staining indicative of gradual differentiation did not occur. These results suggest that induction of atubular glomeruli leads to ablation of PECs and subsequent migration of visceral podocytes onto Bowman’s capsule, rather than transdifferentiation from PECs to parietal podocytes. PMID:24071005

  4. Initial experience with full-length metal stent to relieve malignant ureteral obstruction.

    PubMed

    Borin, James F; Melamud, Ori; Clayman, Ralph V

    2006-05-01

    Ureteral obstruction caused by extrinsic compression by a malignancy generally can be overcome initially with a ureteral stent. However, the long-term failure rate is high, usually necessitating placement of a nephrostomy tube. Herein, we present the initial case, in this country, of intractable ureteral obstruction managed successfully with the newly developed all-metal Resonance stent (Cook Ireland Ltd., Limerick, Ireland) constructed of MP35N alloy, a composite of nonmagnetic nickel-cobalt-chromium-molybdenum. The patient is a 64-year-old woman with metastatic breast cancer causing retroperitoneal fibrosis and ureteral obstruction diagnosed laparoscopically. The obstruction failed to respond to placement of a single 7F double-J stent and then of two 6F double-J stents in the left ureter. As a last resort, in order to avoid nephrostomy-tube placement, the 6F metal stent was placed; this provided unobstructed flow of urine, as documented on a subsequent Whitaker test and, most recently, on a renal scan, 4 months after initial stent placement. PMID:16724898

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

    NASA Technical Reports Server (NTRS)

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

    1999-01-01

    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.

  6. Urothelial Signaling

    PubMed Central

    Andersson, Karl-Erik

    2013-01-01

    The urothelium, which lines the inner surface of the renal pelvis, the ureters, and the urinary bladder, not only forms a high-resistance barrier to ion, solute and water flux, and pathogens, but also functions as an integral part of a sensory web which receives, amplifies, and transmits information about its external milieu. Urothelial cells have the ability to sense changes in their extracellular environment, and respond to chemical, mechanical and thermal stimuli by releasing various factors such as ATP, nitric oxide, and acetylcholine. They express a variety of receptors and ion channels, including P2X3 purinergic receptors, nicotinic and muscarinic receptors, and TRP channels, which all have been implicated in urothelial-neuronal interactions, and involved in signals that via components in the underlying lamina propria, such as interstitial cells, can be amplified and conveyed to nerves, detrusor muscle cells, and ultimately the central nervous system. The specialized anatomy of the urothelium and underlying structures, and the possible communication mechanisms from urothelial cells to various cell types within the bladder wall are described. Changes in the urothelium/lamina propria (“mucosa”) produced by different bladder disorders are discussed, as well as the mucosa as a target for therapeutic interventions. PMID:23589830

  7. Urinary tract anomalies in patients with anorectal malformation.

    PubMed

    Islam, M N; Hasina, K; Reza, M S; Hasanuzzaman, S M; Akter, T; Talukder, S A

    2015-04-01

    Urinary tract anomalies are common associated anomalies in anorectal malformation (ARM) and major contributory factor for high morbidity and mortality in ARM. In this study, urinary tract anomalies were evaluated in 72 patients of ARM (43 high varieties & 29 low varieties) that were admitted in Dhaka Medical College & Hospital (DMCH) during the period of January 2007 to April 2008. In all cases, evaluation was done by ultrasonogram (USG) and voiding cysto-urethrography (VCUG). Intravenous urography (IVU) was done in selected cases. Urinary tract anomalies were found in 20(27.85%) cases of ARM patients. These anomalies were significantly higher 16(37.2%) in high variety of ARM than 4(13.8%) those with low variety of ARM. The pattern of urological anomalies were vesicoureteral reflux (VUR - 35%), hydronephrosis due to PUJ obstruction (25%), posterior urethral valve (PUV - 15%), renal agenesis (10%), duplex ureter (10%) and bladder diverticulum (5%). Before definite management of ARM urological evaluation is essential to prevent renal damage and to reduce the morbidity and mortality. PMID:26007265

  8. Ureteroscopy-assisted retrograde nephrostomy (UARN) without ureteral access sheath (UAS)

    PubMed Central

    Kawahara, Takashi; Ito, Hiroki; Terao, Hideyuki; Uemura, Hiroji; Yao, Masahiro; Matsuzaki, Junichi

    2015-01-01

    Introduction We previously described ureteroscopy assisted retrograde nephrostomy (UARN). In UARN, it is possible to continuously visualize the dilation of the ureter from puncture to insertion of the nephroaccess sheath with minimal complication. But in the course of making nephrostomy, UARN requires ureteral access sheath (UAS). UAS has a potential risk of ureteral stricture. Herein, we report the first case of UARN without the use of UAS. Presentation of case A 53-year-old female was referred to our hospital for treatment of her right renal stone. Because her stone burden was 27 mm, we planned to perform percutaneous nephrolithotomy (PCNL) using UARN without UAS. Discussion UAS facilitates a decrease in the intrarenal pressure due to irrigation, and it makes controlling the URS easier. However, in terms of the risk of ureteral stricture, unnecessary insertion of a UAS should be avoided. Conclusion We describe the first case of a renal stone successfully treated by PCNL using the UARN method without the use of a UAS. PMID:25813125

  9. Cancer survival in Incheon, Republic of Korea, 1997-2001.

    PubMed

    Woo, Z H; Hong, Y C; Kim, W C; Pu, Y K

    2011-01-01

    The Incheon cancer registry was established in 1997. Cancer is not a notifiable disease, hence registration of cases is done by active methods. The registry contributed survival data for 42 cancer sites or types registered during 1997-2001. The follow-up information has been obtained predominantly by passive methods, with median follow-up ranging between 1-44 months for various cancers. The proportion with histologically verified diagnosis for different cancers ranged between 16-100%; death certificates only (DCOs) comprised 0-51%; 49-100% of total registered cases were included for the survival analysis. The top-ranking cancers on 5-year age-standardized relative survival rates were testis (98%), thyroid (90%), ureter (87%), adrenal gland (86%), nonmelanoma skin (83%), corpus uteri (82%), Hodgkin lymphoma (81%), breast and cervix (74%). Five-year relative survival by age group showed a decreasing trend with increasing age groups for cancers of the stomach, small intestine, colon, gall bladder, larynx, lung, breast, cervix and ovary, and was fluctuating for other cancers. PMID:21675420

  10. The unacknowledged impact of urinary schistosomiasis in children: 5 cases from Kumasi, Ghana.

    PubMed

    Antwi, S; Aboah, K E K; Sarpong, C K G

    2014-12-01

    Urinary schistosomiasis is a parasitic disease caused by Shistosoma haematobium. It is prevalent in several parts of Africa particularly in areas where there are large water bodies. In most affected communities, the condition is often accepted as normal since to them, all growing children pass blood in their urine and "grow out of it". Mass treatment of school children has been a regular exercise often undertaken by stake holders to decrease the disease burden and reduce transmission in selected communities. Urinary schistosomiasis can have devastating impact on the urinary tract which is often unacknowledged and unevaluated. Such omission could have implication for progressive renal damage which, if not detected and treated, could lead to end stage renal failure and death. We present five (5) cases of urinary schistosomiasis with severe obstructive uropathy seen at the paediatric nephrology/urology units of Komfo Anokye Teaching Hospital, Ghana. All five cases had some degree of anaemia and hypertension. Two of the five cases presented with end stage renal failure and died subsequently whilst two underwent successful surgery. One made a spontaneous recovery from the urinary obstruction though still has significant renal impairment. This potential devastating effect of urinary schistosomiasis on the kidneys calls for thorough evaluation and assessment of each confirmed case to include blood pressure measurement, full blood count, and ultrasonography of the urinary system. Mass screening programmes should be combined with portable ultrasonography of the kidneys, ureters and bladder. PMID:25709140

  11. Microfilaruria in onchocerciasis

    PubMed Central

    Buck, Alfred A.; Anderson, Robert I.; Colston, John A. C.; Wallace, Craig K.; Connor, Daniel H.; Harman, Louis E.; Donner, Martin W.; Ganley, James P.

    1971-01-01

    Microfilariae of O. volvulus were recovered from the urine of 11% of the residents of a village in the Republic of Chad where onchocerciasis was holoendemic. A follow-up study of the same population 3 years after the original investigation revealed that microfilaruria was still present and that living microfilariae of O. volvulus could be recovered from small urine samples obtained by high catherization of the ureters. Radiological changes consistent with chronic pyelitis were found in 4 out of 14 persons with microfilaruria who were examined by retrograde pyelography. The recovery of microfilariae in the urine was associated with the intensity of the infection, as determined by counts of microfilariae in skin snips and the number of onchocercomata. A systematic comparison for differences between onchocerciasis patients with and without microfilaruria revealed that the microfilaruria patients had a low weight: height ratio, deficient antibody responses in indirect haemagglutination tests with O. volvulus antigen, elevated serum aminotransferase levels, and reduced systolic blood pressure. ImagesFig. 1Fig. 2Fig. 8 PMID:5316914

  12. Kidney Stones

    PubMed Central

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

    1980-01-01

    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

  13. Dero (Allodero) lutzi Michaelsen, 1926 (Oligochaeta: Naididae) associated with Scinax fuscovarius (Lutz, 1925) (Anura: Hylidae) from Semi-deciduous Atlantic Rain Forest, southern Brazil.

    PubMed

    Oda, Fh; Petsch, Dk; Ragonha, Fh; Batista, Vg; Takeda, Am; Takemoto, Rm

    2015-01-01

    Amphibians are hosts for a wide variety of ecto- and endoparasites, such as protozoans and parasitic worms. Naididae is a family of Oligochaeta whose species live on a wide range of substrates, including mollusks, aquatic macrophytes, sponges, mosses, liverworts, and filamentous algae. However, some species are known as endoparasitic from vertebrates, such as Dero (Allodero) lutzi, which is parasitic of the urinary tracts of frogs, but also have a free-living stage. Specimens in the parasitic stage lack dorsal setae, branchial fossa, and gills. Here we report the occurrence of D. (A.) lutzi associated with anuran Scinax fuscovarius from Semi-deciduous Atlantic Rain Forest in southern Brazil. The study took place at the Caiuá Ecological Station, Diamante do Norte, Paraná, southern Brazil. Seven specimens of S. fuscovarius were examined for parasites but only one was infected. Parasites occurred in ureters and urinary bladder. Previous records of this D. (A.) lutzi include the Brazilian States of Santa Catarina, São Paulo, Rio de Janeiro, and Minas Gerais, as well as Cuba and North America. This is a new locality record for this species in Brazil. Reports of Dero (Allodero) lutzi are rare, due to difficulty of observation, and such events are restricted only the fortuitous cases. It is important to emphasize the necessity of future studies, which are fundamental to the understanding of biological and ecological aspects of this species. PMID:25945624

  14. Chronic expanding hematoma in the retroperitoneal space: a case report

    PubMed Central

    2013-01-01

    Background Chronic expanding hematoma is a rare condition that develops after surgery, trauma, or injury. It can also develop at any location in the body in the absence of trauma. Clinical findings and various diagnostic imaging modalities can aid in the differential diagnosis of this condition. In general, hematomas are naturally reabsorbed and rarely cause serious problems. However, hematomas that develop slowly without a history of trauma, surgery, or bleeding disorders could be difficult to differentiate from soft tissue neoplasms. In the present case, we describe a patient, without any history or physical evidence of trauma, who exhibited a large chronic expanding hematoma in the retroperitoneal space that resulted in hydronephrosis because of the pressure exerted on the left ureter. Case presentation A 69-year-old man presented to our hospital with a swollen lesion in the left flank. A mass, 19 cm in diameter, was detected in the retroperitoneal space by computed tomography. We suspected the presence of a chronic expanding hematoma, soft tissue tumor, or left renal artery aneurysm. Surgical treatment was performed. However, postoperative histopathological examination indicated that the mass was a nonmalignant chronic expanding hematoma. No recurrence was observed during a 2-year follow-up period. Conclusion In patients without a history of trauma who present slowly growing masses, the differential diagnosis should include chronic expanding hematoma in addition to cysts and soft tissue tumors. Moreover, the use of magnetic resonance imaging and computed tomography is essential to differentiate between chronic expanding hematoma and soft tissue tumors. PMID:24237992

  15. Role of cyclooxygenase-2 in the development of interstitial fibrosis in kidneys following unilateral ureteral obstruction in mice.

    PubMed

    Kamata, Mariko; Hosono, Kanako; Fujita, Tomoe; Kamata, Kouju; Majima, Masataka

    2015-03-01

    Unilateral ureteral obstruction (UUO) induced tubulointerstitial fibrosis in kidneys mimics the pathogenesis of chronic kidney diseases and is considered a suitable model for studying the mechanisms leading to fibrosis. To study the role of cyclooxygenase-2 (COX-2) in kidney fibrosis, we investigated whether a selective COX-2 inhibitor, celecoxib, affected renal interstitial fibrosis during UUO in mice. To induce UUO, the left proximal ureter was ligated in male C57BL/6 mice. The mice were fed a diet with or without celecoxib from the day of UUO induction. Following UUO, the renal pelvis was observed to be dilated and the kidney cortex was significantly thinner than that of sham-operated mice. Immunofluorescent staining of type I, III, and IV collagen in UUO kidneys revealed that interstitial collagen deposition was significantly increased in the celecoxib-treated group. Expression of type I, III, and IV collagen in UUO kidneys was also significantly higher in the celecoxib-treated group than in the vehicle-treated group. In the celecoxib-treated group, mRNA levels of TGF-?/FGF-2 were also significantly higher than those in the vehicle-treated group. The present study demonstrates that COX-2 plays a protective role against fibrosis in UUO kidneys and suggests that supplementation of COX-2 products, such as PG analogues, will be a good option for preventing interstitial fibrosis. PMID:25776498

  16. 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

    2012-01-01

    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

  17. Technical complications in organ procurement.

    PubMed

    Fernández, E Domínguez; Schmid, M; Schlosser, K; Mauer, D

    2007-12-01

    It is of crucial importance that harvested organs are not discarded because of lesions inflicted during the procurement operation. From January 2005 to January 2006, a total of 395 organs were procured: 266 kidneys, 102 livers, and 27 pancreas. Two kidneys were lost due to vascular lesions, and 1 liver could not be transplanted because of a severe parenchymal injury (0.75% total organ losses). In 33 of 198 cases (16.7%) despite lesions to renal vessels or to the ureter, the kidneys were transplanted after back-table repair procedures. Vascular lesions were observed in 10% of the evaluated livers (8 of 102) and in 3 of 18 pancreatic grafts. In the literature, a total organ loss of 0.75% because of technical problems demonstrates a high standard of visceral organ procurement in our region. Hence, reparable vascular and ureteral lesions in 10% to 16.4% indicated the need for better surgical training and standardization in procurement techniques. We believe that double-checking both the organ and quality reports and giving immediate feedback to the procurement surgeons in cases of technical problems are effective ways to perform quality control. It must be our goal to increase the response rate of the quality forms. PMID:18089303

  18. A Biomechanical Model of Artery Buckling

    PubMed Central

    Han, Hai-Chao

    2010-01-01

    The stability of arteries under blood pressure load is essential to the maintenance of normal arterial function and the loss of stability can lead to tortuosity and kinking that are associated with significant clinical complications. However, mechanical analysis of arterial bent buckling is lacking. To address this issue, this paper presents a biomechanical model of arterial buckling. Using a linear elastic cylindrical arterial model, the mechanical equations for arterial buckling were developed and the critical buckling pressure was found to be a function of the wall stiffness (Young’s modulus), arterial radius, length, wall thickness, and the axial strain. Both the model equations and experimental results demonstrated that the critical pressure is related to the axial strain. Arteries may buckle and become tortuous due to reduced (sub-physiological) axial strain, hypertensive pressure, and a weakened wall. These results are in accordance with, and provide a possible explanation to the clinical observations that these changes are the risk factors for arterial tortuosity and kinking. The current model is also applicable to veins and ureters. PMID:17689541

  19. Immunoglobulin G4-Related Retroperitoneal Fibrosis Treated with Hochuekkito, a Kampo Medicine, following Steroid Treatment.

    PubMed

    Fukuchi, Minoru; Sakurai, Shinji; Kogure, Toshiaki; Naitoh, Hiroshi; Kuwano, Hiroyuki

    2014-05-01

    We report a case of immunoglobulin G4 (IgG4)-related retroperitoneal fibrosis (RF) with complete remission and no relapses after therapy with steroids and Hochuekkito, a Kampo (i.e. traditional Japanese herbal) medicine. A 62-year-old Japanese man was admitted to our hospital for treatment of a retroperitoneal mass detected by computed tomography. The mass had a maximum diameter of 11.0 cm; it involved the left ureter and was associated with left hydronephrosis. After inserting a ureteral stent, we performed a biopsy by laparotomy. Histopathology revealed IgG4-related RF. The lesion disappeared after 7 months of steroid therapy. We subsequently used Hochuekkito as an alternative maintenance treatment because of steroid-related complications. The patient has not relapsed in the 3 years since starting the medication. To the best of our knowledge, this is the first case of IgG4-related RF treated with Hochuekkito as a maintenance treatment. PMID:24987323

  20. TERT promoter mutations are associated with distant metastases in upper tract urothelial carcinomas and serve as urinary biomarkers detected by a sensitive castPCR

    PubMed Central

    Liu, Li; Yuan, Xiaotian; Liu, Jikai; Kong, Feng; Wang, Chang; Ren, Hongbo; Yan, Keqiang; Hu, Sanyuan; Xu, Zhonghua; Björkholm, Magnus; Fan, Yidong; Zhao, Shengtian; Liu, Cheng; Xu, Dawei

    2014-01-01

    TERT promoter C228T and C250T mutations occur in various malignancies including bladder cancer (BC) and may serve as urinary tumor markers. However, the mutation association with clinical variables in upper tract urothelial carcinomas (UTUCs) is unclear. There is also a lack of sensitive tools to detect the minor mutant TERT promoter in bulk urinary DNA. Here we analyzed 220 UTUC patients [98 with renal pelvic carcinoma (RPC) and 122 with ureter carcinoma (UC)] and developed a Competitive Allele-Specific TaqMan PCR (castPCR) for urinary assay. We identified C228T or C250T mutations in 42 of 98 (43%) RPC and 23 of 122 (19%) UC tumors. Distant metastases were significantly correlated with UTUC patients harboring TERT promoter mutations (P = 0.001). C228T were detected in 6/10 and 9/10 of urine samples from patients with mutation-carrying tumors using Sanger sequencing and castPCR, respectively. When urine samples from 70 BC patients were analyzed together, the sensitivity of urinary C228T assay was 89% and 50% for castPCR and Sanger sequencing, respectively (P < 0.001). Collectively, TERT promoter mutations occur in UTUCs with a high frequency in RPCs and predict distant metastasis. castPCR assays of the mutation are a useful tool for urine-based diagnostics of urological malignancies. PMID:25474136

  1. Minimally invasive surgical management of ureteropelvic junction obstruction: laparoscopic and robot-assisted laparoscopic pyeloplasty.

    PubMed

    Munver, Ravi; Del Pizzo, Joseph J; Sosa, R Ernest; Poppas, Dix P

    2003-01-01

    Ureteropelvic junction (UPJ) obstruction is characterized by a functionally significant impairment of urinary transport caused by an intrinsic or extrinsic obstruction in the area where the ureter joins the renal pelvis. The majority of cases are congenital in origin; however, acquired conditions at the level of the ureteropelvic junction may also present with symptoms and signs of obstruction. Until recently, open pyeloplasty and endoscopic techniques have been the main surgical options, with the intent of complete excision or incision of the obstruction. The introduction of laparoscopy and robot-assisted applications has allowed for minimally invasive reconstructive surgery that mirrors open surgical techniques. These techniques offer substantial benefits to patients by reducing morbidity, hastening postoperative recovery, and improving cosmetic outcome. During the last decade, laparoscopic pyeloplasty has garnered much interest. However, because of the technically challenging nature of this procedure, it is performed only at select medical centers by surgeons with advanced laparoscopic training. The recent introduction of robotics to the field of minimally invasive surgery may facilitate this procedure and allow for more widespread implementation by surgeons of varying skill levels. This review is limited primarily to the treatment of congenital or acquired UPJ obstruction via laparoscopic and robot-assisted laparoscopic pyeloplasty. Herein, we report the early results, ongoing evolution, and potential future role for these novel surgical procedures. PMID:14649575

  2. [Quality of life in patients with a modified Mainz-pouch II urinary diversion].

    PubMed

    Dzami?, Z; Hadzi-Djoki?, J; Tuli?, C; Vuksanovi?, A; Lali?, N; A?imovi?, M; Janici?, A; Durutovi?, O

    1999-01-01

    The type of urinary derivation after radical cystectomy due to urinary bladder carcinoma does not influence survival substantially, but it may influence the quality of life of the patients very much. One of modifications of classical ureterosigmoidostomy that has been focused by urologist in recent years in the sigma rectum pouch (Mainy pouch II), for its substantially improved aspects of quality of life and earlier occupational rehabilitation of these patients. In the period August 1994 through March 1998 we made Meinz pouch II (the modification implies fixation of the pouch to the parietal peritoneum and implantation of the ureter into the pouch as suggested by Camey-Le-Duc). This surgical technique is associated with lots of advantages as the continent form of urinary derivation, and as a fairly simple surgical technique it is an improvement in this type of surgery. Intactness of the abdominal wall (no urostoma), frequency of defecation/urination in 3-4 hr intervals during the day and 4-5 hours during the night, absolutely volitonal control of these functions, rapid postoperative recovery with stabilization of renal function parameters, low percentage of ascending infections, higher degree of occupational rehabilitation, i.e. lower incidence of disability and good psychosocial status are all advantages of this method in the light of the quality of life of these otherwise very difficult patients. PMID:10951770

  3. [Continent urostomy: sigmoid reservoir and sigmoid hydraulic valve].

    PubMed

    Benchekroun, A; Lachkar, A; Bouslikhane, N; Nouini, Y; Benslimane, L; Farih, M H; Belahnech, Z; Marzouk, M; Faik, M

    1997-01-01

    We report our experience of continent sigmoidostomy. The technique consisted in urinary diversion with sigmoid pouch and hydraulic valve. Eleven patients underwent this procedure (10 men and 1 women, mean age 48 years, range 20 to 77 years). Indications were bladder tumor in 7 cases, bladder exstrophy in 2 patients, neurogenic bladder in 1 case and 1 bladder with a small capacity secondary to a stricture of traumatic urethra. The pouch was made according to the detubularized model. The sigmoid was opened on its antimesenteric edge, leaving the distal portion of the sigmoid intended to do the sigmoid valve. The posterior edges of the colonic segment opened were alined then secured by a Dexon 3/0 whipping then the anterior adges were secured, as the former after reimplantation of the ureters according to Camey Leduc or Politano Leadbetter's procedure. The post operative follow-up was marked by a fistula of the pouch in one case treated by securing it. All the patients were continent day and night. The purpose of this study was the description of the technique and the results of the continent sigmoïdostomy. PMID:9765769

  4. Simultaneous Cystectomy and Nephroureterectomy due to Synchronous Upper Urinary Tract Tumors and Invasive Bladder Cancer: Open and Laparoscopic Approaches

    PubMed Central

    Pérez-Utrilla Pérez, Manuel; Aguilera Bazán, Alfredo; Alonso Dorrego, José M.; Vitón Herrero, Rebeca; Cisneros Ledo, Jesús; de la Peña Barthel, Javier

    2012-01-01

    Introduction It is not unusual for bladder tumors to appear following transitional cell carcinoma of the upper urinary tract (UUT), with involvement of the UUT, following invasive bladder cancer, being less common. The synchronous presence of transitional cell carcinoma of the bladder and of the UTT is exceptional. Methods Fifteen simultaneous cystectomies with nephroureterectomies were performed due to synchronous UUT and invasive bladder cancers (1997–2009). Surgery was performed using an open approach in 10 patients, while the last 5 procedures were performed laparoscopically. Results The mean age was 68.7 years. Mean surgery time was 348.6 minutes. Mean blood loss was 816 ml. Acute renal failure was the most frequent postoperative complication being present in 5 patients (33%). There was 1 case of a leak in the ureter-intestinal anastomosis (open approach), which required placement of a left-sided percutaneous nephrostomy. There were 2 cases of postoperative mortality, both in the open approach series and with intestinal neobladder. Mean follow-up time for the whole series was 21.25 months. Eight cases experienced metastatic progression of the disease (mean follow-up 17 months). Conclusion Though multi-site studies with longer follow-up and a greater numbers of patients are needed, the moment at which urothelial tumors appear seems to influence their prognosis, with lower survival rates for tumors that synchronically appear. PMID:24917718

  5. Wnt5a Is Necessary for Normal Kidney Development in Zebrafish and Mice

    PubMed Central

    Huang, Liwei; Xiao, An; Choi, Soo Young; Kan, Quane; Zhou, Weibin; Chacon-Heszele, Maria F.; Ryu, Yun Kyoung; McKenna, Sarah; Zuo, Xiaofeng; Kuruvilla, Rejji; Lipschutz, Joshua H.

    2015-01-01

    Background Wnt5a is important for the development of various organs and postnatal cellular function. Little is known, however, about the role of Wnt5a in kidney development, although WNT5A mutations were identified in patients with Robinow syndrome, a genetic disease which includes developmental defects in kidneys. Our goal in this study was to determine the role of Wnt5a in kidney development. Methods Whole-mount in situ hybridization was used to establish the expression pattern of Wnt5a during kidney development. Zebrafish with wnt5a knockdown and Wnt5a global knockout mice were used to identify kidney phenotypes. Results In zebrafish, wnt5a knockdown resulted in glomerular cyst formation and dilated renal tubules. In mice, Wnt5a global knockout resulted in pleiotropic, but severe, kidney phenotypes, including agenesis, fused kidney, hydronephrosis and duplex kidney/ureter. Conclusions Our data demonstrated the important role of Wnt5a in kidney development. Disrupted Wnt5a resulted in kidney cysts in zebrafish and pleiotropic abnormal kidney development in mice. PMID:25412793

  6. [The long-term "stone trail": treatment experience using ureterorenoscopy].

    PubMed

    Martov, A G; Kamalov, A A; Gushchin, B L

    1994-01-01

    A residual "stone trace" is not a rare finding after impulse destruction of large stones. A complex of conservative treatment of lithotripsy of the fragments and sand which comprise the sand trace are not universally effective. Long-standing "stone trace" is characterized by a single or several large fragments of the crushed stone, failure of both conservative and lithotripsy treatment, the trace existence surpassing 1 month. Ureterorenoscopy was used for the trace management in 41 patients. The trace (2-6.5 cm in length) was localized in the lower, middle and upper third of the ureter in 28, 10 and 3 patients, respectively. Transureteral lithotripsy and lithoextraction were made by ureterorenoscopes (11.5 and 12.5 Tr) and miniscope (9.5 Tr). Lithotripsy was made using ultrasonic electrohydraulic and pneumatic lithotriptors. In transureteral endoscopic destruction of long-standing traces the authors point out apparent inflammation in the ureteral wall at the trace side, ready-to-bleed ureteral mucosa, poor endoscopic image, preferable initial use of atraumatic pneumatic lithotripsy followed by lithoextraction, previous renal drainage by means of transcutaneous puncture nephrostomy in acute inflammation or advanced retention changes of the kidney, etc. Ureterorenoscopy proved able to eliminating the traces. Side effects were reported in the form of an episode of pyelonephritis aggravation cured conservatively in 17% of the cases. PMID:8017000

  7. The Retrograde and Retroperitoneal Totally Laparoscopic Hysterectomy for Endometrial Cancer

    PubMed Central

    Volpi, Eugenio; Bernardini, Luca; Ferrero, Anna Maria

    2012-01-01

    Introduction. We retrospectively report our experience with the utilization of an original procedure for total laparoscopic hysterectomy based on completely retrograde and retroperitoneal technique for surgical staging and treatment of the endometrial cancer. The surgical, financial, and oncological advantages are here discussed. Methods. The technique used here has been based on a combination of a retroperitoneal approach with a retrograde and lateral dissection of the bladder and retrograde culdotomy with variable resection of parametrium. No disposable instruments and no uterine manipulator were utilized. Results. Intraoperative and postoperative complications were observed in 10% of the cases overall. Operative time length and mean haemoglobin drop value results were 129?min and 125?mL, respectively. Most patients were dismissed on days 3–5 from the hospital. Seventy-eight percent of the patients were alive with no evidence of disease at mean followup of 49 months. Conclusions. Our original laparoscopic technique is based on a retroperitoneal approach in order to rapidly control main uterine vessels coagulation, constantly check the ureter, and eventually decide type and site of lymph nodes removal. This procedure has important cost saving implications and the avoidance of uterine manipulator is of matter in case such as these of uterine malignancy. PMID:22844589

  8. Endemic nephropathy and upper urothelial carcinoma - new insights in molecular biology.

    PubMed

    Jankovic Velickovic, Lj; Dolicanin, Z; Stefanovic, V

    2014-01-01

    (Full text is available at http://www.manu.edu.mk/prilozi). Upper Tract Urothelial Carcinoma (UTUC) is an uncommon disease which occurs more frequently in some regions of Balkan countries than in other areas in the world. Investigation of UTUC in the South Morava River basin and its tributaries where BEN is endemic revealed increased frequency not only of tumour of the renal pelvis and ureter but also of urinary bladder tumours. A comparative morphological and immunohistochemical study of UTUC in the BEN region and control rural and city populations free of BEN, identify growth pattern as the best morphological characteristic which differentiated BEN and control tumours, i.e. solid growth for BEN tumours and papillary for control tumours. Overexpression of tumour suppressor p53 as well as decreased expression of E-CD was detected in BEN tumours. Other cells cycle related molecular markers - Cyclin D1, p16, and HER-2 showed no difference in expression between groups, as well as the proliferative marker Ki-67. Investigation of apoptosis-related markers identifies Bax as a specific marker of BEN-associated UTUC. Decrease of the pro-apoptotic protein Bax together with alteration of Survivin may be indicative of specific disturbances of an intrinsic apoptotic pathway in UTUC arising in endemic areas. Key words: Balkan Endemic Nephropathy, Upper tract urothelial carcinoma, E-cadherin, Cells cycle related markers, Apoptosis. PMID:24802310

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

    PubMed

    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

    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

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

    PubMed Central

    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

    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

  11. [Side effects of the treatment of cervix cancer].

    PubMed

    Böttcher, H D; Schütz, J; Mathei, B

    1983-06-01

    Between 1962 and 1980, 237 patients with carcinomas of the cervix have been treated at the Radiologic Hospital of the University of Münster. With respect to the year of the treatment, six groups were formed depending on the observation period which was one year, two years, three years, four years, five years or more than five years. 68 women (29%) out of these groups had vesical reactions and 116 (49%) intestinal reactions. Most of the bladder reactions were early reactions appearing during the first three months, and the rate of vesical and intestinal troubles was higher after combined therapy with operation and irradiation than after primary radiotherapy. The therapy effects to bladder and intestine were classified by a method proposed by Holstein and Hess according to which even insignificant troubles are taken into consideration. 15 patients had stases concerning the ureters or kidneys. In five cases a rectovaginal fistula and in four cases a vesicovaginal fistula was demonstrated as a therapy effect. Furthermore, the following reactions were observed: radiation sickness, cutaneous reactions, marked vaginal fluor, heavy lumbago, general abdominal troubles, vaginal bleedings, fever after the insertion of radium as well as thrombosis and embolism. PMID:6879614

  12. [Efficiency of imaging methods (urography, CT contrast-enhanced) in acute stage of ureterolithiasis-interpretation problems based on description case and bibliography review].

    PubMed

    Piwo?ski, Maciej; Kucharczyk, Bartosz

    2013-01-01

    An osmotic diuresis phenomenon appearing in renal colic during urography was refered. The pressures occurent in renal pelvis during obstruction of ureter and normal conditions were described. The pressure surge patomechanism in renal collecting system as a cause of renal rupture and retroperitoneal extravasation of urine was discussed. Another causes of extravasation of urine were mentioned. Case description. The patient case with ureterolithiasis (stone placed in ureteric orifice) complicated with spontaneous pelvic rupture. The extravasation of urine and ureterolithiasis were confirmed by ultrasonography and urography. Temporary nephrostomy and antibiotic therapy were performed. The stone underwent spontaneous passage. Absence of characteristic symptoms of urine extravasation makes the diagnosis difficult, requiring additional imaging studys. Proper differentiation of real urine extravasation from diffusion through the renal parenchyma to the perirenal area due to osmotic diuresis is important part of diagnosis. Elevated inflammatory parameters and infection of urinary tract often coexist with peripelvic extravasation. Ureterolithiasis complicated by urinary tract infection requires renal drainage and antibiotic therapy as a first-line treatment. Either nephrostomy or antibiotic therapy are successful treatment of urine extravasation. PMID:24052980

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

    PubMed

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

    2004-01-01

    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

  14. Noncontrast helical CT for ureteral stones.

    PubMed

    Boridy, I C; Nikolaidis, P; Kawashima, A; Sandler, C M; Goldman, S M

    1998-01-01

    Noncontrast helical computed tomography (CT) has recently been found to be superior to excretory urography (IVU) in the evaluation of patients with suspected ureterolithiasis. Noncontrast helical CT does not require the use of intravenous contrast material with its associated cost and risk of adverse reactions and can be completed within 5 min, in most cases. Noncontrast CT often detects extraurinary pathology responsible for the patient's symptoms. CT is also more sensitive than IVU in detecting the calculus, regardless of its size, location, and chemical composition. However, confidently differentiating ureteral calculi from phleboliths along the course of the ureter may, at times, be difficult. The "tissue-rim" sign, a rim of soft tissue attenuation around the suspicious calcification, is helpful in making this distinction. Noncontrast CT does not provide physiological information about renal function and the degree of obstruction. A pilot study has suggested a proportional relationship between the extent of perinephric edema and the degree of obstruction. The cost of the examination and the radiation dose delivered to the patient may be higher with CT. Despite these limitations, noncontrast helical CT has quickly become the imaging study of choice in evaluating patients with acute flank pain. PMID:9542010

  15. Rat Urinary Bladder Carcinogenesis by Dual-Acting PPAR? + ? Agonists

    PubMed Central

    Oleksiewicz, Martin B.; Southgate, Jennifer; Iversen, Lars; Egerod, Frederikke L.

    2008-01-01

    Despite clinical promise, dual-acting activators of PPAR? and ? (here termed PPAR?+? agonists) have experienced high attrition rates in preclinical and early clinical development, due to toxicity. In some cases, discontinuation was due to carcinogenic effect in the rat urothelium, the epithelial layer lining the urinary bladder, ureters, and kidney pelvis. Chronic pharmacological activation of PPAR? is invariably associated with cancer in rats and mice. Chronic pharmacological activation of PPAR? can in some cases also cause cancer in rats and mice. Urothelial cells coexpress PPAR? as well as PPAR?, making it plausible that the urothelial carcinogenicity of PPAR?+? agonists may be caused by receptor-mediated effects (exaggerated pharmacology). Based on previously published mode of action data for the PPAR?+? agonist ragaglitazar, and the available literature about the role of PPAR? and ? in rodent carcinogenesis, we propose a mode of action hypothesis for the carcinogenic effect of PPAR?+? agonists in the rat urothelium, which combines receptor-mediated and off-target cytotoxic effects. The proposed mode of action hypothesis is being explored in our laboratories, towards understanding the human relevance of the rat cancer findings, and developing rapid in vitro or short-term in vivo screening approaches to faciliate development of new dual-acting PPAR agonist compounds. PMID:19197366

  16. Pharmacokinetic analysis of blood distribution of intravenously administered 153Gd-labeled Gd(DTPA)2- and 99mTc(DTPA) in rats.

    PubMed

    Wedeking, P; Eaton, S; Covell, D G; Nair, S; Tweedle, M F; Eckelman, W C

    1990-01-01

    Rat plasma distribution data obtained following IV administration of 99mTc(DTPA) alone or after co-administration of 99mTc(DTPA) and 153Gd-labeled Gd(DTPA)2- at 0.001, 0.1, and 1.0 mmol Gd/kg were evaluated using compartmental modeling techniques. A three-compartment open model was found to fit the data significantly better (P less than 0.01) than a two- or four-compartment open model. This model incorporates and links the plasma and urine data and includes a delay to account for the transit time through the kidneys/ureters. The two nonplasma compartments of the model were assumed to be related to rapidly and slowly equilibrating tissues. Tc(DTPA) and Gd(DTPA)2- had nearly identical pharmacokinetic profiles in plasma and the rate constants were essentially the same. No significant dose dependent pharmacokinetic differences were found for the range of Gd(DTPA)2- doses tested. Simulations of the proposed three-compartment model were used to generate concentration-time curves for each of the three compartments. PMID:2082126

  17. Genitourinary health in a population-based cohort of males with Duchenne and Becker muscular dystrophies

    PubMed Central

    Zhu, Yong; Romitti, Paul A.; Conway, Kristin M. Caspers; Kim, Sunkyung; Zhang, Ying; Yang, Michele; Mathews, Katherine D.

    2015-01-01

    Introduction Genitourinary (GU) health among patients with Duchenne and Becker muscular dystrophies (DBMD) has not been explored using population-based data. Methods Medical records of 918 males ascertained by the Muscular Dystrophy Surveillance, Tracking, and Research Network were reviewed for documentation of GU-related hospitalizations and prescribed medications. Percentages of males who received these medical interventions were calculated, hazard ratios (HR) and 95% confidence intervals (CI) were estimated for associations with sociodemographics (study site, race/ethnicity), symptoms (early-versus late-onset, ambulation status, scoliosis), and treatments (respiratory support, steroids). Results Among the 918 males, 81 (9%) had a GU condition; voiding dysfunction (n=40), GU tract infection (n=19), and kidney/ureter calculus (n=9) were most common. A Kaplan-Meier curve produced a cumulative probability of 27%. Cox regression showed GU conditions were more common when males were non-ambulatory (HR=2.7, 95% CI=1.3-5.6). Discussion These findings highlight increased awareness of GU health and multidisciplinary care of DBMD patients. PMID:25297835

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

    PubMed

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

    2012-07-24

    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

  19. Interleukin-12 and Trastuzumab in Treating Patients With Cancer That Has High Levels of HER2/Neu

    ClinicalTrials.gov

    2013-02-27

    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

  20. The History of Kidney Stone Dissolution Therapy: 50 Years of Optimism and Frustration With Renacidin

    PubMed Central

    Gonzalez, Ricardo D.; Whiting, Bryant M.

    2012-01-01

    Abstract Background and Purpose Over the last 50 years, chemolysis as a primary or adjuvant treatment for urinary stones has fallen in and out of favor. We review the literature for a historical perspective on the origins and chronology of Renacidin therapy, focusing on landmark studies and impracticalities that have seemingly condemned it to history. Materials and Methods A MEDLINE search was performed on the topic of chemolysis of urinary calculi. Historical literature was reviewed with regard to stone composition, treatment modalities, outcomes, and complications. Results A total of 61 articles were reviewed, 40 of which were case series, representing a total of 817 patients studied. Mulvaney first introduced Renacidin in 1959 as a modification of Suby and Albright's 1943 solution. Because of an overabundance of nonstandardized irrigation protocols, six deaths were reported in the early 1960s resulting in a Food and Drug Administration ban on the practice of upper urinary tract stone dissolution. Over time, Renacidin returned to the urologist's arsenal, appearing first as an adjunct to dissolve catheter and bladder calculi and later (1990) as an approved agent for renal pelvis and ureter use. This feat was almost single-handedly the result of a successful hemiacidrin case series published in 1971 by Nemoy and Stamey. By using daily urine cultures, prophylactic antibiotics, and meticulous intrarenal pressure monitoring, Nemoy and Stamey virtually eliminated all major irrigation complications, paving the way for a flurry of studies. More importantly, they established the link between residual struvite stones, persistent infection, and recurrent staghorn stone formation. Conclusions Dissolution of urinary calculi by chemolysis has been shown to be safe and effective if performed with sterile urine cultures, prophylactic antibiotics, and low intrapelvic pressures. The pioneers of this therapy are remembered for their attempts to develop an alternative to open surgery, and, in the process, solidified the “stone-free” concept for infection-based stones. PMID:21999455

  1. A Numerical Investigation of Peristaltic Waves in Circular Tubes

    NASA Astrophysics Data System (ADS)

    Xiao, Q.; Damodaran, M.

    Peristaltic pumping is a process of fluid transport arising from the progressive waves, which travel along the walls of a flexible channel. It is a primary physiological transport mechanism that is inherent in many tubular organs of the human body such as the ureter, the gastro-intestinal tract, the urethra, and so on. Many studies exist in literature with the aim of understanding the characteristics of peristaltic flow under the assumption of low Reynolds number and infinitely long wavelength in a two-dimensional channel. However, peristaltic pumping is also the mechanism used in other industrial applications such as the blood pump for which the Reynolds number has a moderately high value. As studies concerning moderate to high Reynolds number flow in the circular tube are rare in literature, in the present study, the peristaltic flow of an incompressible fluid is numerically simulated using the finite volume method for solving the incompressible Navier-Stokes equations in primitive variable formulation by means of an infinite train of sinusoidal waves traveling along the wall of an axi-symmetric tube. The computational model presented in this work covers a wider range of Reynolds number (0.01-100), wave amplitude (0-0.8), and wavelength (0.01-0.4) than the those attempted in previous studies reported in literature and some new results pertaining to the distribution of velocity, pressure, wall shear stress for different peristaltic flow conditions characterizing flow at moderately higher Reynolds number have been obtained. The effect of the wave amplitude, wavelength, and Reynolds number on the "flow trapping" mechanism induced by peristalsis has also been investigated here for higher ranges of values of the parameters characterizing peristalsis.

  2. Kidney stone ablation times and peak saline temperatures during Holmium:YAG and Thulium fiber laser lithotripsy, in vitro, in a ureteral model

    NASA Astrophysics Data System (ADS)

    Hardy, Luke A.; Wilson, Christopher R.; Irby, Pierce B.; Fried, Nathaniel M.

    2015-02-01

    Using a validated in vitro ureter model for laser lithotripsy, the performance of an experimental Thulium fiber laser (TFL) was studied and compared to clinical gold standard Holmium:YAG laser. The Holmium laser (? = 2120 nm) was operated with standard parameters of 600 mJ, 350 ?s, 6 Hz, and 270-?m-core optical fiber. TFL (? = 1908 nm) was operated with 35 mJ, 500 ?s, 150-500 Hz, and 100-?m-core fiber. Urinary stones (60% calcium oxalate monohydrate / 40% calcium phosphate), of uniform mass and diameter (4-5 mm) were laser ablated with fibers through a flexible video-ureteroscope under saline irrigation with flow rates of 22.7 ml/min and 13.7 ml/min for the TFL and Holmium laser, respectively. The temperature 3 mm from tube's center and 1 mm above mesh sieve was measured by a thermocouple and recorded during experiments. Total laser and operation times were recorded once all stone fragments passed through a 1.5-mm sieve. Holmium laser time measured 167 +/- 41 s (n = 12). TFL times measured 111 +/- 49 s, 39 +/- 11 s, and 23 +/- 4 s, for pulse rates of 150, 300, and 500 Hz (n = 12 each). Mean peak saline irrigation temperatures reached 24 +/- 1 °C for Holmium, and 33 +/- 3 °C, 33 +/- 7 °C, and 39 +/- 6 °C, for TFL at pulse rates of 150, 300, and 500 Hz. To avoid thermal buildup and provide a sufficient safety margin, TFL lithotripsy should be performed with pulse rates below 500 Hz and/or increased saline irrigation rates. The TFL rapidly fragmented kidney stones due in part to its high pulse rate, high power density, high average power, and reduced stone retropulsion, and may provide a clinical alternative to the conventional Holmium laser for lithotripsy.

  3. Growth on demand: Reviewing the mechanobiology of stretched skin

    PubMed Central

    Zöllner, Alexander M.; Holland, Maria A.; Honda, Kord S.; Gosain, Arun K.; Kuhl, Ellen

    2013-01-01

    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. redHere 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. redThis 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.redTo 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

  4. Effects of lateral funiculus sparing, spinal lesion level, and gender on recovery of bladder voiding reflexes and hematuria in rats.

    PubMed

    Ferrero, Sunny L; Brady, Tiffany D; Dugan, Victoria P; Armstrong, James E; Hubscher, Charles H; Johnson, Richard D

    2015-02-01

    Deficits in bladder function are complications following spinal cord injury (SCI), severely affecting quality of life. Normal voiding function requires coordinated contraction of bladder and urethral sphincter muscles dependent upon intact lumbosacral reflex arcs and integration of descending and ascending spinal pathways. We previously reported, in electrophysiological recordings, that segmental reflex circuit neurons in anesthetized male rats were modulated by a bilateral spino-bulbo-spinal pathway in the mid-thoracic lateral funiculus. In the present study, behavioral measures of bladder voiding reflexes and hematuria (hemorrhagic cystitis) were obtained to assess the correlation of plasticity-dependent recovery to the degree of lateral funiculus sparing and mid-thoracic lesion level. Adult rats received mid-thoracic-level lesions at one of the following severities: complete spinal transection; bilateral dorsal column lesion; unilateral hemisection; bilateral dorsal hemisection; a bilateral lesion of the lateral funiculi and dorsal columns; or a severe contusion. Voiding function and hematuria were evaluated by determining whether the bladder was areflexic (requiring manual expression, i.e., "crede maneuver"), reflexive (voiding initiated by perineal stroking), or "automatic" (spontaneous voiding without caretaker assistance). Rats with one or both lateral funiculi spared (i.e., bilateral dorsal column lesion or unilateral hemisection) recovered significantly faster than animals with bilateral lateral funiculus lesions, severe contusion, or complete transection. Bladder reflex recovery time was significantly slower the closer a transection lesion was to T10, suggesting that proximity to the segmental sensory and sympathetic innervation of the upper urinary tract (kidney, ureter) should be avoided in the choice of lesion level for SCI studies of micturition pathways. In addition, hematuria duration was significantly longer in males, compared to females, despite similar bladder reflex onset times. We conclude that the sparing of the mid-thoracic lateral funiculus on one side is required for early recovery of bladder reflex voiding function and resolution of hematuria. PMID:25137571

  5. Renal and systemic pH imaging by contrast-enhanced MRI.

    PubMed

    Raghunand, Natarajan; Howison, Christine; Sherry, A Dean; Zhang, Shanrong; Gillies, Robert J

    2003-02-01

    Perturbations of renal and systemic pH accompany diseases of the kidney, such as renal tubular acidosis, and the ability to image tissue pH would be helpful to assess the extent and severity of such conditions. A dual-contrast-agent strategy using two gadolinium agents, the pH-insensitive GdDOTP(5-) and the pH-sensitive GdDOTA-4AmP(5-), has been developed to generate pH maps by MRI. The renal pharmacokinetics of the structurally dissimilar pH-insensitive contrast agents GdDTPA(2-) and GdDOTP(5-) were found to be similar. On that basis, and on the basis of similarity of structure and charge, the renal pharmacokinetics of GdDOTP(5-) and GdDOTA-4AmP(5-) were assumed to be identical. Dynamic T(1)-weighted images of mice were acquired for 1 hr each following boluses of GdDOTP(5-) and GdDOTA-4AmP(5-). The time-varying apparent concentration of GdDOTP(5-) and the time-varying enhancement in longitudinal relaxation rate following GdDOTA-4AmP(5-) were calculated for each pixel and used to compute pH images of the kidneys and surrounding tissues. MRI pH maps of control mice show acidic regions corresponding to the renal papilla, calyx, and ureter. Pretreatment of mice with the carbonic anhydrase inhibitor acetazolamide resulted in systemic metabolic acidosis and accompanying urine alkalinization that was readily detected by this dual-contrast-agent approach. PMID:12541244

  6. Scaffold-enhanced albumin and n-butyl-cyanoacrylate adhesives for tissue repair: ex vivo evaluation in a porcine model.

    PubMed

    McNally-Heintzelman, Karen M; Riley, Jill N; Heintzelman, Douglas L

    2003-01-01

    An ex vivo study was conducted in a porcine model to compare the tensile strength of tissue samples repaired by three different repair methods: (i) scaffold-enhanced light-activated albumin protein solder, (ii) scaffold-enhanced n-butyl-cyanoacrylate adhesive, and (iii) conventional sutures. Biodegradable polymer scaffolds of controlled porosity were fabricated with poly(L-lactic-co-glycolic acid) (PLGA) and salt particles using a solvent-casting and particulate-leaching technique. Repairs were conducted on seventeen different tissues including the carotid, femoral, splenic, coronary, and pulmonary arteries, aorta, small intestine, ureter, sciatic nerve, spleen, atrium, kidney, muscle, skin, lung, liver and pancreas. Acute breaking strengths were measured and the data were analyzed by Student's T-test. The resultant repairs using the scaffold-enhanced light-activated adhesive (Group I) were found to yield equivalent tensile strengths to conventional sutures (Group III), with significantly smaller mean standard deviations (8% vs. 25%). The cyanoacrylate-doped scaffold (Group II) repairs performed extremely well with tensile strengths approximately 30% higher for organ tissue and approximately 20% higher for vascular tissue than with the other two repair techniques evaluated in this study. The addition of the polymer scaffold assists in tissue alignment and reduces problems associated with adhesive runaway from the repair site. With appropriate packaging, scaffold-enhanced adhesives offer the potential for quick application in the field by less skilled professionals, paraprofessionals and bystanders in emergency situations--both military and civilian--outside a hospital or clinic setting. PMID:12724912

  7. Vasohibin?1 deficiency enhances renal fibrosis and inflammation after unilateral ureteral obstruction

    PubMed Central

    Watatani, Hiroyuki; Maeshima, Yohei; Hinamoto, Norikazu; Yamasaki, Hiroko; Ujike, Haruyo; Tanabe, Katsuyuki; Sugiyama, Hitoshi; Otsuka, Fumio; Sato, Yasufumi; Makino, Hirofumi

    2014-01-01

    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

  8. Fgfr2 is integral for bladder mesenchyme patterning and function.

    PubMed

    Walker, K A; Ikeda, Y; Zabbarova, I; Schaefer, C M; Bushnell, D; De Groat, W C; Kanai, A; Bates, C M

    2015-04-15

    While urothelial signals, including sonic hedgehog (Shh), drive bladder mesenchyme differentiation, it is unclear which pathways within the mesenchyme are critical for its development. Studies have shown that fibroblast growth factor receptor (Fgfr)2 is necessary for kidney and ureter mesenchymal development. The objective of the present study was to determine the role of Fgfr2 in the bladder mesenchyme. We used Tbx18cre mice to delete Fgfr2 in the bladder mesenchyme (Fgfr2(BM-/-)). We performed three-dimensional reconstructions, quantitative real-time PCR, in situ hybridization, immunolabeling, ELISAs, immunoblot analysis, void stain on paper, ex vivo bladder sheet assays, and in vivo decerebrated cystometry. Compared with control bladders, embryonic day 16.5 (E16.5) Fgfr2(BM-/-) bladders had thin muscle layers with less ?-smooth muscle actin and thickened lamina propria with increased collagen type Ia and IIIa that intruded into the muscle. The reciprocal changes in mutant layer thicknesses appeared partly due to a cell fate switch. From postnatal days 1 to 30, Fgfr2(BM-/-) bladders demonstrated progressive muscle loss and increased collagen expression. Postnatal Fgfr2(BM-/-) bladder sheets exhibited decreased agonist-mediated contractility and increased passive stretch tension versus control bladder sheets. Cystometry revealed high baseline and threshold pressures and shortened intercontractile intervals in Fgfr2(BM-/-) versus control bladders. Mechanistically, whereas Shh expression appeared normal, mRNA and protein readouts of hedgehog activity were increased in E16.5 Fgfr2(BM-/-) versus control bladders. Moreover, E16.5 Fgfr2(BM-/-) bladders exhibited higher levels of Cdo and Boc, hedgehog coreceptors that enhance sensitivity to Shh, compared with control bladders. In conclusion, loss of Fgfr2 in the bladder mesenchyme leads to abnormal bladder morphology and decreased compliance and contractility. PMID:25656370

  9. Characteristics of adherence of enteroaggregative Escherichia coli to human and animal mucosa.

    PubMed Central

    Yamamoto, T; Endo, S; Yokota, T; Echeverria, P

    1991-01-01

    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

  10. A Secreted BMP Antagonist, Cer1, Fine Tunes the Spatial Organization of the Ureteric Bud Tree during Mouse Kidney Development

    PubMed Central

    Chi, Lijun; Saarela, Ulla; Railo, Antti; Prunskaite-Hyyryläinen, Renata; Skovorodkin, Ilya; Anthony, Shelagh; Katsu, Kenjiro; Liu, Yu; Shan, Jingdong; Salgueiro, Ana Marisa; Belo, José António; Davies, Jamie; Yokouchi, Yuji; Vainio, Seppo J.

    2011-01-01

    The epithelial ureteric bud is critical for mammalian kidney development as it generates the ureter and the collecting duct system that induces nephrogenesis in dicrete locations in the kidney mesenchyme during its emergence. We show that a secreted Bmp antagonist Cerberus homologue (Cer1) fine tunes the organization of the ureteric tree during organogenesis in the mouse embryo. Both enhanced ureteric expression of Cer1 and Cer1 knock out enlarge kidney size, and these changes are associated with an altered three-dimensional structure of the ureteric tree as revealed by optical projection tomography. Enhanced Cer1 expression changes the ureteric bud branching programme so that more trifid and lateral branches rather than bifid ones develop, as seen in time-lapse organ culture. These changes may be the reasons for the modified spatial arrangement of the ureteric tree in the kidneys of Cer1+ embryos. Cer1 gain of function is associated with moderately elevated expression of Gdnf and Wnt11, which is also induced in the case of Cer1 deficiency, where Bmp4 expression is reduced, indicating the dependence of Bmp expression on Cer1. Cer1 binds at least Bmp2/4 and antagonizes Bmp signalling in cell culture. In line with this, supplementation of Bmp4 restored the ureteric bud tip number, which was reduced by Cer1+ to bring it closer to the normal, consistent with models suggesting that Bmp signalling inhibits ureteric bud development. Genetic reduction of Wnt11 inhibited the Cer1-stimulated kidney development, but Cer1 did not influence Wnt11 signalling in cell culture, although it did inhibit the Wnt3a-induced canonical Top Flash reporter to some extent. We conclude that Cer1 fine tunes the spatial organization of the ureteric tree by coordinating the activities of the growth-promoting ureteric bud signals Gndf and Wnt11 via Bmp-mediated antagonism and to some degree via the canonical Wnt signalling involved in branching. PMID:22114682

  11. Phosphodiesterase (PDE) inhibitors in the treatment of lower urinary tract dysfunction

    PubMed Central

    Ückert, Stefan; Oelke, Matthias

    2011-01-01

    Several disorders of the human upper and lower urinary tract, such as urinary stone disease, lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) and detrusor overactivity, can be therapeutically addressed by influencing the function of the smooth musculature of the ureter, prostate or urinary bladder, respectively. In order to ensure a drug effect without significant adverse events, a certain degree of tissue selectivity is mandatory. The treatment of said conditions aims to focus on orally available drugs acting via intracellular signalling pathways. Specifically, the cyclic nucleotide monophosphate cyclic GMP represents an important mediator in the control of the outflow region (bladder, urethra). The use of phosphodiesterase (PDE) inhibitors, such as sildenafil, tadalafil, vardenafil, avanafil or udenafil, known to restrain the degradation of the second messenger cyclic GMP, offers great opportunities in the treatment of lower urinary tract dysfunction. PDE inhibitors are regarded as efficacious, have a rapid onset of action and favourable effect-to-side-effect ratio. The role of PDE5 inhibitors in the treatment of BPH/LUTS and the overactive bladder has already been addressed in randomized, double-blind, placebo-controlled trials, as well as preliminary open-label studies enrolling either several hundreds or only 20 patients. The purpose of this review is to focus on the potential use and clinical significance of PDE inhibitors in the treatment of storage and voiding dysfunctions of the lower urinary tract. The strategy of modulating the activity of PDE isoenzymes might represent a novel approach in patients with lower urinary tract dysfunction (LUTD). PMID:21745238

  12. Uterine Artery Embolization for Ureteric Obstruction Secondary to Fibroids

    SciTech Connect

    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

    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.

  13. Dynamic, size-selective effects of protamine sulfate and hyaluronidase on the rat glomerular filtration barrier in vivo.

    PubMed

    Sverrisson, Kristinn; Axelsson, Josefin; Rippe, Anna; Asgeirsson, Daniel; Rippe, Bengt

    2014-11-15

    The proteinuric actions of protamine sulfate (PS) have classically been, at least partly, attributed to alterations of the negatively charged glomerular endothelial glycocalyx. To investigate whether the charge-selective properties of the glomerular filtration barrier (GFB) would be altered by PS, we assessed the glomerular sieving of conventional, uncharged, polydispersed Ficoll (n-Ficoll) compared with charge modified, conformationally intact, anionic (carboxymethylated) Ficoll (a-Ficoll) before and after systemic infusions of PS in rats. For comparison, we also investigated the impact of hyaluronidase (hyase), which partially degrades the glycocalyx, on GFB permeability. In anaesthetized Wistar rats, blood access was achieved, and the left ureter was cannulated for urine collection. Rats were infused with either n-Ficoll or a-Ficoll before and during systemic infusions with either PS or hyase. Plasma and urine samples were taken repeatedly and analyzed by high-performance size exclusion chromatography to assess glomerular sieving coefficients (?) for Ficoll (radius 10-80 Å). The GFB showed a significant glomerular charge selectivity for Ficoll molecules of radius 20-35 Å. PS and hyase infusions reversibly increased ? for large Ficoll molecules (Ficoll molecules of radius 50-80 Å). Thus, for PS, ? for a-Ficoll molecules of radius 70 Å increased from 2.47 × 10(-5) ± 1.1(-5) to 7.25 × 10(-5) ± 1.1(-5) (P < 0.05) at 15 min. For hyase, changes in a-Ficoll molecules of radius 50-80 Å were, however, not statistically significant. Neither PS nor hyase had any effect on ? for n-Ficoll molecules of radius 20-45 Å or a-Ficoll molecules of radius 20-45 Å. It is concluded that systemically administered PS and hyase in moderate doses dynamically decreased the size selectivity of the rat GFB without affecting its charge selective properties. PMID:25209861

  14. mTOR inhibition with temsirolimus causes acute increases in glomerular permeability, but inhibits the dynamic permeability actions of puromycin aminonucleoside.

    PubMed

    Axelsson, Josefin; Rippe, Anna; Rippe, Bengt

    2015-05-15

    Inhibitors of the mammalian target of rapamycin (mTORi) can produce de novo proteinuria in kidney transplant patients. On the other hand, mTORi has been shown to suppress disease progression in several animal models of kidney disease. In the present study, we investigated whether glomerular permeability can be acutely altered by the mTORi temsirolimus and whether mTORi can affect acute puromycin aminonucleoside (PAN) or angiotensin II (ANG II)-induced glomerular hyperpermeability. In anesthetized Wistar rats, the left ureter was cannulated for urine collection, while simultaneously blood access was achieved. Temsirolimus was administered as a single intravenous dose 30 min before the start of the experiments in animals infused with PAN or ANG II or in nonexposed animals. Polydispersed FITC-Ficoll-70/400 (molecular radius 10-80 Å) and (51)Cr-EDTA infusion was given during the whole experiment. Measurements of Ficoll in plasma and urine were performed sequentially before the temsirolimus injection (baseline) and at 5, 15, 30, 60, and 120 min after the start of the experiments. Urine and plasma samples were analyzed by high-performance size-exclusion chromatography (HPSEC) to assess glomerular sieving coefficients (?) for Ficoll10-80Å. Temsirolimus per se increased baseline glomerular permeability to Ficoll50-80Å 45 min after its administration, a reactive oxygen species (ROS)-dependent phenomenon. PAN caused a rapid and reversible increase in glomerular permeability, peaking at 5 min, and again at 60-120 min, which could be blocked by the ROS scavenger tempol. mTORi abrogated the second permeability peak induced by PAN. However, it had no effect on the immediate ANG II- or PAN-induced increases in glomerular permeability. PMID:25740597

  15. Correlation between MRI and double-balloon urethrography findings in the diagnosis of female periurethral lesions.

    PubMed

    Portnoy, Orith; Kitrey, Noam; Eshed, Iris; Apter, Sara; Amitai, Marianne M; Golomb, Jacob

    2013-12-01

    This study aims to evaluate the correlation of MRI findings with double-balloon urethrography (DBU) in diagnosing female urethral diverticula and other periurethral lesions. In this retrospective study, females with clinically suspected periurethral lesions who underwent both MRI and DBU between 2008 and 2012 were evaluated. MRI was performed on a 1.5 Tesla unit using a pelvic phased array coil. Protocol included small FOV pelvic images, multiplanar T2-w, T1-w with and without contrast injection. DBU was performed by a dedicated catheter. Images were evaluated in consensus by two readers. Diverticula were evaluated by, size, number, complexity, location and connection to urethra, and other periurethral lesions were evaluated by size, location and connection. Supplement clinical and surgical data were retrieved from medical records and telephone interviews. Seventeen females (mean age 44 years, range 20-69) were included in the study. Diverticula were diagnosed by both modalities (9 cases), by neither (6 cases, 88% correlation) by MRI alone (1 case) and by DBU alone (1 case). Among diverticula, correlation of number, complexity, location and demonstration of connection to urethra was 89%, 67%, 67%, and 56%, respectively. Alternative diagnosis solely by MRI included vaginal wall cysts (3 cases), endometriosis (1 case) and ectopic ureter (1 case). No periurethral lesion was found by either modality in 2 cases. The correlation between MRI and DBU in diagnosing female periurethral lesions is very good for anatomical delineation of diverticula. MRI, which does not involve radiation, may also indicate alternative diagnoses that can contribute to proper patient management. PMID:24016825

  16. Ureteroscopy for stone disease in the paediatric population: a systematic review.

    PubMed

    Ishii, Hiro; Griffin, Stephen; Somani, Bhaskar K

    2015-06-01

    The aim of the present review was to look at the role of ureteroscopy (URS) for treatment of paediatric stone disease. We conducted a systematic review using studies identified by a literature search between January 1990 and May 2013. All English-language articles reporting on a minimum of 50 patients aged ?18 years treated with URS for stone disease were included. Two reviewers independently extracted the data from each study. A total of 14 studies (1718 procedures) were reported in patients with a mean (range) age of 7.8 (0.25-18.0) years. The mean (range) stone burden was 9.8 (1-30) mm and the mean (range) stone-free rate (SFR) 87.5 (58-100)% with initial therapeutic URS. The majority of these stones were in the ureter (n = 1427, 83.4%). There were 180 (10.5%) Clavien I-III complications and 38 cases (2.2%) where there was a failure to complete the initial ureteroscopic procedure and an alternative procedure was performed. To assess the impact of age on failure rate and complications, studies were subcategorized into those that included children with either a mean age <6 years (four studies, 341 procedures) or a mean age >6 years. (10 studies, 1377 procedures). A higher failure rate (4.4 vs 1.7%) and a higher complication rate (24.0 vs 7.1%) were observed in children whose mean age was <6 years. URS for paediatric stone disease is a relatively safe procedure with a reasonably good SFR, but there seems to be a higher failure and complication rate in children aged <6 years. PMID:25203925

  17. Vitamin A deficiency in quail

    USGS Publications Warehouse

    Nestler, R.B.; Bailey, W.W.

    1943-01-01

    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.

  18. n-3 fatty acids inhibit defects and fatty acid changes caused by phenytoin in early gestation in mice.

    PubMed

    High, K A; Kubow, S

    1994-11-01

    Our previous work has shown that n-3 fatty acids exert a protective effect against phenytoin-induced cleft palate when phenytoin was administered midgestation [gestational days (GD) 12 and 13] to CD-1 mice. The effects of dietary n-3 fatty acids on phenytoin teratogenicity were investigated at an earlier gestational period (GD 9) to examine whether n-3 fatty acids could exert protective action against other teratogenic effects of phenytoin apart from cleft palate. The effect of phenytoin exposure on maternal hepatic polyunsaturated fatty acid composition was also studied since delta 6 desaturase activity has been shown to be modified by pharmacological action. Female CD-1 mice were fed a standard laboratory diet (SLD), safflower oil (SAFF) or a cod liver/linseed oil (CLO/LO)-based diet for three weeks prior to impregnation and throughout pregnancy. Pregnant mice were administered a single i.p. dose of phenytoin on GD 9, and teratological assessments were performed on GD 19. Tissues were harvested on GD 10 for maternal hepatic phospholipid fatty acid analysis from another group of phenytoin-treated mice. The CLO/LO and the SLD mice, as compared to the SAFF-fed animals, showed a reduction in total malformations and fetal growth retardation due to phenytoin. Open eye defect was the only anomaly induced by phenytoin in the CLO/LO fetuses while phenytoin produced a variety of malformations in the SAFF fetuses such as tail defects, cleft palate, open eye and absence or blockage of the ureter.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7869858

  19. Dynamic Real-time Microscopy of the Urinary Tract Using Confocal Laser Endomicroscopy

    PubMed Central

    Wu, Katherine; Liu, Jen-Jane; Adams, Winifred; Sonn, Geoffrey A.; Mach, Kathleen E.; Pan, Ying; Beck, Andrew H.; Jensen, Kristin C.; Liao, Joseph C.

    2014-01-01

    OBJECTIVES To develop the diagnostic criteria for benign and neoplastic conditions of the urinary tract using probe-based confocal laser endomicroscopy (pCLE), a new technology for dynamic, in vivo imaging with micron-scale resolution. The suggested diagnostic criteria will formulate a guide for pCLE image interpretation in urology. METHODS Patients scheduled for transurethral resection of bladder tumor (TURBT) or nephrectomy were recruited. After white-light cystoscopy (WLC), fluorescein was administered as contrast. Different areas of the urinary tract were imaged with pCLE via direct contact between the confocal probe and the area of interest. Confocal images were subsequently compared with standard hematoxylin and eosin analysis. RESULTS pCLE images were collected from 66 participants, including 2 patients who underwent nephrectomy. We identified key features associated with different anatomic landmarks of the urinary tract, including the kidney, ureter, bladder, prostate, and urethra. In vivo pCLE of the bladder demonstrated distinct differences between normal mucosa and neoplastic tissue. Using mosaicing, a post hoc image-processing algorithm, individual image frames were juxtaposed to form wideangle views to better evaluate tissue microarchitecture. CONCLUSIONS In contrast to standard pathologic analysis of fixed tissue with hematoxylin and eosin, pCLE provides real time microscopy of the urinary tract to enable dynamic interrogation of benign and neoplastic tissues in vivo. The diagnostic criteria developed in this study will facilitate adaptation of pCLE for use in conjunction with WLC to expedite diagnosis of urinary tract pathology, particularly bladder cancer. PMID:21601243

  20. Surgery-Related Complications and Sequelae in Management of Tuberculosis of Spine

    PubMed Central

    Moon, Myung-Sang; Moon, Young-Wan; Moon, Hanlim; Kim, Sung-Sim

    2014-01-01

    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

  1. Cancer mortality in four northern wheat-producing states.

    PubMed Central

    Schreinemachers, D M

    2000-01-01

    Chlorophenoxy herbicides are used both in cereal grain agriculture and in nonagricultural settings such as right-of-ways, lawns, and parks. Minnesota, North Dakota, South Dakota, and Montana grow most of the spring and durum wheat produced in the United States. More than 90% of spring and durum wheat is treated with chlorophenoxy herbicides, in contrast to treatment of approximately 30% of winter wheat. In this ecologic study I used wheat acreage as a surrogate for exposure to chlorophenoxy herbicides. I investigated the association of chlorophenoxy herbicides with cancer mortality during 1980-1989 for selected counties based on level of agriculture ([greater and equal to] 20%) and rural population ([greater and equal to] 50%). Age-standardized cancer mortality rates were determined for grouped counties based on tertiles of wheat acreage per county or for individual counties for frequently occurring cancers. The cancer sites that showed positive trends of increasing cancer mortality with increasing wheat acreage were esophagus, stomach, rectum, pancreas, larynx, prostate, kidney and ureter, brain, thyroid, bone, and all cancers (men) and oral cavity and tongue, esophagus, stomach, liver and gall bladder and bile ducts, pancreas, cervix, ovary, bladder, and other urinary organs, and all cancers (women). Rare cancers in men and women and cancers in boys and girls were studied by comparing counties above and below the median of wheat acreage per county. There was increased mortality for cancer of the nose and eye in both men and women, brain and leukemia in both boys and girls, and all cancers in boys. These results suggest an association between cancer mortality and wheat acreage in counties of these four states. PMID:11017893

  2. Cocaine-and Amphetamine-Regulated Transcript Peptide (CARTp): Distribution and Function in Rat Urinary Bladder

    PubMed Central

    Zvarova, K.; Herrera, G. M.; May, V.; Vizzard, M. A.

    2015-01-01

    We investigated the distribution of CARTp(55-102) in rat lower urinary tract and evaluated its effect on urinary bladder function in vitro. Immunohistochemistry and a vertical isolated tissue bath system were used. Neurons, clusters of non-neuronal endocrine cells, and nerve fibers stained positive for CARTp(55-102) in young adult rat urinary bladder. In addition, a dense plexus of CARTp-immunoreactive (IR) nerve fibers was detected in ureters and small blood vessels in the bladder. The CARTp-expressing neuronal elements were nitric oxide synthase (NOS)- and tyrosine hydroxylase (TH)-IR, whereas all non-neuronal CARTp-IR elements stained positively only for TH (100%). In isolated bladder strips, CARTp significantly increased the amplitude of electric field stimulation (EFS)-induced detrusor contractions at stimulation frequencies ? 12.5 Hz (p ? 0.001) as well as amplitude and frequency of spontaneous phasic urinary bladder smooth muscle (UBSM) contractions (p ? 0.05). The responses to CARTp stimulation were dose-dependent and increased in the presence of the urothelium. To determine if the CARTp-increase in nerve mediated contractions may involve an action of CARTp on specific neural pathways, we blocked cholinergic, purinergic and adrenergic pathways and determined CARTp actions on EFS-medicated contractions. CARTp enhancement of EFS-mediated contractions does not involve alteration in purinergic, adrenergic or cholinergic pathways. The study demonstrates that CARTp(55-102) is highly expressed in rat urinary bladder. CARTp increased the amplitude of EFS-induced detrusor contractions as well as the amplitude and frequency of spontaneous phasic urinary bladder smooth muscle contractions. We conclude that CARTp may alter the release of compounds from the urothelium that leads to an enhancement of UBSM contractility/excitability. PMID:24740629

  3. Concentration profiles of calcium and oxalate in urine, tubular fluid and renal tissue--some theoretical considerations.

    PubMed

    Hautmann, R; Osswald, H

    1983-02-01

    This paper analyzes some aspects of the pathophysiology of urolithiasis. It is emphasized that a better understanding of factors contributing to stone formation can only be gained when the primary nucleation site is identified. Three compartments are considered in which supersaturation as a precondition for stone formation could be present: urine in the urinary tract, tubular fluid from the glomerulus down to the duct of Bellini, and the interstitium of the medulla. From calculations based on micropuncture data it becomes apparent that the oxalate concentration in the tubular fluid at the bend of Henle's loop is 1 or 2 orders of magnitude lower than in the duct of Bellini and that the oxalate concentration maximum invariably must be located in the final urine. The calculation of a tubular concentration profile of oxalate shows, that the probability of intra luminal crystal formation is even less likely for plasma oxalate values of 2-3 microM as compared to 1.2 microM, which therefore should be the correct value. The time necessary for the growth of crystals up to a critical size which can obstruct tubules or ureter is not available in the urinary tract nor in the tubules. However, in the medullary interstitium, where solute concentration is highest, nearly unlimited time for crystal growth is available due to the fact, that in this compartment convective flow is very low. It is concluded that the interstitium of the inner medulla has the best chances to function as the primary nucleation site where particles can be formed of a size which subsequently can obstruct the urinary tract. PMID:6834526

  4. Iodine-125 prostate seed brachytherapy in renal transplant recipients: an analysis of oncological outcomes and toxicity profile

    PubMed Central

    Bucci, Joseph; Malouf, David

    2014-01-01

    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

  5. Retrospective evaluation of idiopathic hematuria and associated pathology in Grant's gazelles (Gazella granti): 10 cases.

    PubMed

    Georoff, Timothy A; Garner, Michael M; Hoover, John P; Backues, Kay A

    2009-12-01

    Ten cases of hematuria in Grant's gazelle (Gazella granti) (two male and eight female) from five institutions were examined and the clinicopathologic data summarized. Five gazelles died spontaneously and five were euthanized. All gazelles had marked hematuria without pyuria. Mean age at the onset of clinical signs and time of euthanasia or death was 5.0 +/- 1.4 yr and 8.2 +/- 3.7 yr, respectively. The severity of clinical signs with hematuria ranged from episodes of chronic intermittent hematuria to marked dysuria, with urinary bladder rupture secondary to obstructive blood clots in one case. Submandibular edema was the most common associated clinical sign (five of 10 cases). Serum chemistries from eight gazelles obtained during hematuria episodes revealed hypocalcemia (8/8), hypoproteinemia (7/8), hypoalbuminemia (7/8), and hyperphosphatemia (6/8). Fifty percent of the gazelles (4/8) developed anemia over the course of hematuria episodes. Prothrombin times and partial thromboplastin times were presumed increased in two of four animals evaluated. The predominant histologic lesions in seven of 10 gazelles reviewed were vascular necrosis, vasculitis, and perivasculitis in the urinary tract. Lesions in necropsied gazelles were identified in the urinary bladder (7/10 gazelles), kidney (3/10), and ureter (3/10). Additional urinary tract lesions included tubulointerstitial nephritis (5/10 gazelles), hemorrhagic cystitis (4/10), renal tubular necrosis (4/10), and subacute renal infarcts (2/10). Polymerase chain reaction testing on paraffin-embedded urinary tract tissue for alcelaphine herpesvirus-1 and -2, ovine herpesvirus-2, bluetongue virus, and epizootic hemorrhagic disease virus was negative for the six cases tested. One gazelle that had been vaccinated for Leptospira interrogans had a titer to serovar icterohaemorrhagiae, but serum from the six other gazelles tested was negative for all L. interrogans serovars. No exposure to any toxic agent was identified. An underlying cause for vascular lesions associated with episodic hematuria in Grant's gazelles remains to be determined. PMID:20063809

  6. End-to-end ureteral anastomosis and double-pigtail ureteral stent placement for treatment of iatrogenic ureteral trauma in two dogs.

    PubMed

    Wormser, Chloe; Clarke, Dana L; Aronson, Lillian R

    2015-07-01

    Case Description-A 6-month-old spayed female Soft-Coated Wheaten Terrier and 8-month-old spayed female Shih Tzu were referred because of complications related to inadvertent ureteral ligation and transection during recent ovariohysterectomy. Clinical Findings-The Soft-Coated Wheaten Terrier had a 2-day history of stranguria and polyuria that began after ovariohysterectomy. Initial examination findings were unremarkable with the exception of high rectal temperature. The Shih Tzu had a 10-day history of pyrexia, vomiting, diarrhea, and stranguria that began after ovariohysterectomy. On examination, the dog had signs of depression; clinicopathologic tests revealed hypoalbuminemia, neutrophilia, lymphocytosis, and monocytosis. Abdominal ultrasonography was performed for both dogs, revealing severe unilateral pyelectasia and hydroureter (proximal portion). Treatment and Outcome-Both dogs underwent exploratory celiotomy; ureteral ligation and transection was confirmed. Ventral cystotomy was performed to allow retrograde placement of a double-pigtail ureteral stent into the affected ureter and renal pelvis. End-to-end ureteral anastomosis was performed over the stent with the aid of an operating microscope. Stent position was confirmed via fluoroscopy, and incisions were closed routinely. Dogs continued to have intermittent signs of stranguria until stent removal via cystoscopy 6 or 7 weeks after surgery. Ultrasonographic examination of the urogenital tract was performed 2 or 4 months after surgery, revealing resolution of pyelectasia and hydroureter. Clinical Relevance-The surgical technique used provided a viable option for preserving renal function in dogs with focal, iatrogenic ureteral trauma. Use of a ureteral stent facilitated ureteral anastomosis and minimized postoperative complications. PMID:26086234

  7. Hereditary nonpolyposis colon cancer: Analysis of linkage to 2p 15-16 places the COCA1 locus telomeric to D2S123 and reveals genetic heterogeneity in seven Canadian families

    SciTech Connect

    Green, R.C.; Young, T.L. (Memorial Univ. of Newfoundland, St. John's (Canada)); Narod, S.A.; Tonin, P.; Ginsburg, O.; Miller, S. (Montreal General Hospital, Montreal (Canada) Royal Victoria Hospital, Montreal (Canada)); Morasse, J. (Hopital St-Francois d'Assise, Quebec City (Canada)); Cox, J.; Fitzgerald, G.W.N. (Grenfell Regional Health Services, St. Anthony, Newfoundland (Canada)); Jothy, S. (Royal Victoria Hospital, Montreal (Canada)) (and others)

    1994-06-01

    Hereditary nonpolyposis colon cancer (HNPCC) is an autosomal dominant trait responsible for approximately 6% of colorectal cancers. Linkage of the HNPCC trait to the D2S123 locus on 2p 15-16 has previously been reported in two families. This HNPCC locus is now designated [open quotes]COCA1[close quotes]. The authors have tested seven Canadian HNPCC families, who have a variety of clinical presentations, for linkage to a panel of microsatellite polymorphisms in the vicinity of D2S123. One family was clearly linked to the COCA1 locus (LOD = 4.21), and a second family is likely to be linked (LOD = 0.92). In three families linkage was excluded. In the remaining two families the data were inconclusive. In the linked family, individuals with cancer of the endometrium or ureter share a common haplotype with 12 family members with colorectal cancer. This supports the suspected association between these extracolonic neoplasms and the HNPCC syndrome. In addition, five of the six individuals with adenomatous polyps (but no colorectal cancer) have the same haplotype as the affected individuals, while the sixth carries a recombination. One individual with colorectal cancer carries a recombination that places the COCA1 locus telomeric to D2S123. This study localizes the COCA1 gene to an 8-cM region that is consistent with the location of the hMSH2 gene. The authors also confirm that families presently classified as HNPCC are genetically heterogeneous. 36 refs., 4 figs., 2 tabs.

  8. Congenital Vascular Anomalies.

    PubMed

    Gravereaux, Edwin C.; Nguyen, Louis L.; Cunningham, Leslie D.

    2004-04-01

    Congenital vascular anomalies are rare. The cardiovascular specialist should nevertheless be aware of the more common types of vascular anomalies and understand the implications for patient treatment and the likelihood of associated morbidity. The presentation of congenital arteriovenous malformations can range from asymptomatic or cosmetic lesions, to those causing ischemia, ulceration, hemorrhage, or high-output congestive heart failure. Treatment of large, symptomatic arteriovenous malformations often requires catheter-directed embolization prior to the attempt at complete surgical excision. Later recurrence, due to collateral recruitment, is frequent. Graded compression stockings and leg elevation are the mainstays of treatment for the predominantly venous congenital vascular anomalies. Most congenital central venous disorders are clinically silent. An exception is the retrocaval ureter. Retroaortic left renal vein, circumaortic venous ring, and absent, left-sided or duplicated inferior vena cava are relevant when aortic or inferior vena cava procedures are planned. The treatment of the venous disorders is directed at prevention or management of symptoms. Persistent sciatic artery, popliteal entrapment syndrome, and aberrant right subclavian artery origin are congenital anomalies that are typically symptomatic at presentation. Because they mimic more common diseases, diagnosis is frequently delayed. Delay can result in significant morbidity for the patient. Failure to make the diagnosis of persistent sciatic artery and popliteal entrapment can result in critical limb ischemia and subsequent amputation. Unrecognized aberrant right subclavian artery origin associated with aneurysmal degeneration can rupture and result in death. The treatment options for large-vessel arterial anomalies are surgical, sometimes in combination with endovascular techniques. PMID:15066242

  9. Brachylaima aspersae n. sp. (Digenea: Brachylaimidae) infecting farmed snails in NW Spain: morphology, life cycle, pathology, and implications for heliciculture.

    PubMed

    Segade, P; Crespo, C; García, N; García-Estévez, J M; Arias, C; Iglesias, R

    2011-02-10

    The life cycle of Brachylaima aspersae n. sp. (Trematoda: Brachylaimidae) in heliciculture farms is elucidated in light of field and experimental studies. Embryonated asymmetrical eggs (33.3 ?m × 20.2 ?m) are passed in the faeces of the definitive host, the domestic mouse (Mus musculus), and are ingested by its unique first intermediate host, the helicid snail Helix aspersa aspersa. After hatching, the miracidium develops into a highly branched sporocyst in the connective tissues of the digestive gland. Microcaudate cercariae emerging from this gastropod migrate up the ureter of the second intermediate host, the snails H. a. aspersa and H. a. maxima, and develop into non-encysted metacercariae in the kidney. Following predation of infected snails, the metacercariae develop into adults preferentially in the proximal portion of the duodenum of the definitive host. The strict oioxenic character for the first intermediate host, as well as the cercarial chaetotaxy (3 C(I)V+1 C(I)D, 10 C(II), 5 C(III)V, 14 C(III)L, 2 C(III)D, 16 H, 6 S(I), 6 S(II), 6 S(III), 2 A(I)L+1 A(I)V, 1 A(II)L, 3 ML, 1 P(I)L and 3 P(III)L), the distinct pars prostatica, the variable appearance of testes (rounded to irregular, with smooth or slightly to moderately lobulated margins), the size of eggs, the position of acetabulum (located somewhat posterior to the anterior third of body), and the microhabitat of the adult in the final host allow differentiation of B. aspersae from other well-known species in the genus. Massive infections with sporocysts or metacercariae of this brachylaimid may induce extensive pathological changes in the organs affected. Our results confirm that control of rodents in heliciculture farms is essential to minimize the potential health risks and morbimortality associated with this newly described species. PMID:21075524

  10. Blocking the Class I Histone Deacetylase Ameliorates Renal Fibrosis and Inhibits Renal Fibroblast Activation via Modulating TGF-Beta and EGFR Signaling

    PubMed Central

    Liu, Na; He, Song; Ma, Li; Ponnusamy, Murugavel; Tang, Jinhua; Tolbert, Evelyn; Bayliss, George; Zhao, Ting C.; Yan, Haidong; Zhuang, Shougang

    2013-01-01

    Background Histone deacetylase (HDAC) inhibitors are promising anti-fibrosis drugs; however, nonselective inhibition of class I and class II HDACs does not allow a detailed elucidation of the individual HDAC functions in renal fibrosis. In this study, we investigated the effect of MS-275, a selective class I HDAC inhibitor, on the development of renal fibrosis in a murine model of unilateral ureteral obstruction (UUO) and activation of cultured renal interstitial fibroblasts. Methods/Findings The UUO model was established by ligation of the left ureter and the contralateral kidney was used as a control. At seven days after UUO injury, kidney developed fibrosis as indicated by deposition of collagen fibrils and increased expression of collagen I, fibronectin and alpha-smooth muscle actin (alpha-SMA). Administration of MS-275 inhibited all these fibrotic responses and suppressed UUO-induced production of transforming growth factor-beta1 (TGF-beta), increased expression of TGF-beta receptor I, and phosphorylation of Smad-3. MS-275 was also effective in suppressing phosphorylation and expression of epidermal growth factor receptor (EGFR) and its downstream signaling molecule, signal transducer and activator of transcription-3. Moreover, class I HDAC inhibition reduced the number of renal tubular cells arrested in the G2/M phase of the cell cycle, a cellular event associated with TGF-beta1overproduction. In cultured renal interstitial fibroblasts, MS-275 treatment inhibited TGF-beta induced phosphorylation of Smad-3, differentiation of renal fibroblasts to myofibroblasts and proliferation of myofibroblasts. Conclusions and Significance These results demonstrate that class I HDACs are critically involved in renal fibrogenesis and renal fibroblast activation through modulating TGF-beta and EGFR signaling and suggest that blockade of class I HDAC may be a useful treatment for renal fibrosis. PMID:23342059

  11. Retroperitoneoscopic versus open mini-incision ureterolithotomy for upper- and mid-ureteric stones: a prospective randomized study.

    PubMed

    Prakash, Jai; Singh, Vishwajeet; Kumar, Manoj; Kumar, Manoj; Sinha, Rahul Janak; Sankhwar, Satyanarayan

    2014-04-01

    To compare the retroperitoneoscopic ureterolithotomy (RPLU) versus open mini-incision ureterolithotomy (MIOU) for large and impacted proximal or mid-ureteric stones in prospective randomized manner and to assess the outcome results. In a prospective randomized study between January 2009 and December 2012, 35 RPLU and 35 MIOU were included in the study. The indications for ureterolithotomy were as primary treatment of large and impacted stones more than 1.5 cm in the proximal and mid-ureter and as salvage treatment of failed ureteroscopy (URS)/extracorporeal shock wave lithotripsy (SWL). The two groups were compared for visual pain score on the first and second postoperative day, analgesic requirement, stone removal in one attempt, operative time, blood loss, postoperative complications, hospital stays and the period of convalescence. The difference in the visual pain score and the tramadol requirement was significantly higher in MIOU group. The hospital stay (RPLU 2.86 ± 0.43, MIOU 5.71 ± 0.67, P ? 0.001) and period of convalescence (RPLU 12.29 ± 4.06, MIOU 24.11 ± 5.55, P ? 0.001) were also significantly higher in MIOU group. The complications were 11.4 % (P ? 0.02) in RPLU versus 17.4 % in MIOU group. However, the stone removal in one attempt was similar in both groups. In condition of failed URS/SWL, unavailability of the full endoscopic armamentarium and limitation of costs, RPLU and MIOU both are safe and effective treatment options for large impacted upper- and mid-ureteric stones and RPLU has better tolerability, lesser hospital time and equal stone clearance rate. PMID:24272062

  12. Demographic characteristics and metabolic risk factors in Croatian children with urolithiasis.

    PubMed

    Miloševi?, Danko; Batini?, Danica; Turudi?, Daniel; Batini?, Danko; Topalovi?-Grkovi?, Marija; Gradiški, Ivan Pavao

    2014-03-01

    The aim of this study was to assess demographic data, clinical presentation, metabolic features, and treatment in 76 children with urolithiasis presented from 2002 to 2011. Urolithiasis is responsible for 2.5/1,000 pediatric hospitalizations, with new cases diagnosed in 1.1/1,000 admissions. From the observed period, two-fold rise of incidence rate was observed. Compiling the data from other pediatric institutions in our country, we estimated present overall incidence rate in Croatia as 6.5/100,000 children under 18 years. There were 41 boys and 35 girls (ratio 1.17:1). The mean age at diagnosis was 9.7 (range 0.8-16) years and follow-up duration was 5.3 (range 1.8-10) years. Renal colic (75.0 %) and hematuria (57.89 %) were the main symptoms. In 65.78 % of children, stones were unilateral. Stones were located in kidney in 52.63 %, in the ureter in 26.32 %, and in bladder in 6.58 % cases. Stone analysis showed calcium oxalate in 75.0 % of the cases. Associated urinary tract abnormalities were found in 19.73 % children. Most common metabolic disturbances were hypercalciuria (47.37 %) and idiopathic or mild hyperoxaluria (18.42 %). Urine saturation (EQUIL2) was elevated in 61.84 % cases. Spontaneous stone evacuation occurred in 51.21 % children. Extracorporeal shock wave lithotripsy, surgical evacuation, and endoscopic removal of calculi were performed in 21.0, 6.58, and 5.26 % of cases, respectively. Follow-up conservative therapy, consisting of fluid/diet recommendations and additional potassium citrate and/or chlorothiazide in children with increased risk, was sufficient for stone recurrence prevention in 92.1 % of children. In conclusion, the study gave insight in epidemiology and metabolic disturbances of urinary stone disease in Croatian children. PMID:24096520

  13. Ureteral wall thickness at the impacted ureteral stone site: a critical predictor for success rates after SWL.

    PubMed

    Sarica, Kemal; Kafkasli, Alper; Yazici, Özgür; Çetinel, Ali Cihangir; Demirkol, Mehmet Kutlu; Tuncer, Murat; ?ahin, Cahit; Eryildirim, Bilal

    2015-02-01

    The aim of the study was to determine the possible predictive value of certain patient- and stone-related factors on the stone-free rates and auxiliary procedures after extracorporeal shock wave lithotripsy in patients with impacted proximal ureteral calculi. A total of 111 patients (86 male, 25 females M/F: 3.44/1) with impacted proximal ureteral stones treated with shock wave lithotripsy were evaluated. Cases were retrieved from a departmental shock wave lithotripsy database. Variables analyzed included BMI of the case, diameter of proximal ureter and renal pelvis, stone size and Hounsfield unit, ureteral wall thickness at the impacted stone site. Stone-free status on follow-up imaging at 3 months was considered a successful outcome. All patients had a single impacted proximal ureteral stone. While the mean age of the cases was 46 ± 13 years (range 26-79 years), mean stone size was 8.95 mm (5.3-15.1 mm). Following shock wave lithotripsy although 87 patients (78.4%) were completely stone-free at 3-month follow-up visit, 24 (21.6%) cases had residual fragments requiring further repeat procedures. Prediction of the final outcome of SWL in patients with impacted proximal ureteral stones is a challenging issue and our data did clearly indicate a highly significant relationship between ureteral wall thickness and the success rates of shock wave lithotripsy particularly in cases requiring additional procedures. Of all the evaluated stone- and patient-related factors, only ureteral wall thickness at the impacted stone site independently predicted shock wave lithotripsy success. PMID:25417717

  14. Epidemiological urinalysis of children from kindergartens of Can Gio, Ho Chi Minh City - Vietnam

    PubMed Central

    2013-01-01

    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

  15. Relationship Between Spontaneous Passage Rates of Ureteral Stones Less Than 8 mm and Serum C-Reactive Protein Levels and Neutrophil Percentages

    PubMed Central

    Park, Chang Hyun; Ha, Ji Yong; Park, Choal Hee; Kim, Chun Il; Kim, Kwang Se

    2013-01-01

    Purpose A ureter obstruction caused by a ureteral stone results in inflammatory changes in the proximal submucosal layer and prevents the spontaneous passage of the ureteral stone. Accordingly, we analyzed the relationship between the spontaneous passage rates of ureteral stones less than 8 mm in size and serum C-reactive protein (CRP) levels and neutrophil percentages. Materials and Methods A total of 187 patients who were diagnosed with ureteral stones less than 8 mm in size and were managed consecutively at Keimyung University Dongsan Medical Center from January 2001 to January 2011 were retrospectively analyzed. Ureteral stone removal was defined as no ureteral stone shown in an imaging test without any treatment for 8 weeks after diagnosis. The patients were divided into three groups according to the levels of serum CRP and into two groups according to neutrophil percentage. The associations between these factors and ureteral stone passage rates were then examined. Results The ureteral stone passage rates of the low serum CRP level group, the medium serum CRP level group, and the high serum CRP level group were 94.1% (159/169), 70% (7/10), and 50.0% (4/8), respectively. The passage rates of ureteral stones in the group with a normal neutrophil percentage and in the group with a higher neutrophil percentage were 94.5% (121/128) and 83.1% (49/59), respectively (p=0.011). Conclusions Measuring serum CRP levels and neutrophil percentages in patients with small ureteral stones of less than 8 mm is useful in predicting whether the stone will be spontaneously passed. When the serum CRP level and neutrophil percentage of a patient are high, aggressive treatment such as extracorporeal shock wave lithotripsy should be considered. PMID:24044096

  16. Extended lymph node dissection in robot-assisted radical prostatectomy: lymph node yield and distribution of metastases

    PubMed Central

    Kim, Kwang Hyun; Lim, Sey Kiat; Koo, Kyo Chul; Han, Woong Kyu; Hong, Sung Joon; Rha, Koon Ho

    2014-01-01

    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

  17. Targeted microbubbles: a novel application for the treatment of kidney stones.

    PubMed

    Ramaswamy, Krishna; Marx, Vanessa; Laser, Daniel; Kenny, Thomas; Chi, Thomas; Bailey, Michael; Sorensen, Mathew D; Grubbs, Robert H; Stoller, Marshall L

    2015-07-01

    Kidney stone disease is endemic. Extracorporeal shockwave lithotripsy was the first major technological breakthrough where focused shockwaves were used to fragment stones in the kidney or ureter. The shockwaves induced the formation of cavitation bubbles, whose collapse released energy at the stone, and the energy fragmented the kidney stones into pieces small enough to be passed spontaneously. Can the concept of microbubbles be used without the bulky machine? The logical progression was to manufacture these powerful microbubbles ex vivo and inject these bubbles directly into the collecting system. An external source can be used to induce cavitation once the microbubbles are at their target; the key is targeting these microbubbles to specifically bind to kidney stones. Two important observations have been established: (i) bisphosphonates attach to hydroxyapatite crystals with high affinity; and (ii) there is substantial hydroxyapatite in most kidney stones. The microbubbles can be equipped with bisphosphonate tags to specifically target kidney stones. These bubbles will preferentially bind to the stone and not surrounding tissue, reducing collateral damage. Ultrasound or another suitable form of energy is then applied causing the microbubbles to induce cavitation and fragment the stones. This can be used as an adjunct to ureteroscopy or percutaneous lithotripsy to aid in fragmentation. Randall's plaques, which also contain hydroxyapatite crystals, can also be targeted to pre-emptively destroy these stone precursors. Additionally, targeted microbubbles can aid in kidney stone diagnostics by virtue of being used as an adjunct to traditional imaging methods, especially useful in high-risk patient populations. This novel application of targeted microbubble technology not only represents the next frontier in minimally invasive stone surgery, but a platform technology for other areas of medicine. PMID:25402588

  18. Targeted microbubbles: a novel application for the treatment of kidney stones

    PubMed Central

    Ramaswamy, Krishna; Marx, Vanessa; Laser, Daniel; Kenny, Thomas; Chi, Thomas; Bailey, Michael; Sorensen, Mathew D.; Grubbs, Robert H.; Stoller, Marshall L.

    2015-01-01

    Kidney stone disease is endemic. Extracorporeal shockwave lithotripsy was the first major technological breakthrough where focused shockwaves were used to fragment stones in the kidney or ureter. The shockwaves induced the formation of cavitation bubbles, whose collapse released energy at the stone, and the energy fragmented the kidney stones into pieces small enough to be passed spontaneously. Can the concept of microbubbles be used without the bulky machine? The logical progression was to manufacture these powerful microbubbles ex vivo and inject these bubbles directly into the collecting system. An external source can be used to induce cavitation once the microbubbles are at their target; the key is targeting these microbubbles to specifically bind to kidney stones. Two important observations have been established: (i) bisphosphonates attach to hydroxyapatite crystals with high affinity; and (ii) there is substantial hydroxyapatite in most kidney stones. The microbubbles can be equipped with bisphosphonate tags to specifically target kidney stones. These bubbles will preferentially bind to the stone and not surrounding tissue, reducing collateral damage. Ultrasound or another suitable form of energy is then applied causing the microbubbles to induce cavitation and fragment the stones. This can be used as an adjunct to ureteroscopy or percutaneous lithotripsy to aid in fragmentation. Randall’s plaques, which also contain hydroxyapatite crystals, can also be targeted to pre-emptively destroy these stone precursors. Additionally, targeted microbubbles can aid in kidney stone diagnostics by virtue of being used as an adjunct to traditional imaging methods, especially useful in high-risk patient populations. This novel application of targeted microbubble technology not only represents the next frontier in minimally invasive stone surgery, but a platform technology for other areas of medicine. PMID:25402588

  19. Predicting a successful ureteral access sheath insertion: a bi-center prospective study.

    PubMed

    Mogilevkin, Yakov; Sofer, Mario; Margel, David; Greenstein, Alexander; Lifshitz, David

    2014-08-01

    Introduction: The use of a ureteral access sheath (UAS) may provide significant advantages, particularly in the treatment of a large renal stone burden. However, in some patients passage of a UAS up the ureter is impossible. We prospectively evaluated the ability to insert a 14Fr UAS and analyzed the possible predictors for a successful insertion. Patients and methods: In a bi-center, prospective study, 248 consecutive patients undergoing ureteroscopy and retrograde intrarenal surgery (RIRS) were recruited. In each case we attempted initially to pass a 14Fr Flexor-Cook UAS. If passage was difficult, gradual dilation using semi-rigid ureteral dilators (Cook Medical) was performed. Patients were categorized into three groups: successful passage with and without dilation and failure to pass the UAS. Age, gender, body mass index (BMI), indwelling double-J stent and a history of previous ureteroscopy or double-J stent were all analyzed as possible predictors for a successful UAS insertion. Results: In 22% of the patients we could not pass a 14Fr UAS. Of the preoperative parameters that were examined we have found three independent predictors for a successful 14Fr UAS insertion: age [odds ratio - 1.5 and 95%CI (1.3-1.9)], previous same side procedures [odds ratio - 9.7 and 95% CI (8.3-14.5)] and indwelling double-J stent [odds ratio - 21.73 and 95%CI (20- 30)]. Gender, BMI and side of surgery did not predict success rate. Conclusions: Insertion of a 14Fr UAS prior to RIRS may fail in approximately one fifth of the patients. An indwelling double-J stent, a history of previous ureteroscopy or double-J stent and older age are all significant predictors for a successful 14Fr UAS insertion. PMID:25099819

  20. The Hedgehog Signal Induced Modulation of Bone Morphogenetic Protein Signaling: An Essential Signaling Relay for Urinary Tract Morphogenesis

    PubMed Central

    Nakagata, Naomi; Miyagawa, Shinichi; Suzuki, Kentaro; Kitazawa, Sohei; Yamada, Gen

    2012-01-01

    Background Congenital diseases of the urinary tract are frequently observed in infants. Such diseases present a number of developmental anomalies such as hydroureter and hydronephrosis. Although some genetically-modified mouse models of growth factor signaling genes reproduce urinary phenotypes, the pathogenic mechanisms remain obscure. Previous studies suggest that a portion of the cells in the external genitalia and bladder are derived from peri-cloacal mesenchymal cells that receive Hedgehog (Hh) signaling in the early developmental stages. We hypothesized that defects in such progenitor cells, which give rise to urinary tract tissues, may be a cause of such diseases. Methodology/Principal Findings To elucidate the pathogenic mechanisms of upper urinary tract malformations, we analyzed a series of Sonic hedgehog (Shh) deficient mice. Shh?/? displayed hydroureter and hydronephrosis phenotypes and reduced expression of several developmental markers. In addition, we suggested that Shh modulation at an early embryonic stage is responsible for such phenotypes by analyzing the Shh conditional mutants. Tissue contribution assays of Hh-responsive cells revealed that peri-cloacal mesenchymal cells, which received Hh signal secreted from cloacal epithelium, could contribute to the ureteral mesenchyme. Gain- and loss-of-functional mutants for Hh signaling revealed a correlation between Hh signaling and Bone morphogenetic protein (Bmp) signaling. Finally, a conditional ablation of Bmp receptor type IA (BmprIA) gene was examined in Hh-responsive cell lineages. This system thus made it possible to analyze the primary functions of the growth factor signaling relay. The defective Hh-to-Bmp signaling relay resulted in severe urinary tract phenotypes with a decrease in the number of Hh-responsive cells. Conclusions/Significance This study identified the essential embryonic stages for the pathogenesis of urinary tract phenotypes. These results suggested that Hh-responsive mesenchymal Bmp signaling maintains the population of peri-cloacal mesenchyme cells, which is essential for the development of the ureter and the upper urinary tract. PMID:22860096

  1. Nucleic acid-based tissue biomarkers of urologic malignancies.

    PubMed

    Dietrich, Dimo; Meller, Sebastian; Uhl, Barbara; Ralla, Bernhard; Stephan, Carsten; Jung, Klaus; Ellinger, Jörg; Kristiansen, Glen

    2014-08-01

    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

  2. Congenital ureteropelvic junction obstruction: physiopathology, decoupling of tout court pelvic dilatation-obstruction semantic connection, biomarkers to predict renal damage evolution.

    PubMed

    Alberti, C

    2012-02-01

    The widespread use of fetal ultrasonography results in a frequent antenatally observation of hydronephrosis, ureteropelvic junction obstruction (UPJO) accounting for the greatest fraction of congenital obstructive nephropathy. UPJO may be considered, in most cases, as a functional obstructive condition, depending on defective fetal smooth muscle/nerve development at this level, with lack of peristaltic wave propagation--aperistaltic segment--and, therefore, poor urine ejection from the renal pelvis into the ureter. The UPJO-related physiopathologic events are, at first, the compliant dilatation of renal pelvis that, acting as hydraulic buffer, protects the renal parenchyma from the rising intrapelvic pressure-related potential damages, and, subsequently, beyond such phase of dynamic balance, the tubular cell stretch-stress induced by increased intratubular pressure and following parenchymal inflammatory lesions: inflammatory infiltrates, fibroblast proliferation, activation of myofibroblasts, tubulo-interstitial fibrosis. Reactive oxygen species (ROS), nitric oxide (NO), several chemo- and cytokines, growth factors, prostaglandins and eicosanoids, angiotensin-II are the main pathogenetic mediators of the obstructive nephropathy. Apoptosis of tubular cells is the major cause of the tubular atrophy, together with epithelial-mesenchymal transdifferentiation. Some criticisms on tout court semantic renal pelvis dilatation-obstruction connection have been raised considering that the renal pelvis expansion isn't, in any case, linked to an ostructive condition, as it may be verified by diuretic (furosemide) renogram together with scintiscan-based evaluation of differential renal function. In this regard, rather than repetitive invasive nuclear procedures that expose the children to ionizing radiations, an intriguing noninvasive strategy, based on the evaluation of urinary biomarkers and urinary proteome, can define the UPJO-related possible progress of parenchymal lesions, thus predicting which patients must require an obstruction correcting surgery and in which patients, instead, the hydronephrosis will spontaneously resolve. PMID:22428472

  3. Poorly differentiated mesenteric carcinoma of unknown primary site detected by abscess formation: case report

    PubMed Central

    2014-01-01

    Background Carcinoma of unknown primary site (CUP) is said to account for approximately 3 to 5% of all carcinomas. However, an isolated lesion in the abdominal cavity is rare, and there are no reports describing associated abscess formation. Case presentation A 76-year-old woman had consulted a previous physician complaining of fever and right lower quadrant abdominal pain. Enhanced computed tomography (CT) showed an abscess formation around the cecum. She was treated conservatively with antibiotics, but the symptoms relapsed and she consulted our hospital. Enhanced CT showed a persistent abscess, a tumorous lesion in the mesentery and right hydronephrosis. Because malignancy could not be ruled out, surgical treatment was selected. At laparotomy, encapsulated abscesses were found on the mesenteric side and outside of the ileocecal region. When we raised the ileocecal region, a tumor was found to be fixed to the right ureter, and there was leakage of white, solid tumor content. This tumor content was submitted to intraoperative frozen section diagnosis which revealed a carcinoma. Ileocecal resection with D3 lymph node dissection and retroperitoneal tumor resection was thus performed. There were no abnormal findings in the uterus and adnexa, nor any evidence of peritoneal dissemination. We regarded this case as an incomplete resection and chemotherapy with paclitaxel and carboplatin was administered. The patient has remained alive and disease-free for almost one year since the primary operation. Conclusion We described a case with mesenteric CUP discovered during surgery for an intra-abdominal abscess. It is necessary to pay attention to treatment-resistant intraperitoneal abscesses as they may accompany a tumor. PMID:24397776

  4. Predictive parameters for medical expulsive therapy in ureteral stones: a critical evaluation.

    PubMed

    Sahin, Cahit; Eryildirim, Bilal; Kafkasli, Alper; Coskun, Alper; Tarhan, Fatih; Faydaci, Gokhan; Sarica, Kemal

    2015-06-01

    To evaluate the predictive value of some certain radiological as well as stone-related parameters for medical expulsive therapy (MET) success with an alpha blocker in ureteral stones. A total 129 patients receiving MET for 5 to 10 mm ureteral stones were evaluated. Patients were divided into two subgroups where MET was successful in 64 cases (49.61 %) and unsuccessful in 65 cases (50.39 %). Prior to management, stone size, location, position in the ureter, degree of hydronephrosis, diameter of ureteral lumen proximal to the stone, ureteral wall thickness along with patient's demographics including body mass index (BMI) values were evaluated and recorded. The possible predictive values of these parameters for stone expulsion (and stone expulsion time) were evaluated in a comparative manner between two groups. The overall mean patient age and stone size values were 38.02 ± 0.94 years and 40.31 ± 1.13 mm(2), respectively. Regarding the predictive values of these parameters for MET-success, while stone size and localization, degree of hydronephrosis, proximal ureteral diameter and ureteral wall thickness were found to be highly predictive for MET-success, patients age, BMI values and stone density had no predictive value on this aspect. Our findings indicated that some stone and anatomical factors may be used to predict the success of MET in an effective manner. With this approach unnecessary use of these drugs that may cause a delay for stone removal will be avoided and the possible adverse effects of obstruction as well as stone-related clinical symptoms could be minimized. PMID:25820291

  5. [Regenerative medicine: applications and development in urology.

    PubMed

    Pinto, F; Calarco, A; Brescia, A; Sacco, E; D'Addessi, A; Racioppi, M; Bassi, P F

    2007-01-01

    PURPOSE. Congenital abnormalities and acquired disorders can lead to organ damage and loss. Nowadays, transplantation represents the only effective treatment option. However, there is a marked decrease in the number of organ donors, which is even yearly worsening due to the population aging. The regenerative medicine represents a realistic option that allows to restore and maintain the normal functions of tissues and organs. This article reviews the principles of regenerative medicine and the recent advances with regard to its application to the genitourinary tract. RECENT FINDINGS. The field of regenerative medicine involves different areas of technology, such as tissue engineering, stem cells and cloning. Tissue engineering involves the field of cell transplantation, materials science and engineering in order to create functional replacement tissues. Stem cells and cloning permit the extraction of pluripotent, embryonic stem cells offering a potentially limitless source of cells for tissue engineering applications. Most current strategies for tissue engineering depend upon a sample of autologous cells from the patient's diseased organ. Biopsies from patients with extensive end-stage organ failure, however, may not yield enough normal cells. In these situations, stem cells are envisaged as being an alternative source. Stem cells can be derived from discarded human embryos (human embryonic stem cells), from fetal tissue or from adult sources (bone marrow, fat, skin). Therapeutic cloning offers a potentially limitless source of cells for tissue engineering applications. Regenerative medicine and tissue engineering scientists have increasingly applied the principles of cell transplantation, materials science and bioengineering to construct biological substitutes that will restore and maintain normal function in urological diseased and injured tissues such as kidney, ureter, bladder, urethra and penis. CONCLUSIONS. Regenerative medicine offers several applications in acquired and congenital genito-urinary diseases. Tissue engineering, stem cells and, mostly, cloning have been applied in experimental studies with excellent results. Few preliminary human applications have been developed with promising results. PMID:21086380

  6. Renal Transplant Outcome in Children with an Augmented Bladder

    PubMed Central

    Lopez Pereira, P.; Ortiz Rodriguez, Ruben; Fernandez Camblor, Carlota; Martínez Urrutia, María José; Lobato Romera, Roberto; Espinosa, Laura; Jaureguizar Monereo, Enrique

    2013-01-01

    Objective: Studies evaluating renal transplant (RT) outcome in children who underwent an augmentation cystoplasty (AC) are contradictory and the current knowledge is based on studies with a limited number of patients. The aim of this study is to compare RT outcome between children who underwent AC and those without augmentation. Patients and methods: A total of 20p who underwent an AC prior to the RT (12 with ureter and 8 with intestine) were enrolled in the study and were compared to a control group of 24p without AC, transplanted in the same time period (1991–2011). Data including; age at transplant, allograft source, urological complications, urinary tract infections (UTI) incidence, the presence of VUR, and patient and graft survival were compared between the groups. Results: Mean age at RT and mean follow-up were 9.7 vs. 7.9?years and 6.9 vs. 7.9?years in the AC group and control group, respectively (NS). The graft originated in living donors for 60% of AC patients and 41.6% of the control RT patients. The rate of UTI were 0.01 UTI/patient/year and 0.004 UTI/patient/year in the augmented group and controls, respectively (p?=?0.0001). In the AC group of 14p with UTIs, 10 (71%) had VUR and 5p out of 8 (62.5%) in the control group had VUR. In the AC group, of the 7p with ?3 UTIs, 3 (43%) were non-compliant with CIC and the incidence of UTIs was not related with the type of AC or if the patient did CIC through a Mitrofanoff conduit or through the urethra. Graft function at the end of study was 92.9?±?36.85?ml/min/m2 in the AC group and 88.17?±?28.2?ml/min/m2 in the control group (NS). Graft survival at 10?years was also similar 88% in the AC group and 84.8% in controls. In the AC group 3p lost their grafts and 5 in the control group with respective mean follow-up of 10.6?±?4.3 and 7.1?+?4.7?years. Conclusion: There are no significant differences in the RT outcome between children transplanted with AC or without. However, recurrent UTIs are more frequent in the former group and these UTIs are related with non-compliance with CIC or the presence of VUR but, even so, UTIs will not lead to impaired graft function in most of the patients. PMID:24400288

  7. Knockout of the aryl hydrocarbon receptor results in distinct hepatic and renal phenotypes in rats and mice

    SciTech Connect

    Harrill, Joshua A. [The Hamner Institute for Health Sciences, Institute for Chemical Safety Sciences, RTP, NC 27709 (United States); Hukkanen, Renee R.; Lawson, Marie; Martin, Greg [The Dow Chemical Company, Midland, MI 48640 (United States); Gilger, Brian [North Carolina State University, College of Veterinary Medicine, Raleigh, NC 27606 (United States); Soldatow, Valerie [University of North Carolina, Department of Environmental Sciences and Engineering, Chapel Hill, NC 27599 (United States); LeCluyse, Edward L. [The Hamner Institute for Health Sciences, Institute for Chemical Safety Sciences, RTP, NC 27709 (United States); Budinsky, Robert A.; Rowlands, J. Craig [The Dow Chemical Company, Midland, MI 48640 (United States); Thomas, Russell S., E-mail: RThomas@thehamner.org [The Hamner Institute for Health Sciences, Institute for Chemical Safety Sciences, RTP, NC 27709 (United States)

    2013-10-15

    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. - Highlights: • An AHR knockout rat was generated on a Sprague–Dawley outbred background. • AHR-KO rats lack expression of AHR protein. • AHR-KO rats are insensitive to TCDD-mediated effects. • Data suggests difference in the role of AHR in tissue development of rats and mice. • Abnormalities in vascular development are observed in AHR-KO mouse, but not rat. • Renal pathology is observed in AHR-KO rat, but not mouse.

  8. Effect of Medullary Tonicity on Urinary Sodium Excretion in the Rat

    PubMed Central

    Reineck, H. John; Parma, Retta

    1982-01-01

    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

  9. Are Hounsfield densities of ureteral stones a predictive factor for effectiveness of extracorporeal shock wave lithotripsy?

    PubMed Central

    Cakiroglu, Basri; Eyyupoglu, S Erkan; Tas, Tuncay; Balci, MB Can; Hazar, Ismet; Aksoy, S Hilmi; Sinanoglu, Orhun

    2014-01-01

    Extracorporeal Shock Wave Lithotripsy (SWL) has long been used successfully to dissolve ureteral stones. We researched whether Hounsfield values of ureteral stones is a factor that affects the success of SWL. Methods: Data from 144 patients who had diagnoses of ureteral stones and underwent SWL, were retrospectively reviewed between January 2011 and December 2012. Urinary tomography of patients was processed and classified into 3 groups by Hounsfield units (Group 1, < 500 HU; Group 2, 500-1000 HU; and Group 3, > 1000 HU) and 2 groups by stone size (Group A; < 1 cm, Group B; > 1 cm). SWL success was analyzed for both of these group types. Failure was defined as any fragments of the stone that remained within the ureter. Results were analyzed by evaluating the predictive factors in both groups. Results: The study included 144 patients (100 men, 44 women) who fit the inclusion criteria. In Hounsfield unit Group 1 (12 women and 44 men), the mean age was 37.2 ± 13.2, stone size was 8.5 ± 2.5 mm, number of shocks was 3240 ± 1414 (1200-7500) and number of treatments was 1.4 ± 0.6. In Group 2 (26 women and 32 men), the mean age was 33.6 ± 7.6, stone size was 9.6 ± 3.1 mm, process number was 3375 ± 2103 (1200-8750) and shock amount was 1.6 ± 0.8. In Group 3 (6 women and 24 men), the mean age was 42.2 ± 13.6, stone size was 11.7 ± 3.0 mm, number of shocks was 4513 ± 2458 (1300-8700) and number of treatments was 2.1 ± 1.2. In size Group 1 (28 women and 74 men), the mean age was 35.8 ± 10.6, stone size was 8.1 ± 1.4 mm, process number was 3105 ± 1604, shock amount was 1.4 ± 0.5 and HU value was 580 ± 297. In Group 2 (16 women and 26 men), the mean age was 39.9 ± 14.2, stone size was 13.9 ± 2.4 mm, number of shocks was 4722 ± 2467, number of treatments was 2.3 ± 1.1 and HU value was 912 ± 270. Conclusion: Although stone density predicted the failure of SWL, size of the stone is more important criterion for successful lithotripsy of ureteral stones. PMID:24995083

  10. Validation of Multi-Detector Computed Tomography as a Non-Invasive Method for Measuring Ovarian Volume in Macaques (Macaca fascicularis)

    PubMed Central

    Jones, Jeryl C.; Appt, Susan E.; Werre, Stephen R.; Tan, Joshua C.; Kaplan, Jay R.

    2013-01-01

    The purpose of this study was to validate low radiation dose, contrast-enhanced, multi-detector computed tomography (MDCT) as a non-invasive method for measuring ovarian volume in macaques. Computed tomography scans of four known-volume phantoms and nine mature female cynomolgus macaques were acquired using a previously described, low radiation dose scanning protocol, intravenous contrast enhancement, and a 32-slice MDCT scanner. Immediately following MDCT, ovaries were surgically removed and the ovarian weights were measured. The ovarian volumes were determined using water displacement. A veterinary radiologist who was unaware of actual volumes measured ovarian CT volumes three times, using a laptop computer, pen display tablet, hand-traced regions of interest, and free image analysis software. A statistician selected and performed all tests comparing the actual and CT data. Ovaries were successfully located in all MDCT scans. The iliac arteries and veins, uterus, fallopian tubes, cervix, ureters, urinary bladder, rectum, and colon were also consistently visualized. Large antral follicles were detected in six ovaries. Phantom mean CT volume was 0.702±SD 0.504 cc and the mean actual volume was 0.743±SD 0.526 cc. Ovary mean CT volume was 0.258±SD 0.159 cc and mean water displacement volume was 0.257±SD 0.145 cc. For phantoms, the mean coefficient of variation for CT volumes was 2.5%. For ovaries, the least squares mean coefficient of variation for CT volumes was 5.4%. The ovarian CT volume was significantly associated with actual ovarian volume (ICC coefficient 0.79, regression coefficient 0.5, P = 0.0006) and the actual ovarian weight (ICC coefficient 0.62, regression coefficient 0.6, P = 0.015). There was no association between the CT volume accuracy and mean ovarian CT density (degree of intravenous contrast enhancement), and there was no proportional or fixed bias in the CT volume measurements. Findings from this study indicate that MDCT is a valid non-invasive technique for measuring the ovarian volume in macaques. PMID:20131358

  11. Comparison of different pulsed and Q-switched solid state laser systems for endoscopic laser-induced shockwave lithotripsy: performance and laser/stone interactions

    NASA Astrophysics Data System (ADS)

    Steiger, Erwin

    1990-06-01

    At present the laser induced shock wave lithotripsy (LISL) of urinary and biliary stones via fiber optic beam delivery is governed by two competing' laser systems: The flashlamp-pumped pulsed dye laser and the Q-switched Nd:YAG laser. The pulsed radiation of the dye system with pulse durations in the 1-2 .tsec region can be easily transmitted through extremely flexible fused silica fibers with core diameters of only 200 im whilst the Q-switched Nd:YAG laser with pulselengths of 5-25 nsec needs fibers with more than 400 tm core diameter. The dye laser releases acoustic shock waves for fragmentation simply by stone contact, the Q-switched Nd:YAG produces these waves in the surrounding aqueous medium by laser induced optical breakdown (LIB) when refocused by optical means or through additional metal absorbers, i.e. opto - mechanical couplers. We report on the system performances and laser/stone interactions of two alternative solid-state laser systems with variable pulselengths in the range of 1.7 - 30 sec and 30 - 1000 nsec, respectively: The pulsed psec-Nd:YAG laser and the Q-switched alexandrite laser. Regarding the endoscopic laser lithotripsy of urinary and biliary stones in the ureter or common bile duct, respectively, the laser energy delivery system, i.e. the optical fiber; is the most stressed part. Therefore we used long-pulse solid-state laser systems like the pulsed Nd:YAG laser with a pulse-slicing unit and a pulselength-tunable Q-switched alexandrite laser and studied fragmentation of synthetic plaster samples as well as urinary and biliary stones. The radiation of both laser systems can be effectively transmitted via standard 200 im core diameter optical quartz fibers what is absolutely necessary when used in conjunction with small caliber rigid or flexible endoscopes. As a compact and reliable solid-state system the alexandrite laser lithotripter is much less expensive than an extracorporeal shock wave lithotripter with the same fragmentation results and may become the laser of choice for LISL.

  12. Mapping of the fate of cell lineages generated from cells that express the Wnt4 gene by time-lapse during kidney development.

    PubMed

    Shan, Jingdong; Jokela, Tiina; Skovorodkin, Ilya; Vainio, Seppo

    2010-01-01

    The Wnt4 gene encodes a secreted signaling molecule controlling the development of several organs, such as the kidney, adrenal gland, ovary, mammary gland and pituitary gland. It is thought to act in the embryonic kidney as an auto-inducer of nephrogenesis controlling mesenchyme-to-epithelium transition, and Wnt4-deficient mice die soon after birth, probably of kidney failure. Given the requirement for Wnt4 signaling in the control of organogenesis, the targeting of Cre recombinase under the control of the Wnt4 promoter would provide a valuable tool for fate mapping and functional genomics. We report here on the generation and characterization of a Wnt4(EGFPCre) knock-in allele where the EGFPCre fusion cDNA and Neo selection cassette were targeted into the Wnt4 locus. EGFP-derived fluorescence was observed in the pretubular aggregates of the E14.5 embryonic kidney that normally express Wnt4 mRNA. Characterization of the pattern of recombination of the floxed Rosa26(LacZ) reporter with the Wnt4(EGFPCre) allele revealed that in addition to the embryonic kidney, reporter-derived staining was observed in the embryonic gonad, spinal cord, lung and adrenal gland, i.e. the sites of Wnt4 gene expression. Time-lapse fate mapping of the Wnt4(EGFPCre)-activated yellow fluorescent protein (YFP) from the Rosa26 locus in organ culture revealed that the cells that had expressed the Wnt4 gene contributed to the nephrons, some of the cells around the stalk of the developing ureter and also certain presumptive medullary stromal cells. Moreover, the time-lapse movies suggested that the first few pretubular cell aggregates may not mature into nephrons but instead appear to disintegrate. In association with this, Rosa26(YFP)-positive stromal cells emerge around these disintegrating structures. Such cells may be transient, since their derivatives are neither detected later in the more mature kidney nor is there an overlap of the Wnt4(EGFPCre); Rosa26(LacZ)-marked cells with those of the endothelial cells, the smooth muscle cells or the macrophages. The Wnt4(EGFPCre) allele provides a useful new tool for conditional mutagenesis and provides the first time-lapse-based map of the fate of nephron precursor cells. PMID:19740593

  13. Ulinastatin attenuates renal interstitial inflammation and inhibits fibrosis progression in rats under unilateral ureteral obstruction.

    PubMed

    Jiang, Guo-Tao; Chen, Xiao; Li, Dong; An, Hui-Xia; Jiao, Jun-Dong

    2014-09-01

    The aim of the present study was to examine the protective effects of the urinary trypsin inhibitor ulinastatin (UTI) on renal interstitial inflammation and fibrosis in rats subjected to unilateral ureteral obstruction (UUO). A total of 24 male Wistar rats were randomly divided into the three groups; the sham operation (SOR) group (n=8), the UUO group (n=8) and the UUO+UTI group (post?UUO UTI treatment, n=8). UUO was performed with complete ligation of the left ureter. As a medical intervention, saline (4 ml kg?1 d?1) and UTI (40000 units kg?1 d?1) were injected, respectively, into the animals of the corresponding groups on day one following surgery. The rats in all three groups were euthanized on day seven post surgery. Blood samples were harvested for blood urea nitrogen (BUN) and serum creatinine (Scr) content measurements. The degree of interstitial pathological changes in the tissues from the obstructed kidneys were observed through hematoxylin and eosin (H&E) and Masson staining. The CD68+ macrophage amount, tumor necrosis factor?? (TNF??), interleukin 1? (IL?1?), nuclear factor??B (NF??B), transforming growth factor??1 (TGF??1) and type I collagen (Col?I) levels were examined immunohistochemically. The protein expression levels of NF??B were examined using western blot analysis. Total superoxide dismutase (SOD) activity and malondialdehyde (MDA) content of homogenates were measured spectrophotometrically. The results revealed that ulinastatin had no statistically significant effect on the BUN and Scr levels (P>0.05). However, in comparison with the SOR group, the UUO group exhibited significantly more severe renal interstitial pathological injury in terms of tubular dilation, epithelial atrophy, renal interstitial inflammatory cell infiltration and proliferation of fibrous tissues, as well as significantly elevated levels of interstitial CD68+ macrophages, IL?1?, TNF??, NF??B, TGF??1 and Col?I (P<0.01). UTI treatment significantly reduced UUO?induced renal interstitial damage with reduced levels of interstitial CD68+ macrophages, IL?1?, TNF??, NF??B, TGF??1 and Col?I and MDA (P<0.05), and increased SOD levels (P<0.05). In conclusion, the present study indicated that UTI is able to effectively inhibit UUO?side renal interstitial inflammatory reaction and fibrosis in UUO?inflicted rats. PMID:24926571

  14. [Robotic surgery in gynecology].

    PubMed

    Hibner, Micha?; Marianowski, Piotr; Szymusik, Iwona; Wielgós, Miros?aw

    2012-12-01

    Introduction of robotic surgery in the first decade of the 21 century was one of the biggest breakthroughs in surgery since the introduction of anesthesia. For the first time in history the surgeon was placed remotely from the patient and was able to operate with the device that has more degrees of freedom than human hand. Initially developed for the US Military in order to allow surgeons to be removed from the battlefield, surgical robots quickly made a leap to the mainstream medicine. One of the first surgical uses for the robot was cardiac surgery but it is urology and prostate surgery that gave it a widespread popularity Gynecologic surgeons caught on very quickly and it is estimated that 31% of hysterectomies done in the United States in 2012 will be done robotically. With over half a million hysterectomies done each year in the US alone, gynecologic surgery is one of the main driving forces behind the growth of robotic surgery Other applications in gynecology include myomectomy oophorectomy and ovarian cystectomy resection of endometriosis and lymphadenectomy Advantages of the surgical robot are clearly seen in myomectomy The wrist motion allows for better more precise suturing than conventional "straight stick" laparoscopy The strength of the arms allow for better pulling of the suture and the third arm for holding the suture on tension. Other advantage of the robot is scaling of the movements when big movement on the outside translates to very fine movement on the inside. This enables much more precise surgery and may be important in the procedures like tubal anastomosis and implantation of the ureter Three-dimensional vision provides excellent depth of field perception. It is important for surgeons who are switching from open surgeries and preliminary evidence shows that it may allow for better identification of lesions like endometriosis. Another big advantage of robotics is that the surgeon sits comfortably with his/her arms and head supported. This results in much less fatigue and therefore increases precision and potentially may decrease the number of medical errors. The eyes of the surgeon are directed at where the hands should be, which is more natural, allows for a more natural body position and mimics open surgery Robot also enables better teaching, especially when two consoles are used. The surgeon and the student may be either sharing the instruments with two consoles or switching between one another. In a situation where the student operates, the surgeon can use the telestation to teach. Robotic simulator attached to one of the consoles allows students to practice after hours. In summary surgical robot is a great tool, especially in gynecology but also in urology cardiac surgery general surgery and laryngology The device will evolve and most likely with time will eliminate laparoscopy PMID:23488297

  15. Low Dose Studies with Focused X-Rays in cell and Tissue Models: Mechanisms of Bystander and Genomic Instability Responses

    SciTech Connect

    Kathy Held; Kevin Prise; Barry Michael; Melvyn Folkard

    2002-12-14

    The management of the risks of exposure of people to ionizing radiation is important in relation to its uses in industry and medicine, also to natural and man-made radiation in the environment. The vase majority of exposures are at a very low level of radiation dose. The risks are of inducing cancer in the exposed individuals and a smaller risk of inducing genetic damage that can be indicate that they are low. As a result, the risks are impossible to detect in population studies with any accuracy above the normal levels of cancer and genetic defects unless the dose levels are high. In practice, this means that our knowledge depends very largely on the information gained from the follow-up of the survivors of the atomic bombs dropped on Japanese cities. The risks calculated from these high-dose short-duration exposures then have to be projected down to the low-dose long-term exposures that apply generally. Recent research using cells in culture has revealed that the relationship between high- and low-dose biological damage may be much more complex than had previously been thought. The aims of this and other projects in the DOE's Low-Dose Program are to gain an understanding of the biological actions of low-dose radiation, ultimately to provide information that will lead to more accurate quantification of low-dose risk. Our project is based on the concept that the processes by which radiation induces cancer start where the individual tracks of radiation impact on cells and tissues. At the dose levels of most low-dose exposures, these events are rare and any individual cells only ''sees'' radiation tracks at intervals averaging from weeks to years apart. This contrasts with the atomic bomb exposures where, on average, each cell was hit by hundreds of tracks instantaneously. We have therefore developed microbeam techniques that enable us to target cells in culture with any numbers of tracks, from one upwards. This approach enables us to study the biological ha sis of the relationship between high- and low-dose exposures. The targeting approach also allows us to study very clearly a newly recognized effect of radiation, the ''bystander effect'', which appears to dominate some low-dose responses and therefore may have a significant role in low-dose risk mechanisms. Our project also addresses the concept that the background of naturally occurring oxidative damage that takes place continually in cells due to byproducts of metabolism may play a role in low-dose radiation risk. This project therefore also examines how cells are damaged by treatments that modify the levels of oxidative damage, either alone or in combination with low-dose irradiation. In this project, we have used human and rodent cell lines and each set of experiments has been carried out on a single cell type. However, low-dose research has to extend into tissues because signaling between cells of different types is likely to influence the responses. Our studies have therefore also included microbeam experiments using a model tissue system that consists of an explant of a small piece of pig ureter grown in culture. The structure of this tissue is similar to that of epithelium and therefore it relates to the tissues in which carcinoma arises. Our studies have been able to measure bystander-induced changes in the cells growing out from the tissue fragment after it has been targeted with a few radiation tracks to mimic a low-dose exposure.

  16. Low Dose Studies with Focused X-rays in Cell and Tissue Models: Mechanisms of Bystander and Genomic Instability Responses

    SciTech Connect

    Barry D. Michael; Kathryn Held; Kevin Prise

    2002-12-19

    The management of the risks of exposure of people to ionizing radiation is important in relation to its uses in industry and medicine, also to natural and man-made radiation in the environment. The vase majority of exposures are at a very low level of radiation dose. The risks are of inducing cancer in the exposed individuals and a smaller risk of inducing genetic damage that can be transmitted to children conceived after exposure. Studies of these risks in exposed population studies with any accuracy above the normal levels of cancer and genetic defects unless the dose levels are high. In practice, this means that our knowledge depends very largely on the information gained from the follow-up of the survivors of the atomic bombs dropped on Japanese cities. The risks calculated from these high-dose short-duration exposures then have to be projected down to the low-dose long-term exposures that apply generally. Recent research using cells in culture has revealed that the relations hi between high- and low-dose biological damage may be much more complex than had previously been thought. The aims of this and other projects in the DOE's Low-Dose Program are to gain an understanding of the biological actions of low-dose radiation, ultimately to provide information that will lead to more accurate quantification of low-dose risk. Our project is based on the concept that the processes by which radiation induces cancer start where the individual tracks of radiation impact on cells and tissues. At the dose levels of most low-dose exposures, these events are rare and any individual cells only ''sees'' radiation tracks at intervals averaging from weeks to years apart. This contracts with the atomic bomb exposures where, on average, each cell was hit by hundreds of tracks instantaneously. We have therefore developed microbeam techniques that enable us to target cells in culture with any number of tracks, from one upwards. This approach enables us to study the biological basis of the relationship between high- and low-dose exposures. The targeting approach also allows us to study very clearly a newly recognized effect of radiation, the ''bystander effect'', which appears to dominate some low-dose responses and therefore may have a significant role in low-dose risk mechanisms. Our project also addresses the concept that the background of naturally occurring oxidative damage that takes place continually in cells due to byproducts of metabolism may play a role in treatments that modify the levels of oxidative damage, either alone or in combination with low-dose irradiation. In this project, we have used human and rodent cell lines and each set of experiments has been carried out on a single cell type. However, low-dose research has to extend into tissues because signaling between cells of different types is likely to influence the responses. Our studies have therefore also included microbeam experiments using a model tissue system that consists of an explant of a small piece of pig ureter grown in culture. The structure of this tissue is similar to that of epithelium and there it relates to the tissues in which carcinoma arises. Our studies have been able to measure bystander-induced changes in the cells growing out from the tissue fragment after it has been targeted with a few radiation tracks to mimic a low-dose exposure.