[Renal cirsoid aneurysm (congenital arteriovenous fistula): a rare cause of severe hematuria].

PubMed

Pereira Arias, José Gregorio; Ullate Jaime, Vicente; Pereda Martínez, Esther; Gutiérrez Díez, José María; Ateca Díaz-Obregón, Ricardo; Ramírez Rodríguez, Maria Mar; Berreteaga Gallastegui, José Ramón

2007-06-01

Congenital arteriovenous fistulas are an exceptional clinical feature. Although they are frequently asymptomatic, their presentation as severe hematuria pose an excellent diagnostic exercise and often immediate therapeutic action. We report the case of a 75-year-old female patient presenting with severe hematuria producing anaemia, high blood pressure and congestive heart failure. Image tests revealed right ureteral-hydronephrosis with bladder blockage by blood clots. The endoscopic study (cystoscopy and ureterorenoscopy) alerted about the origin of the hematuria from the right kidney, finally requiring nephrectomy as definitive treatment. Pathology revealed the presence of a round formation with multiple vascular channels, arterial and venous, in the pyelocalicial submucosa, with focal epithelial erosion, compatible with congenital arteriovenous fistula. We review the diagnostic and therapeutic features in the literature. Renal congenital arteriovenous fistulas represent a diagnostic dilemma. They may present asymptomatic or condition clinical features derived from the shunt and high cardiac output (hypertensive cardiopathy and congestive heart failure) or from the erosion and acute hemorrhage into the urinary tract (severe renal hematuria). Treatment should be conservative with embolization or supraselective sclerosis. Nevertheless, in cases of big fistulas, post embolization revascularization, or hemodynamic instability nephrectomy is an excellent option.

Vesical schistosomiasis with terminal hematuria in sub-Saharan patients.

PubMed

Pereira, J; Calleja, E; Marne, C; Borque, A

2014-03-01

To know the characteristics of vesical schistosomiasis caused by schistosoma hematobium in immigrant patients. The retrospective study of 41 cases microbiologically diagnosed in our hospital over the last 16 years is presented. Data was collected on origin, age, presentation form, diagnostic tests and treatment. All were African patients whose ages ranged from 4 to 32 years and who had terminal macroscopic hematuria. Most of the patients (85%) were men. In all of the cases, diagnosis was by a urinary microbiological study and in one case, cystoscopy with a biopsy of a typical vesical lesion. Terminal hematuria is the most representative clinical sign. They were treated with praziquantel. The epidemiology and intermittent terminal hematuria in African patients should lead to the suspicion of vesical schistosomiasis as the first diagnostic option. Urinary microbiological study is a rapid, non-invasive, test with high diagnostic yield that would avoid performing invasive studies. Its simple treatment assures high level of compliance and consequent efficacy. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.

Severe hematuria after transurethral electrocoagulation in a patient with an arteriovesical fistula

PubMed Central

2013-01-01

Background Arteriovesical fistulas are extremely rare. Only eleven cases were previously reported in the literature. They can occur iatrogenically, traumatically or spontaneously. Case presentation We report an unusual case of a 62-year-old woman with arteriovesical fistula that developed fatal hematuria after transurethral electrocoagulation. Computed tomography (CT) and selective angiography revealed a pseudoaneurysm of the right superior vesical artery with arteriovesical fistula formation, which was managed by transarterial embolization. Conclusions Contrast enhanced CT or CT angiography should be performed when a pulsatile hemorrhage is revealed during cystoscopy. Therapeutic vesical arterial embolization should be considered as a safe and effective procedure for arteriovesical fistulas. Transurethral electrocoagulation may cause severe hematuria for pulsatile bladder bleeding in patients with pelvic vascular malformation. PMID:24289138

Severe hematuria after transurethral electrocoagulation in a patient with an arteriovesical fistula.

PubMed

Zheng, Xiangyi; Lin, Yiwei; Chen, Bin; Zhou, Xianyong; Zhou, Xiaofeng; Shen, Yuehong; Xie, Liping

2013-12-01

Arteriovesical fistulas are extremely rare. Only eleven cases were previously reported in the literature. They can occur iatrogenically, traumatically or spontaneously. We report an unusual case of a 62-year-old woman with arteriovesical fistula that developed fatal hematuria after transurethral electrocoagulation. Computed tomography (CT) and selective angiography revealed a pseudoaneurysm of the right superior vesical artery with arteriovesical fistula formation, which was managed by transarterial embolization. Contrast enhanced CT or CT angiography should be performed when a pulsatile hemorrhage is revealed during cystoscopy. Therapeutic vesical arterial embolization should be considered as a safe and effective procedure for arteriovesical fistulas. Transurethral electrocoagulation may cause severe hematuria for pulsatile bladder bleeding in patients with pelvic vascular malformation.

Should the presence of a culture positive urinary tract infection exclude patients from rapid evaluation hematuria protocols?

PubMed

Vasdev, Nikhil; Thorpe, Andrew C

2013-08-01

Current rapid evaluation protocols for patients with hematuria tend to exclude those with urinary tract infection since this is assumed to be evidence of a benign treatable cause. The likelihood of a urinary tract cancer in such patients is, however, uncertain, and we have therefore analyzed a prospective hematuria clinic database to determine risk. A total of 1,740 patients were enrolled prospectively in this study at our unit's one stop fast track hematuria clinic between April 2003 and March 2006. Evaluation of patients consisted of basic demographics, history and examination, urinalysis, urine culture, urine cytology, and serum creatinine. All patients then underwent a renal ultrasound, intravenous urogram, and cystoscopy. A total of 1,067 males and 673 females with a mean (range) age of 60.8 (16-96) years were included in the study. One hundred sixty-one patients had a positive mid-stream urine (MSU) on a specimen collected at the hematuria clinic. Amongst this group 20% (32) patients had a urologic malignancy diagnosed, of whom 12% (4) had metastatic disease at presentation. Only 1% (3) of patients had a urologic malignancy with a previous history of a treated urinary tract infection (UTI) and negative MSU at the clinic. The risk of urologic malignancy was 24% (303) in the remaining 1,249 patients with no history of a UTI prior to presentation and a negative MSU on a specimen collected at the one stop fast track hematuria clinic. Despite selection bias inherent in this analysis, it appears that the presence of UTI does not decrease the likelihood of having a urologic malignancy diagnosed. Hence, there is no indication to delay prompt evaluation in patients with hematuria and a positive urine culture collected at the hematuria clinic. Copyright © 2013 Elsevier Inc. All rights reserved.

Pancreatic Anastomosis Leak 15 Years after Simultaneous Pancreas-Kidney Transplantation from Late-Onset Allograft Cytomegalovirus Duodenal Ulcers Presenting with Gross Hematuria

PubMed Central

Tantisattamo, Ekamol; Chung, Heath; Okado, Manami

2013-01-01

Cytomegalovirus (CMV) infection is one of the most important causes of morbidity and mortality in solid organ transplantation. It can present with hematuria, the most common urological complication in the early post-simultaneous pancreas-kidney (SPK) transplant period. In SPK transplantation, CMV infection usually occurs 1 month after transplantation. We report an instance of bladder-drained SPK transplant presenting with recurrent gross hematuria from CMV infected duodenal graft ulcers 15 years after preserved well-functioning grafts. Serum quantitative Polymerase Chain Reaction (qPCR) for CMV was negative. Postmortem duodenal graft staining for CMV was positive, and revealed the cause of the inciting ulcer. To our knowledge, our patient is the first reported case of very late onset invasive CMV disease causing duodenal graft ulcers 15 years after transplantation, as previously reported cases of posttransplant CMV disease occurred only as late as 18 months. In addition, the absence of correlation between CMV viremia and CMV-infected duodenal allograft in SPK transplant has not been reported. Our case demonstrates that CMV viral load is -unreliable to diagnose invasive CMV disease, and tissue biopsy should be obtained to avoid missed diagnosis causing high morbidity and mortality. PMID:24349888

Hemoglobinuria Misidentified as Hematuria: Review of Discolored Urine and Paroxysmal Nocturnal Hemoglobinuria

PubMed Central

Veerreddy, Prashant

2013-01-01

Discolored urine is a common reason for office visits to a primary care physician and urology referral. Early differentiation of the type or cause of discolored urine is necessary for accurate diagnosis and prompt management. Paroxysmal nocturnal hemoglobinuria is a clonal disorder caused by acquired somatic mutations in the PIG-A gene on the X- chromosome of hemopoietic stem cells and leads to deficiency of surface membrane anchor proteins. The deficiency of these proteins leads to an increased risk of hemolysis of erythrocytes and structural damage of platelets, resulting in a clinical syndrome characterized by complement-mediated intravascular hemolytic anemia, bone marrow failure, and venous thrombosis. Patients with this clinical syndrome present with paroxysms of hemolysis, causing hemoglobinuria manifesting as discolored urine. This can be easily confused with other common causes of discolored urine and result in extensive urologic work-up. Three commonly confused entities of discolored urine include hematuria, hemoglobinuria, and myoglobinuria. Specific characteristics in a dipstick test or urinalysis can guide differentiation of these three causes of discolored urine. This article begins with a case summary of a woman presenting with cranberry-colored urine and a final delayed diagnosis of paryxysmal nocturnal hemoglobinuria. Her hemoglobinuria was misdiagnosed as hematuria, leading to extensive urologic work-up. The article also gives an overview of the approach to diagnosing and treating discolored urine. PMID:25512715

Loin pain hematuria syndrome.

PubMed

Taba Taba Vakili, Sahar; Alam, Tausif; Sollinger, Hans

2014-09-01

Loin pain hematuria syndrome is a rare disease with a prevalence of ∼0.012%. The most prominent clinical features include periods of severe intermittent or persistent unilateral or bilateral loin pain accompanied by either microscopic or gross hematuria. Patients with loin pain hematuria syndrome initially present with hematuria, flank pain, or most often both hematuria and flank pain. Kidney biopsies from patients with loin pain hematuria typically reveal only minor pathologic abnormalities. Further, loin pain hematuria syndrome is not associated with loss of kidney function or urinary tract infections. Loin pain hematuria syndrome-associated hematuria and pain are postulated to be linked to vascular disease of the kidney, coagulopathy, renal vasospasm with microinfarction, hypersensitivity, complement activation on arterioles, venocalyceal fistula, abnormal ureteral peristalsis, and intratubular deposition of calcium or uric acid microcrystals. Many patients with loin pain hematuria syndrome also meet criteria for a somatoform disorder, and analgesic medications, including narcotics, commonly are used to treat loin pain hematuria syndrome-associated pain. Interventional treatments include renal denervation, kidney autotransplantation, and nephrectomy; however, these methods should be used only as a last resort when less invasive measures have been tried unsuccessfully. In this review article, we discuss and critique current clinical practices related to loin pain hematuria syndrome pathophysiology, diagnosis, treatment, and prognosis. Copyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

The influence of renal manifestations to the progression of autosomal dominant polycystic kidney disease

PubMed Central

Idrizi, A; Barbullushi, M; Petrela, E; Kodra, S; Koroshi, A; Thereska, N

2009-01-01

Background: Renal stones, urinary tract infections (UTI) and gross hematuria (GH) are the most important renal manifestations of autosomal dominant polycystic kidney disease (ADPKD). They are not only common, but are also frequent cause of morbidity, influencing renal dysfunction. The aim of this study was to evaluate the frequency of these manifestations in our patients with ADPKD and their impact on renal function. Methods: One hundred eighty ADPKD patients were included in the study. Subjects were studied for the presence of UTI, gross hematuria frequency and responsible factors of nephrolithiasis. Survival times were calculated as the time to renal replacement therapy or time of serum creatinine value up to 10 mg/dl. Kaplan-Meier product-limit survival curves were constructed, and log rank test was used to compare the survival curves. Results: Kidney stones were present in 76/180 (42% of pts). The stones were composed of urate (47%) calcium oxalate (39%), and other compounds 14%. UTI was observed in 60% (108 patients). Patients treated with urinary disinfectants had a significant lower frequency of urinary infection (p<0.001) and hematuria (p<0.001) after one year than untreated patients. Gross hematuria was present in 113 patients (63%). In 43 patients hematuria was diagnosed before age 30 (38%), while in 70 patients it was diagnosed after age 30 (62%). Conclusions: UTI is frequent in our ADPKD patients. The correct treatment of UTI decreases its frequency and has beneficial role in the rate of progression to renal failure in ADPKD patients. Patients with recurrent episodes of gross hematuria may be at risk for more severe renal disease. PMID:19918304

Perforation of the urinary bladder caused by transurethral insertion of a pencil for the purpose of masturbation in a 29-year-old female.

PubMed

Bantis, Athanasios; Sountoulides, Petros; Kalaitzis, Christos; Giannakopoulos, Stelios; Agelonidou, Eleni; Foutzitzi, Soultana; Touloupidis, Stavros

2010-01-01

The urethra is a usual site of introduction of foreign bodies for autoerotic stimulation. We present an unusual case of bladder perforation caused by foreign body that was self-inserted in the urethra and consequently slipped inside the bladder in a 29-year-old female patient with psychiatric disease. The patient was referred to our department for macroscopic hematuria and abdominal pain. Imaging studies revealed the presence of a foreign body in the pelvic area which had perforated the left lateral wall of the bladder. The foreign body was removed via open cystotomy. In psychiatric patients hematuria and pelvic pain may result from insertion of a foreign body in the bladder usually during masturbation.

Perforation of the Urinary Bladder Caused by Transurethral Insertion of a Pencil for the Purpose of Masturbation in a 29-Year-Old Female

PubMed Central

Bantis, Athanasios; Sountoulides, Petros; Kalaitzis, Christos; Giannakopoulos, Stelios; Agelonidou, Eleni; Foutzitzi, Soultana; Touloupidis, Stavros

2010-01-01

The urethra is a usual site of introduction of foreign bodies for autoerotic stimulation. We present an unusual case of bladder perforation caused by foreign body that was self-inserted in the urethra and consequently slipped inside the bladder in a 29-year-old female patient with psychiatric disease. The patient was referred to our department for macroscopic hematuria and abdominal pain. Imaging studies revealed the presence of a foreign body in the pelvic area which had perforated the left lateral wall of the bladder. The foreign body was removed via open cystotomy. In psychiatric patients hematuria and pelvic pain may result from insertion of a foreign body in the bladder usually during masturbation. PMID:20862362

Castleman's Disease: An Interesting Cause of Hematuria.

PubMed

Tolofari, Sotonye Karl; Chow, Wai-Man; Hussain, Basharat

2015-03-01

Castleman's disease is a rare benign lymphoproliferative disorder, characterized by benign growths of the lymph node tissue. It is associated with a number of malignancies, including Kaposi sarcoma, non-Hodgkin's and Hodgkins lymphoma, and POEMS syndrome. This report describes the case of a 38 year old gentleman, presenting with painless hematuria. Initial investigations, including flexible cystoscopy were unremarkable. However, subsequent imaging including CT Urogram and MR pelvis revealed multiple prevesical lesions. Histology obtained from excision biopsy revealed histological features consistent with Castleman's disease. In this report we discuss the nature, presentation and treatment modalities of this rare condition.

Creation and validation of a visual macroscopic hematuria scale for optimal communication and an objective hematuria index.

PubMed

Wong, Lih-Ming; Chum, Jia-Min; Maddy, Peter; Chan, Steven T F; Travis, Douglas; Lawrentschuk, Nathan

2010-07-01

Macroscopic hematuria is a common symptom and sign that is challenging to quantify and describe. The degree of hematuria communicated is variable due to health worker experience combined with lack of a reliable grading tool. We produced a reliable, standardized visual scale to describe hematuria severity. Our secondary aim was to validate a new laboratory test to quantify hemoglobin in hematuria specimens. Nurses were surveyed to ascertain current hematuria descriptions. Blood and urine were titrated at varying concentrations and digitally photographed in catheter bag tubing. Photos were processed and printed on transparency paper to create a prototype swatch or card showing light, medium, heavy and old hematuria. Using the swatch 60 samples were rated by nurses and laymen. Interobserver variability was reported using the generalized kappa coefficient of agreement. Specimens were analyzed for hemolysis by measuring optical density at oxyhemoglobin absorption peaks. Interobserver agreement between nurses and laymen was good (kappa = 0.51, p <0.001). Subgroup analysis showed substantial agreement for light hematuria (kappa = 0.71). Overall agreement improved when the moderate (kappa = 0.28) and heavy (kappa = 0.53) hematuria categories were combined (kappa = 0.70). Compared to known blood concentrations the assay of optical density at oxyhemoglobin absorption peaks showed a linear trend. A simple visual scale to grade and communicate hematuria with adequate interobserver agreement is feasible. The test for optical density at oxyhemoglobin absorption peaks is a new method, validated in our study, to quantify hemoglobin in a hematuria specimen. Copyright (c) 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Glomerulonephritis (For Parents)

MedlinePlus

... a doctor right away to find the cause. Diagnosis At the doctor's office, explain your child's symptoms. ... Phosphorus Blood in the Urine (Hematuria) Living With Lupus Urine Tests Chronic Kidney Diseases Your Urinary System ...

Nephrolithiasis and hematuria--sometimes a stony road to diagnosis.

PubMed

Sellin, L; Quack, I; Weiner, S M; Waldherr, R; Henning, B; Hofebauer, S; Rump, L C

2005-08-01

We report a case of a young man with a history of kidney stones. Occurrence of gross hematuria several months after the extracorporeal shock wave, lithotripsy (ESWL) treatment lead to hospitalization. By ultrasound and abdominal CT scan, the urologist could exclude post-renal causes of the gross hematuria and acute renal failure. After transfer to a department of nephrology hemodialysis was started, an immediate kidney biopsy was performed and prednisolone was administered on the same day. The kidney biopsy revealed an anti-glomerular basement membrane (GBM) disease. The renal function did not recover and the patient remained on hemodialysis. In the literature it has been hypothesized that ESWL-treated patients are prone to develop anti-GBM disease by liberation of glomerular basement antigen through the ESWL high energy shock waves. An additional hypothesis considering the higher susceptibility for anti-GBM disease among certain HLA-tissue types is discussed with regard to our case. Unfortunately, the prolonged track to diagnosis and delayed immunosuppressive treatment could not prevent poor clinical outcome. Although anti-GBM disease is a rather rare disease, it should be included as a differential diagnosis for hematuria--especially months after ESWL treatment. Otherwise early diagnosis may be missed and as in our patient immunosuppressive treatment will remain unsuccessful to recover renal function.

An evidence-based approach to the management of hematuria in children in the emergency department.

PubMed

Pade, Kathryn H; Liu, Deborah R

2014-09-01

Hematuria is defined as an abnormal number of red blood cells in urine. Even a tiny amount of blood (1 mL in 1000 mL of urine) is sufficient to make urine appear pink or red. In the pediatric population, the majority of etiologies are benign and often asymptomatic. However, hematuria may also be a sign of renal pathology, local infection, or systemic disease. Hematuria can be differentiated into 2 categories: macroscopic hematuria (visible to the naked eye) and microscopic hematuria (> 5 red blood cells/high-powered field on urinalysis). This review will outline the current literature regarding evaluation and management of pediatric patients who present to the emergency department with hematuria. Obtaining a thorough history and the appropriate diagnostic tests will be discussed in depth.

Analysis of 4931 renal biopsy data in central China from 1994 to 2014.

PubMed

Xu, Xiu; Ning, Yong; Shang, Weifeng; Li, Menglan; Ku, Ming; Li, Qing; Li, Yueqiang; Dai, Wei; Shao, Jufang; Zeng, Rui; Han, Min; He, Xiaofeng; Yao, Ying; Lv, Yongman; Liu, Xiaocheng; Ge, Shuwang; Xu, Gang

2016-08-01

The purpose of this study is to investigate the changing spectrum and clinicopathologic correlation of biopsy-proven renal diseases in central China. We retrospectively analyzed data of 4931 patients who underwent renal biopsy in ten hospitals between September 1994 and December 2014. Among them, 81.55% were primary glomerular diseases (GD), and 13.02% were secondary GD. IgA nephropathy (IgAN) was the most common primary GD (43.45%), followed by focal glomerulonephritis (16.79%), mesangial proliferative glomerulonephritis (MsPGN, 14.35%), and membranous nephropathy (MN, 13.28%). IgAN was leading primary GD in patients under 60 years old, while MN was the leading one over 60 years old. The most frequent secondary GD was lupus nephritis (LN) (47.35%). The prevalence of IgAN, MN and minimal change disease was found to increase significantly (p < 0.001, p < 0.001, and p < 0.01, respectively), while that of MsPGN, membranoproliferative glomerulonephritis and LN decreased significantly (p < 0.001, p < 0.001, and p < 0.05, respectively). The main indication for renal biopsy was proteinuria and hematuria (49.03%), followed by nephrotic syndrome (NS, 20.36%). IgAN was the most common cause in patients with proteinuria and hematuria, chronic-progressive kidney injury, hematuria and acute kidney injury; and MN was the leading cause of NS. Primary GD remained the predominant renal disease in central China. IgAN and LN were the most prevalent histopathologic lesions of primary and secondary GD, respectively. The spectrum of biopsy-proven renal disease had a great change in the past two decades. Proteinuria and hematuria was the main indication for renal biopsy.

Hemorrhagic cystitis in a patient receiving conventional doses of dacarbazine for metastatic malignant melanoma: case report and review of the literature.

PubMed

Mohammadianpanah, Mohammad; Shirazi, Mehdi; Mosalaei, Ahmad; Omidvari, Shapour; Ahmadloo, Niloofar

2007-06-01

Hemorrhagic cystitis is a potentially life-threatening complication in patients receiving cancer therapy. This urologic emergency is commonly associated with the chemotherapeutic use of oxazaphosphorine alkylating agents. This report describes a case of hemorrhagic cystitis associated with dacarbazine treatment. A 63-year-old man with asymptomatic metastatic malignant melanoma received 3 cycles of dacarbazine (600-850 mg/m2) monochemotherapy, each 3 weeks apart. Two weeks after the third cycle, he presented with gross hematuria and mild dysuria. Physical examination revealed no significant finding. Hematuria was confirmed by urinalysis, and urinary infection was excluded by repeated urine cultures. Ultrasonography revealed diffuse bladder wall thickening with no discrete mass or ulceration. Cystoscopy findings revealed generalized inflammation and edema of the mucosa of the bladder, confirming the diagnosis of hemorrhagic cystitis. The patient's gross hematuria continued for 2 weeks and then completely resolved with supportive care. Two weeks after complete resolution, the patient experienced 2 transient episodes of gross hematuria that lasted a few hours and subsided spontaneously. Dacarbazine is currently considered the standard first-line treatment in patients with advanced malignant melanoma. At standard prescribed doses (a single dose of 850-1000 mg/m2 or 250 mg/m2 for 5 days per cycle), dacarbazine is a reasonably well tolerated chemotherapeutic drug; nausea, vomiting, and myelosuppression are the most common adverse effects. Association of dacarbazine with hemorrhagic cystitis has not been reported previously (in a PubMed literature search from 1950-2006), and only 1 case report associates temozolomide (an analog of dacarbazine) with hemorrhagic cystitis. Based on the Naranjo adverse drug reactions probability scale, an objective assessment revealed dacarbazine to be a probable cause of hemorrhagic cystitis in this case. This case report suggests that dacarbazine at conventional doses was a probable cause of hemorrhagic cystitis. Regular urinalysis and early intervention are recommended, as a means of detecting early hematuria and subsequently reducing or discontinuing dacarbazine treatment. Adequate hydration before, during, and after dacarbazine administration may be useful in preventing this complication.

Use of Recombinant Factor VIIa in a Pediatric Patient With Initial Presentation of Refractory Acute Immune Thrombocytopenic Purpura and Severe Bleeding

PubMed Central

Gurion, Reut; Siu, Anita; Weiss, Aaron R.; Masterson, Margaret

2012-01-01

Severe bleeding in acute immune thrombocytopenic purpura (ITP) is rare but can cause significant complications to the patient. Here we report the case of a pediatric patient with acute ITP and hematuria refractory to anti-D immune globulin, high dose intravenous immunoglobulin G, and high dose steroids. Her hematuria was successfully treated with recombinant factor VIIa (rFVIIa). While further investigation on the use of rFVIIa in ITP is warranted, this case report contributes to the pediatric literature for its use during the course of an initial presentation of ITP with hemorrhagic complications. PMID:23258971

[Development of a new technique to detect the laterality of microscopic hematuria by means of gas cystoscopy].

PubMed

Kamoi, K; Teraski, T; Kojima, M; Uchida, M; Watanabe, H

1996-04-01

We developed a new technique to determine the laterality of microscopic hematuria by means of gas cystoscopy. An originally designed catheter system consisted of two catheters. On the tip of an inner catheter, a urine dipstick for blood was attached, with a cap on the tip of an outer catheter to keep the dipstick dry. In order to react a dipstick with the urine coming out from a ureteral orifice in the bladder, CO2 was insufflated into the bladder through a cystoscope (gas cystoscopy). The laterality of microscopic hematuria was determined in the bladder, based on the color reaction on the dipstick. This technique was performed successfully in 14 (88%) of 16 cases with microscopic hematuria. The laterality of microscopic hematuria was determined to be ipsilateral in 6 patients, which coincided with the side of a urological upper urinary tract disorder. In contract, bilateral microscopic hematuria was confirmed in 8 patients with glomerular disorders. The diagnostic process in patients with microscopic hematuria remains unsolved for urologists and nephrologists. This technique may provide a new approach in diagnosing microscopic hematuria.

What factors are associated with unplanned return following transurethral resection of bladder tumor? An analysis of a large single institution's experience.

PubMed

Ghali, Fady; Moses, Rachel A; Raffin, Eric; Hyams, Elias S

2016-10-01

This study sought to evaluate factors associated with unplanned hospital return (UR) following transurethral resection of bladder tumor (TURBT), the largest source of readmission among ambulatory urological procedures. A retrospective review of TURBTs at a single academic institution between April 2011 and August 2014 was performed. Demographics, comorbidities, length of stay, tumor size and multiple other factors were recorded. UR was recorded within 30 days of surgery. Bivariate and multivariable analyses were performed to determine factors associated with UR. Among 708 patients undergoing TURBT, 23.9% were female with a mean age of 70 years. The rate of UR was 10.9%. The most common cause of UR was gross hematuria, accounting for 70%. On bivariate analysis, Foley catheter placement in the operating room, non-aspirin anticoagulation and index length of stay longer than 24 h were associated with hematuria-related UR (p < 0.05). Preoperative antibiotics, female gender and aspirin therapy were associated with lower rates of hematuria-related UR (p < 0.05), while tumor size, distance of residence to the hospital, and Foley on hospital discharge (rather than from the operating room) had no association (p > 0.05). On multivariable analysis, only Foley placement in the operating room remained associated with higher rates of hematuria-related UR, while preoperative antibiotics, female gender and aspirin therapy remained associated with a lower likelihood of this event. UR following TURBT is common and typically results from gross hematuria. Patients with postoperative Foley catheterization in the operating room may require additional counseling or supervision before discharge, and should be considered for discharge with a Foley rather than having a prompt voiding trial.

The frequency of hematuria in acne vulgaris patients during isotretinoin treatment.

PubMed

Yesilkaya, Burcu; Alli, Nuran; Artuz, R Ferda; Ulu, Ezgi; Kartal, Demet; Cinar, S Levent

2017-03-01

Systemic isotretinoin (13-cis-retinoic acid) is effective in the treatment of acne vulgaris. The most common side effects are mucocutaneous ones. Hematuria seen secondary to isotretinoin treatment is thought to be due to mucosal dryness in the urinary system. This study aims to determine the frequency of hematuria in acne vulgaris patients during isotretinoin treatment. Eighty-eight subjects aged 16-32 years were included in the study group and 52 subjects were in the control group. The subjects were treated for 6 months and were monitored monthly by complete urine analyzes. They were also examined each month in terms of cheilitis, xerosis, epistaxis, rectal bleeding, fatigue, myalgia, weight loss, dry eye, conjunctivitis, headache, dysuria and pollakiuria. In the study group, 15 subjects (17%) had hematuria at least once during the study, and in the control group, four subjects (7.7%) had hematuria. The difference was not statistically significant (p = 0.118). Among the subjects who had hematuria, 11 of them (73.3%) were female and four of them (33.3%) were male in the study group while all the subjects with hematuria in the control group were female. Hematuria and gender did not show a statistically significant correlation. Hematuria was observed in 17% of the study group; this frequency rate was not different from that of the normal population. In subjects having isotretinoin treatment, if all the other reasons or disorders are excluded, one must keep in mind that hematuria may be due to isotretinoin use.

Idiopathic renal hematuria in a dog; the usefulness of a method of partial occlusion of the renal artery.

PubMed

Mishina, M; Watanabe, T; Yugeta, N; Maeda, H; Fujii, K; Wakao, Y; Takahashi, M; Yamamura, H

1997-04-01

Exploratory laparotomy was performed on a dog suspected of having idiopathic renal hematuria. Two catheters were inserted into the bilateral ureters, and hematuria from the left kidney was confirmed. The blood flow was occluded in the ventral and dorsal rami of the left renal artery in order to localize the site of hemorrhage. As hematuria disappeared when the dorsal ramus was occluded, the site of renal hematuria was localized to the area dominated by the dorsal ramus of the renal artery. As a result of ligating the dorsal ramus of the left renal artery in this dog, renal hematuria subsided, and the dog has shown a favorable course, to date, one year after surgery.

Rapid versus gradual bladder decompression in acute urinary retention.

PubMed

Etafy, Mohamed H; Saleh, Fatma H; Ortiz-Vanderdys, Cervando; Hamada, Alaa; Refaat, Alaa M; Aal, Mohamed Abdel; Deif, Hazem; Gawish, Maher; Abdellatif, Ashraf H; Gadalla, Khaled

2017-01-01

To demonstrate a benefit in diminished adverse events such as hypotension and hematuria with gradual drainage of the bladder when compared to rapid decompression in patients with acute urinary retention (AUR) due to benign prostatic hyperplasia in a case-control study. Sixty-two patients matched our selection criteria presenting with AUR. They were divided into two groups - the first was managed by rapid drainage of the bladder, the second was managed by gradual drainage through a urethral catheter (The first 100 mL immediately evacuated, then the rest evacuated gradually over 2 h). The mean age was 64.4 and 63.2 years in the first and second group, respectively. Diagnosed cause was benign hyperplasia of the prostate. Hematuria occurred in two patients in the first group and none in the second group. The two cases of hematuria were mild and treated conservatively. After the relief of the obstruction, the mean blood pressure was noticed to decrease by 15 mmHg and 10 mmHg in the first and second group, respectively, however, no one developed significant hypotension. Pain relief was achieved after complete drainage in the first group and after the evacuation of 100 mL in the second group. We conclude that there is no significant difference between rapid and gradual decompression of the bladder in patients with AUR. Hematuria and hypotension may occur after rapid decompression of the obstructed urinary bladder, but these complications are rarely clinically significant.

Rapid versus gradual bladder decompression in acute urinary retention

PubMed Central

Etafy, Mohamed H.; Saleh, Fatma H.; Ortiz-Vanderdys, Cervando; Hamada, Alaa; Refaat, Alaa M.; Aal, Mohamed Abdel; Deif, Hazem; Gawish, Maher; Abdellatif, Ashraf H.; Gadalla, Khaled

2017-01-01

Objective: To demonstrate a benefit in diminished adverse events such as hypotension and hematuria with gradual drainage of the bladder when compared to rapid decompression in patients with acute urinary retention (AUR) due to benign prostatic hyperplasia in a case–control study. Methods: Sixty-two patients matched our selection criteria presenting with AUR. They were divided into two groups – the first was managed by rapid drainage of the bladder, the second was managed by gradual drainage through a urethral catheter (The first 100 mL immediately evacuated, then the rest evacuated gradually over 2 h). Results: The mean age was 64.4 and 63.2 years in the first and second group, respectively. Diagnosed cause was benign hyperplasia of the prostate. Hematuria occurred in two patients in the first group and none in the second group. The two cases of hematuria were mild and treated conservatively. After the relief of the obstruction, the mean blood pressure was noticed to decrease by 15 mmHg and 10 mmHg in the first and second group, respectively, however, no one developed significant hypotension. Pain relief was achieved after complete drainage in the first group and after the evacuation of 100 mL in the second group. Conclusions: We conclude that there is no significant difference between rapid and gradual decompression of the bladder in patients with AUR. Hematuria and hypotension may occur after rapid decompression of the obstructed urinary bladder, but these complications are rarely clinically significant. PMID:29118535

Perineal Pseudoaneurysm from Traumatic Foley Removal Leads to Recurrent Life-Threatening Hematuria.

PubMed

Liang, Lorraine Min-Shan; Xue, Jingbing; Erturk, Erdal

2015-01-01

Hematuria resulting from urethral traumatic catheter insertion and removal is often encountered. Usually, hematuria resolves with conservative measures. We report a case of traumatic Foley removal leading to intermittent life-threatening hematuria resulting in blood loss anemia requiring multiple transfusions and multiple episodes of hypotension requiring pressors. A pelvic angiogram revealed a pseudoaneurysm of the left pudendal artery, which was treated with microcoil embolization leading to resolution of bleeding.

Blood in the Urine (Hematuria)

MedlinePlus

... 2 weeks later to make sure the urine is free of red blood cells. If hematuria only happens once, there's usually ... follow-up tests to make sure your urine is free of red blood cells. If the hematuria goes away, your doctor ...

Perineal Pseudoaneurysm from Traumatic Foley Removal Leads to Recurrent Life-Threatening Hematuria

PubMed Central

Xue, Jingbing; Erturk, Erdal

2015-01-01

Abstract Hematuria resulting from urethral traumatic catheter insertion and removal is often encountered. Usually, hematuria resolves with conservative measures. We report a case of traumatic Foley removal leading to intermittent life-threatening hematuria resulting in blood loss anemia requiring multiple transfusions and multiple episodes of hypotension requiring pressors. A pelvic angiogram revealed a pseudoaneurysm of the left pudendal artery, which was treated with microcoil embolization leading to resolution of bleeding. PMID:27579388

Preliminary experience with epsilon aminocaproic acid for treatment of intractable upper tract hematuria in children with hematological disorders.

PubMed

Kaye, Jonathan D; Smith, Edwin A; Kirsch, Andrew J; Cerwinka, Wolfgang H; Elmore, James M

2010-09-01

Gross, intractable hematuria is rare in children. Although the role of epsilon aminocaproic acid in the management of refractory hematuria is well established in the adult population, few data exist about its use in children for this indication. We present our initial experience with epsilon aminocaproic acid for the treatment of intractable hematuria after more conservative measures failed, and propose an algorithm for administration of epsilon aminocaproic acid in children. We reviewed the charts of all patients treated with epsilon aminocaproic acid for intractable gross hematuria at our institution during a period of 36 months. All patients underwent hematological evaluation and any underlying bleeding dyscrasias were addressed. All patients also underwent renal and bladder ultrasound, retrograde pyelogram and ureteroscopy. Demographic information, medical and surgical histories, and epsilon aminocaproic acid dosing and outcomes were recorded. Three boys and 1 girl 11 to 17 years old were treated with epsilon aminocaproic acid. Three patients had sickle trait (1 with nutcracker phenomenon) and 1 had hemophilia A. Three patients required packed red blood cell transfusions to maintain hematocrit. Three renal angiograms were performed, all of which were nondiagnostic. Duration of hematuria ranged from 1 to 52 weeks before administration of epsilon aminocaproic acid. Endoscopic evaluation demonstrated hematuria localized to 1 ureteral orifice in all 4 patients. All patients received 100 mg/kg epsilon aminocaproic acid orally every 6 hours, which uniformly led to cessation of hematuria. Epsilon aminocaproic acid is useful for the management of gross refractory hematuria when more conservative measures fail. Because of its potential side effects, it should be used cautiously. 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

WhatsApp Use In The Evaluation of Hematuria.

PubMed

Sener, Tarik Emre; Butticè, Salvatore; Sahin, Bahadir; Netsch, Christopher; Dragos, Laurian; Pappalardo, Rosa; Magno, Carlo

2018-03-01

The advancements in telemedicine provide the possibility to send photos of hematuria cases to professionals for further evaluation. We aimed to evaluate the inter-rater reliability of WhatsApp use in the evaluation of hematuria. Between December 2014 and April 2016, 212 patients were evaluated prospectively for hematuria by 2 groups of urologists; Group A: in direct contact with patients for evaluation; Group B: "blind" urologist who had no access to the patients' data but received pictures via WhatsApp. Two photos of voided urine in a sterile container were taken and sent using WhatsApp. The opinions of Group A and B about the grade of hematuria were evaluated. Shapiro-Wilk test and Fleiss' kappa statistics were used for statistical analyses. The median age of patients was 71 (min 22, max 96). The Group A urologists were in accordance in 96.22% of cases. Group B urologists had common opinions in 99.5% (n = 203) and there was almost perfect agreement between 2 groups (λ = 0.992). The number of common opinions among "blind" urologists is more than the number of common opinions among the consultants. When further classification is performed as serious and non-serious hematuria, the rate of misdiagnosing serious cases is approximately 6.5-7%. However, using WhatsApp, the urologists can differentiate normal urine and any form of hematuria with 100% accuracy. It is possible to evaluate hematuria remotely and also reduce unnecessary costs of services for hematuria of mild clinical significance by using telemedicine. WhatsApp can provide valuable aid to tertiary hospitals where the urologist is not always present as well as in rural areas. Copyright © 2017 Elsevier B.V. All rights reserved.

Association between arsenic exposure from drinking water and hematuria: Results from the Health Effects of Arsenic Longitudinal Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

McClintock, Tyler R.; Department of Environmental Medicine, New York University School of Medicine, New York, NY; Department of Urology, New York University School of Medicine, New York, NY

2014-04-01

Arsenic (As) exposure has been associated with both urologic malignancy and renal dysfunction; however, its association with hematuria is unknown. We evaluated the association between drinking water As exposure and hematuria in 7843 men enrolled in the Health Effects of Arsenic Longitudinal Study (HEALS). Cross-sectional analysis of baseline data was conducted with As exposure assessed in both well water and urinary As measurements, while hematuria was measured using urine dipstick. Prospective analyses with Cox proportional regression models were based on urinary As and dipstick measurements obtained biannually since baseline up to six years. At baseline, urinary As was significantly relatedmore » to prevalence of hematuria (P-trend < 0.01), with increasing quintiles of exposure corresponding with respective prevalence odds ratios of 1.00 (reference), 1.29 (95% CI: 1.04–1.59), 1.41 (95% CI: 1.15–1.74), 1.46 (95% CI: 1.19–1.79), and 1.56 (95% CI: 1.27–1.91). Compared to those with relatively little absolute urinary As change during follow-up (− 10.40 to 41.17 μg/l), hazard ratios for hematuria were 0.99 (95% CI: 0.80–1.22) and 0.80 (95% CI: 0.65–0.99) for those whose urinary As decreased by > 47.49 μg/l and 10.87 to 47.49 μg/l since last visit, respectively, and 1.17 (95% CI: 0.94–1.45) and 1.36 (95% CI: 1.10–1.66) for those with between-visit increases of 10.40 to 41.17 μg/l and > 41.17 μg/l, respectively. These data indicate a positive association of As exposure with both prevalence and incidence of dipstick hematuria. This exposure effect appears modifiable by relatively short-term changes in drinking water As. - Highlights: • Hematuria is the most common symptom of urinary tract disease. • Arsenic exposure is associated with renal dysfunction and urologic malignancy. • Water arsenic was positively associated with prevalence and incidence of hematuria. • Reduction in exposure lowered hematuria risk especially in low-to-moderate exposed. • Arsenic-related hematuria may represent nonmalignant or premalignant condition.« less

Urinalysis: case presentations for the primary care physician.

PubMed

Sharp, Victoria J; Lee, Daniel K; Askeland, Eric J

2014-10-15

Urinalysis is useful in diagnosing systemic and genitourinary conditions. In patients with suspected microscopic hematuria, urine dipstick testing may suggest the presence of blood, but results should be confirmed with a microscopic examination. In the absence of obvious causes, the evaluation of microscopic hematuria should include renal function testing, urinary tract imaging, and cystoscopy. In a patient with a ureteral stent, urinalysis alone cannot establish the diagnosis of urinary tract infection. Plain radiography of the kidneys, ureters, and bladder can identify a stent and is preferred over computed tomography. Asymptomatic bacteriuria is the isolation of bacteria in an appropriately collected urine specimen obtained from a person without symptoms of a urinary tract infection. Treatment of asymptomatic bacteriuria is not recommended in nonpregnant adults, including those with prolonged urinary catheter use.

An Inexpensive, Point-of-Care Urine Test for Bladder Cancer in Patients Undergoing Hematuria Evaluation.

PubMed

Acharya, Abhinav P; Theisen, Kathryn M; Correa, Andres; Meyyappan, Thiagarajan; Apfel, Abraham; Sun, Tao; Tarin, Tatum V; Little, Steven R

2017-11-01

Although hematuria (blood in urine) is the most common symptom of bladder cancer, 70-98% of hematuria cases are benign. These hematuria patients unnecessarily undergo costly, invasive, and expensive evaluation for bladder cancer. Therefore, there remains a need for noninvasive office-based tests that can rapidly and reliably rule out bladder cancer in patients undergoing hematuria evaluation. Herein, a clinical assay for matrix metalloproteinases ("Ammps") is presented, which generates a visual signal based on the collagenase activity (in urine of patients) on the Ammps substrates. Ammps substrates are generated by crosslinking gelatin with Fe(II) chelated alginate nanoparticles, which precipitate in urine samples. The cleavage of gelatin-conjugated alginate (Fe(II)) nanoparticles by collagenases generates free-floating alginate (Fe(II)) nanoparticles that participate in Fenton's reaction to generate a visual signal. In a pilot study of 88 patients, Ammps had 100% sensitivity, 85% specificity, and a negative predictive value (NPV) of 100% for diagnosing bladder cancer. This high NPV can be useful in ruling out bladder cancer in patients referred for hematuria evaluation. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Endometrial polyps in 2 African pygmy hedgehogs

PubMed Central

2005-01-01

Abstract Reports of spontaneously occurring endometrial polyps in animals are rare and have only involved a few species. This report is intended to advise veterinarians that older African pygmy hedgehogs may develop endometrial polyps and that these lesions can be a cause of bloody vaginal discharge, sometimes interpreted as hematuria. PMID:16048013

Management of bilateral idiopathic renal hematuria in a dog with silver nitrate

PubMed Central

Di Cicco, Michael F.; Fetzer, Tara; Secoura, Patricia L.; Jermyn, Kieri; Hill, Tracy; Chaloub, Serge; Vaden, Shelly

2013-01-01

Renal hematuria has limited treatment options. This report describes management of bilateral idiopathic renal hematuria in a dog with surgically assisted installation of 0.5% silver nitrate solution. Initial treatment resulted in freedom from clinical signs or recurrent anemia for 10 months; however, recurrence of bleeding following a nephrectomy resulted in euthanasia. PMID:24155476

Nutcracker syndrome in adolescent with perineal pain: An interesting case of an adolescent with perineal pain due to pelvic congestion from nutcracker syndrome with relief after balloon venoplasty and sclerotherapy.

PubMed

Boyer, Kathleen; Filan, Eamon; Ching, Brian; Rooks, Veronica; Kellicut, Dwight

2018-02-01

Nutcracker phenomenon is the descriptor for a patient's anatomy whenever the left renal vein becomes compressed between the abdominal aorta and the superior mesenteric artery. Nutcracker syndrome is the terminology used when the nutcracker phenomenon is accompanied by symptoms including pain (abdominal, flank, pelvic), hematuria, and orthostatic proteinuria. Diagnosis can be made with Doppler ultrasound, venography, computed tomography, or magnetic resonance imaging. This case demonstrates some of the typical findings of nutcracker syndrome. The limited clinical features and interesting imaging findings, in addition to the young age of the patient, make this a notable case.

Sex disparities in diagnosis of bladder cancer after initial presentation with hematuria: a nationwide claims-based investigation.

PubMed

Cohn, Joshua A; Vekhter, Benjamin; Lyttle, Christopher; Steinberg, Gary D; Large, Michael C

2014-02-15

Women have disproportionately higher mortality rates relative to incidence for bladder cancer. Multiple etiologies have been proposed, including delayed diagnosis and treatment. Guidelines recommend ruling out malignancy in men and women presenting with hematuria. This study sought to determine the difference in timing from presentation with hematuria to diagnosis of bladder cancer in women versus men. This is a retrospective population-based study examining the timing from presentation with hematuria to diagnosis of bladder cancer, based on data from the MarketScan databases, which include enrollees of more than 100 health insurance plans of approximately 40 large US employers from 2004 through 2010. All study patients presented with hematuria and were subsequently diagnosed with bladder cancer. The primary outcome measure was number of days between initial presentation with hematuria and diagnosis of bladder cancer by sex. A total of 5416 men and 2233 women met inclusion criteria. Mean days from initial hematuria claim to bladder cancer claim was significantly longer in women (85.4 versus 73.6 days, P < .001), and the proportion of women with >6 month delay in bladder cancer diagnosis was significantly higher (17.3% versus 14.1%, P < .001). Women were more likely to be diagnosed with urinary tract infection (odds ratio = 2.32, 95% confidence interval = 2.07-2.59) and less likely to undergo abdominal or pelvic imaging (odds ratio = 0.80, 95% confidence interval = 0.71-0.89). Both men and women experience significant delays between presentation with hematuria and diagnosis of bladder cancer, with longer delays for women. This may be partly responsible for the sex-based discrepancy in outcomes associated with bladder cancer. © 2013 American Cancer Society.

Macroscopic Hematuria After Conventional or Hypofractionated Radiation Therapy: Results From a Prospective Phase 3 Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sanguineti, Giuseppe, E-mail: sanguineti@ifo.it; Arcidiacono, Fabio; Landoni, Valeria

2016-10-01

Purpose: To assess the macroscopic hematuria rates within a single-institution randomized phase 3 trial comparing dose-escalated, conventionally fractionated radiation therapy (CFRT) and moderately hypofractionated radiation therapy (MHRT) for localized prostate cancer. Methods and Materials: Patients with intermediate- to high-risk localized prostate cancer were treated with conformal RT and short-course androgen deprivation. Both the prostate and the entire seminal vesicles were treated to 80 Gy in 40 fractions over 8 weeks (CFRT) or 62 Gy in 20 fractions over 5 weeks (MHRT). The endpoint of the present study was the development of any episode or grade of macroscopic hematuria. The median follow-up period was 93 monthsmore » (range 6-143). Results: Macroscopic hematuria was reported by 25 of 168 patients (14.9%). The actuarial estimate of hematuria at 8 years was 17.0% (95% confidence interval [CI] 10.7%-23.3%). The number of patients with hematuria was 6 and 19 in the CFRT and MHRT arms, respectively, for an actuarial 8-year estimate of 9.7% and 24.3%, respectively (hazard ratio 3.468, 95% CI 1.385-8.684; P=.008). Overall, 8 of 25 patients were found to have biopsy-proven urothelial carcinoma (3 in the CFRT arm and 5 in the MHRT arm; P=.27). Thus, the 8-year actuarial incidence of macroscopic hematuria (after censoring urothelial cancer–related episodes) was 4.1% and 18.2% after CFRT and MHRT, respectively (hazard ratio 4.961, 95% CI 1.426-17.263; P=.012). The results were confirmed by multivariate analysis after accounting for several patient-, treatment-, and tumor-related covariates. Conclusions: MHRT was associated with a statistically significant increased risk of macroscopic hematuria compared with CFRT.« less

HYPNOTHERAPY INTERVENTION FOR LOIN PAIN HEMATURIA: A CASE STUDY1

PubMed Central

Elkins, Gary R.; Koep, Lauren L.; Kendrick, Cassie E.

2012-01-01

Loin pain hematuria is characterized by chronic loin pain, hematuria, and dysuria. There are no known effective treatments for loin pain hematuria and longer-term use of analgesics and surgical options are often ineffective or associated with negative side effects. This article reports on a 17-year-old female patient diagnosed with loin pain hematuria who presented with unilateral, uncontrolled loin pain following numerous unsuccessful attempts at controlling her symptoms with traditional medical interventions—including antibiotics, opioids, and renal denervation. The patient received 8 sessions of hypnotherapy. Baseline, end-point, and follow-up measures administered included the General Health Questionnaire, Hospital Anxiety and Depression Scale, McGill Pain Questionnaire, Pain Discomfort Scale, and visual analogue measures of pain, academic interference, and social interference. At follow-up, results indicated clinically significant decreases in pain, anxiety, and depression with nearly complete remission of presenting symptoms. PMID:22098573

A Cough Deteriorating Gross Hematuria: A Clinical Sign of a Forthcoming Life-Threatening Rupture of an Intraparenchymal Aneurysm of Renal Artery (Wunderlich's Syndrome)

PubMed Central

Anastasiou, Ioannis; Pournaras, Christos; Mitropoulos, Dionysios; Constantinides, Constantinos A.

2013-01-01

Macroscopic hematuria regards the 4% to 20% of all urological visits. Renal artery aneurysms (RAAs) are detected in approximately 0.01%–1% of the general population, while intraparenchymal renal artery aneurysms (IPRAAs) are even more rarely detected in less than 10% of patients with RAAs. We present a case of a 58-year-old woman that came into the emergency room (ER) complaining of a gross hematuria during the last four days. Although in the ER room the first urine sample was clear after a cough episode, a severe gross hematuria began which led to a hemodynamically unstable patient. Finally, a radical nephrectomy was performed, and an IPRAA was the final diagnosis. A cough deteriorating hematuria could be attributed to a ruptured intraparenchymal renal artery aneurysm, which even though constitutes a rare entity, it is a life-threatening medical emergency. PMID:23864981

Risks of repeated visits for uninvestigated dyspepsia in three community hospitals of Khon Kaen, Thailand.

PubMed

Premgamone, Amorn; Maskasem, Srinoi; Thamrongwarangoon, Apisit; Ussavaphark, Wichai

2010-03-01

Uninvestigated dyspepsia (UD) is common and only 26.4% of these are peptic ulcer disease, while 50% are non-ulcer dyspepsia. A recent study found that nephrolithiasis with urinary tract infection may have the dyspeptic symptoms. The authors searched for any associations between repeated UD and pyuria, hematuria and other factors. A case-control study was performed. It consisted of 489 patients with repeated UD who had visited community hospitals for at least two times per year and 489 controls sampled from the data of the subjects, free of dyspeptic symptoms, from the multi-stage random survey for subjective health complaints in the same province. Multivariate logistic regression models were used for case-control comparisons. By logistic regression analysis, UD was significantly associated with problems caused by purine-rich foods (PRFs), chronic fatigue, flank paresthesia, hematuria, myofascial pain, and pyuria. The respective adjusted odds ratios and 95% confidence interval (CI) were: 6.67 (4.58, 9.68), 5.06 (3.46, 7.40), 3.98 (2.41, 6.60), 2.97 (2.01, 4.38), 1.91 (1.32, 2.76) and 1.58 (1.01, 2.45). The variables of age (> 48), sex, dysuria, poly-arthralgia, headache and back pain were not significantly associated with UD. The foods that aggravated UD were bamboo shoots, fermented rice noodles, beef alcohol and insects. The rate of pyuria and hematuria was significantly increased with the number of visits within a year [p-value (Chi-square for trend), 0.015 and 0.032]. These findings indicate that pyuria, hematuria, and purine-rich foods were associated with repeated hospital visits for dyspepsia.

Urologic Outcomes of Children With Hemorrhagic Cystitis After Bone Marrow Transplant at a Single Institution.

PubMed

Au, Jason K; Graziano, Christopher; Elizondo, Rodolfo A; Ryan, Sheila; Roth, David R; Koh, Chester J; Gonzales, Edmond T; Tu, Duong T; Janzen, Nicolette; Naik, Swati; Seth, Abhishek

2017-03-01

To analyze clinical outcomes and the risk factors associated with genitourinary (GU) morbidity and mortality in children who present with hemorrhagic cystitis (HC) after bone marrow transplant (BMT). A retrospective chart review of patients with HC who had undergone BMT at a single pediatric hospital from 2008 to 2015 was conducted. Demographic data, severity of hematuria, HC management, and mortality were analyzed. Bivariate analysis and binary logistic regression were performed to identify risk factors. Out of 43 patients who met inclusion criteria, 67.4% were male with a median age at BMT of 10.2 years (interquartile range 5.8-14.6). Percutaneous nephrostomy catheters were inserted in 5 patients for urinary diversion. All-cause mortality was 32.6% (N = 14). Intravesical retroviral therapy (P <.001), HC grade (P <.001), total Foley time (P <.001), total gross hematuria time (P <.001), total days hospitalized (P = .012), and days to most improved hematuria (P = .032) were associated with significant GU morbidity on bivariate analysis. On multivariable analysis, days to most improved hematuria was associated with significant GU morbidity odds ratio of 1.177 (1.006-1.376) (P = .042). Status of percutaneous nephrostomy was not associated with increased mortality (P = .472); however, in the multivariate model, BK viremia (P = .023), need for renal dialysis (P = .003), and presence of Foley catheter (P = .005) were associated with increased mortality. Children with HC after BMT fall in a very high-risk category with high mortality and significant GU morbidity. The presence of a Foley catheter, need for dialysis, and BK viremia are associated with increased mortality. Copyright © 2016 Elsevier Inc. All rights reserved.

Radio-frequency ablation: new technology for palliative treatment of hematuria in disseminated renal cell carcinoma.

PubMed

Matuszewski, Margin; Krajka, Kazimierz

2007-01-01

Hematuria is often a significant symptom in patients with disseminated renal cell carcinoma. We present a case in which the minimally invasive procedure of radio-frequency ablation was used in a patient with serious hematuria. The procedure was completely successful and there were no complications. In our opinion it may be recommended in such a situation.

Increased hematuria following hypergravic exposure in middle-aged women

NASA Technical Reports Server (NTRS)

Goldwater, D. J.; Ohara, D. B.; Sandler, H.

1982-01-01

The effects of simulated weightlessness on orthostatic tolerance were studied in 9 women (55 to 65 years old) who underwent acceleration and lower body negative pressure before and after 10 days of horizontal bed rest. The results of this study show the first known association of microscopic hematuria with hypergravic and orthostatic stress which suggests similarities to the 'stress hematuria syndrome' previously seen with heavy exercise (Boileau et al., 1980). In addition, the sporadic occurrence of this phenomenon indicates a multifactorial etiology in predisposed individuals. Bedrest or weightlessness simulation per se does not seem to significantly alter renal function, but may decrease microscopic hematuria with an orthostatic component.

Acute glomerulonephritis: a 7 years follow up of children in center of Iran.

PubMed

Sepahi, Mohsen Akhavan; Shajari, Ahmad; Shakiba, Mehrdad; Shooshtary, Fatemeh Khalife; Salimi, Mohammad Hossein

2011-01-01

Acute glomerulonephritis (AGN) is a type of renal disease which indicates the inflammation of glomerulus and nephrons. This study was carried on 94 children, <15 years old with the diagnosis of AGN who were admitted to Qom and Yazd's hospitals between 2000 and 2006. Data were collected using hospital records on admission, progression notes and outpatient follow up. Among 94 patients, 55.3% were male and 44.6% were female. Mean age of patients was 8.2±2.7 years old. Acute post streptococcal glomerulonephritis (APSGN) was reported in 92.5%, membranoproliferative glomerulonephritis in 4.2%, hemolytic uremic syndrome in 2.1% and IgA nephropathy in 1.06%. There was no significant differences between GN types and gender (P=0.54). Clinical manifestation included edema in 68.8%, oliguria in 36.3%, gross hematuria in 69.1%, HTN in 61.7% and anuria in 1.06%. Microscopic hematuria was detected in all patients. In the time of follow up none of patients had hypertension, 3.1% had proteinuria and 6.3% had microscopic hematuria. APSGN is the most common causes of AGN in Qom and Yazd's children. Early diagnosis and treatment of APSGN may protect children from long term morbidity and mortality and improve quality of life.

Intermittent catheterisation with hydrophilic-coated catheters (SpeediCath) reduces the risk of clinical urinary tract infection in spinal cord injured patients: a prospective randomised parallel comparative trial.

PubMed

De Ridder, D J M K; Everaert, K; Fernández, L García; Valero, J V Forner; Durán, A Borau; Abrisqueta, M L Jauregui; Ventura, M G; Sotillo, A Rodriguez

2005-12-01

To compare the performance of SpeediCath hydrophilic-coated catheters versus uncoated polyvinyl chloride (PVC) catheters, in traumatic spinal cord injured patients presenting with functional neurogenic bladder-sphincter disorders. A 1-year, prospective, open, parallel, comparative, randomised, multi centre study included 123 male patients, > or =16 y and injured within the last 6 months. Primary endpoints were occurrence of symptomatic urinary tract infection (UTI) and hematuria. Secondary endpoints were development of urethral strictures and convenience of use. The main hypothesis was that coated catheters cause fewer complications in terms of symptomatic UTIs and hematuria. 57 out of 123 patients completed the 12-month study. Fewer patients using the SpeediCath hydrophilic-coated catheter (64%) experienced 1 or more UTIs compared to the uncoated PVC catheter group (82%) (p = 0.02). Thus, twice as many patients in the SpeediCath group were free of UTI. There was no significant difference in the number of patients experiencing bleeding episodes (38/55 SpeediCath; 32/59 PVC) and no overall difference in the occurrence of hematuria, leukocyturia and bacteriuria. The results indicate that there is a beneficial effect regarding UTI when using hydrophilic-coated catheters.

Endovascular management of recurrent stenosis following left renal vein transposition for the treatment of Nutcracker syndrome.

PubMed

Baril, Donald T; Polanco, Patricio; Makaroun, Michel S; Chaer, Rabih A

2011-04-01

Nutcracker syndrome is an entity resulting from left renal vein compression by the superior mesenteric artery and the aorta, leading to symptoms of left flank pain and hematuria. Conventional treatment has been surgical, commonly through transposition of the left renal vein to a more caudal location on the inferior vena cava. Additionally, endovascular approaches, primarily via renal vein stenting, have been described for treatment of this syndrome. We report the case of a patient with Nutcracker syndrome who underwent successful left renal vein transposition but then developed recurrent symptoms 10 months postoperatively and was successfully treated with angioplasty and stenting. Copyright © 2011 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

Urinary Schistosomiasis in an Adolescent Refugee from Africa: An Uncommon Cause of Hematuria and an Emerging Infectious Disease in Europe.

PubMed

Poddighe, Dimitri; Castelli, Lucia; Pulcrano, Giovanna; Grosini, Alessia; Balzaretti, Michela; Spadaro, Salvatore; Bruni, Paola

2016-10-01

We report a case of urinary schistosomiasis in an adolescent refugee from Gambia (arrived to Italy illegally), who was brought to the Emergency Department of our hospital. The patient complained of gross hematuria and, in the absence of clinical evidence of bacterial urinary infection, was admitted to the pediatric ward, considering his provenience and social setting. An appropriate collection and microscopic analysis of urine samples led to the detection of bilharzia. Much attention should be paid to this emerging disease in Europe by physicians in order to recognize and treat it timely, which could prevent future and higher costs for public health systems and could reduce the potential risk of environmental spreading. In fact, there are some areas in Italy where the parasite can find its intermediate host to complete its lifecycle.

Renal Trauma from Recreational Accidents Manifests Different Injury Patterns than Urban Renal Trauma

PubMed Central

Lloyd, Granville L.; Slack, Sean; McWilliams, Kelly L.; Black, Aaron; Nicholson, Tristan M.

2013-01-01

Purpose The majority of blunt renal trauma is a consequence of motor vehicle collisions and falls. Prior publications based on urban series have shown that significant renal injuries are almost always accompanied by gross hematuria alone or microscopic hematuria with concomitant hypotension. We present a series of blunt renal trauma sustained during recreational pursuits, and describe the mechanisms, injury patterns and management. Materials and Methods Database review from 1996 to 2009 identified 145 renal injuries. Children younger than age 16 years, and trauma involving licensable motor vehicles, penetrating injuries and work related injuries were excluded from analysis. Grade, hematuria, hypotension, age, gender, laterality, mechanism, management, injury severity score and associated injuries were recorded. Results We identified 106 patients meeting the criteria and 85% of the injuries were snow sport related. Age range was 16 to 76 years and 92.5% of patients were male. There were 39 grade 1 injuries, 30 grade 2, 22 grade 3, 12 grade 4 and 3 grade 5 injuries. Gross hematuria was present in 56.7%, 77.2% and 83.3% of grade 2, grade 3 and grade 4 injuries, respectively. None of the patients with grade 2 or greater injuries and microscopic hematuria had hypotension except 1 grade 5 pedicle injury. The nephrectomy and renorrhaphy rate for grade 1 to grade 4 injuries was 0%. Conclusions Compared to urban series of blunt renal trauma, recreationally acquired injuries appear to follow different patterns, including a paucity of associated injuries or hypotension. If imaging were limited to the presence of gross hematuria, or microscopic hematuria with hypotension, 23% of grade 2 to grade 4 injuries would be missed. Men are at higher risk than women. However, operative intervention is rarely helpful. PMID:22591969

Gross hematuria and urinary retention among men from a nationally representative survey in Sierra Leone.

PubMed

Patel, Hiten D; Kamara, Thaim B; Kushner, Adam L; Groen, Reinou S; Allaf, Mohamad E

2014-06-01

To estimate the prevalence of gross hematuria and urinary retention among men in Sierra Leone and report on barriers to care and associated disability. Gross hematuria and urinary retention are classic urologic complaints that require medical attention for significant underlying pathology, but their burden has not been quantified in a developing country. A cluster randomized, cross-sectional household survey was administered in Sierra Leone using the Surgeons OverSeas Assessment of Surgical need tool as a verbal head-to-toe examination. A total of 2 respondents in each of 25 households in 75 clusters were surveyed to assess surgical needs. Data on questions related to blood from the penis and the inability to urinate for men>12 years were included in the present analysis to determine the period and point prevalence of hematuria and urinary retention. From 3645 total respondents, 1054 (28.9%) were men>12 years included in the analysis. Period and point prevalence of gross hematuria were 21.8 per 1000 (95% confidence interval [CI] 13.0-30.7) and 12.3 per 1000 (95% CI 5.7-19.0), respectively, and for urinary retention, they were 19.9 per 1000 (95% CI 11.5-28.4) and 4.7 per 1000 (95% CI 0.5-8.9), respectively. Lack of financial resources was the major barrier to care. Disability assessment showed 19.1% were not able to work as a result of urinary retention, and 34.8% felt ashamed of their gross hematuria. The results provide a prevalence estimate of gross hematuria and urinary retention for men in Sierra Leone. Accessible medical and surgical care will be critical for early intervention and management. Copyright © 2014 Elsevier Inc. All rights reserved.

The role of molecular genetics in diagnosing familial hematuria(s).

PubMed

Deltas, Constantinos; Pierides, Alkis; Voskarides, Konstantinos

2012-08-01

Familial microscopic hematuria (MH) of glomerular origin represents a heterogeneous group of monogenic conditions involving several genes, some of which remain unknown. Recent advances have increased our understanding and our ability to use molecular genetics for diagnosing such patients, enabling us to study their clinical characteristics over time. Three collagen IV genes, COL4A3, COL4A4, and COL4A5 explain the autosomal and X-linked forms of Alport syndrome (AS), and a subset of thin basement membrane nephropathy (TBMN). A number of X-linked AS patients follow a milder course reminiscent of that of patients with heterozygous COL4A3/COL4A4 mutations and TBMN, while at the same time a significant subset of patients with TBMN and familial MH progress to chronic kidney disease (CKD) or end-stage kidney disease (ESKD). A mutation in CFHR5, a member of the complement factor H family of genes that regulate complement activation, was recently shown to cause isolated C3 glomerulopathy, presenting with MH in childhood and demonstrating a significant risk for CKD/ESKD after 40 years old. Through these results molecular genetics emerges as a powerful tool for a definite diagnosis when all the above conditions enter the differential diagnosis, while in many at-risk related family members, a molecular diagnosis may obviate the need for another renal biopsy.

Medical Planning Criteria for Implementation of Clinical Hyperbaric Facilities.

DTIC Science & Technology

1984-12-01

Leprosy 2. Mycosis, selected refractory 3. Gas gangrene . . 4. Soft tissue infection 5. Diabetic ulcer 6. Sickle cell crisis /hematuria 7. Anemia due to...ulcer 25060 , 25061 25069 6. Sickle cell crisis /hematuria 28250 _ 28260 43 o •.. . " • 7. Anemia due to exceptional blood loss 28510 8. Meningitis...1 .001 1.33 3 . Scleroderma (21) 1 .033 1.00 40 Sickle cell crisis /hematuria (6) 1 .127 2.00 4 Skin grafts/flaps, compromised (34) 1 .074 1.87 10

Massive gross hematuria in a sickle cell trait patient with renal papillary necrosis. Conservative approach using a balloon ureteral catheter to tamponade the papilla bleeding.

PubMed

Herard, A; Colin, J; Youinou, Y; Drancourt, E; Brandt, B

1998-08-01

We report the case of a patient with heterozygous sickle cell trait presenting with massive gross hematuria. Ureteroscopy revealed bleeding from the tip of papilla of the inferior calica and allowed us to tamponade the bleeding with a balloon ureteral dilator set (Cook(R) Urology). We show the value of the endourological approach in the conservative management of these patients at high risk of recurrent hematuria.

Gross Hematuria: Assessment and Management at the End of Life

PubMed Central

Groninger, Hunter; Phillips, Jayne M.

2013-01-01

A distressing complication for patients and families, gross hematuria at the end of life challenges hospice and palliative care clinicians to utilize skills in medical and nursing management, communication and clarification of patient goals, and relief of symptom burden. Massive hemorrhage in the genitourinary tract can radically alter the terminal trajectory for patients and necessitate intensive interventions aimed at promoting comfort. Here, a case of gross hematuria in an adult hospice patient serves to broaching decision-making challenges and management strategies. PMID:24826082

Association between arsenic exposure from drinking water and hematuria: results from the Health Effects of Arsenic Longitudinal Study.

PubMed

McClintock, Tyler R; Chen, Yu; Parvez, Faruque; Makarov, Danil V; Ge, Wenzhen; Islam, Tariqul; Ahmed, Alauddin; Rakibuz-Zaman, Muhammad; Hasan, Rabiul; Sarwar, Golam; Slavkovich, Vesna; Bjurlin, Marc A; Graziano, Joseph H; Ahsan, Habibul

2014-04-01

Arsenic (As) exposure has been associated with both urologic malignancy and renal dysfunction; however, its association with hematuria is unknown. We evaluated the association between drinking water As exposure and hematuria in 7843 men enrolled in the Health Effects of Arsenic Longitudinal Study (HEALS). Cross-sectional analysis of baseline data was conducted with As exposure assessed in both well water and urinary As measurements, while hematuria was measured using urine dipstick. Prospective analyses with Cox proportional regression models were based on urinary As and dipstick measurements obtained biannually since baseline up to six years. At baseline, urinary As was significantly related to prevalence of hematuria (P-trend<0.01), with increasing quintiles of exposure corresponding with respective prevalence odds ratios of 1.00 (reference), 1.29 (95% CI: 1.04-1.59), 1.41 (95% CI: 1.15-1.74), 1.46 (95% CI: 1.19-1.79), and 1.56 (95% CI: 1.27-1.91). Compared to those with relatively little absolute urinary As change during follow-up (-10.40 to 41.17 μg/l), hazard ratios for hematuria were 0.99 (95% CI: 0.80-1.22) and 0.80 (95% CI: 0.65-0.99) for those whose urinary As decreased by >47.49 μg/l and 10.87 to 47.49 μg/l since last visit, respectively, and 1.17 (95% CI: 0.94-1.45) and 1.36 (95% CI: 1.10-1.66) for those with between-visit increases of 10.40 to 41.17 μg/l and >41.17 μg/l, respectively. These data indicate a positive association of As exposure with both prevalence and incidence of dipstick hematuria. This exposure effect appears modifiable by relatively short-term changes in drinking water As. Copyright © 2014 Elsevier Inc. All rights reserved.

Association between arsenic exposure from drinking water and hematuria: results from the Health Effects of Arsenic Longitudinal Study

PubMed Central

McClintock, Tyler R.; Chen, Yu; Parvez, Faruque; Makarov, Danil V.; Ge, Wenzhen; Islam, Tariqul; Ahmed, Alauddin; Rakibuz-Zaman, Muhammad; Hasan, Rabiul; Sarwar, Golam; Slavkovich, Vesna; Bjurlin, Marc A.; Graziano, Joseph H.; Ahsan, Habibul

2014-01-01

Arsenic (As) exposure has been associated with both urologic malignancy and renal dysfunction; however, its association with hematuria is unknown. We evaluated the association between drinking water As exposure and hematuria in 7,843 men enrolled in the Health Effects of Arsenic Longitudinal Study (HEALS). Cross-sectional analysis of baseline data was conducted with As exposure assessed in both well water and urinary As measurements, while hematuria was measured using urine dipstick. Prospective analyses with Cox proportional regression models were based on urinary As and dipstick measurements obtained biannually since baseline up to six years. At baseline, urinary As was significantly related to prevalence of hematuria (P-trend < 0.01), with increasing quintiles of exposure corresponding with respective prevalence odds ratios of 1.00 (reference), 1.29 (95% CI: 1.04–1.59), 1.41 (95% CI: 1.15–1.74), 1.46 (95% CI: 1.19–1.79), and 1.56 (95% CI: 1.27–1.91). Compared to those with relatively little absolute urinary As change during follow-up (−10.40 to 41.17 μg/l), hazard ratios for hematuria were 0.99 (95% CI: 0.80–1.22) and 0.80 (95% CI: 0.65–0.99) for those whose urinary As decreased by >47.49 μg/l and 10.87 to 47.49 μg/l since last visit, respectively, and 1.17 (95% CI: 0.94–1.45) and 1.36 (95% CI: 1.10–1.66) for those with between-visit increases of 10.40 to 41.17 μg/l and >41.17 μg/l, respectively. These data indicate a positive association of As exposure with both prevalence and incidence of dipstick hematuria. This exposure effect appears modifiable by short-term changes in drinking water As. PMID:24486435

Gross intermittent hematuria after laparoscopic donor nephrectomy

PubMed Central

Gaurav, G; Santosh, K; Samiran, A; Ganesh, G

2008-01-01

Laparoscopic donor nephrectomy is a routine practice but still requires an intense level of attention to prevent complications. We report a rare case of gross hematuria in postoperative period after an uneventful laparoscopic donor nephrectomy. PMID:19547672

[Secondary amyloidosis of the bladder and massive hematuria].

PubMed

García-Escudero López, A; Arruza Echevarría, A; Leunda Saizar, J; Infante Riaño, R; Padilla Nieva, J; Ortiz Barredo, E

2010-01-01

To report four additional cases of secondary amyloidosis of the bladder, an extremely rare condition, as shown by the cases reported in the literature. Four clinical cases are reported, all of them occurring as hematuria, which was massive and fulminant and resulted in death in three patients. Secondary amyloidosis of the bladder is of the AA type, which is more common in females and mainly secondary to rheumatoid arthritis, but also to ankylosing spondylitis and long-standing chronic inflammatory conditions. Hematuria is the main and virtually only symptom. A pathological and immunohistochemical study confirmed diagnosis. All three patients who experienced massive, fatal hematuria had an intercurrent condition requiring urethral catheterization, which was the triggering factor. Despite its rarity, as shown by the few cases reported, secondary amyloidosis of the bladder should be considered in patients already diagnosed with systemic amyloidosis and/or the conditions reported who require simple urethral catheterization.

Povidone iodine sclerotherapy for treatment of idiopathic renal hematuria in two dogs.

PubMed

Adelman, Lauren B; Bartges, Joseph; Whittemore, Jacqueline C

2017-01-15

CASE DESCRIPTION A 6-year-old spayed female Great Pyrenees (dog 1) and a 2-year-old spayed female German Shepherd Dog (dog 2) were evaluated because of gross hematuria of 5 and 2 months' duration, respectively. CLINICAL FINDINGS In both dogs, coagulation times were within reference limits, results of aerobic bacterial culture of urine samples were negative, echogenic debris could be seen within the urinary bladder ultrasonographically, and hematuric urine could be seen exiting the right ureterovesicular junction, with grossly normal urine exiting the left ureterovesicular junction, during cystoscopy. A diagnosis of idiopathic renal hematuria was made in both dogs. TREATMENT AND OUTCOME Both dogs underwent retrograde ureteropyelography, unilateral povidone iodine sclerotherapy, and ureteral stent placement. The right ureter was occluded with a ureteropelvic junction balloon catheter, and a 5% povidone iodine solution was infused into the renal pelvis 3 times. A double-pigtail ureteral stent was then placed. Both dogs recovered without complications, with cessation of gross hematuria within 12 hours. Cystoscopic removal of the ureteral stent was performed in dog 1 after 4 months; at that time, the urine sediment contained 5 to 10 RBCs/hpf. In dog 2, urine sediment contained 50 to 75 RBCs/hpf 2 weeks after sclerotherapy, with continued resolution of gross hematuria 8 weeks after sclerotherapy. The owners declined removal of the stent in dog 2. CLINICAL RELEVANCE Findings suggested that povidone iodine sclerotherapy may be an effective renal-sparing treatment for idiopathic renal hematuria in dogs. Further evaluation with longer follow-up times is warranted.

Urogenital involvement in the Klippel-Trenaunay-Weber syndrome. Treatment options and results.

PubMed

Vicentini, Fabio C; Denes, Francisco T; Gomes, Cristiano M; Danilovic, Alexandre; Silva, Frederico A; Srougi, Miguel

2006-01-01

Klippel-Trenaunay-Weber syndrome (KTWS) is a congenital condition characterized by vascular malformations of the capillary, venous and lymphatic systems associated to soft tissue and bone hypertrophy in the affected areas. This syndrome may involve bladder, kidney, urethra, ureter and genitals. We report the treatment of 7 KTWS patients with urogenital involvement. From 1995 to 2005, 7 patients with KTWS were evaluated and the charts of these patients were reviewed. Patients' median age was 19-years (range 4 to 46-years) and only 1 was female. The clinical presentation included genital deformities in 3 cases, hematuria in 2 and urethrorragia in 2, one of which associated with cryptorchidism and phimosis. Three patients had an association of pelvic and genital malformations, including 2 patients with hematuria due to vesical lesions and 1 patient with left ureterohydronephrosis due to a pelvic mass. Two patients had urethral lesions. Treatment included endoscopic laser coagulation for 1 patient with recurrent hematuria and 1 patient with urethrorrhagia, pelvic radiotherapy for 1 patient with hematuria and circumcision in 2 patients with genital deformities. One patient required placement of a double-J catheter to relieve obstruction. Hematuria and urethrorragia were safely and effectively controlled with laser applications. Circumcision was also effective. The patient treated with radiotherapy developed a contracted bladder and required a continent urinary diversion. Urogenital involvement in patients with KTWS is not rare and must be suspected in the presence of hematuria or significant cutaneous deformity of the external genitalia. Surgical treatment may be warranted in selected cases.

A Novel Mutation in a Kazakh Family with X-Linked Alport Syndrome

PubMed Central

Rakhimova, Saule E.; Nigmatullina, Nazym B.; Momynaliev, Kuvat T.; Ramanculov, Yerlan M.

2015-01-01

Alport syndrome is a genetic condition that results in hematuria, progressive renal impairment, hearing loss, and occasionally lenticonus and retinopathy. Approximately 80% of Alport syndrome cases are caused by X-linked mutations in the COL4A5 gene encoding type IV collagen. The objective of this study was to define the SNP profiles for COL4A5 in patients with hereditary nephritis and hematuria. For this, we examined four subjects from one Kazakh family clinically affected with X-linked Alport syndrome due to COL4A5 gene mutations. All 51 exons of the COL4A5 gene were screened by linkage analysis and direct DNA sequencing, resulting in the identification of a novel mutation (G641E) in exon 25. The mutation was found only in two affected family individuals but was not present in healthy family members or 200 unrelated healthy controls. This result demonstrates that this novel mutation is pathogenic and has meaningful implications for the diagnosis of patients with Alport syndrome. PMID:26168235

A Novel Mutation in a Kazakh Family with X-Linked Alport Syndrome.

PubMed

Baikara, Barshagul T; Zholdybayeva, Elena V; Rakhimova, Saule E; Nigmatullina, Nazym B; Momynaliev, Kuvat T; Ramanculov, Yerlan M

2015-01-01

Alport syndrome is a genetic condition that results in hematuria, progressive renal impairment, hearing loss, and occasionally lenticonus and retinopathy. Approximately 80% of Alport syndrome cases are caused by X-linked mutations in the COL4A5 gene encoding type IV collagen. The objective of this study was to define the SNP profiles for COL4A5 in patients with hereditary nephritis and hematuria. For this, we examined four subjects from one Kazakh family clinically affected with X-linked Alport syndrome due to COL4A5 gene mutations. All 51 exons of the COL4A5 gene were screened by linkage analysis and direct DNA sequencing, resulting in the identification of a novel mutation (G641E) in exon 25. The mutation was found only in two affected family individuals but was not present in healthy family members or 200 unrelated healthy controls. This result demonstrates that this novel mutation is pathogenic and has meaningful implications for the diagnosis of patients with Alport syndrome.

Nephron sparing by partial median nephrectomy for treatment of renal hemangioma in a dog.

PubMed

Mott, J C; McAnulty, J F; Darien, D L; Steinberg, H

1996-04-15

A 6-year-old neutered male Golden Retriever was admitted for evaluation of intermittent hematuria of 2 months' duration. A 3-cm heterogeneous mass causing distortion of the caudomedial aspect of the left kidney was detected via ultrasonography. Histologic examination of a renal tissue sample obtained by ultrasound-guided biopsy revealed a telangiectatic vascular plexus of unknown origin. Low glomerular filtration rate was identified by a modified exogenous creatinine clearance test. Excretory urography revealed a filling defect in the medial aspect of the caudal pole of the kidney, near the hilus. Because total renal function was low, a decision was made to perform nephron-sparing surgery involving resection of centrally located renal parenchymal and pelvic tissue by en bloc resection in the median plane, instead of radical nephrectomy. After surgery, the hematuria resolved and further decrease in renal function was not evident. Nephron-sparing surgery is a viable option for dogs with compromised renal function when there is concern that radical nephrectomy may precipitate uremia.

Squamous cell carcinoma of the bladder mimicking interstitial cystitis and voiding dysfunction.

PubMed

Prudnick, Colton; Morley, Chad; Shapiro, Robert; Zaslau, Stanley

2013-01-01

Squamous cell carcinoma (SCC) of the bladder is a relatively uncommon cause of bladder cancer accounting for <5% of bladder tumors in the western countries. SCC has a slight male predominance and tends to occur in the seventh decade of life. The main presenting symptom of SCC is hematuria, and development of this tumor in the western world is associated most closely with chronic indwelling catheters and spinal cord injuries. A 39-year-old Caucasian female presented with bladder and lower abdominal pain, urinary frequency, and nocturia which was originally believed to be interstitial cystitis (IC) but was later diagnosed as SCC of the bladder. Presentation of SCC without hematuria is an uncommon presentation, but the absence of this symptom should not lead a practitioner to exclude the diagnosis of SCC. This case is being reported in an attempt to explain the delay and difficulty of diagnosis. Background on the risk factors for SCC of the bladder and the typical presenting symptoms of bladder SCC and IC are also reviewed.

Emphysematous cystitis: a rare cause of gross hematuria.

PubMed

Chang, Chirn-Bin; Chang, Chia-Chu

2011-05-01

Emphysematous cystitis is a relatively rare infectious condition of the urinary bladder. The mortality rate is high if the diagnosis is delayed or if the treatment is inadequate. We present an uncommon case of emphysematous cystitis and highlight the risk factors for this disease. An 81-year-old man with a past medical history of type 2 diabetes and a central pontine infarction presented to the Emergency Department due to gross hematuria. Computed tomography (CT) and plain radiography revealed localized gas within the bladder that was compatible with the diagnosis of emphysematous cystitis. A Foley catheter was inserted. Urine culture grew Klebsiella pneumoniae; 2 g cefotaxime daily was initiated. Subsequent plain radiography and CT scan showed regression of intraluminal gas. We recommend CT for the definitive diagnosis of emphysematous cystitis. Adequate antibiotic therapy, strict blood glucose control, adequate drainage of urine, and early goal-directed therapy for suspected sepsis are suggested to prevent the complications of emphysematous cystitis. Copyright © 2011 Elsevier Inc. All rights reserved.

The development of reversible hematuria and oliguria following elevation of renal venous pressure.

DOT National Transportation Integrated Search

1963-01-01

An investigation was completed to study the acute effects of elevated renal venous pressure in the development of reversible gross hematuria and oliguria. Both isolated and intact dog kidney preparations were utilized. Results demonstrate that gross ...

Blood in the Urine (Hematuria) (For Parents)

MedlinePlus

... weeks later, just to make sure the urine is free of red blood cells. Hematuria that only happens once won't ... up tests to make sure your child's urine is free of red blood cells. Reviewed by: Robert S. Mathias, MD Date reviewed: ...

Can renal and bladder ultrasound replace CT urogram in patients investigated for microscopic hematuria?

PubMed

Tan, Wei Shen; Sarpong, Rachael; Khetrapal, Pramit; Rodney, Simon; Mostafid, Hugh; Cresswell, Joanne; Hicks, James; Rane, Abhay; Henderson, Alastair; Watson, Dawn; Cherian, Jacob; Williams, Norman; Brew-Graves, Chris; Feber, Andrew; Kelly, John D

2018-04-24

Computed tomography urogram (CTU) is recommended when investigating patients with hematuria. We determine the incidence of urinary tract cancer and compare the diagnostic accuracy of CTU and renal and bladder ultrasound (RBUS) at identifying urinary tract cancer. The DETECT I study (clinicaltrials.gov NCT02676180) is a prospective observational study recruiting patients ≥18 years following a presentation of macroscopic or microscopic haematuria at 40 hospitals. All patients had cystoscopy and upper tract imaging (CTU, RBUS or both). 3,556 patients with a median age of 68 years were recruited, of which 2166 had RBUS and 1692 had CTU in addition to cystoscopy. The incidence of bladder, renal and upper tract urothelial cancer (UTUC) were 11.0%, 1.4% and 0.8% respectively in macroscopic hematuria patients. Patients with microscopic hematuria had a 2.7%, 0.4% and 0% incidence of bladder, renal and UTUC respectively. The sensitivity and negative predictive value (NPV) of RBUS for the detection of renal cancer was 85.7% and 99.9% respectively but 14.3% and 99.7% for the detection of UTUC. RBUS was poor at identifying renal calculi. Sensitivity of RBUS was lower than CTU for the detection of bladder cancer (both <85%). Cystoscopy has a specificity and PPV of 98.3% and 83.9% respectively. CTU can be safely replaced with RBUS in patients with microscopic hematuria. The incidence of UTUC is 0.8% in patients with macroscopic hematuria and CTU is recommended. Patients with suspected renal calculi will require non-contrast renal tract CT. Imaging cannot replace cystoscopy to diagnose bladder cancer. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

[Macroscopic hematuria secondary to nutcracker syndrome and successful endovascular treatment].

PubMed

Hinojosa, Carlos A; Anaya-Ayala, Javier E; Boyer-Duck, Estefanía; Laparra-Escareno, Hugo; Torres-Machorro, Adriana; Lizola, Rene

2017-12-01

Nutcracker syndrome is a rare entity, and in the majority of cases is the result of extrinsic compression of the left renal vein between the superior mesenteric artery and the aorta, associated with functional stenosis. To present the case of a 19-year-old female with no significant medical history with confirmed diagnosed of nutcracker syndrome treated successfully by endovascular means. She was referred to the Vascular Surgery Department with a 6-month history of macroscopic haematuria, after other aetiologies were ruled out. Abdominal computed tomography angiography revealed compression of the left renal vein; the patient underwent endovascular treatment, and a 12×16 mm balloon expandable stent was placed with immediate angiographic improvement, decreased pressure gradients and progressive resolution of haematuria. At one year, she remains symptom-free. Nutcracker syndrome is uncommon, and a high index of suspicion is needed. Macroscopic haematuria is not always present, and in our case stent placement demonstrated effectiveness in the resolution of symptoms at 12 months' follow--up. We also present a brief review of the literature. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

Therapeutic options for intractable hematuria in advanced bladder cancer.

PubMed

Abt, Dominik; Bywater, Mirjam; Engeler, Daniel Stephan; Schmid, Hans-Peter

2013-07-01

Intractable hematuria is a common and severe complication in patients with inoperable bladder carcinoma. The aim was to provide an overview of therapeutic options for such cases, and analyze their effectiveness and risk profile, so a systematic literature search of peer-reviewed papers published up to September 2012 was carried out. Various options are available to treat hematuria in patients with inoperable bladder cancer; these include orally administered epsilon-aminocaproic acid, intravesical formalin, alum or prostaglandin irrigation, hydrostatic pressure, urinary diversion, radiotherapy, embolization and intraarterial mitoxantrone perfusion. These treatment options are associated with different prospects of success, risks and side-effects. Well-designed and large studies comparing options are completely lacking. Despite various treatment options, management of intractable hematuria in patients with inoperable bladder cancer remains a challenge, and most of the reported methods should be seen as experimental. Interventional radiology and alum instillation seem to be suitable alternative options for patients who, after critical consideration, cannot be treated by irrigation, transurethral resection or palliative cystectomy. © 2013 The Japanese Urological Association.

Chronic hematuria and localized bladder damage following combined cyclophosphamide and local radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kende, G.; Wajsman, Z.; Thomas, P.R.M.

1979-01-01

A 13-year-old white male had Ewing sarcoma of the right pubic and ischial bones. Initial therapy consisted of 5400 rads in seven weeks to the right side of the pelvis and 14 intravenous injections of cyclophosphamide (Cytoxan, CTX) at 500 mg/m/sup 2/; BCNU and Adriamycin maintenance therapy continued for a total of two years. He has now been disease-free for five years. Three months following the completion of the right pelvic radiotherapy (RT), while on intravenous CTX, severe hematuria appeared, which subsided, but at present he has continuous microscopic hematuria, as well as periodic episodes of gross hematuria. Serial cystocopiesmore » initially revealed thickening and hemorrhagic and edematous changes on the right (irradiated) side of the bladder, and recent multiple telangiectatic patches have been demonstrated as a late healing phase. This case demonstrates the additive toxicity to the bladder of CTX and RT, illustrating that the hemorrhagic cystitis can be extremely protracted lasting five years.« less

Giant kidney worm (Dioctophyma renale) infections in dogs from Northern Paraná, Brazil.

PubMed

Nakagawa, Tizianne Larissa Duim Ribeiro; Bracarense, Ana Paula Frederico Rodrigues Loureiro; dos Reis, Antônio Carlos Faria; Yamamura, Milton Hissashi; Headley, Selwyn Arlington

2007-04-30

This article describes the pathological observations of Dioctophyma renale in dogs from the northern region of the State of Paraná, Brazil. A female, 6-year-old dog, Fila Brasileiro breed and a 16-year-old, male Poodle were diagnosed positive for D. renale during routine necropsy. Clinically, both dogs demonstrated hematuria, and the Poodle had a radiographic diagnosis of prostatic tumor, but neither had a clinical diagnosis of this infection prior to necropsy. Three giant worms were observed in the urinary bladder of the first case and one within the renal pelvis of the other dog. Histological findings were similar in both cases and represented compressive atrophy due to the presence of the nematode. Additionally, aspects of the life cycle, pathogenesis and epidemiology associated with this parasitism in Brazil are also discussed.

Mucosa-sparing, KTP laser coagulation of submucosal telangiectatic vessels in patients with radiation-induced cystitis: a novel approach.

PubMed

Talab, Saman Shafaat; McDougal, W Scott; Wu, Chin-Lee; Tabatabaei, Shahin

2014-08-01

This study aimed evaluate the safety and feasibility of endoscopic potassium titanyl phosphate (KTP) laser application in the management of patients with radiation-induced hemorrhagic cystitis (RHC). We retrospectively reviewed the records of 20 patients with RHC who underwent endoscopic KTP laser ablation of telangiectatic bladder vessels between October 2005 and January 2013. After initial cystoscopy, KTP laser was used to ablate the submucosal vasculature while preserving the overlying mucosa. The surgical outcome was evaluated by duration of hematuria-free interval, number of episodes of hematuria, and number of required medical and/or surgical interventions after initial treatment. Overall, 20 patients underwent 26 sessions of KTP laser ablation of bladder vessels. The procedure was able to stop bleeding 92% of the time and the average hematuria-free interval after ablation was 11.8 months, with a range of 1-37 months. In 13 patients (65%) hematuria resolved after 1 session of KTP laser treatment, whereas 5 patients (25%) required multiple sessions. Two patients (10%) with severe hematuria continued to have bleeding after laser treatment, which necessitated proximal diversion of urine with percutaneous nephrostomy tubes to control bleeding. This study suggests that KTP laser, with its unique photoselectivity property, is a safe, effective, and durable treatment with minimal side effects for ablation of submucosal bladder vessels in patients with RHC. Copyright © 2014 Elsevier Inc. All rights reserved.

[Intravesical active prostate bleeding diagnosed in B-mode ultrasound].

PubMed

Kirchgesner, T; Danse, E; Tombal, B

2013-09-01

Hematuria is one of the most frequent minor complications after prostatic biopsy. We would like to report the case of a 68-year-old patient with massive hematuria after prostatic biopsy and intravesical active prostate bleeding diagnosed in B-mode ultrasonography. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

[Hemangioma of the renal calyx].

PubMed

Jlidi, R; Jemni, M; Zakhama, A; Mokni, M; Kraim, C; Bouzakoura, C

1991-01-01

A case of renal hemangioma in a child is reported. The patient presented with severe painless hematuria. Intravenous pyelography showed a filling defect in the middle calyx of the right kidney. Ultrasonography showed a hypoechoic zone in the renal sinus. Hematuria was unilateral on right side at cystoscopy. Total nephrectomy was performed. The diagnosis was confirmed by histology.

Renal vein thrombosis mimicking urinary calculus: a dilemma of diagnosis.

PubMed

Wang, Yimin; Chen, Shanwen; Wang, Wei; Liu, Jianyong; Jin, Baiye

2015-07-02

Renal vein thrombosis (RVT) with flank pain, and hematuria, is often mistaken with renal colic originating from ureteric or renal calculus. Especially in young and otherwise healthy patients, clinicians are easily misled by clinical presentation and calcified RVT. A 38-year-old woman presented with flank pain and hematuria suggestive of renal calculus on ultrasound. She underwent extracorporeal shock wave lithotripsy that failed, leading to the recommendation that percutaneous lithotomy was necessary to remove the renal calculus. In preoperative view of the unusual shape of the calculus without hydronephrosis, noncontrast computed tomography was taken and demonstrated left ureteric calculus. However computed tomography angiography revealed, to our surprise, a calcified RVT that was initially thought to be a urinary calculus. This case shows that a calcified RVT might mimic a urinary calculus on conventional ultrasonography and ureteric calculus on noncontrast computed tomography. Subsequent computed tomography angiography disclosed that a calcified RVT caused the imaging findings, thus creating a potentially dangerous clinical pitfall. Hence, it is suggested that the possibility of a RVT needs to be considered in the differential diagnosis whenever one detects an uncommon shape for a urinary calculus.

Variation in the Diagnostic Evaluation among Persons with Hematuria: Influence of Gender, Race and Risk Factors for Bladder Cancer.

PubMed

Ark, Jacob T; Alvarez, JoAnn R; Koyama, Tatsuki; Bassett, Jeffrey C; Blot, William J; Mumma, Michael T; Resnick, Matthew J; You, Chaochen; Penson, David F; Barocas, Daniel A

2017-11-01

We sought to determine whether race, gender and number of bladder cancer risk factors are significant predictors of hematuria evaluation. We used self-reported data from SCCS (Southern Community Cohort Study) linked to Medicare claims data. Evaluation of subjects diagnosed with incident hematuria was considered complete if imaging and cystoscopy were performed within 180 days of diagnosis. Exposures of interest were race, gender and risk factors for bladder cancer. Of the 1,412 patients evaluation was complete in 261 (18%). On our adjusted analyses African American patients were less likely than Caucasian patients to undergo any aspect of evaluation, including urology referral (OR 0.72, 95% CI 0.56-0.93), cystoscopy (OR 0.67, 95% CI 0.50-0.89) and imaging (OR 0.75, 95% CI 0.59-0.95). Women were less likely than men to be referred to a urologist (OR 0.59, 95% CI 0.46-0.76). Also, although all patients with 2 or 3 risk factors had 31% higher odds of urology referral (OR 1.31, 95% CI 1.02-1.69), adjusted analyses indicated that this effect was only apparent among men. Only 18% of patients with an incident hematuria diagnosis underwent complete hematuria evaluation. Gender had a substantial effect on referral to urology when controlling for socioeconomic factors but otherwise it had an unclear role on the quality of evaluation. African American patients had markedly lower rates of thorough evaluation than Caucasian patients. Number of risk factors predicted referral to urology among men but it was otherwise a poor predictor of evaluation. There is opportunity for improvement by increasing the completion of hematuria evaluations, particularly in patients at high risk and those who are vulnerable. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

[Vesical schistosomiasis, case report and Spanish literature review].

PubMed

Donate Moreno, M J; Pastor Navarro, H; Giménez Bachs, J M; Carrión López, P; Segura Martín, M; Salinas Sánchez, A S; Virseda Rodríguez, J A

2006-01-01

Urinary schistosomiasis is an infection caused by parasite, Schistosoma haematobium. Squistosomiasis is an endemic disease in Africa and Middle East. We are presenting a case of a young immigrant male from Mali that came to our clinic with hematuria and miccional irritative syndrome during a year. Parasitological study reported Schimosoma's eggs and ecography showed a possible vesical newformation. After RTU, anatomopatological study confirms the presence of a vesical esquistosomiasis. Now pacient is asyntomatic after he was treated with Praziquantel.

Urethral polyp-like lesions on prostatic urethra caused by Chlamydia trachomatis infection: a case report.

PubMed

Muranaka, Takashi; Takahashi, Satoshi; Hirose, Takaoki; Hattori, Atsuo

2014-11-01

Urethral polyp is one of differential diagnoses for the male patients complain of gross-hematuria and/or hematospermia. However, there have been limited numbers of case reports including infectious etiology. Here we reported clinical course and pathological findings of one rare case who was diagnosed and treated as urethral polyp-like lesions on the prostatic urethra caused by Chlamydia trachomatis infection. A 25 year-old man who had a past history of frequent sexual intercourse with unspecified female sexual partner visited the clinic. His chief complaint was gross-hematuria and hematospermia. Endoscopic findings showed that non-specific hemorrhagic polyp-like lesions. To determine the pathological findings including malignant diseases and diagnosis, transurethral resection was performed. Because the pathological findings were similar to those of chlamydial proctitis, additional examination was done. As the results, nucleic acid amplification test of C. trachomatis in urine specimen was positive and immunohistochemical staining of specific chlamydia antigen in resected specimen was also positive. Treatment by orally minocyline 100 mg twice daily for 4 weeks was introduced. After the treatment, symptom was disappeared and nucleic acid amplification test of C. trachomatis in urine specimen turned to be negative. No recurrence was reported 2 years posttreatment. Copyright © 2014 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

What Is New in Evaluation of Asymptomatic Microscopic Hematuria in Women?: Best Articles From the Past Year.

PubMed

Kenton, Kimberly

2017-09-01

This month we focus on current research in asymptomatic microscopic hematuria. Dr. Kenton discusses four recent publications, which are concluded with a "bottom line" that is a take-home message. A complete reference for each can be found on on this page along with direct links to abstracts.

Hematuria as a sign of aorto-caval fistula.

PubMed Central

Brewster, D C; Ottinger, L W; Darling, R C

1977-01-01

An aorto-caval fistula is a rare complication of an abdominal aortic aneurysm (AAA). Typical features, including congestive heart failure and a loud abdominal bruit, may be present and allow prompt diagnosis, but not infrequently they are absent or overlooked and the diagnosis not made preoperatively. Four patients with an AAA and an aorto-caval fistula are described, each of whom presented with hematuria. We believe the presence of hematuria in a patient with a symptomatic AAA should suggest the diagnosis of an aorto-caval fistula. A correct preoperative diagnosis may contribute to better planning of the operative procedure, reduced blood loss, and avoidance of possible pulmonary embolization. Images Fig. 1a. Fig. 1b. Fig. 2a. Fig. 2b. Fig. 3. Fig. 4. PMID:603281

Prostate Artery Embolization (PAE) in the Management of Refractory Hematuria of Prostatic Origin Secondary to Iatrogenic Urological Trauma: A Safe and Effective Technique.

PubMed

Kably, Isaam; Pereira, Keith; Chong, William; Bhatia, Shivank

2016-02-01

Incidence of refractory hematuria of prostatic origin (RHPO) is extremely rare, with an iatrogenic etiology even rarer. When conservative methods fail to control bleeding, more invasive surgical methods are needed. In this article we describe our experience with prostatic artery embolization (PAE) as a minimally invasive alternative treatment option in patients with RHPO secondary to iatrogenic urologic trauma. Three patients presented with RHPO. The etiologies were transurethral resection of prostate surgery, Foley catheter removal with a supratherapeutic international normalized ratio and self-traumatic Foley catheter removal respectively. Stepwise management with conservative and medical methods failed to control bleeding. Under local anesthesia and moderate sedation, bilateral PAE was performed via a right common femoral artery access and using cone beam computed tomography. An embolic mixture containing 300-500 um Embosphere® Microspheres (Biosphere Medical, Rockland, MA) was injected under fluoroscopic guidance until stasis was achieved. PAE using the described technique was a technical and clinical success in all three patients. Hematuria resolved within a period of 24 hours. There were no intra- or periprocedural complications. PAE offers a reasonable option in treatment of RHPO, regardless of the cause and may be attempted prior to surgical techniques or sometimes in conjunction. Being minimally invasive and performed under local anesthesia, PAE is especially useful when excessive bleeding prevents adequate visualization of a bleeding source during cystoscopy and in the elderly age group with several comorbidities. An added advantage is the prostatic parenchymal ischemia leading to significant prostate volume reduction and alleviation of the obstructive symptoms. Copyright © 2016 Elsevier Inc. All rights reserved.

Urinary tract infection-like symptom is associated with worse bladder cancer outcomes in the Medicare population: Implications for sex disparities.

PubMed

Richards, Kyle A; Ham, Sandra; Cohn, Joshua A; Steinberg, Gary D

2016-01-01

To determine the time to bladder cancer diagnosis from initial infection-like symptoms and its impact on cancer outcomes. Using Surveillance, Epidemiology and End Results-Medicare, we designed a retrospective cohort study identifying beneficiaries aged ≥ 66 years diagnosed with bladder cancer from 2007 to 2009. Patients were required to have a hematuria or urinary tract infection claim within 1 year of bladder cancer diagnosis (n = 21 216), and have 2 years of prior Medicare data (n = 18 956) without any precedent hematuria, bladder cancer or urinary tract infection claims (n = 12 195). The number of days to bladder cancer diagnosis was measured, as well as the impact of sex and presenting symptom on time to diagnosis, pathology, and oncological outcomes. The mean time to bladder cancer diagnosis was 72.2 days in women versus 58.9 days in men (P < 0.001). A logistic regression model identified the greatest predictors of ≥ pT2 pathology were both women (odds ratio 2.08, 95% confidence interval 1.70-2.55) and men (odds ratio 1.71, 95% confidence interval 1.49-1.97) presenting with urinary tract infection. Cox proportional hazards analysis identified an increased risk of mortality from bladder cancer and all causes in women presenting with urinary tract infection (hazard ratio 1.37, 95% confidence interval 1.10-1.71, and hazard ratio 1.47, 95% confidence interval 1.28-1.69) compared with women with hematuria. Women have a longer interval from urinary tract infection to diagnosis of bladder cancer. Urinary tract infection presentation can adversely affect time to diagnosis, pathology and survival. Time to diagnosis seems not to be an independent predictor of bladder cancer outcomes. © 2015 The Japanese Urological Association.

Prevalence of hypertension, obesity, hematuria and proteinuria amongst healthy adolescents living in Western Saudi Arabia

PubMed Central

Hothan, Kholoud A.; Alasmari, Bashaer A.; Alkhelaiwi, Omniya K.; Althagafi, Khalid M.; Alkhaldi, Abdulaziz A.; Alfityani, Ahmed K.; Aladawi, Mohannad M.; Sharief, Sara N.; Desoky, Sherif El; Kari, Jameela A.

2016-01-01

Objectives: To determine the prevalence of hypertension, obesity, hematuria, and proteinuria among healthy adolescents and to determine the associated risk factors. Methods: This is a cross-sectional study of 8 intermediate schools in Jeddah, Saudi Arabia between March 2015 and June 2015. Samples were selected randomly and equal proportions from each school for both genders were ensured. Both blood pressure and body mass index were measured and a brief questionnaire was filled out for the specified studied group. Urine dipstick analysis was carried out for 294 children. A second questionnaire was completed for hypertensive and obese subjects in addition to those with hematuria and proteinuria. Results: A total of 401 children (200 males) with a mean (SD) age of 13.87 (1.27) were included. Hypertension was found in 17.2% with a male to female ratio of 1.4:1. Pre-hypertension was found in 4.2% of our sample with a male to female ratio of 2.1:1. Obesity was found in 19.2% with a male to female ratio of 1.5:1. Obesity was found to be the most significant risk factor for hypertension with a related risk: 2.87, 95% and confidence interval: 1.9-4.3. For urine abnormalities, 10.2% of samples were positive for proteinuria, 17% for hematuria, and 3.1% for both. Conclusion: It was found that there is a positive correlation between the incidence of obesity and hypertension in adolescents. Hematuria and proteinuria were also found to be high. Screening and prevention programs are therefore recommended. PMID:27652364

Sole Dependence on Urine Testing Strips and the Ability to Identify Clinically Significant Disease: Challenging the Current Paradigm for Heme Detection in General Clinical Situations.

PubMed

Rothschild, Bruce

2016-05-01

The ability of health care professionals to provide patient care is potentially compromised when predicated on untested, although longstanding, perspectives. One such example is urinalysis testing, which has been currently simplified to use only urine testing strips for detection of microscopic hematuria. To determine whether urine testing strips are sufficient for identification of clinically significant findings in urinalysis. To determine the presence of microscopic hematuria, I examined a collection of urine specimens that had tested heme negative during the 3-month study period. Of the 342 patients from whom urine specimens were examined during this interval, 50 had microscopic hematuria, despite having tested negative for heme via urine testing strip. Also, 30% were not receiving any medication known to produce microscopic hematuria, and 18% had clinically significant pathology. Diagnosis of significant clinical pathologic manifestations would have been compromised had microscopic examination not been performed on the urine specimens from the cohort individuals. Examination of the novel approach of including microscopic examination of specimens in a specific clinical situation challenges the dominant paradigm of reliance on assaying using urine testing strips only, revealing that the current method is not only unreliable for determining microscopic hematuria but also is less than optimal in general clinical practice. The findings of this study provide evidence of the importance of microscopic evaluation as a routine component of urinalysis. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Early changes of the anemia phenomenon in male 100-km ultramarathoners.

PubMed

Chiu, Yu-Hui; Lai, Jiun-I; Wang, Shih-Hao; How, Chorng-Kuang; Li, Li-Hua; Kao, Wei-Fong; Yang, Chen-Chang; Chen, Ray-Jade

2015-02-01

Sports anemia is a widely observed phenomenon after prolonged running. There are various factors that contribute to sports anemia, including hemodilution, exercise-induced oxidative stress, iron deficiency, gastrointestinal bleeding, hematuria, and hemolysis resulting from foot-strike and/or from compression of contracting muscles on capillaries. Until now, there has been no published report that describes the overall hematological, urinary, and fecal consequences in Asian male ultramarathoners after a 100-km (62.5-mile) ultramarathon event. A total of 25 male runners were recruited into our study. Blood was drawn 1 week before, immediately after, and then 24 hours subsequent to the race. Hematological samples were analyzed for the anemia phenomenon. Additionally, urinary and fecal samples were collected before and after the race for detection of occult blood. The blood hemoglobin and erythropoietin values of the recruited runners showed a statistically significant rise in the immediate post-race values and a rapid drop in values at 24 hours post-race. Blood concentrations of red blood cells and hematocrit were significantly lower at 24 hours post-race compared with pre-race. The white blood cell count, interleukin-6, tumor necrosis factor-alpha, high-sensitivity C-reactive protein, and ferritin all showed significant increases both immediately after and 24 hours post-race compared with pre-race hematological values. There were immediate decreases of both haptoglobin and iron, as well as an increase of total iron-binding capacity levels in post-race blood tests. For both urinary and fecal samples, there was a statistically significant difference between the pre- and post-race results in occult blood. Running a 100-km ultramarathon will induce substantial sports anemia, and oxidative stress response, hemolysis, hematuria, and gastrointestinal bleeding are typical factors that contribute to its onset. Copyright © 2014. Published by Elsevier Taiwan.

Pheochromocytoma of urinary bladder - a case report.

PubMed

Sharma, Shaleen; Gokhro, Sunil; Sharma, K K; Sadasukhi, T C

2007-08-01

Pheochromocytomas are catecholamine producing neuroendocrine tumours. Bladder involvement with pheochromocytoma is rare that usually presents with hypertension, hematuria and syncope often related to voiding. Clinical manifestation may be inconsistent and high index of suspicion is required for accurate diagnosis. We report a case, who presented with gross intermittent hematuria and mild elevation of pulserate and bloodpressure. Patient was adequately treated with partial cystectomy.

Urogenital schistosomiasis and urological assessment of hematuria in preschool-aged children in rural communities of Nigeria.

PubMed

Salawu, Oyetunde T; Odaibo, Alexander B

2014-02-01

The study evaluates the prevalence of urogenital schistosomiasis and diagnostic performance of chemical reagent strips used for disease diagnosis in preschool-aged children (≤ 5 years) in Nigeria rural communities. Urine samples from 419 children were observed microscopically for Schistosoma haematobium and screened for hematuria using standard urine chemical reagent strips. Prevalence and intensity of infection were 9.8% and 14.4 eggs/10 ml of urine, respectively. Prevalence of infection was similar in girls (10%) and boys (9.6%) (p > 0.05). The intensity of infection was higher in boys (17.1 eggs/10 ml of urine) than in girls (12.8 eggs/10 ml of urine); however, this was not gender dependent (p > 0.05). The occurrence of hematuria was not associated with gender (p > 0.05), but was associated with prevalence of infection (p < 0.05). Infection with S. haematobium occurs early in life in the communities and although intensity of infection is low, it could have serious implications in disease transmission. Hematuria, although moderately sensitive to infection, is an important morbidity indicator of urogenital schistosomiasis in the study population. Copyright © 2013 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Microscopic hematuria and calculus-related ureteral obstruction.

PubMed

Stewart, D P; Kowalski, R; Wong, P; Krome, R

1990-01-01

The evaluation of patients with ureteral calculi in the emergency department has historically included urinalysis (UA) and intravenous pyelograms (IVP). This retrospective study was done to determine if a statistically significant relationship existed between the degree of calculus-related ureteral obstruction, proven by IVP, and the presence or absence of microscopic hematuria. Urine red blood cells were recorded as less than 3 rbc/hpf (negative) or greater than or equal to 3 rbc/hpf (positive). IVPs were recorded as nonsevere or severe. IVP criteria were based on the presence or absence of extravasation, greater than 2-hour ureteral filling times, and a numerical scoring system of 1 to 4 for ureteral or calyceal dilatation and nephrogenic effect. Eighty-nine men (72%) had non-severe obstructions and 34 (28%) had severe obstructions. Twenty-five women (68%) had nonsevere obstructions and 12 (32%) had severe obstructions. Of the 28 patients with normal UAs, 11 had severe ureteral obstructions and 17 had nonsevere ureteral obstructions. There were no statistically significant differences between the presence or absence of significant microscopic hematuria and the presence or absence of severe ureteral obstruction. Microscopic hematuria is neither sensitive nor specific in determining the degree of calculus-related ureteral obstruction.

Simultaneous uterine and urinary bladder rupture in an otherwise successful vaginal birth after cesarean delivery.

PubMed

Ho, Szu-Ying; Chang, Shuenn-Dhy; Liang, Ching-Chung

2010-12-01

Uterine rupture is the primary concern when a patient chooses a trial of labor after a cesarean section. Bladder rupture accompanied by uterine rupture should be taken into consideration if gross hematuria occurs. We report the case of a patient with uterine rupture during a trial of labor after cesarean delivery. She had a normal course of labor and no classic signs of uterine rupture. However, gross hematuria was noted after repair of the episiotomy. The patient began to complain of progressive abdominal pain, gross hematuria and oliguria. Cystoscopy revealed a direct communication between the bladder and the uterus. When opening the bladder peritoneum, rupture sites over the anterior uterus and posterior wall of the bladder were noted. Following primary repair of both wounds, a Foley catheter was left in place for 12 days. The patient had achieved a full recovery by the 2-year follow-up examination. Bladder injury and uterine rupture can occur at any time during labor. Gross hematuria immediately after delivery is the most common presentation. Cystoscopy is a good tool to identify the severity of bladder injury. Copyright © 2010 Elsevier. Published by Elsevier B.V. All rights reserved.

[Autosomal dominant polycystic kidney].

PubMed

Jorge Adad, S; Estevão Barbosa, M; Fácio Luíz, J M; Furlan Rodrigues, M C; Iwamoto, S

1996-01-01

A 48-year-old male had autosomic dominant polycystic kidneys with dimensions, to the best of our knowledge, never previously reported; the right kidney weighed 15,100 g and measured 53 x 33 x 9cm and the left one 10.200 g and 46 x 21 x 7cm, with cysts measuring up to 14cm in diameter. Nephrectomy was done to control persistent hematuria and to relief disconfort caused by the large kidneys. The renal function is stable four years after transplantation.

Renal Infarction Caused by Spontaneous Renal Artery Dissection: Treatment with Catheter-Directed Thrombolysis and Stenting

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jeon, Yong Sun, E-mail: radjeon@korea.com; Cho, Soon Gu; Hong, Ki Cheon

2009-03-15

Spontaneous renal artery dissection (SRAD) is rare and presents a diagnostic and therapeutic challenge. We report a case of a 36-year-old man who had an SRAD-complicated renal infarction. The patient experienced severe unilateral flank pain. Enhanced abdominal computed axial tomography scan showed renal infarction, and urinalysis showed no hematuria. Selective renal angiography was essential to evaluate the extent of dissection and suitability for repair. The patient was treated with catheter-directed thrombolysis and frenal artery stenting.

Association Between Use of Antithrombotic Medication and Hematuria-Related Complications

PubMed Central

Wallis, Christopher J. D.; Juvet, Tristan; Lee, Yuna; Matta, Rano; Herschorn, Sender; Kodama, Ronald; Kulkarni, Girish S.; Satkunasivam, Raj; Geerts, William; McLeod, Anne; Narod, Steven A.

2017-01-01

Importance Antithrombotic medications are among the most commonly prescribed medications. Objective To characterize rates of hematuria-related complications among patients taking antithrombotic medications. Design, Setting, and Participants Population-based, retrospective cohort study including all citizens in Ontario, Canada, aged 66 years and older between 2002 and 2014. The final follow-up date was December 31, 2014. Exposures Receipt of an oral anticoagulant or antiplatelet medication. Main Outcomes and Measures Hematuria-related complications, defined as emergency department visit, hospitalization, or a urologic procedure to investigate or manage gross hematuria. Results Among 2 518 064 patients, 808 897 (mean [SD] age, 72.1 [6.8] years; 428 531 [53%] women) received at least 1 prescription for an antithrombotic agent over the study period. Over a median follow-up of 7.3 years, the rates of hematuria-related complications were 123.95 events per 1000 person-years among patients actively exposed to antithrombotic agents vs 80.17 events per 1000 person-years among patients not exposed to these drugs (difference, 43.8; 95% CI, 43.0-44.6; P < .001, and incidence rate ratio [IRR], 1.44; 95% CI, 1.42-1.46). The rates of complications among exposed vs unexposed patients (80.17 events/1000 person-years) were 105.78 for urologic procedures (difference, 33.5; 95% CI, 32.8-34.3; P < .001, and IRR, 1.37; 95% CI, 1.36-1.39), 11.12 for hospitalizations (difference, 5.7; 95% CI, 5.5-5.9; P < .001, and IRR, 2.03; 95% CI, 2.00-2.06), and 7.05 for emergency department visits (difference, 4.5; 95% CI, 4.3-4.7; P < .001, and IRR, 2.80; 95% CI, 2.74-2.86). Compared with patients who were unexposed to thrombotic agents, the rates of hematuria-related complications were 191.61 events per 1000 person-years (difference, 117.3; 95% CI, 112.8-121.8) for those exposed to both an anticoagulant and antiplatelet agent (IRR, 10.48; 95% CI, 8.16-13.45), 140.92 (difference, 57.7; 95% CI, 56.9-58.4) for those exposed to anticoagulants (IRR, 1.55; 95% CI, 1.52-1.59), and 110.72 (difference, 26.5; 95% CI, 25.9-27.0) for those exposed to antiplatelet agents (IRR, 1.31; 95% CI, 1.29-1.33). Patients exposed to antithrombotic agents, compared with patients not exposed to these drugs, were more likely to be diagnosed as having bladder cancer within 6 months (0.70% vs 0.38%; odds ratio, 1.85; 95% CI, 1.79-1.92). Conclusions and Relevance Among older adults in Ontario, Canada, use of antithrombotic medications, compared with nonuse of these medications, was significantly associated with higher rates of hematuria-related complications (including emergency department visits, hospitalizations, and urologic procedures to manage gross hematuria). PMID:28973248

National Patterns of Urethral Evaluation and Risk Factors for Urethral Injury in Patients With Penile Fracture.

PubMed

Pariser, Joseph J; Pearce, Shane M; Patel, Sanjay G; Bales, Gregory T

2015-07-01

To examine the epidemiology and timing of penile fracture, patterns of urethral evaluation, and risk factors for concomitant urethral injury. The National Inpatient Sample (2003-2011) was used to identify patients with penile fractures. Clinical data included age, race, comorbidity, insurance, hospital factors, timing, hematuria, and urinary symptoms. Rates of formal urethral evaluation (cystoscopy or urethrogram) and urethral injury were calculated. Multivariate logistic regression was used to identify predictors of urethral evaluation and risk factors for urethral injury. A weighted population of 3883 patients with penile fracture was identified. Presentations during weekends (37%) and summers (30%) were overrepresented (both P <.001). Urethral evaluation was performed in 882 patients (23%). Urethral injury was diagnosed in 813 patients (21%) with penile fracture. There was an increased odds of urethral evaluation with hematuria (odds ratio [OR] = 2.99; 95% confidence interval [CI], 1.03-8.73; P = .045) and a decrease for Hispanics (OR = 0.42; 95% CI, 0.22-0.82; P = .011). Older age (32-41 years: OR = 1.84; 95% CI, 1.07-3.16; P = .027; >41 years: OR = 2.25; 95% CI, 1.25-4.05; P = .007), black race (OR = 1.93; 95% CI, 1.12-3.34; P = .018), and hematuria (OR = 17.03; 95% CI, 3.20-90.54; P = .001) were independent risk factors for urethral injury. Penile fractures, which occur disproportionately during summer and weekends, were associated with a 21% risk of urethral injury. Urethral evaluations were performed in a minority of patients. Even in patients with hematuria, 55% of patients underwent formal urethral evaluation. On multivariate analysis of patients with penile fracture, hematuria as well as older age and black race were independently associated with concomitant urethral injury. Copyright © 2015 Elsevier Inc. All rights reserved.

Ureteropyeloscopy in the diagnosis of patients with upper tract hematuria: an initial clinical study.

PubMed

Yazaki, T; Kamiyama, Y; Tomomasa, H; Shimizu, H; Okano, Y; Iiyama, T; Iizumi, T; Umeda, T

1999-05-01

To study the usefulness and safety of ureteropyeloscopy in the diagnosis of upper tract hematuria of unknown etiology by standard diagnostic methods. Fifteen patients with upper tract hematuria of unknown etiology were the subjects of the present study. Prior to ureteropyeloscopy, they underwent standard diagnostic methods, including cystourethroscopy, excretory urography and computed tomography scan. The upper tract (ureter, renal pelvis and calyces) was inspected systematically with a flexible ureteropyeloscope under epidural anesthesia. A biopsy specimen was obtained when neoplasm of a suspicious lesion was seen. Bleeding and hemangiomatous lesions were fulgurated at the time of ureteropyeloscopy. Unilateral gross hematuria was seen in 12 patients. Imaging studies revealed a filling defect in four patients, ureteral stenosis in one patient and nutcracker phenomenon in one patient. Urine cytology was positive in three patients and suspicious in four patients. Results of ureteropyeloscopy were papillary tumor in three patients, whitish encrustation in one patient, redness of the renal pelvis in one patient, bleeding from the renal calyx in two patients, hemangiomatous lesion in one patient, ureteral stenosis in two patients and no abnormalities in five patients. Biopsies were performed in five patients. The pathology results were transitional cell carcinoma in four patients and no abnormality in one patient. Although a ureteral stent catheter was placed in one patient, no serious complications were encountered during or after the procedures. Ureteropyeloscopy was useful and relatively safe. This endoscopic examination can differentiate insignificant lesions from significant lesions by visual inspection of the lesions, in addition, pathological diagnosis by biopsy specimen can also be performed if deemed necessary. Ureteropyeloscopy is recommended in the diagnosis of upper tract hematuria of unknown etiology.

Hematuria and clot retention after transvaginal oocyte aspiration: a case report.

PubMed

Modder, Joshua; Kettel, L Michael; Sakamoto, Kyoko

2006-09-01

To report a case of bladder injury with hematuria and urinary retention after transvaginal oocyte aspiration. Case report. Emergency room in a university medical center. A 28-year-old woman presented with urinary retention and suprapubic pain 8 hours after oocyte aspiration. Foley catheter, intravenous fluid bolus, bladder irrigation, and computed tomography with postvoid films that showed a blood clot in the bladder. Patient was discharged home with antibiotics and catheter in place. Clinical follow-up. Patient passed voiding trial 4 days later and was artificially inseminated. No further hematuria or voiding problems were reported, and she had a successful pregnancy. Patients who elect to undergo oocyte aspiration should be warned about the possibility of bladder injury because of the close proximity of the ovaries to the bladder, and physicians should have an appropriate treatment plan.

Ruptured renal arteriovenous malformation successfully treated by catheter embolization: a case report.

PubMed

Takeuchi, Nobuhiro; Nomura, Yusuke

2014-01-09

Renal arteriovenous fistula (RAVF) is a comparatively rare malformation. Here, we report a case of ruptured RAVF that was successfully treated by catheter embolization. An 89-year-old female was transferred to our institution with massive gross hematuria in March 2011. Plain abdominal computed tomography (CT) revealed dilated left renal pelvis with high-density contents. Hematoma was suspected. Subsequent plain abdominal magnetic resonance imaging revealed left hydronephrosis and blood retention in the dilated left renal pelvis. No renal or ureteral cancer was evident. Hematuria was conservatively treated using hemostatic agents but hematuria persisted. Repeated urinary cytology revealed no malignant cells. On day 9, the patient went into septic and/or hemorrhagic shock. Fluid and catecholamine infusion, blood transfusion, and antibacterial drugs were rapidly initiated, and the patient's general condition gradually improved. Contrast-enhanced abdominal CT revealed marked expansion of the hematoma in the renal pelvis and microaneurysms in the segmental arteries of the left kidney. Inflammation improved, and a left double-J stent was inserted. Selective renal angiography revealed RAVF with microaneurysms in the left segmental arteries; therefore, catheter embolization using metallic coils was performed, which resolved hematuria. We report a case of ruptured renal arteriovenous malformation, which was successfully treated by catheter embolization.

Primary non-Hodgkin’s lymphoma of the prostate with intractable hematuria: A case report and review of the literature

PubMed Central

HU, SHANBIAO; WANG, YINHUAI; YANG, LUOYAN; YI, LU; NIAN, YEQI

2015-01-01

Cases of primary non-Hodgkin’s lymphoma of the prostate are globally rare. The present study reports a case of prostatic diffuse large B-cell lymphoma (DLBCL) with intractable hematuria in a 75-year-old male. The patient presented with difficulties in urination and gross hematuria. A prostate biopsy was performed immediately, followed by conservative treatment for bleeding. A bilateral iliac arteriography and chemoembolization were then performed as emergency procedures under local anesthesia due to significant bleeding and a sharply decreased blood pressure, indicating the failure of the conservative treatment. Consequently, the bleeding was effectively controlled. Pathological examination of the prostate biopsy confirmed the presence of a DLBCL of non-germinal center B-cell origin. Immunohistochemical examination demonstrated cluster of differentiation (CD)20(++), CD3(+), leukocyte common antigen(+++), B-cell lymphoma-2(+) and prostate-specific antigen(−) results. Due to the poor general condition and low hemoglobin levels of the patient, a low-dose Rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) chemotherapy regimen was administered. Subsequent to three courses of chemotherapy, the patient achieved complete remission. In conclusion, combining R-CHOP and bilateral selective iliac arterial chemoembolization could be a safe and effective way to treat patients with non-Hodgkin’s lymphoma of the prostate and intractable hematuria. PMID:25663879

HANAC Syndrome Col4a1 Mutation Causes Neonate Glomerular Hyperpermeability and Adult Glomerulocystic Kidney Disease

PubMed Central

Chen, Zhiyong; Migeon, Tiffany; Verpont, Marie-Christine; Zaidan, Mohamad; Sado, Yoshikazu; Kerjaschki, Dontscho; Ronco, Pierre

2016-01-01

Hereditary angiopathy, nephropathy, aneurysms, and muscle cramps (HANAC) syndrome is an autosomal dominant syndrome caused by mutations in COL4A1 that encodes the α1 chain of collagen IV, a major component of basement membranes. Patients present with cerebral small vessel disease, retinal tortuosity, muscle cramps, and kidney disease consisting of multiple renal cysts, chronic kidney failure, and sometimes hematuria. Mutations producing HANAC syndrome localize within the integrin binding site containing CB3[IV] fragment of the COL4A1 protein. To investigate the pathophysiology of HANAC syndrome, we generated mice harboring the Col4a1 p.Gly498Val mutation identified in a family with the syndrome. Col4a1 G498V mutation resulted in delayed glomerulogenesis and podocyte differentiation without reduction of nephron number, causing albuminuria and hematuria in newborns. The glomerular defects resolved within the first month, but glomerular cysts developed in 3-month-old mutant mice. Abnormal structure of Bowman’s capsule was associated with metalloproteinase induction and activation of the glomerular parietal epithelial cells that abnormally expressed CD44, α-SMA, ILK, and DDR1. Inflammatory infiltrates were observed around glomeruli and arterioles. Homozygous Col4a1 G498V mutant mice additionally showed dysmorphic papillae and urinary concentration defects. These results reveal a developmental role for the α1α1α2 collagen IV molecule in the embryonic glomerular basement membrane, affecting podocyte differentiation. The observed association between molecular alteration of the collagenous network in Bowman’s capsule of the mature kidney and activation of parietal epithelial cells, matrix remodeling, and inflammation may account for glomerular cyst development and CKD in patients with COL4A1-related disorders. PMID:26260163

HANAC Syndrome Col4a1 Mutation Causes Neonate Glomerular Hyperpermeability and Adult Glomerulocystic Kidney Disease.

PubMed

Chen, Zhiyong; Migeon, Tiffany; Verpont, Marie-Christine; Zaidan, Mohamad; Sado, Yoshikazu; Kerjaschki, Dontscho; Ronco, Pierre; Plaisier, Emmanuelle

2016-04-01

Hereditary angiopathy, nephropathy, aneurysms, and muscle cramps (HANAC) syndrome is an autosomal dominant syndrome caused by mutations in COL4A1 that encodes the α1 chain of collagen IV, a major component of basement membranes. Patients present with cerebral small vessel disease, retinal tortuosity, muscle cramps, and kidney disease consisting of multiple renal cysts, chronic kidney failure, and sometimes hematuria. Mutations producing HANAC syndrome localize within the integrin binding site containing CB3[IV] fragment of the COL4A1 protein. To investigate the pathophysiology of HANAC syndrome, we generated mice harboring the Col4a1 p.Gly498Val mutation identified in a family with the syndrome. Col4a1 G498V mutation resulted in delayed glomerulogenesis and podocyte differentiation without reduction of nephron number, causing albuminuria and hematuria in newborns. The glomerular defects resolved within the first month, but glomerular cysts developed in 3-month-old mutant mice. Abnormal structure of Bowman's capsule was associated with metalloproteinase induction and activation of the glomerular parietal epithelial cells that abnormally expressed CD44,α-SMA, ILK, and DDR1. Inflammatory infiltrates were observed around glomeruli and arterioles. Homozygous Col4a1 G498V mutant mice additionally showed dysmorphic papillae and urinary concentration defects. These results reveal a developmental role for the α1α1α2 collagen IV molecule in the embryonic glomerular basement membrane, affecting podocyte differentiation. The observed association between molecular alteration of the collagenous network in Bowman's capsule of the mature kidney and activation of parietal epithelial cells, matrix remodeling, and inflammation may account for glomerular cyst development and CKD in patients with COL4A1-related disorders. Copyright © 2016 by the American Society of Nephrology.

Arterioureteral Fistula: Treatment of a Hemorrhagic Shock with Massive Hematuria by Placing a Balloon Catheter.

PubMed

Merzeau, Nicolas; Riquet, Hervé; Nicolacopoulos, Ioannis; Alame, Abbas; Larré, Stéphane

2017-01-01

Arterioureteral fistulas (AUF) are serious diseases with increasing incidence. This case report relates the management of AUF in a patient with a history of abdominal oncological surgery, pelvic radiotherapy, and a double J stent in place. The fistula was discovered during a hemorrhagic shock with massive hematuria. The bleeding was controlled by a balloon catheter which led to endovascular treatment consisting of a covered stent.

Arterioureteral Fistula: Treatment of a Hemorrhagic Shock with Massive Hematuria by Placing a Balloon Catheter

PubMed Central

Riquet, Hervé; Nicolacopoulos, Ioannis; Alame, Abbas

2017-01-01

Arterioureteral fistulas (AUF) are serious diseases with increasing incidence. This case report relates the management of AUF in a patient with a history of abdominal oncological surgery, pelvic radiotherapy, and a double J stent in place. The fistula was discovered during a hemorrhagic shock with massive hematuria. The bleeding was controlled by a balloon catheter which led to endovascular treatment consisting of a covered stent. PMID:28465857

Possible health effects of living in proximity to mining sites near Potosí, Bolivia.

PubMed

Farag, Sara; Das, Riva; Strosnider, William H J; Wilson, Robin Taylor

2015-05-01

The goal of this study was to determine the health effects of living downstream from mines in the Potosí region of Bolivia. Histories, physical examinations, and urinalyses were completed on adults recruited from mining and nonmining villages in Bolivia. Blood concentrations of Cd, Hg, and Pb were determined in a subset of participants. Multiple logistic regression analyses were performed. Mining region participants had significantly higher frequencies of hypertension, hematuria, and ketonuria. Hematuria was significantly elevated among those watering livestock downstream from mines and eating grains from their own farm (odds ratio = 4.3; 95% confidence interval, 1.1 to 17.7). Significantly higher blood concentrations of Pb were observed in a subsample of participants with hematuria (4.80 μg/dL vs 10.91 μg/dL; P = 0.026). Efforts to abate environmental exposure to toxic metals seem warranted.

Loin pain hematuria syndrome

PubMed Central

Zubair, Adeel S.; Salameh, Hassan; Erickson, Stephen B.; Prieto, Mikel

2016-01-01

Loin pain hematuria syndrome (LPHS), first described in 1967, is a rare pain syndrome, which is not well understood. The syndrome is characterized by severe intermittent or persistent flank pain, either unilateral or bilateral, associated with gross or microscopic hematuria. LPHS is a diagnosis of exclusion as there still is not a consensus of validated diagnostic criteria, though several criteria have been proposed. The wide differential diagnosis would suggest a meticulous yet specific diagnostic work-up depending on the individual clinical features and natural history. Several mechanisms regarding the pathophysiology of LPHS have been proposed but without pinpointing the actual causative etiology, the treatment remains symptomatic. Treatment modalities for LPHS are diverse including simple analgesia, opioid analgesic and kidney autotransplantation. This review article summarizes the current understanding regarding the pathophysiology of LPHS along with the steps required for proper diagnosis and a discussion of the different therapeutic approaches for LPHS. PMID:26798473

[Could isolated mesangial deposits of C3 be responsible of glomerular hematuric nephropathies (author's transl)].

PubMed

Saint-Andre, J P; Touzard, D; Houssin, A; Simard, C

1982-01-01

This communication presents three cases of prolonged macroscopic hematuria in young subjects. Complementary explorations eliminated urologic or vascular causes. Renal biopsies showed minimal glomerular lesions with light microscopy, normal basement membranes in electron microscopy and mesangial deposits of C3 and properdine in immunofluorescence. Although the mesangial deposits of C3 lack specificity and the number of observations is small, it appears useful to report such cases so as to indicate their frequency and perhaps their autonomy, in glomerular hematuric nephropathies.

Bladder Tumor in Women with Microscopic Hematuria: An Iranian Experience and a Review of the Literature

PubMed Central

Abbaszadeh, Shahin; Taheri, Saeed; Nourbala, Mohammad Hossein

2009-01-01

Aim. In this study we report our experience with microhematuria and its relation with bladder tumors in Iranian women. Materials and Methods. Overall 249 women were evaluated. Microscopic hematuria was defined as three or more red blood cells per high-power field on at least two different occasions. Patients with a history of gross hematuria or coagulation disorders, having organic diseases, urinary stones, urinary tract infections, nephrological diseases, and local lesions such as urethral caruncle were excluded from the study population. Final diagnosis of malignant tumors was done with cystoscopy and biopsy specimen pathological assessment in all cases. Results. Age for the study population was 49.7 ± 11.8 years. 95 (38%) of patients were identified during routine check up and presenting symptoms in other patients were frequency, dysuria, stress urge incontinence, urge incontinence, feeling of incomplete urine emptying, and flunk pain, respectively. Finally, 7 (2.8%) of study subjects were confirmed as having bladder tumors. One of tumor cases was diagnosed 24 months after initial assessments. Patients with bladder tumor were significantly older; more frequently had diverticulum in their bladder wall (P < .05). Conclusion. Female microscopic hematuria is relevant and deserves evaluations, especially in elderly patients. Patients whose reason for microhematuria would not be diagnosed at the initial evaluations should be followed. PMID:19639044

Primary BK virus (BKV) infection due to possible BKV transmission during bone marrow transplantation is not the major cause of hemorrhagic cystitis in transplanted children.

PubMed

Bogdanovic, G; Priftakis, P; Taemmeraes, B; Gustafsson, A; Flaegstad, T; Winiarski, J; Dalianis, T

1998-11-01

In allogeneic bone marrow transplanted (BMT) patients BK virus (BKV) reactivation has been associated with haemorrhagic cystitis (HC). However, it is far from obvious which patients will develop HC, since BKV, a human polyomavirus, is ubiquitious and infects children at an early age. To investigate if a primary BKV infection, as such or possibly due to transmission of BKV by the marrow graft during BMT, was correlated to the development of HC, 45 children were followed for possible BKV seroconversion and development of HC at different time points after BMT. Serum samples were collected from the 45 allogeneic BMT children and their donors before transplantation, and from the patients at 3, 6 and 12 months after BMT. These sera were analysed for the presence of specific antibodies towards BKV by hemagglutination inhibition (HAI) and by IgG- and IgM-class specific enzyme linked immunosorbent (ELISA) assays. Twelve of the 45 BMT children had a documented episode of HC or hematuria. All patients and 98% of the donors were HAI positive before BMT, while with ELISA 87% of the patients and 84% of the donors were positive. Moreover, most HC and hematuria children (11/12) were seropositive with both assays before BMT, making it impossible to investigate possible BKV transmission through the bone marrow graft during BMT by serology. Still, serological changes such as ELISA seroconversion, IgM antibodies and/or HAI titer increases were significantly (p=0.016) more common in patients with HC (58%) than without HC (24%), but these changes occured mainly after HC symptomatology had already resolved. However, there was a near significant difference (p=0.053) in BKV seroprevalence by ELISA among the donors of patients with HC or hematuria (67%) as compared to the donors (91%) of patients without HC.

[Feasibility and safety evaluation of retrograde inserting of ureteric catheter via flexible cystoscope].

PubMed

Jin, Xiao-dong; Li, Zhong-yi; Luo, Xue-hong; Chen, Zhao-dian; Cai, Song-liang; Xie, Li-ping

2008-06-24

To introduce a method of retrograde ureteric catheter placement via flexible cystoscope , and to evaluate the feasibility and safety of this method. 112 patients, 62 males and 50 females undergoing retrograde ureteropyelography by 2 same physicians in cooperation were randomly divided into two equal groups with 31 males and 25 females each: one group via flexible cystoscope and the other group via rigid cystoscope. The catheterizing time, visual analogue scale (VAS) pain score, gross hematuria rate, and fever rate were compared between these 2 groups. Fifty-five patients underwent ureteric catheter placement successfully via flexible cystoscope (98%, 55/56), while 53 cases were technically successful by rigid cystoscope (95%, 53/56). The inserting time in women patients of the flexible cystoscopy group was (7.6 +/- 1.8) min, significantly shorter than that of the men [(8.0 +/- 1.8) min, P < 0.05]. The inserting time in women patients of the rigid cystoscopy group was (7.4 +/- 1.5) min, significantly shorter than that of the men [(8.2 +/- 1.2) min, P < 0.05]. However, there were not significant differences in the inserting times in both men and women between these 2 groups (both P > 0.05). The VAS pain scores in men and women of the flexible cystoscope group were 3. 5 and 2. 3 respectively, both significantly lower than those of the rigid cystoscopy group (7.2 and 3.3 respectively, both P < 0.05). The gross hematuria rate of the flexible cystoscope group was 8.6% (5/56), significantly lower than that of the rigid cystoscopy group (25.0%, 14/56, P < 0.05). Four patients had a fever after flexible cystoscopy while 6 cases did after rigid cystoscopy, however, without significant difference between these 2 groups (P > 0.05). Retrograde placement of ureteric catheter via flexible cystoscope is safe and reliable as rigid cystoscopy. Meanwhile, inserting ureteric catheter via flexible cystoscope causes the patients less pain and less chance of hematuria.

Prognosis of clinical renal disease and incidence of new renal findings in patients with rheumatoid arthritis: follow-up of a population-based study.

PubMed

Karstila, K; Korpela, M; Sihvonen, S; Mustonen, J

2007-12-01

The objective of this study was to assess the long-term prognosis of nephropathy findings and the incidence of new abnormal clinical renal findings in patients with rheumatoid arthritis (RA). The original population-based cross-sectional study of 604 RA patients was carried out in 1988, 103 nephropathy patients being found. Controls matched for age, sex, and duration of RA were selected from among RA patients with normal renal function and urinalysis in 1988. In 2003, a follow-up study was made of the 103 nephropathy patients and 102 controls, and the median follow-up time was 13 years. In the original nephropathy group, serum creatinine exceeded 200 mumol/l in 8% of the original isolated hematuria patients, in 30% of the isolated proteinuria patients, in 57% of the combined hematuria and proteinuria patients, but in none of the isolated chronic renal failure (CRF) patients (p = 0.001 for the difference). Probable or definitive renal amyloidosis was diagnosed in 19% of the nephropathy patients. Dialysis therapy was given to 10 out of the 103 nephropathy patients, nine of them belonging to the original isolated proteinuria or combined hematuria and proteinuria groups. There were six renal deaths among the nephropathy patients, and none in the controls. In the control group, new abnormal renal findings, in most cases mild, were detected in 28%. Serum creatinine exceeded 200 mumol/l in 4% of the controls, and dialysis therapy was given to 2% of the controls. Probable or definitive renal amyloidosis was diagnosed in 4% of this group. With regards to the development or progression of chronic renal failure, the long-term clinical prognosis of isolated hematuria and isolated CRF was found to be favorable. Proteinuria alone or combined with hematuria or CRF was related to evidently poorer prognosis.

Extracorporeal shock wave therapy ameliorates cyclophosphamide-induced rat acute interstitial cystitis though inhibiting inflammation and oxidative stress-in vitro and in vivo experiment studies

PubMed Central

Chen, Yen-Ta; Yang, Chih-Chao; Sun, Cheuk-Kwan; Chiang, Hsin-Ju; Chen, Yi-Ling; Sung, Pei-Hsun; Zhen, Yen-Yi; Huang, Tein-Hung; Chang, Chia-Lo; Chen, Hong-Hwa; Chang, Hsueh-Wen; Yip, Hon-Kan

2014-01-01

Background: We investigated whether extracorporeal shock wave (ECSW) therapy can attenuate cyclophosphamide (CYP)-induced acute interstitial cystitis (AIC) in rats. Methods and Results: Eighteen male-adult Sprague-Dawley rats were equally divided into group 1 (sham control), group 2 (AIC induced by 150 mg/kg CYP by intra-peritoneal injection) and group 3 (AIC + ECSW 200 impulses at 0.11 mJ/mm2 to the urinary bladder at 3 and 24 h after CYP treatment). Smooth-muscle cells co-culture with menadione (25 µM) with and without ECSW treatment was performed. Western-blot results demonstrated that ECSW significant attenuated oxidative stress and inflammatory reactions in this in-vitro studies (all p < 0.001). 24-hour urine amount and microscopic findings of red-blood-cell count (i.e., hematuria) were higher in group 2 than in groups 1 and 3, and significantly higher in group 3 than in group 1 (all p < 0.001). The urine levels of albumin and interleukin-6 showed an identical pattern of hematuria among all three groups (all p < 0.001). The cellular and mRNA expressions of macrophage migration inhibitory factor (MIF)+, CD74+, CD68+, substance p+, and Cox-2+ cells in the bladder tissue exhibited an identical pattern of hematuria among all groups (all p < 0.0001). The integrity of epithelial layer and collagen-deposition area as stained by Sirius red displayed an opposite pattern of hematuria among the three groups (p < 0.0001). The protein expression of IL-12, iNOS, TNF-α, NF-κB, MMP-9, NOX-1, NOX-2, RANTES, and Oxyblot displayed an identical pattern of hematuria among all groups (all p < 0.01). Conclusion: ECSW therapy markedly attenuated CYP-induced AIC through inhibitions of the inflammation and oxidative stress. PMID:25628776

[Asymptomatic Renal Stones: Do they really Exist?].

PubMed

Seseke, S; Rudolph, R; Rebmann, U

2011-11-01

Asymptomatic renal calculi without any history of colic, hematuria or infection can be found as an incidental finding during preven-tive check-ups. The aim of our study was to eval-uate whether these stones provoke symptoms with the need for further treatment during the follow-up and whether they cause cortical defects which may consecutively affect the renal func-tion. In a prospective study we evaluated 104  patients with renal calculi. The -medical history, radiological findings and functional imaging as well as urine and blood analyses were recorded and evaluated. The influence of stone size and localisation on the development of acute stone-related symptoms, renal function and renal scarring were evaluated. Furthermore, we analysed whether localised pathological findings in radiographic or functional imaging may influence the creatinine level. The follow-up was be-tween 12 and 48  months (median: 25  months). During the study period 27 / 104 of our patients (26 %) developed symptomatic events (renal colic, hematuria, infection) in which patients with middle pole calculi with a mean -cumulative stone diameter of 9.8  mm had the -highest risk. A localised renal scarring could be found in 36.6 %. These patients had a significantly higher risk in presenting an increased creatinine level. Increasing stone size was diagnosed in 39  cases (37.5 %). Asymptomatic renal stones have to be controlled regularly in order to prevent the -patient from loss of renal function and hypertension caused by increasing stones or urinary tract infection. © Georg Thieme Verlag KG Stuttgart ˙ New York.

Arteriovenous fistula and prolonged hematuria after renal biopsy: treatment with epsilon aminocaproic acid

PubMed Central

Silverberg, D. S.; Dossetor, J. B.; Eid, T. C.; Mant, M. J.; Miller, J. D. R.

1974-01-01

A patient with membranoproliferative glomerulonephritis and mild hypertension is described who, after a renal biopsy, developed an arteriovenous fistula and then severe continuous hematuria from the seventh to the 38th postbiopsy day. Treatment with epsilon aminocaproic acid was associated with rapid and permanent cessation of bleeding, gradual improvement in renal function, and disappearance of the renal artery bruit. No complications were encountered. ImagesFIG. 2FIG. 3FIG. 4FIG. 5FIG. 6 PMID:4817213

Giant prostatic hyperplasia: report of a previously asymptomatic man presenting with gross hematuria and hypovolemic shock

PubMed Central

Wroclawski, Marcelo Langer; Carneiro, Ariê; Tristão, Rodrigo Alves; Sakuramoto, Paulo Kouiti; Youssef, Jorg Daoud Merched; Lopes, Antonio Correa; Santiago, Lucila Heloísa Simardi; Pompeo, Antonio Carlos Lima

2015-01-01

Giant prostatic hyperplasia is a rare condition characterized by very high volume benign prostatic enlargement (>500g). Few cases have been reported so far and most of them are associated with severe lower urinary symptoms. We report the first case of asymptomatic giant prostatic hyperplasia in an elderly man who had a 720g prostate adenoma, sudden gross hematuria and hypovolemic shock. The patient was successfully treated with open transvesical prostatectomy and had an uneventful postoperative recovery. PMID:26132361

A cheap minimally painful and widely usable alternative for retrieving ureteral stents.

PubMed

Söylemez, Haluk; Sancaktutar, Ahmet Ali; Bozkurt, Yaşar; Atar, Murat; Penbegül, Necmettin; Yildirim, Kadir

2011-01-01

To describe a cheap, minimally painful and widely usable method for retrieving ureteral stents by using an ureteroscope. Sixty-seven patients with ureteral stents were enrolled in this study. The patients were randomized into a cystoscopic (35 patients) and a ureteroscopic (32 patients) group. All stents were retrieved by a flexible cystoscope in the first group and by a ureteroscope in the second group under local anesthesia. Patients in each group were assessed for stented time, stent side, cause of stent placement, operative time, peroperative pain, postoperative pain, irritative voiding symptoms and hematuria. Also costs of instruments were calculated. Stents were successfully retrieved in 67 patients. There were no statistical differences in the two groups regarding patient gender and age or stent side, operative time, stented time, mean operative pain score, irritative voiding symptom scores and hematuria. Total selling price was USD 20.399 for flexible instruments and USD 10.516 for rigid ones. Total maintenance price was higher in flexible instruments than in the rigid ones (USD 197.8 and 51.7 per use, respectively). Ureteroscopic stent retrieval is a minimally painful, safe and highly tolerable method under local anesthesia as well as flexible cystoscopic retrieval. Also, it is a cheap and widely usable method. Copyright © 2011 S. Karger AG, Basel.

Histopathologic Findings of Potential Kidney Donors With Asymptomatic Microscopic Hematuria: Impact on Donation.

PubMed

Hassan, E A; Ali, T Z; Abdulbaki, A; Ibrahim, I A; Almanae, H M; Aleid, H A

2017-10-01

Isolated microscopic hematuria (IMH) is not uncommon in potential kidney donors. The aim was to study the kidney biopsy findings of potential kidney donors with IMH and the impact of the histopathologic diagnoses on the decision to accept or decline such donors from kidney donation. In this retrospective study, all the potential kidney donors with IMH were identified from the medical records of patients who underwent kidney biopsies between January 2010 and December 2016. Forty-five such individuals were identified. The mean age of these potential donors was 32.6 years and 76% were male. All of them had normal blood pressure and no significant proteinuria. Seventeen (38%) biopsies showed histopathologic abnormalities; thin basement membrane disease (n = 13; 28%) was the most common cause followed by immunoglobulin (Ig)A nephropathy (n = 4; 9%). Donors with abnormal biopsy findings were excluded from donation. However, 62% of the potential donors had normal kidney biopsy findings and were accepted for kidney donation. IMH justifies extensive work-up including kidney biopsy to identify donors who may have underlying significant glomerular pathology excluding them from kidney donation. On the other hand, kidney biopsy also helps in accepting the donors if it does not show significant abnormality. Copyright © 2017 Elsevier Inc. All rights reserved.

BK virus-associated hemorrhagic cystitis in pediatric cancer patients receiving high-dose cyclophosphamide.

PubMed

Cheerva, Alexandra C; Raj, Ashok; Bertolone, Salvatore J; Bertolone, Kathy; Silverman, Craig L

2007-09-01

Hemorrhagic cystitis (HC) is a known complication of oxazophosphorine chemotherapy. BK virus (BKV) has been commonly found to be associated with hematuria in stem cell transplant patients; however, it has rarely been reported after cyclophosphamide chemotherapy alone. The authors present 3 cases of BK viruria with HC in nontransplant pediatric oncology patients. The 3 patients with BKV had more prolonged hematuria (14 to 16 wk) compared with 1 patient with BKV-negative HC (10 wk). The HC necessitated chemotherapy delays and also prolonged supportive care. One patient was treated with intravenous cidofovir with resolution of BK viruria and hematuria. BKV may have an association with the development of HC in nonstem cell transplant patients receiving high-dose oxazophosphorine chemotherapy. HC may present early and be more prolonged in patients with BK viruria. Patients with HC after cyclophosphamide or ifosfamide with negative bacterial cultures should be studied for BKV. Cidofovir may be beneficial in certain patients with BK viruria and HC; however, definitive data will require a clinical trial.

An Overlapping Case of Alport Syndrome and Thin Basement Membrane Disease.

PubMed

Alganabi, Mashriq; Eter, Ahmad

2016-10-01

We report a case of a 48-year-old male who presented with hematuria of at least 10 years, and has a daughter with hematuria as well. The patient has a history of degenerative hearing loss, decreased vision and cataract formation, but no diabetes, hypertension or proteinuria. A full serology and urology workup was negative for any abnormality. A kidney biopsy for the patient revealed a diagnosis of Alport syndrome but was unable to rule out thin basement membrane disease. The biopsy was inconclusive in making the diagnosis but the patient's clinical presentation led to the diagnosis of Alport syndrome. The patient's 10-year-old daughter also has hematuria with no clear etiology but now can subsequently be anticipatorily managed for Alport syndrome progression. Due to the rarity of the disease, diagnosis is often missed or delayed by primary care providers especially when no associated proteinuria has yet developed. This can lead to confusion and misdiagnosis with thin basement membrane disease, a generally benign hematuria without kidney failure progression. Additionally, biopsy can be inconclusive in these patients, relying on the physician's history and physical examination findings to diagnose. It is important to appropriately diagnose Alport syndrome not only to manage the patient's rate of kidney failure progression but also allow for a higher degree of suspicion, screening and intervention in the patient's family members. Both the inconclusive nature of kidney biopsies and the usefulness of diagnosis for family member screening are often overlooked in medical literature but are explored in this case.

[Carcinosarcoma of the bladder: a case report].

PubMed

Khabir, A; Boudawara, T; Jemel, S; Mhiri, M N; Jlidi, R

2000-02-01

Carcinosarcoma of the urinary bladder is a uncommon tumor with characteristic histopathologic and immunohistochemical findings; his histogenesis have still not been clear; the prognosis seems to be improved by radical cystectomy and adjuvants therapies. We report a case of 47 years old women suffering from suprapubic pains, dysuria and hematuria of five months duration and had a 10 cm suprapubic mass that was found on physical examination. Radiographically, the tumor invaded the dome of the urinary bladder and causes bilateral hydronephrosis. Microscopically it was an urinary bladder carcinosarcoma. Our objective is to discuss the histogenesis, the anatomoclinical and prognosis of these rare tumors.

Emerging role of multi-detector computed tomography in the diagnosis of hematuria following percutaneous nephrolithotomy: A case scenario.

PubMed

Sivanandam, S E; Mathew, Georgie; Bhat, Sanjay H

2009-07-01

Persistent hematuria is one of the most dreaded complications following percutanous nephrolithotomy (PCNL). Although invasive, a catheter-based angiogram is usually used to localize the bleeding vessel and subsequently embolize it. Advances in imaging technology have now made it possible to use a non invasive multi-detector computed tomography (MDCT) angiogram with 3-D reconstruction to establish the diagnosis. We report a case of post-PCNL hemorrhage due to a pseudo aneurysm that was missed by a conventional angiogram and subsequently detected on MDCT angiogram.

Diagnosis and initial management of urological injuries associated with 200 consecutive pelvic fractures.

PubMed

Palmer, J K; Benson, G S; Corriere, J N

1983-10-01

During 26 months 200 consecutive patients with fracture of the bony pelvis were evaluated and treated for urological injury. There was no correlation between the extent of pelvic injury and degree of hematuria but hematuria was present in all patients with a urological injury. All urological injuries occurred with anterior arch fractures. The over-all incidence of injury was 13.5 per cent (bladder 9 per cent, urethra 3.5 per cent and combined 1 per cent). Limited extraperitoneal bladder ruptures were treated successfully by Foley catheter drainage.

Nonoperative management of penetrating kidney injuries: a prospective audit.

PubMed

Moolman, C; Navsaria, P H; Lazarus, J; Pontin, A; Nicol, A J

2012-07-01

The role of nonoperative management for penetrating kidney injuries is unknown. Therefore, we review the management and outcome of penetrating kidney injuries at a center with a high incidence of penetrating trauma. Data from all patients presenting with hematuria and/or kidney injury discovered on imaging or at surgery admitted to the trauma center at Groote Schuur Hospital in Cape Town, South Africa during a 19-month period (January 2007 to July 2008) were prospectively collected and reviewed. These data were analyzed for demographics, injury mechanism, perioperative management, nephrectomy rate and nonoperative success. Patients presenting with hematuria and with an acute abdomen underwent a single shot excretory urogram. Those presenting with hematuria without an indication for laparotomy underwent computerized tomography with contrast material. A total of 92 patients presented with hematuria following penetrating abdominal trauma. There were 75 (80.4%) proven renal injuries. Of the patients 84 were men and the median age was 26 years (range 14 to 51). There were 50 stab wounds and 42 gunshot renal injuries. Imaging modalities included computerized tomography in 60 cases and single shot excretory urography in 18. There were 9 patients brought directly to the operating room without further imaging. A total of 47 patients with 49 proven renal injuries were treated nonoperatively. In this group 4 patients presented with delayed hematuria, of whom 1 had a normal angiogram and 3 underwent successful angioembolization of arteriovenous fistula (2) and false aneurysm (1). All nonoperatively managed renal injuries were successfully treated without surgery. There were 18 nephrectomies performed for uncontrollable bleeding (11), hilar injuries (2) and shattered kidney (3). Post-nephrectomy complications included 1 infected renal bed hematoma requiring percutaneous drainage. Of the injuries found at laparotomy 12 were not explored, 2 were drained and 5 were treated with renorrhaphy. Penetrating trauma is associated with a high nephrectomy rate (24.3%). However, a high nonoperative success rate (100%) is achievable with minimal morbidity (9%). Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Diet Influences Expression of Autoimmune Associated Genes and Disease Severity By Epigenetic Mechanisms in a Transgenic Lupus Model

PubMed Central

Strickland, Faith M.; Hewagama, Anura; Wu, Ailing; Sawalha, Amr H.; Delaney, Colin; Hoeltzel, Mark F.; Yung, Raymond; Johnson, Kent; Mickelson, Barbara; Richardson, Bruce C.

2013-01-01

Objective Lupus flares when genetically predisposed people encounter appropriate environmental agents. Current evidence indicates that the environment contributes by inhibiting T cell DNA methylation, causing overexpression of normally silenced genes. DNA methylation depends on both dietary transmethylation micronutrients and Erk-regulated DNA methyltransferase 1 (Dnmt1) levels. We used transgenic mice to study interactions between diet, Dnmt1 levels and genetic predisposition on the development and severity of lupus. Methods A doxycycline-inducible Erk defect was bred into lupus-resistant (C57BL/6) or lupus-susceptible (C57BL/6xSJL) mouse strains. Doxycycline treated mice were fed a standard commercial diet for eighteen weeks then switched to diets supplemented(MS) or restricted(MR) intransmethylation micronutrients. Disease severity was assessed by anti-dsDNA antibodies, proteinuria, hematuria and histopathology of kidney tissues. Pyrosequencing was used to determine micronutrient effects on DNA methylation. Results Doxycycline induced modest levels of anti-dsDNA antibodies in C57BL/6 mice and higher levels in C57BL/6xSJL mice. Doxycycline-treated C57BL/6xSJL mice developed hematuria and glomerulonephritis on the MR and standard but not the MS diet. In contrast C57BL/6 mice developed kidney disease only on the MR diet. Decreasing Erk signaling and methyl donors also caused demethylation and overexpression of the CD40lg gene in female mice, consistent with demethylation of the second X chromosome. Both the dietary methyl donor content and duration of treatment influenced methylation and expression of the CD40lg gene. Conclusions Dietary micronutrients that affect DNA methylation can exacerbate or ameliorate SLE disease in this transgenic murine lupus model, and contribute to lupus susceptibility and severity through genetic/epigenetic interactions. PMID:23576011

Recurrent abdominal pain in childhood urolithiasis.

PubMed

Polito, Cesare; La Manna, Angela; Signoriello, Giuseppe; Marte, Antonio

2009-12-01

Our goal was to establish the clinical presentation and features of pain attacks in children with recurrent abdominal pain (RAP) and urolithiasis. We compared the rate of previous appendectomy among 100 consecutive patients with that of 270 control subjects. We also compared the frequency of pain attacks with that reported by children with functional or organic gastrointestinal RAP. Fifty-three patients had no history of dysuria or gross hematuria, and only 35 had hematuria at the first visit; 41 patients were evaluated for urolithiasis only because of a family history of kidney stones associated with RAP. Twenty-nine patients had been previously hospitalized for abdominal symptoms. Sixteen patients and 4 control subjects (1.5%) had undergone a previous appendectomy (P < .0001). Two to 28 months before the diagnosis of urolithiasis, 37 patients underwent abdominal ultrasonography, which did not show urinary stones. Sixty-nine percent of subjects younger than 8 years of age had central/diffuse abdominal pain. The mean frequency of pain attacks was 4 to 9 times lower than in patients with functional or organic gastrointestinal RAP. Because of the inconstant occurrence of dysuria and hematuria, the location of pain in areas other than the flank, and the lack of calculi shown on imaging studies performed after pain attacks, the urologic origin of pain may be overlooked and ineffective procedures performed. The possibility of urolithiasis should be considered in children with RAP who have a family history of urolithiasis and/or infrequent pain attacks, even when dysuria and hematuria are lacking, and in younger children even when pain is not lateral.

Long-term Results of Endovascular Stent Graft Placement of Ureteroarterial Fistula

DOE Office of Scientific and Technical Information (OSTI.GOV)

Okada, Takuya, E-mail: okabone@gmail.com; Yamaguchi, Masato, E-mail: masato03310402@yahoo.co.jp; Muradi, Akhmadu, E-mail: muradiakhmadu@gmail.com

2013-08-01

PurposeTo evaluate the safety, efficacy, and long-term results of endovascular stent graft placement for ureteroarterial fistula (UAF).MethodsWe retrospectively analyzed stent graft placement for UAF performed at our institution from 2004 to 2012. Fistula location was assessed by contrast-enhanced computed tomography (CT) and angiography, and freedom from hematuria recurrence and mortality rates were estimated.ResultsStent graft placement for 11 UAFs was performed (4 men, mean age 72.8 {+-} 11.6 years). Some risk factors were present, including long-term ureteral stenting in 10 (91 %), pelvic surgery in 8 (73 %), and pelvic radiation in 5 (45 %). Contrast-enhanced CT and/or angiography revealed fistulamore » or encasement of the artery in 6 cases (55 %). In the remaining 5 (45 %), angiography revealed no abnormality, and the suspected fistula site was at the crossing area between urinary tract and artery. All procedures were successful. However, one patient died of urosepsis 37 days after the procedure. At a mean follow-up of 548 (range 35-1,386) days, 4 patients (36 %) had recurrent hematuria, and two of them underwent additional treatment with secondary stent graft placement and surgical reconstruction. The hematuria recurrence-free rates at 1 and 2 years were 76.2 and 40.6 %, respectively. The freedom from UAF-related and overall mortality rates at 2 years were 85.7 and 54.9 %, respectively.ConclusionEndovascular stent graft placement for UAF is a safe and effective method to manage acute events. However, the hematuria recurrence rate remains high. A further study of long-term results in larger number of patients is necessary.« less

An Overlapping Case of Alport Syndrome and Thin Basement Membrane Disease

PubMed Central

Alganabi, Mashriq; Eter, Ahmad

2016-01-01

We report a case of a 48-year-old male who presented with hematuria of at least 10 years, and has a daughter with hematuria as well. The patient has a history of degenerative hearing loss, decreased vision and cataract formation, but no diabetes, hypertension or proteinuria. A full serology and urology workup was negative for any abnormality. A kidney biopsy for the patient revealed a diagnosis of Alport syndrome but was unable to rule out thin basement membrane disease. The biopsy was inconclusive in making the diagnosis but the patient’s clinical presentation led to the diagnosis of Alport syndrome. The patient’s 10-year-old daughter also has hematuria with no clear etiology but now can subsequently be anticipatorily managed for Alport syndrome progression. Due to the rarity of the disease, diagnosis is often missed or delayed by primary care providers especially when no associated proteinuria has yet developed. This can lead to confusion and misdiagnosis with thin basement membrane disease, a generally benign hematuria without kidney failure progression. Additionally, biopsy can be inconclusive in these patients, relying on the physician’s history and physical examination findings to diagnose. It is important to appropriately diagnose Alport syndrome not only to manage the patient’s rate of kidney failure progression but also allow for a higher degree of suspicion, screening and intervention in the patient’s family members. Both the inconclusive nature of kidney biopsies and the usefulness of diagnosis for family member screening are often overlooked in medical literature but are explored in this case. PMID:27635185

Primary Glomerulonephritis with Unique C4d Deposition and Concurrent Non-infectious Intermediate Uveitis: a Case Report and Literature Review

PubMed Central

2018-01-01

C4 glomerulopathy is a recently introduced entity that presents with bright C4d staining and minimal or absent immunoglobulin and C3 staining. We report a case of a 62-year-old man with C4 glomerulonephritis (GN) and uveitis. He presented to the nephrology department with proteinuria and hematuria. The patient also had intermediate uveitis along with proteinuria and hematuria. A kidney biopsy that was performed in light of continuing proteinuria and hematuria showed a focal proliferative, focal sclerotic glomerulopathy pattern on light microscopy, absent staining for immunoglobulin or C3 by immunofluorescence microscopy, with bright staining for C4d on immunohistochemistry, and electron-dense deposits on electron microscopy. Consequently, C4 GN was suggested as the pathologic diagnosis. Although laser microdissection and mass spectrometry for glomerular deposit and pathologic evaluation of the retinal tissue were not performed, this is the first report of C4 GN in Korea and the first case of coexisting C4 GN and uveitis in the English literature. PMID:29713256

Nontraumatic Exertional Rhabdomyolysis Leading to Acute Kidney Injury in a Sickle Trait Positive Individual on Renal Biopsy.

PubMed

Janga, Kalyana C; Greenberg, Sheldon; Oo, Phone; Sharma, Kavita; Ahmed, Umair

2018-01-01

A 26-year-old African American male with a history of congenital cerebral palsy, sickle cell trait, and intellectual disability presented with abdominal pain that started four hours prior to the hospital visit. The patient denied fever, chills, diarrhea, or any localized trauma. The patient was at a party at his community center last evening and danced for 2 hours, physically exerting himself more than usual. Labs revealed blood urea nitrogen (BUN) level of 41 mg/dL and creatinine (Cr) of 2.8 mg/dL which later increased to 4.2 mg/dL while still in the emergency room. Urinalysis revealed hematuria with RBC > 50 on high power field. Imaging of the abdomen revealed no acute findings for abdominal pain. With fractional excretion of sodium (FeNa) > 3%, findings suggested nonoliguric acute tubular necrosis. Over the next couple of days, symptoms of dyspepsia resolved; however, BUN/Cr continued to rise to a maximum of 122/14 mg/dL. With these findings, along with stable electrolytes, urine output matching the intake, and prior use of proton pump inhibitors, medical decision was altered for the possibility of acute interstitial nephritis. Steroids were subsequently started and biopsy was taken. Biopsy revealed heavy deposits of myoglobin. Creatinine phosphokinase (CPK) levels drawn ten days later after the admission were found to be elevated at 334 U/dl, presuming the levels would have been much higher during admission. This favored a diagnosis of acute kidney injury (AKI) secondary to exertional rhabdomyolysis. We here describe a case of nontraumatic exertional rhabdomyolysis in a sickle cell trait (SCT) individual that was missed due to findings of microscopic hematuria masking underlying myoglobinuria and fractional excretion of sodium > 3%. As opposed to other causes of ATN, rhabdomyolysis often causes FeNa < 1%. The elevated fractional excretion of sodium in this patient was possibly due to the underlying inability of SCT positive individuals to reabsorb sodium/water and concentrate their urine. Additionally, because of their inability to concentrate urine, SCT positive individuals are prone to intravascular depletion leading to renal failure as seen in this patient. Disease was managed with continuing hydration and tapering steroids. Kidney function improved and the patient was discharged with a creatinine of 3 mg/dL. A month later, renal indices were completely normal with persistence of microscopic hematuria from SCT.

An ignored cause of red urine in children: rhabdomyolysis due to carnitine palmitoyltransferase II (CPT-II) deficiency.

PubMed

Melek, Engin; Bulut, Fatma Derya; Atmış, Bahriye; Yılmaz, Berna Şeker; Bayazıt, Aysun Karabay; Mungan, Neslihan Önenli

2017-02-01

Carnitine palmitoyltransferase II (CPT-II) deficiency is an autosomal recessively inherited disorder involving the β-oxidation of long-chain fatty acids, which leads to rhabdomyolysis and subsequent acute renal failure. The clinical phenotype varies from a severe infantile form to a milder muscle form. Here, we report a 9-year-old boy referred to our hospital for the investigation of hematuria with a 2-day history of dark urine and malaise. As no erythrocytes in the microscopic examination of the urine and hemoglobinuria were present, myoglobinuria due to rhabdomyolysis was the most probable cause of dark urine. After excluding the other causes of rhabdomyolysis, with the help of metabolic investigations, the patient was suspected to have CPT-II deficiency, the most common cause of metabolic rhabdomyolysis. Our aim in presenting this case is to emphasize considering rhabdomyolysis in the differential diagnosis of dark urine in order to prevent recurrent rhabdomyolysis and renal injury.

[A new variant of Munchausen's syndrome by proxy: the father in an active role].

PubMed

Prakken, A B; den Hartog, L; Waelkens, J J

1991-06-01

The case is described of an eleven-year-old boy with abdominal pain and hematuria. The hematuria appears to be fabricated by the father of the boy by adding cooked meat to the urine samples. The medical history of the father is very suspect for the Münchhausen syndrome. The case of the son differs in some respects from the normal pattern of the Münchhausen by proxy syndrome: the age of the son, the role of the father as active inducer and the low social class of the family.

Gastrocystoplasty and Hematuria-dysuria Syndrome. What Role Plays Helicobacter Pylori? Case Report and Literature Review

PubMed Central

Aponte, Hernán A.; Clavijo, Rafael A.; Quiroz, Yesica J.; Dallos, Diego F.; Ruiz, William N.; Ramirez-Troche, Nelson E.; Martin, Oscar Dario

2015-01-01

49 years male, who comes to the urology department, complaining of 8 months of lower abdominal pain, burning and oppressive type, of variable intensity reaching 9/10, which is occasionally exacerbated by urination, associated with intermittent gross hematuria, dysuria, refers no fever at any time. Patient with past medical history of bladder and right kidney Tuberculosis (TBC) 25 years ago, treated with a simple right nephrectomy and bladder augmentation with antrum segment of stomach, for low bladder capacity. Never showed any symptom during those 25 years lapsing time PMID:26793505

Life-threatening hematuria requiring transcatheter embolization following radiofrequency ablation of renal cell carcinoma.

PubMed

Roach, H; Whittlestone, T; Callaway, M P

2006-01-01

Radiofrequency ablation is increasingly being acknowledged as a valid treatment for renal cell carcinoma in patients in whom definitive curative resection is deemed either undesirable or unsafe. A number of published series have shown the technique to have encouraging results and relatively low complication rates. In this article, we report a case of delayed life-threatening hematuria requiring transcatheter embolization of a bleeding intrarenal artery in a patient who had undergone imaging-guided radiofrequency ablation of a 3 cm renal cell carcinoma. To our knowledge, such a complication has not been reported previously.

Successful Management of Neobladder Variceal Bleeding

DOE Office of Scientific and Technical Information (OSTI.GOV)

Atwal, Dinesh; Chatterjee, Kshitij, E-mail: kchatterjee@uams.edu; Osborne, Scott

Hematuria from a neobladder can occur due to a variety of pathologies including tumors, stones, and fistulas. Variceal bleeding in a neobladder is a very rare condition with only one case reported in literature. We present a case of a patient with cirrhosis and portal hypertension and an ileocolic orthotopic neobladder presenting with hematuria. Computed tomographic angiography showed dilated varices around the neobladder which were successfully embolized. To the best of our knowledge, this is the first report case of variceal bleeding in a neobladder successfully managed with the combination of TIPS (transjugular intrahepatic portosystemic shunt) procedure and embolization.

Wilms tumor in a child with trisomy 13.

PubMed

Sweeney, H; Pelegano, J

2000-01-01

A 4-year-old black boy with trisomy 13, a history of frequent urinary tract infections, and a horseshoe kidney with painless gross hematuria was examined. An abdominal mass was detected and surgically resected. Examination of the surgical specimen revealed a Wilms tumor. Given the concurrence of trisomy 13 and Wilms tumor and the presence of another such case in the literature, there may be just cause to suspect a locus on chromosome 13 that affects the probability of developing Wilms tumor. Given the increasingly longer survival of patients with trisomy 13, clinicians may need to be aware of the possibility of renal malignant disease in this population of patients.

Henoch-Schönlein Purpura Complicated by Hepatocellular Carcinoma.

PubMed

Akizue, Naoki; Suzuki, Eiichiro; Yokoyama, Masayuki; Inoue, Masanori; Wakamatsu, Toru; Saito, Tomoko; Kusakabe, Yuko; Ogasawara, Sadahisa; Ooka, Yoshihiko; Tawada, Akinobu; Maru, Yugo; Matsue, Hiroyuki; Chiba, Tetsuhiro

2017-11-15

Although Henoch-Schönlein purpura (HSP) is known to be accompanied by malignancies, cases with hepatobiliary cancer are extremely rare. A 62-year-old man with palpable purpura rapidly extending to both lower legs was admitted to our hospital. He was undergoing follow-up for cirrhosis caused by chronic hepatitis B virus infection and hepatocellular carcinoma (HCC). He had renal dysfunction with hematuria and proteinuria and abdominal pain. Based on the clinical presentation and skin biopsy findings, he was diagnosed with HSP. The administration of steroids resulted in the rapid improvement of the patient's symptoms and he was discharged 12 days after admission.

A Rare Cause of Death in a Woman: Iatrogenic Bladder Rupture in a Patient With an Indwelling Foley Catheter.

PubMed

Paul, Anthea B Mahesan; Simms, Lary; Paul, Abraham E; Mahesan, Andrew A; Ramzanali, Ammani

2016-05-01

The CDC estimates that 12-25% of all hospitalized patients receive a urinary catheter during their hospital stay. Foley catheter failure is uncommon and Foley catheter failure associated with iatrogenic urinary bladder rupture (IUBR) is extremely rare. Symptoms are often nonspecific and thus misdiagnosis and delayed treatment is common. In this case report, we present a case of IUBR in a woman from Foley catheter failure, which ultimately led to her demise. This case adds to the literature the importance of suspicion for IUBR in patients with indwelling Foley catheters presenting with lower abdominal pain, hematuria, and decreased urine output.

Solifenacin improves double-J stent-related symptoms in both genders following uncomplicated ureteroscopic lithotripsy.

PubMed

Lee, Yuan-Ju; Huang, Kuo-How; Yang, Hung-Ju; Chang, Hong-Chiang; Chen, Jun; Yang, Teng-Kai

2013-06-01

The objective of this study is to evaluate the effects of solifenacin on double-J stent-related symptoms following uncomplicated ureterosocpic lithotripsy (URSL). A total of 70 patients who underwent double-J ureteral stent insertion following URSL were consecutively recruited and received solifenacin postoperatively. Another 70 age- and sex-matched subjects without solifenacin therapy were enrolled as a control group. The clinical data including stone and stent characteristics were collected. All subjects completed the brief-form Ureteral Symptom Score Questionnaire (Chinese-version) to assess the lower urinary tract symptoms, stent-related body pain and hematuria 2 weeks after operation. The severity of stent-related symptoms was compared between two groups. The mean age was 53.8 in solifenacin group and 53.4 years in the control group (p = 0.87). The stone characteristics, stent size, position and curl completeness were similar in both groups. Compared to the control group, solifenacin group had significantly lower total symptom score, urgency and urge incontinence scores. As for stent-related body pain, solifenacin group had significantly less flank, abdominal, urethral pain and hematuria scores (all p < 0.05). The solifenacin versus control group showed significant benefits in lower urinary tract symptoms, stent-related pain and hematuria in both genders (all p < 0.05). Four subjects encountered minor adverse events (5.7 %) and one had urinary retention (1.4 %) in solifenacin group. For patients undergoing URSL and double-J stent indwelling, postoperative solifenacin use was effective and well-tolerated for the treatment of lower urinary tract symptoms, stent-related body pain and hematuria irrespective of genders.

[Analysis of diagnosis and treatment of Alport syndrome].

PubMed

An, X G; Zhang, Y Q; Ding, J; Wang, F; Xiao, H J; Yao, Y

2016-09-01

To investigate the clinical characteristics and the status of diagnosis and treatment of patients with Alport syndrome in China. Patients with affirmative diagnosis of Alport syndrome from Department of Pedatrics, Peking University First Hospital in the past 20 years (1995-2015) were analyzed retrospectively. The clinical data including initial symptoms, visit reasons, age at onset of disease, family history, hereditary mode, methods of diagnosis, misdiagnosis and mistreatment were collected. A total of 398 patients with Alport syndrome were included in this study, 48.2% of patients had the onset of symptoms before age of 3 years. The rate of onset of symptoms and diagnosis before age of 17 years were 95.7%. The initial symptoms included gross hematuria (37.2%), microscopic hematuria and proteinuria (25.1%), microscopic hematuria (14.8%), edema of eyelid and lower limbs (10.3%), increased foam in urine (4.3%), etc.; 39.5% of patients had no symptoms of urinary tract. Only 14.0% of the patients were diagnosed as Alport syndrome for the first time, and 86.0% of the patients were misdiagnosed. Hormones and immunosuppressive agents were used in 19.0% of patients diagnosed as Alport syndrome, and in 43.0% of patients there was misdiagnosis. Skin biopsy and immunofluorescence of type Ⅳ collagen ɑ5 chain in epithelial basement membrane had a detection rate of 77.8%. Electron microscopy of glomerular basement membrane had a detection rate of 92.6%, and genetic testing 96.6%. The time interval of diagnosis was 18.2 months and was gradually shortened in recent years. Alport syndrome developed at a very young age. Hematuria was the most frequent initial symptom. There was a high rate of misdiagnosis and mistreatment for Alport syndrome. Genetic testing for Alport syndrome had advantages of high detection rate, genetic consultation and prenatal diagnosis.

Evaluation of an Epigenetic Profile for the Detection of Bladder Cancer in Patients with Hematuria.

PubMed

van Kessel, Kim E M; Van Neste, Leander; Lurkin, Irene; Zwarthoff, Ellen C; Van Criekinge, Wim

2016-03-01

Many patients enter the care cycle with gross or microscopic hematuria and undergo cystoscopy to rule out bladder cancer. Sensitivity of this invasive examination is limited, leaving many patients at risk for undetected cancer. To improve current clinical practice more sensitive and noninvasive screening methods should be applied. A total of 154 urine samples were collected from patients with hematuria, including 80 without and 74 with bladder cancer. DNA from cells in the urine was epigenetically profiled using 2 independent assays. Methylation specific polymerase chain reaction was performed on TWIST1. SNaPshot™ methylation analysis was done for different loci of OTX1 and ONECUT2. Additionally all samples were analyzed for mutation status of TERT (telomerase reverse transcriptase), PIK3CA, FGFR3 (fibroblast growth factor receptor 3), HRAS, KRAS and NRAS. The combination of TWIST1, ONECUT2 (2 loci) and OTX1 resulted in the best overall performing panel. Logistic regression analysis on these methylation markers, mutation status of FGFR3, TERT and HRAS, and patient age resulted in an accurate model with 97% sensitivity, 83% specificity and an AUC of 0.93 (95% CI 0.88-0.98). Internal validation led to an optimism corrected AUC of 0.92. With an estimated bladder cancer prevalence of 5% to 10% in a hematuria cohort the assay resulted in a 99.6% to 99.9% negative predictive value. Epigenetic profiling using TWIST1, ONECUT2 and OTX1 results in a high sensitivity and specificity. Accurate risk prediction might result in less extensive and invasive examination of patients at low risk, thereby reducing unnecessary patient burden and health care costs. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Role of MRI in differentiating various causes of non-traumatic paraparesis and tetraparesis.

PubMed

Ahmed, Nisar; Akram, Hamid; Qureshi, Ishtiaq Ahmed

2004-10-01

To assess the frequency of various causes of non-traumatic paraparesis and tetraparesis in adults based only on the findings of magnetic resonance imaging (MRI). Non-interventional descriptive study carried out from May 2001 to October 2002 at Radiology Department, CMH, Rawalpindi. A total of 100 adult patients who presented with non-traumatic paraparesis or tetraparesis, were studied. MRI spine of all the patients and MRI brain of selected patients, was carried out. Based on MRI findings alone causes of non-traumatic paraparesis and tetraparesis were categorized. Paraparesis was more frequent than tetraparesis. Cord compression was found in 72% cases. Neoplastic compression, infective spondylitis and non-compressive myelopathies were the main causes of paraparesis while spondylotic myelopathy was the main cause of tetraparesis. Based upon MRI findings causes of non-traumatic paraparesis or tetraparesis can be subcategorized into spondylotic, infective or neoplastic cord compression and non-compressive myelopathies. Further subcategorization of neoplastic lesions according to their compartment of origin can also be done.

Severe coagulation factor VII deficiency caused by a novel homozygous mutation (p. Trp284Gly) in loop 140s.

PubMed

Hao, Xiuping; Cheng, XiaoLi; Ye, Jiajia; Wang, Yingyu; Yang, LiHong; Wang, Mingshan; Jin, Yanhui

2016-06-01

Congenital coagulation factor VII (FVII) deficiency is a rare disorder caused by mutation in F7 gene. Herein, we reported a patient who had unexplained hematuria and vertigo with consanguineous parents. He has been diagnosed as having FVII deficiency based on the results of reduced FVII activity (2.0%) and antigen (12.8%). The thrombin generation tests verified that the proband has obstacles in producing thrombin. Direct sequencing analysis revealed a novel homozygous missense mutation p.Trp284Gly. Also noteworthy is the fact that the mutational residue belongs to structurally conserved loop 140s, which majorly undergo rearrangement after FVII activation. Model analysis indicated that the substitution disrupts these native hydrophobic interactions, which are of great importance to the conformation in the activation domain of FVIIa.

Accidental fatal lung injury by compressed air: a case report.

PubMed

Rayamane, Anand Parashuram; Pradeepkumar, M V

2015-03-01

Compressed air is being used extensively as a source of energy at industries and in daily life. A variety of fatal injuries are caused by improper and ignorant use of compressed air equipments. Many types of injuries due to compressed air are reported in the literature such as colorectal injury, orbital injury, surgical emphysema, and so on. Most of these injuries are accidental in nature. It is documented that 40 pounds per square inch pressure causes fatal injuries to the ear, eyes, lungs, stomach, and intestine. Openings of body are vulnerable to injuries by compressed air. Death due to compressed air injuries is rarely reported. Many cases are treated successfully by conservative or surgical management. Extensive survey of literature revealed no reports of fatal injury to the upper respiratory tract and lungs caused by compressed air. Here, we are reporting a fatal event of accidental death after insertion of compressed air pipe into the mouth. The postmortem findings are corroborated with the history and discussed in detail.

Macroscopic Hematuria due to Placenta Percreta: Report of Two Cases and Short Review

PubMed Central

Garas, Antonios; Sveronis, George; Nidimos, Asterios; Gkorezi, Irondiana; Alevra, Zoi; Oeconomou, Athanasios; Zachos, Ioannis

2017-01-01

Herein we present two cases of pregnant women with placenta percreta and severe hematuria during the 24th and 35th weeks of pregnancy, respectively. A timely sonographic diagnosis was feasible in the first case and cesarean section was performed during the 29th week. During the operation, the placenta was invading the bladder wall and concomitant hysterectomy with cystotomy and bladder wall reconstruction was performed. The second case presented in our emergency department with vaginal bleeding during the 35th weeks of pregnancy. She underwent an emergency cesarean section with uterine preservation, cystotomy, and bladder reconstruction. PMID:28698813

A prospective randomized trial of the LoFric hydrophilic coated catheter versus conventional plastic catheter for clean intermittent catheterization.

PubMed

Vapnek, Jonathan M; Maynard, Frederick M; Kim, Jiensup

2003-03-01

We compared the incidence of hematuria, pyuria and clinical urinary tract infection in patients who performed intermittent self-catheterization using a hydrophilic coated LoFric (Astra Tech AB, Mölndal, Sweden) or standard plastic catheter. A total of 62 male patients who performed intermittent self-catheterization to manage neurogenic bladder were randomized into 2 treatment groups at 3 American study sites. Outcome measures included urinary tract infection, microhematuria, pyuria and satisfaction rates. Of the 62 enrolled patients 49 completed the 12-month study. The withdrawal rate was not different in the 2 groups. At the end of the study there was statistically significantly less hematuria in the hydrophilic coated catheter group compared with controls. In addition, there was a significant decrease in the urinary tract infection rate from baseline in the hydrophilic coated catheter group but not in controls. Use of the hydrophilic coated catheter by patients on intermittent self-catheterization is associated with less hematuria and a significant decrease in the incidence of urinary tract infections. Therefore, it may be preferable for some patients, especially those with a history of difficult catheterization, urethral trauma or a high rate of urinary tract infection.

Pituitary stalk compression by the dorsum sellae: possible cause for late childhood onset growth disorders.

PubMed

Taoka, Toshiaki; Iwasaki, Satoru; Okamoto, Shingo; Sakamoto, Masahiko; Nakagawa, Hiroyuki; Otake, Shoichiro; Fujioka, Masayuki; Hirohashi, Shinji; Kichikawa, Kimihiko

2006-06-01

The purpose of this study was to evaluate the relationship between pituitary stalk compression by the dorsum sellae and clinical or laboratory findings in short stature children. We retrospectively reviewed magnetic resonance images of the pituitary gland and pituitary stalk for 34 short stature children with growth hormone (GH) deficiency and 24 age-matched control cases. We evaluated the degree of pituitary stalk compression caused by the dorsum sellae. Body height, GH level, pituitary height and onset age of the short stature were statistically compared between cases of pituitary stalk compression with associated stalk deformity and cases without compression. Compression of the pituitary stalk with associated stalk deformity was seen in nine cases within the short stature group. There were no cases observed in the control group. There were no significant differences found for body height, GH level and pituitary height between the cases of pituitary stalk compression with associated stalk deformity and cases without compression. However, a significant difference was seen in the onset age between cases with and without stalk compression. Pituitary stalk compression with stalk deformity caused by the dorsum sellae was significantly correlated with late childhood onset of short stature.

Lumbar vertebral haemangioma causing pathological fracture, epidural haemorrhage, and cord compression: a case report and review of literature.

PubMed

Vinay, S; Khan, S K; Braybrooke, J R

2011-01-01

Vertebral haemangiomas are recognized to be one of the commonest benign tumours of the vertebral column, occurring mostly in the thoracic spine. The vast majority of these are asymptomatic. Infrequently, these can turn symptomatic and cause neurological deficit (cord compression) through any of four reported mechanisms: (1) epidural extension; (2) expansion of the involved vertebra(e) causing spinal canal stenosis; (3) spontaneous epidural haemorrhage; (4) pathological burst fracture. Thoracic haemangiomas have been reported to be more likely to produce cord compression than lumbar haemangiomas. A forty-nine year old male with acute onset spinal cord compression from a pathological fracture in a first lumbar vertebral haemangioma. An MRI delineated the haemangioma and extent of bleeding that caused the cord compression. These were confirmed during surgery and the haematoma was evacuated. The spine was instrumented from T12 to L2, and a cement vertebroplasty was performed intra-operatively. Written consent for publication was obtained from the patient. The junctional location of the first lumbar vertebra, and the structural weakness from normal bone being replaced by the haemangioma, probably caused it to fracture under axial loading. This pathological fracture caused bleeding from the vascularized bone, resulting in cord compression.

Lumbar vertebral haemangioma causing pathological fracture, epidural haemorrhage, and cord compression: a case report and review of literature

PubMed Central

Vinay, S; Khan, SK; Braybrooke, JR

2011-01-01

Context Vertebral haemangiomas are recognized to be one of the commonest benign tumours of the vertebral column, occurring mostly in the thoracic spine. The vast majority of these are asymptomatic. Infrequently, these can turn symptomatic and cause neurological deficit (cord compression) through any of four reported mechanisms: (1) epidural extension; (2) expansion of the involved vertebra(e) causing spinal canal stenosis; (3) spontaneous epidural haemorrhage; (4) pathological burst fracture. Thoracic haemangiomas have been reported to be more likely to produce cord compression than lumbar haemangiomas. Findings A forty-nine year old male with acute onset spinal cord compression from a pathological fracture in a first lumbar vertebral haemangioma. An MRI delineated the haemangioma and extent of bleeding that caused the cord compression. These were confirmed during surgery and the haematoma was evacuated. The spine was instrumented from T12 to L2, and a cement vertebroplasty was performed intra-operatively. Written consent for publication was obtained from the patient. Clinical Relevance The junctional location of the first lumbar vertebra, and the structural weakness from normal bone being replaced by the haemangioma, probably caused it to fracture under axial loading. This pathological fracture caused bleeding from the vascularized bone, resulting in cord compression. PMID:21756575

Knowledge, Attitudes, and Practices Related to Schistosomiasis Among Children in Northern Senegal.

PubMed

Frigerio, Simona; Bert, Fabrizio; Clari, Marco; Di Fine, Giovanni; Riva, Susanna; Bergese, Ilaria; Diouf, Samba Gueye; Alvaro, Rosaria; Buonomo, Ersilia

Schistosomiasis is a highly prevalent parasitic disease in Senegal. The early symptoms are hematuria and dysuria. Children's comprehension of the disease is fundamental to preventing the infection. The aim of this study was to investigate the knowledge attitudes, and practices related to schistosomiasis among schoolchildren in 2 rural villages in Northern Senegal and to evaluate their impact on the disease. A cross-sectional study was conducted. Data about children's knowledge of schistosomiasis, behavior, and preventive measures were collected through a questionnaire. Questionnaire responses from 575 schoolchildren were analyzed. Correct answers about risky behavior for schistosomiasis were associated with early symptoms (P = 0.010). Wearing shoes and washing hands with soap were associated with not having hematuria and dysuria (P = 0.007 and 0.049, respectively). Playing in rivers was associated with the aforementioned symptoms (P < 0.001). Children who had good knowledge of schistosomiasis reportedly did not have symptoms (P = 0.002). A logistic regression model showed that female sex (odds ratio = 0.35; P = 0.01) and attending a primary school (odds ratio = 0.13; P < 0.001) were significant predictors of a lower risk of the early symptoms of urinary schistosomiasis. This study revealed that the level of knowledge among children in North Senegal about the causes, transmission, prevention, and treatment of schistosomiasis warrants implementing educational intervention. Copyright © 2016 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.

Bladder cancer in patients with spinal cord injury.

PubMed

Hess, Marika J; Zhan, Ellen H; Foo, Dominic K; Yalla, Subbarao V

2003-01-01

The incidence of bladder cancer in spinal cord injury (SCI) is 16 to 28 times higher than that in the general population. The objective of this study was to investigate the characteristics of bladder cancer that are unique to the SCI population. Retrospective review. The charts of 16 patients diagnosed with bladder cancer from 1982 to 2001 were reviewed for type of cancer, exposure to risk factors, presenting symptoms, and survival time. The presenting manifestations were gross hematuria in 14 patients, papillary urethral growth in 1 patient, and acute obstructive renal failure in 1 patient. The diagnosis was made on initial cystoscopic evaluation in 16 patients; 3 patients required further evaluation. Eight of the 11 screening cytologies were suspicious for a malignancy prior to the diagnosis. Seven patients had transitional cell carcinoma, 6 patients had squamous cell carcinoma (SCCA), and 3 patients had both. The bladder wasmanaged with chronic indwelling catheter in 12 patients. Nine patients died of bladder cancer metastases and the remaining 3 patients died of other causes. Six patients survived 5 years or more; 4 were still alive at the completion of this study. Gross hematuria in individuals with SCI warrants aggressive assessment for bladder cancer. Chronic indwelling catheter, smoking, and renal and bladder stones are important risk factors for cancer. The incidence of SCCA in the SCI popullation is much higher than in the general population. Cystoscopic and cytologic evaluation in patients with advanced disease may fail to confirm the diagnosis in a high proportion of patients.

Asymptomatic proteinuria. Clinical significance.

PubMed

Papper, S

1977-09-01

Patients with asymptomatic proteinuria have varied reasons for the proteinuria and travel diverse courses. In the individual with normal renal function and no systemic cause, ie, idiopathic asymptomatic proteinuria, the outlook is generally favorable. Microscopic hematuria probably raises some degree of question about prognosis. The kidney shows normal glomeruli, subtle changes, or an identifiable lesion. The initial approach includes a clinical and laboratory search for systemic disease, repeated urinalyses, quantitative measurements of proteinuria, determination of creatinine clearance, protein electrophoresis where indicated, and intravenous pyelography. The need for regularly scheduled follow-up evaluation is emphasized. Although the initial approach need not include renal biopsy, a decline in creatinine clearance, an increase in proteinuria, or both are indications for biopsy and consideration of drug therapy.

A Rare Cause of Death in a Woman: Iatrogenic Bladder Rupture in a Patient With an Indwelling Foley Catheter

PubMed Central

Paul, Anthea B. Mahesan; Simms, Lary; Paul, Abraham E.; Mahesan, Andrew A.; Ramzanali, Ammani

2016-01-01

The CDC estimates that 12–25% of all hospitalized patients receive a urinary catheter during their hospital stay. Foley catheter failure is uncommon and Foley catheter failure associated with iatrogenic urinary bladder rupture (IUBR) is extremely rare. Symptoms are often nonspecific and thus misdiagnosis and delayed treatment is common. In this case report, we present a case of IUBR in a woman from Foley catheter failure, which ultimately led to her demise. This case adds to the literature the importance of suspicion for IUBR in patients with indwelling Foley catheters presenting with lower abdominal pain, hematuria, and decreased urine output. PMID:27175339

Severe renal hemorrhage caused by pyelonephritis in 7 horses: clinical and ultrasonographic evaluation.

PubMed Central

Kisthardt, K K; Schumacher, J; Finn-Bodner, S T; Carson-Dunkerley, S; Williams, M A

1999-01-01

Case records of 7 horses diagnosed with pyelonephritis were reviewed to determine common features that might aid in diagnosis, treatment, and prognosis of this disease. All 7 horses had been admitted for evaluation of hematuria. During cystoscopy of 5 horses, hemorrhage was observed from one or both ureters. Renal biopsy of 1 horse, laboratory analysis of ureteral discharge of 2 horses, and renal ultrasonography of all horses indicated that pyelonephritis was the cause of hemorrhage. Sonographic renal changes included decreased length, increased echogenicity, abnormal outline, loss of corticomedullary distinction, pyelectasia, and focal hypoechoic or hyperechoic cortical defects. Renal hemorrhage in all horses eventually resolved but recurred in 4 of 5 horses that were followed long-term. Images Figure 1. Figure 2. Figure 3. Figure 4A. Figure 4B. Figure 4C. Figure 5A. Figure 5B. Figure 5C. Figure 6A. Figure 6B. Figure 7. PMID:12001337

Cystic Fibrosis Chest X-Ray Findings: A Teaching Analog

DTIC Science & Technology

2008-07-01

lung volume. There are five specific types of atelectasis: obstructive, compressive, cicatrization , post-operative and adhesive. Obstructive...commonly, a pleural lesion or mass can cause impact on the neighboring lung tissue causing compression of the alveoli in that area. Cicatrization ...Lymphoma Atelectasis Obstructive Compressive Pneumothorax Pleural Effusion Pleural Lesion Cicatrization Radiation Severe Pneumonia Adhesive

[Renal biopsy findings in diabetes mellitus].

PubMed

Kharrat, Mahmoud; Kammoun, Khawala; Charfeddine, Khaled; Yaich, Soumaya; Zaghdene, Saoussen; Chaker, Hanene; Jarraya, Faiçal; Ben Hmida, Mohamed; Jlidi, Rachid; Hachicha, Jamil

2007-03-01

The prevalence of diabetic patients with endstage renal disease is increased overall the word. Renal biopsy is sometimes necessary to precise the type of renal damage. To precise the type and the frequency of non diabetic nephropathy in diabetic patients. We enrolled retrospectively during 17 years, 72 diabetic patients who had a renal biopsy. A non diabetic nephropathy was found in 69.5 % of them. Its presence was correlate to the presence of hematuria and the absence of diabetic retinopathy. We can successfully treated nine patients with minimal-change nephrotic syndrome and one patient with crescentic glomerulonephritis. Renal biopsy must be done in diabetic patient with hematuria or in the absence of diabetic retinopathy.

Renal medullary carcinoma and sickle cell trait: A systematic review.

PubMed

Alvarez, Ofelia; Rodriguez, Maria M; Jordan, Lanetta; Sarnaik, Sharada

2015-10-01

Sickle cell trait (SCT) carries a small risk of renal medullary carcinoma (RMC). We conducted a systematic literature review and reported new four RMC cases (total N = 217). Eighty eight percent had SCT and 8% had sickle cell disease; 50% were children. Males had 2.4× risk than females. Isolated hematuria or in combination with abdominal or flank pain was the presenting sign in 66% cases. Tumor-related mortality was 95%. Four non-metastatic patients were long-term disease-free survivors. Although risk appears to be very low, individuals with SCT should be informed about the low risk of RMC with the hope of early diagnosis. Hematuria should prompt immediate investigation. © 2015 Wiley Periodicals, Inc.

[Ascites and hematuria after falling in an alcoholic patient].

PubMed

Bürkner, A; Neuhaus, V; Schöb, O

2010-02-03

Isolated ruptures of the urinary bladder following minor traumas are a rare abdominal lesion. Diagnosis and treatment are a challenge to emergency physicians and surgeons. This case shows a 46-year-old patient admitted for a minor brain injury after falling during an episode of alcoholic intoxication. Ultrasound and CT scan of the abdomen showed intraabdominal fluid without a parenchymatous lesion. Also a hematuria was significant. The retrograde cystography showed intraabdominal contrast agent. The rupture of the urinary bladder was confirmed by laparoscopy and was intracorporal sutured in double layer technique. Without any postoperative complications the patient was discharged after 4 days. The retrograde cystography after 10 days showed no leckage and the urinary catheter could be removed.

Bicornuate uterine horns with complete cervical-vaginal agenesis and congenital vesicouterine fistula.

PubMed

Kumar, Santosh; Singh, S K; Mavuduru, Ravi; Naveen, A; Agarwal, M M; Vanita, Jain; Mandal, A K

2008-05-01

We present a case of bicornuate uterine horns with complete cervico-vaginal agenesis and associated congenital uterovaginal fistula. The patient presented with cyclical hematuria, amenorrhea, and abdominal lump. The vagina was blind-ending. The cystoscopic examination during cyclical hematuria revealed bloody efflux through a small fistula on the posterior wall of the urinary bladder. The magnetic resonance imaging (MRI) showed bicornuate uterus and cervical agenesis. Hysterectomy and repair of the uterovesical fistula was done. The vagina was reconstructed using an amniotic mould. The report underlies the importance of MRI in diagnosing complexity of such rare anomalies. It also stresses for the need of hysterectomy if cervicovaginal agenesis is present.

Complications of bladder distension during retrograde urethrography.

PubMed

Barsanti, J A; Crowell, W; Losonsky, J; Talkington, F D

1981-05-01

A severe, ulcerative cystitis that resulted in macroscopic hematuria occurred in 8 of 20 healthy dogs undergoing a series of diagnostic tests. Four of the remaining 12 dogs had mild bladder lesions consisting of submucosal edema and hemorrhage. Nine of the 20 dogs developed urinary tract infection after the procedures. These complications seemed associated with the radiographic technique of retrograde urethrography performed when the urinary bladder was distended. To test this hypothesis, retrograde urethrography was performed on 5 additional dogs. With the bladder undistended, no complications occurred. However, distention of these same dogs' bladders for 1 minute or less with sterile lactated Ringer's solution administered through a Foley catheter in the penile urethra resulted in a macroscopic hematuria in all 5 dogs which persisted for 24 hours. A microscopic hematuria continued for 5 days. One dog developed a bacterial urinary tract infection. A severe fibrinopurulent cystitis was present at necropsy of 2 dogs 2 days after distention. The morphologic changes in the bladder gradually diminished over 7 days, but mild submucosal edema and hemorrhage were still present when 2 dogs were necropsied, 7 days after distention. These studies indicated that retrograde urethrography in dogs may be complicated by hemorrhagic cystitis and urinary tract infection if performed with urinary bladder distention.

[Glomerulonephritis and vasculitis as causes of arterial hypertension].

PubMed

Eicken, Sibylle; Gugger, Mathias; Marti, Hans-Peter

2012-05-01

The various types of glomerulonephritis, including many forms of vasculitis, are responsible for about 15% of cases of end-stage renal disease (ESRD). Arterial hypertension represents a frequent finding in patients suffering from glomerulonephritis or vasculitis and hypertension also serves as an indicator for these severe types of diseases. In addition, there are symptoms and signs like hematuria, proteinuria and renal failure. Especially, rapidly progressive glomerulonephritis (RPGN) constitutes a medical emergency and must not be missed by treating physicians. This disease can either occur limited to the kidneys or in the context of a systemic inflammatory disorder, like a vasculitis. If left untreated, RPGN can lead to a necrotizing destruction of glomeruli causing irreversible kidney damage within several months or even weeks. With respect to the immunologically caused vasculitis, there are - depending upon the severity and type of organ involved - many clinical warning signs to be recognized, such as arterial hypertension, hemoptysis, arthalgias, muscle pain, palpable purpura, hematuria, proteinuria and renal failure. In addition, constitutional signs, such as fever and loss of body weight may occur concurrently. Investigations of glomerulonephritis or vasculitis must contain a careful and complete examination of family history and medications used by the respective patient. Thereafter, a thorough clinical examination must follow, including skin, joints and measurement of arterial blood pressure. In addition, a spectrum of laboratory analyses is required in blood, such as full blood screen, erythrocyte sedimentation rate, CRP, creatinine, urea and glucose, and in urine, including urinalysis looking for hematuria, red cell casts and proteinuria. Importantly, proteinuria needs to be quantified by the utilization of a random urine sample. Proteinuria > 3g/d is diagnostic for a glomerular damage. These basic tests are usually followed by more specialized analyses, such as a screening for infections, including search for HIV, hepatitis B or C and various bacteria, and for systemic inflammatory diseases, including tests for antibodies, such as ANA, anti-dsDNA, ANCA, anti-GBM and anti-CCP. In cases of membranous nephropathy, antibodies against phospholipase-A2-receptor need to be looked for. Depending upon the given clinical circumstances and the type of disease, a reasonable tumor screening must be performed, especially in cases of membranous and minimal-change nephropathy. Finally, radiological examinations will complete the initial work-up. In most cases, at least an ultrasound of the kidney is mandatory. Thereafter, in most cases a renal biopsy is required to establish a firm diagnosis to define all treatment options and their chance of success. The elimination of a specific cause for a given glomerulonephritis or vasculitis, such as an infection, a malignancy or a drug-related side-effect, remains the key principle in the management of these diseases. ACE-inhibitors, angiotensin receptor-blockers, aldosteron antagonists and renin-inhibitors remain the mainstay in the therapy of arterial hypertension with proteinuria. Only in cases of persistently high proteinuria, ACE-inhibitors and angiotensin receptor blockers can be prescribed in combination. Certain types of glomerulonephritis and essentially all forms of vasculitis require some form of more specific anti-inflammatory therapy. Respective immunosuppressive drug regimens contain traditionally medications, such as glucocorticoids (e. g. prednisone), cyclosporine A, mycophenolate mofetil, cyclophosphamide, and azathioprine. With respect to more severe forms of glomerulonephritis and vasculitis, the antibody rituximab represents a new and less toxic alternative to cyclophosphamide. Finally, in certain special cases, like Goodpasture's syndrome or severe ANCA-positive vasculitis, a plasma exchange will be useful and even required.

Mortality Predictors in Patients with Severe Dengue in the State of Amazonas, Brazil

PubMed Central

Pinto, Rosemary Costa; de Castro, Daniel Barros; de Albuquerque, Bernardino Cláudio; Sampaio, Vanderson de Souza; dos Passos, Ricardo Augusto; da Costa, Cristiano Fernandes; Sadahiro, Megumi; Braga, José Ueleres

2016-01-01

Dengue is a major public health problem in tropical and subtropical areas worldwide. There is a lack of information on the risk factors for death due to severe dengue fever in developing countries, including Brazil where the state of Amazonas is located. This knowledge is important for decision making and the implementation of effective measures for patient care. This study aimed to identify factors associated with death among patients with severe dengue, in Amazonas from 2001 to 2013. We conducted a retrospective cohort study based on secondary data from the epidemiological surveillance of dengue provided by the Fundação de Vigilância em Saúde do Amazonas, FVS (Health Surveillance Foundation) of the Secretaria de Saúde do Amazonas, SUSAM (Health Secretariat of the State of Amazonas). Data on dengue cases were obtained from the SINAN (Notifiable Diseases Information System) and SIM (Mortality Information System) databases. We selected cases of severe dengue with laboratory confirmation, including dengue-related deaths of residents in the state of Amazonas from January 1, 2001, to December 31, 2013. The explanatory variables analyzed were sex, age, level of education, spontaneous hemorrhagic manifestations, plasma extravasation and platelet count. Patients who died due to severe dengue had more hematuria, gastrointestinal bleeding, and thrombocytopenia than the survivors. Considering the simultaneous effects of demographic and clinical characteristics with a multiple logistic regression model, it was observed that the factors associated with death were age >55 years (odds ratio [OR] 4.98), gastrointestinal bleeding (OR 10.26), hematuria (OR 5.07), and thrombocytopenia (OR 2.55). Gastrointestinal bleeding was the clinical sign most strongly associated with death, followed by hematuria and age >55 years. The study results showed that the best predictor of death from severe dengue is based on the characteristic of age >55 years, together with the clinical signs of gastrointestinal bleeding, hematuria, and low platelet count. PMID:27564084

Hyperbaric Oxygen Therapy for Radiation-Induced Cystitis and Proctitis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Oliai, Caspian; Fisher, Brandon; Jani, Ashish

Purpose: To provide a retrospective analysis of the efficacy of hyperbaric oxygen therapy (HBOT) for treating hemorrhagic cystitis (HC) and proctitis secondary to pelvic- and prostate-only radiotherapy. Methods and Materials: Nineteen patients were treated with HBOT for radiation-induced HC and proctitis. The median age at treatment was 66 years (range, 15-84 years). The range of external-beam radiation delivered was 50.0-75.6 Gy. Bleeding must have been refractory to other therapies. Patients received 100% oxygen at 2.0 atmospheres absolute pressure for 90-120 min per treatment in a monoplace chamber. Symptoms were retrospectively scored according to the Late Effects of Normal Tissues-Subjective, Objective,more » Management, Analytic (LENT-SOMA) scale to evaluate short-term efficacy. Recurrence of hematuria/hematochezia was used to assess long-term efficacy. Results: Four of the 19 patients were lost to follow-up. Fifteen patients were evaluated and received a mean of 29.8 dives: 11 developed HC and 4 proctitis. All patients experienced a reduction in their LENT-SOMA score. After completion of HBOT, the mean LENT-SOMA score was reduced from 0.78 to 0.20 in patients with HC and from 0.66 to 0.26 in patients with proctitis. Median follow-up was 39 months (range, 7-70 months). No cases of hematuria were refractory to HBOT. Complete resolution of hematuria was seen in 81% (n = 9) and partial response in 18% (n = 2). Recurrence of hematuria occurred in 36% (n = 4) after a median of 10 months. Complete resolution of hematochezia was seen in 50% (n = 2), partial response in 25% (n = 1), and refractory bleeding in 25% (n = 1). Conclusions: Hyperbaric oxygen therapy is appropriate for radiation-induced HC once less time-consuming therapies have failed to resolve the bleeding. In these conditions, HBOT is efficacious in the short and long term, with minimal side effects.« less

Can urine dipstick predict an elevated serum creatinine?

PubMed

Shah, Kaushal; Kilian, Barbara; Hsieh, Wei-Jen; Kyrillou, Emily; Hedge, Vishal; Newman, David H

2010-06-01

Chart review studies have suggested that point-of-care urine dipstick testing may accurately predict an elevation in serum creatinine (Cr). We aimed to prospectively evaluate the test characteristics of proteinuria/hematuria in predicting elevated serum Cr. A prospective, observational study was conducted between March 2007 and June 2008 at 2 affiliated, urban hospitals with an annual emergency department census of 150,000. Patients undergoing laboratory urinalysis, point-of-care urine dipstick, and a serum chemistry panel were enrolled. Trained research assistants collected data on consecutive patients 18 hours per day using preformatted data forms and entry into an anonymized Access (Microsoft, Seattle, Wash) database. Demographic baseline variables including age, sex, chief complaint, vital signs, and source of sample (catheter vs "clean catch") were also collected. An elevated Cr level was defined as greater than 1.3 based on the laboratory reference range. Standard statistical methods were used to calculate diagnostic test operating characteristics of proteinuria or hematuria as a predictor of elevated serum Cr. Five thousand four hundred sixteen subjects were enrolled with 28.3% male and a mean age of 50.2 years. Elevated serum Cr greater than 1.3 mg/dL was found in 13.9% (755/5416) of subjects. The sensitivity of either proteinuria or hematuria for elevated Cr was 82.5% (95% confidence interval [CI], 80%-85%) and specificity was 34.4% (95% CI, 33%-36%). Positive predictive value was 16.9% (95% CI, 16%-18%) and negative predictive value was 92.4% (95% CI, 91-94%). The likelihood ratio for a positive test was 1.3 (95% CI, 1.1-1.5), and the likelihood ratio for a negative test was 0.5 (95% CI, 0.3-0.8). Although negative predictive value was high, the presence of proteinuria/hematuria was only moderately predictive of elevated serum Cr level. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Mortality Predictors in Patients with Severe Dengue in the State of Amazonas, Brazil.

PubMed

Pinto, Rosemary Costa; Castro, Daniel Barros de; Albuquerque, Bernardino Cláudio de; Sampaio, Vanderson de Souza; Passos, Ricardo Augusto Dos; Costa, Cristiano Fernandes da; Sadahiro, Megumi; Braga, José Ueleres

2016-01-01

Dengue is a major public health problem in tropical and subtropical areas worldwide. There is a lack of information on the risk factors for death due to severe dengue fever in developing countries, including Brazil where the state of Amazonas is located. This knowledge is important for decision making and the implementation of effective measures for patient care. This study aimed to identify factors associated with death among patients with severe dengue, in Amazonas from 2001 to 2013. We conducted a retrospective cohort study based on secondary data from the epidemiological surveillance of dengue provided by the Fundação de Vigilância em Saúde do Amazonas, FVS (Health Surveillance Foundation) of the Secretaria de Saúde do Amazonas, SUSAM (Health Secretariat of the State of Amazonas). Data on dengue cases were obtained from the SINAN (Notifiable Diseases Information System) and SIM (Mortality Information System) databases. We selected cases of severe dengue with laboratory confirmation, including dengue-related deaths of residents in the state of Amazonas from January 1, 2001, to December 31, 2013. The explanatory variables analyzed were sex, age, level of education, spontaneous hemorrhagic manifestations, plasma extravasation and platelet count. Patients who died due to severe dengue had more hematuria, gastrointestinal bleeding, and thrombocytopenia than the survivors. Considering the simultaneous effects of demographic and clinical characteristics with a multiple logistic regression model, it was observed that the factors associated with death were age >55 years (odds ratio [OR] 4.98), gastrointestinal bleeding (OR 10.26), hematuria (OR 5.07), and thrombocytopenia (OR 2.55). Gastrointestinal bleeding was the clinical sign most strongly associated with death, followed by hematuria and age >55 years. The study results showed that the best predictor of death from severe dengue is based on the characteristic of age >55 years, together with the clinical signs of gastrointestinal bleeding, hematuria, and low platelet count.

Abdominal aortic aneurysm with aorta-left renal vein fistula with left varicocele.

PubMed

Meyerson, S L; Haider, S A; Gupta, N; O'Dorsio, J E; McKinsey, J F; Schwartz, L B

2000-04-01

Abdominal aortic aneurysm with spontaneous aorto-left renal vein fistula is a rare but well-described clinical entity usually with abdominal pain, hematuria, and a nonfunctioning left kidney. This report describes a 44-year-old man with left-sided groin pain and varicocele who was treated with conservative measures only. The diagnosis was eventually made when he returned with microscopic hematuria, elevated serum creatinine level, and nonfunction of the left kidney; computed tomography scan demonstrated a 6-cm abdominal aortic aneurysm, a retroaortic left renal vein, and an enlargement of the left kidney. This patient represents the youngest to be reported with aorto-left renal vein fistula and the second case with a left-sided varicocele.

[Kidney traumatism in general surgery (65 cases)].

PubMed

Brunet, C; Sielezneff, I; Voinchet, V; Rosset, E; Grégoire, R; Thirion, X; Ugarte, S; Farisse, J

1995-01-01

From September 1989 to September 1994, 65 patients, 15 females and 50 males, with a mean age of 32 +/- 14 years were admitted in the emergency unit for renal trauma. In 38.5% of cases multiple trauma was present. Lesional mechanism was most frequently contusions (49.2%) and deceleration injuries (43.1%). Gross hematuria or microscopic hematuria were presents in 72.3% of cases. The sensibility of systematic abdominal echography was 100% in case of perirenal hematoma and 65% in case of parenchymatous lesions. Only 23 patients were operated (35.3%) because of low blood pressure. None secondary operation was necessary in abstention group. Global mortality was 7.7%. Postoperative morbidity was 20% and specific morbidity in abstention group was 10.7%.

Iliac Vein Compression Syndrome due to Bladder Distention Caused by Urethral Calculi

PubMed Central

Ikegami, Akiko; Kondo, Takeshi; Tsukamoto, Tomoko; Ohira, Yoshiyuki; Ikusaka, Masatomi

2015-01-01

We report a rare case of iliac vein compression syndrome caused by urethral calculus. A 71-year-old man had a history of urethral stenosis. He complained of bilateral leg edema and dysuria for 1 week. Physical examination revealed bilateral distention of the superficial epigastric veins, so obstruction of both common iliac veins or the inferior vena cava was suspected. Plain abdominal computed tomography showed a calculus in the pendulous urethra, distention of the bladder (as well as the right renal pelvis and ureter), and compression of the bilateral common iliac veins by the distended bladder. Iliac vein compression syndrome was diagnosed. Bilateral iliac vein compression due to bladder distention (secondary to neurogenic bladder, benign prostatic hyperplasia, or urethral calculus as in this case) is an infrequent cause of acute bilateral leg edema. Detecting distention of the superficial epigastric veins provides a clue for diagnosis of this syndrome. PMID:25802794

Embolization with Tornado coils to control bleeding from an arterioureteral fistula.

PubMed

Jacobs, Bruce L; Maranchie, Jodi K

2007-12-01

Arterioureteral fistulae are rare, but potentially life-threatening causes of bleeding. We present a case of an 82 year-old woman with refractory, transfusion-dependent bleeding from an arterial fistula to her right ureteral stump, following right radical nephrectomy for advanced renal cell carcinoma. Cystoscopy with retrograde ureteral stump embolization using Tornado (Cook Medical, Bloomington, Indiana, USA) coils plus a slurry of thrombin-soaked Gelfoam (Pfizer Inc., New York, New York, USA) was performed, which led to prompt resolution of the patient's hematuria requiring no further hospitalizations or transfusions. Retrograde insertion of coils and injection of thrombin-soaked Gelfoam can be a minimally invasive, safe, and durable alternative for controlling hemorrhage from an arterioureteral fistula to a ureteral stump.

[Compression fracture of a fragile lumbar vertebrae as a cause of low back pain].

PubMed

Ostojić, Zdenko; Ostojić, Ljerka; Pehar, Zoran; Ceramida, Meliha; Letica, Ludvih

2002-01-01

The patient felt sharp back lumbal pain while lifting heavy object in flexion position of the back. Rtg showed compressive fracture of L2. MRI showed secondary posttraumatic edema around compressive fracture of the body of L2. The compressive fracture was caused by intracorporal haemangiome of L2. After six months we had spontaneous sanation of heamgiome. Regarding to the therapy only electromagnetotherapy was used as well as programme of kinezitherapy given according to the condition of the body of L2.

Clinical evaluation of cats with nonobstructive urinary tract diseases.

PubMed

Buffington, C A; Chew, D J; Kendall, M S; Scrivani, P V; Thompson, S B; Blaisdell, J L; Woodworth, B E

1997-01-01

To identify the underlying cause of clinical signs in cats with nonobstructive diseases of the bladder and urethra. Prospective case series. 109 cats examined by the urology service of The Ohio State University's veterinary teaching hospital because of stranguria, hematuria, pollakiuria, or urination in inappropriate locations. History was obtained and a CBC, serum biochemical analyses, serologic tests for FeLV and feline immunodeficiency virus, urinalysis, bacterial culture of urine, and contrast radiography or urethrocystoscopy (females only) were performed. 16 cats had cystic calculi: 8 had struvite uroliths, 7 had calcium oxalate uroliths, and 1 had a urolith of unknown composition in conjunction with an anatomic defect. Anatomic defects, including diverticulae, urethral strictures, and a malpositioned urethra, were identified in 12 cats. A urinary tract infection was identified in 1 cat, and neoplasia was diagnosed in 2. One of the cats with neoplasia also had a struvite urolith. The remaining 80 cats did not have an anatomic defect, urolith, or tumor. Ten of these cats also did not have radiographic or cystoscopic abnormalities and were presumed to have a behavioral disorder. The remaining 70 cats had radiographic or cystoscopic abnormalities, and idiopathic cystitis was diagnosed. In 14 of the cats with idiopathic cystitis, results of a urinalysis were normal. Cats with idiopathic cystitis were significantly more likely to eat dry food exclusively (59%) than were cats in the general population (19%). Results suggest that idiopathic cystitis occurs commonly in cats with stranguria, hematuria, pollakiuria, or inappropriate elimination and is associated with consumption of dry foods. Contrast radiography or cystoscopy is necessary for differentiating idiopathic cystitis from behavioral disorders in some cats.

Bladder cancer diagnosis with CT urography: test characteristics and reasons for false-positive and false-negative results.

PubMed

Trinh, Tony W; Glazer, Daniel I; Sadow, Cheryl A; Sahni, V Anik; Geller, Nina L; Silverman, Stuart G

2018-03-01

To determine test characteristics of CT urography for detecting bladder cancer in patients with hematuria and those undergoing surveillance, and to analyze reasons for false-positive and false-negative results. A HIPAA-compliant, IRB-approved retrospective review of reports from 1623 CT urograms between 10/2010 and 12/31/2013 was performed. 710 examinations for hematuria or bladder cancer history were compared to cystoscopy performed within 6 months. Reference standard was surgical pathology or 1-year minimum clinical follow-up. False-positive and false-negative examinations were reviewed to determine reasons for errors. Ninety-five bladder cancers were detected. CT urography accuracy: was 91.5% (650/710), sensitivity 86.3% (82/95), specificity 92.4% (568/615), positive predictive value 63.6% (82/129), and negative predictive value was 97.8% (568/581). Of 43 false positives, the majority of interpretation errors were due to benign prostatic hyperplasia (n = 12), trabeculated bladder (n = 9), and treatment changes (n = 8). Other causes include blood clots, mistaken normal anatomy, infectious/inflammatory changes, or had no cystoscopic correlate. Of 13 false negatives, 11 were due to technique, one to a large urinary residual, one to artifact. There were no errors in perception. CT urography is an accurate test for diagnosing bladder cancer; however, in protocols relying predominantly on excretory phase images, overall sensitivity remains insufficient to obviate cystoscopy. Awareness of bladder cancer mimics may reduce false-positive results. Improvements in CTU technique may reduce false-negative results.

Observation for clinical effect of phellodendron wet compress in treating the phlebitis caused by infusion.

PubMed

Wan, Ying

2018-05-01

Aim of the study was to observe and analyze the clinical effect of phellodendron wet compress in treating the phlebitis caused by infusion. The research objects were 600 cases of phlebitis caused by infusion, all of which were treated in our hospital from June 2013 to June 2016. All patients were entitled to the right to know. They were randomly divided into the research group and the control group. Patients in the control group were treated with magnesium sulfate solution wet compress, while patients in the research group were treated with phellodendron wet compress. The effects in these two groups were observed and compared. Compared with the control group, the research group has better overall treatment efficiency, p<0.05; shorter average onset of action, p<0.05; less time in relieving red swelling and pain, p<0.05. Phellodendron wet compress shows a beneficial effect in treating the phlebitis caused by infusion. It can not only obviously shorten the onset of action, but also level up the overall treatment efficiency that helps patients to recover.

Hydrofluoric acid burn resulting from ignition of gas from a compressed air duster.

PubMed

Foster, Kevin N; Jones, LouAnn; Caruso, Daniel M

2003-01-01

A young female suffered burns to her hand after the ignition of gas from a compressed air duster. After debridement and dressing, the patient continued to have pain out of proportion to injury that was refractory to intravenous morphine. The material safety data sheet revealed that the chemical used was 1,1-difluoroethane. High temperatures can cause decompensation to form hydrofluoric acid. Calcium gluconate gel was applied topically to the patient's burns, which caused prompt and complete relief of her pain. A review of different compressed air duster products revealed that the main ingredient in each was a halogenated hydrocarbon. Although not considered flammable, all products have warnings regarding the possibility of ignition under various circumstances. Ignition of the gas in compressed air cleaners not only can cause flame burns, it can also cause chemical damage from exposure to hydrogen and fluoride ions. Prompt recognition and treatment is necessary to prevent severe injury.

Vascular compression as a potential cause of occipital neuralgia: a case report.

PubMed

White, J B; Atkinson, P P; Cloft, H J; Atkinson, J L D

2008-01-01

Vascular compression is a well-established cause of cranial nerve neuralgic syndromes. A unique case is presented that demonstrates that vascular compression may be a possible cause of occipital neuralgia. A 48-year-old woman with refractory left occipital neuralgia revealed on magnetic resonance imaging and computed tomographic imaging of the upper cervical spine an atypically low loop of the left posterior inferior cerebellar artery (PICA), clearly indenting the dorsal upper cervical roots. During surgery, the PICA loop was interdigitated with the C1 and C2 dorsal roots. Microvascular decompression alone has never been described for occipital neuralgia, despite the strong clinical correlation in this case. Therefore, both sectioning the dorsal roots of C2 and microvascular decompression of the PICA loop were performed. Postoperatively, the patient experienced complete cure of her neuralgia. Vascular compression as a cause of refractory occipital neuralgia should be considered when assessing surgical options.

Choreito formula for BK virus-associated hemorrhagic cystitis after allogeneic hematopoietic stem cell transplantation.

PubMed

Kawashima, Nozomu; Ito, Yoshinori; Sekiya, Yuko; Narita, Atsushi; Okuno, Yusuke; Muramatsu, Hideki; Irie, Masahiro; Hama, Asahito; Takahashi, Yoshiyuki; Kojima, Seiji

2015-02-01

Therapy for BK virus (BKV)-associated hemorrhagic cystitis (BKV-HC) is limited after hematopoietic stem cell transplantation (HSCT). We examined whether choreito, a formula from Japanese traditional Kampo medicine, is effective for treating BKV-HC. Among children who underwent allogeneic HSCT between October 2006 and March 2014, 14 were diagnosed with BKV-HC (median, 36 days; range, 14 to 330 days) after HSCT, and 6 consecutive children received pharmaceutical-grade choreito extract granules. The hematuria grade before treatment was significantly higher in the choreito group than in the nonchoreito group (P = .018). The duration from therapy to complete resolution was significantly shorter in the choreito group (median, 9 days; range, 4 to 17 days) than in the nonchoreito group (median, 17 days; range, 15 to 66 days; P = .037). In 11 children with macroscopic hematuria, the duration from treatment to resolution of macroscopic hematuria was significantly shorter in the choreito group than in the nonchoreito group (median, 2 days versus 11 days; P = .0043). The BKV load in urine was significantly decreased 1 month after choreito administration. No adverse effects related to choreito administration were observed. Choreito may be a safe and considerably promising therapy for the hemostasis of BKV-HC after HSCT. Copyright © 2015 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

Biological characteristics of pediatric renal cell carcinoma associated with Xp11.2 translocations/TFE3 gene fusions.

PubMed

Song, Hong Cheng; Sun, Ning; Zhang, Wei Ping; He, LeJian; Fu, Libing; Huang, ChengRu

2014-04-01

To investigate the clinical features of pediatric Xp11.2 translocation renal cell carcinoma (RCC). A retrospective review of 22 cases over 35 years. Xp11.2 translocation RCCs were identified in 13 boys and 9 girls with a median age of 10.5 years (range: 2.5-16 years). RCC presented with hematuria in 17, abdominal mass in 1, abdominal masses with hematuria in 2, abdominal pain with hematuria in 1, and as an incidental finding in 1 patient. Ten patients were classified stage I, 10 were stage III, and two were stage IV. Of the 10 patients with stage I RCCs, 3 patients with tumor measuring less than 7 cm had nephron-sparing surgery (NSS) and 17 patients underwent simple nephrectomy. A 15-cm tumor was incompletely removed in one patient and another patient with a 25-cm × 18-cm × 15-cm tumor had gross residual. Of the 15 patients followed up between 6 months and 35 years, 13 were still living and 2 had died after surgery. Xp11.2 translocation RCC is the predominant form of pediatric RCC, associated with advanced stage at presentation. Nephrectomy is the usual treatment for RCC but NSS is an option for patients with tumors measuring<7 cm. Patients with N+M0 maintained a favorable prognosis following surgery alone. © 2014.

Current role of transcatheter arterial embolization for bladder and prostate hemorrhage.

PubMed

Loffroy, R; Pottecher, P; Cherblanc, V; Favelier, S; Estivalet, L; Koutlidis, N; Moulin, M; Cercueil, J P; Cormier, L; Krausé, D

2014-11-01

Intractable hematuria from the bladder or the prostate can be life-threatening and its management remains a difficult clinical problem. Severe bleeding can arise as a result of radiation cystitis, bladder carcinoma, cyclophosphamide-induced cystitis, severe infection, transurethral resection of the prostate and prostate cancer. When irrigation of the bladder through a three-way catheter and fulguration of the bleeding lesions fail to stop the hematuria, a life-threatening situation can develop, when blood transfusion fails to keep pace with the rate of blood loss. Patients with massive uncontrollable hematuria are often elderly and unfit for cystectomy as a treatment. Many urologists have had to manage this difficult problem, and several different treatments have been attempted and described, with varying degrees of success. Transcatheter arterial embolization of the vesical or prostatic arteries is occasionally indicated in these patients when all other measures have failed. There is limited published experience with this procedure, but success in 90% of patients is reported when the vesical or prostatic arteries can be identified. The aim of this review is to describe the current place of transcatheter arterial embolization in the management of severe bladder or prostate bleeding after failed conservative therapy, and to review its efficacy and morbidity. Copyright © 2014 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

Modality-specific occult intrarenal pseudoaneurysm in a renal allograft and the legacy of catheter angiography.

PubMed

Rastogi, Neeraj; Williams, Gethin; Alencar, Herlen

2013-11-01

A 69-year-old man with history of end-stage-renal disease (ESRD) underwent successful kidney transplantation from a cadaveric donor in November 2011. However, posttransplant recovery was complicated by delayed graft function and recurrent gross hematuria. Serial Doppler ultrasound (US) of the renal allograft demonstrated a pseudoaneurysm with interval increase in size. However, it could not be visualized with other modalities, including an initial angiogram (postoperative day 49) and a second angiogram (postoperative day 68), followed by surgical exploration (postoperative day 71), which demonstrated complete intra-aneurysmal thrombosis on intraoperative Doppler US. Unfortunately, the patient's hematuria continued and a repeat Doppler US 48 hours later demonstrated a persistent pseudoaneurysm. Therefore, on postoperative day 75, we performed targeted percutaneous intra-aneurysmal thrombin injection under dual image guidance, which showed complete intra-aneurysmal thrombosis on intraprocedural Doppler US. Hematuria recurred the next day. A third angiogram (postoperative day 77) finally illuminated the hidden pseudoaneurysm occult on the first and second angiographic studies (sensitivity [index case] 33%) and surgery. This allowed for successful coil embolization of a subsegmental feeding branch with an excellent outcome. We support a more aggressive management with serial angiography and embolization of the intrarenal symptomatic pseudoaneurysm rather than surgery in renal allograft recipients, with the benefits outweighing the risks. Copyright © 2013 Elsevier Inc. All rights reserved.

Prospective observational study with an abbreviated protocol in the management of blunt renal injury in children.

PubMed

Graziano, Kathleen D; Juang, David; Notrica, David; Grandsoult, Victoria L; Acosta, Juan; Sharp, Susan W; Murphy, J Patrick; St Peter, Shawn D

2014-01-01

There are no published management schemes for blunt renal injuries. We are conducting a 2-center prospective observational study with a fixed management scheme. Children with CT proven renal injuries were enrolled with permission. Ambulation is allowed when able regardless of grade. Discharge occurs when tolerating a diet and pain is controlled regardless of hematuria. Urinalysis occurs at follow up in 2-4weeks and repeated as indicated. Between 9/2008 and 9/2012, 70 patients were enrolled. Mean age was 11.8years (3-17), and 70% were male. The mean grade of injury was 2.8±1.1 [1-5]. One nephrectomy (1.4%) was performed for a grade 5 injury. Other renal interventions included an embolization for the hilar bleed and one cystotomy for a clot. Mean LOS was 2.9days±2.4days. In patients without other major injury, LOS was 1.9±1.7days (0.4-8days). There were 5 (7%) readmissions: 3 for pain, 1 for hematuria, and 1 for a bladder clot. 58 patients (83%) gave urinalysis samples at initial follow up (med 18days), where 31 (53%) were positive for blood. Children with blunt renal injury may benefit from management without strict bedrest guidelines. Hematuria appears to have little influence on recovery. © 2014.

Long-term safety of left renal vein division and ligation to expedite complex abdominal aortic surgery.

PubMed

Samson, Russell H; Lepore, Michael R; Showalter, David P; Nair, Deepak G; Lanoue, Julien B

2009-09-01

Left renal vein division and ligation (LRVDAL) is performed to facilitate complex abdominal aortic surgery. Surgeons restore continuity of the vein due to concern that ligation could cause renal compromise or hematuria. However, we report the short and long-term safety of left renal vein division and ligation. Between 1992 and 2007, we divided the left renal vein in 56 patients (40 males, 16 females) ages 57 to 84 (average 74-years-old) who were treated for aortic occlusive disease (9) or abdominal aortic aneurysm (47). Patients requiring concomitant renal artery reconstruction were excluded from this review. Suprarenal cross-clamp was used in 51 patients with temporary vessel-loop control of the renal arteries. Creatinine (Cr) and glomerular filtration rates (eGFR) were measured pre-, post-, and long-term after surgery. Outpatient records of all patients that had survived more than 12 months were also reviewed in order to evaluate the late effects on renal function or symptoms possibly related to LRVDAL. Median procedure duration was 157 (61-375) minutes. Median cross-clamp time was 16 (10-45) minutes. Median intensive care unit (ICU) and hospital length of stays were 2 (1-11) days and 7 (4-58) days, respectively. There were no deaths. There were no complications directly related to renal vein ligation. Hematuria, seen in 2 patients, was a result of traumatic insertion of a Foley catheter. Median pre-op and discharge Cr levels were 1.1 mg/dL (0.7-2.4 mg/dL) and 1.1 mg/dL (0.6-2.1 mg/dL), respectively (P < .5). Median change in Cr was 0.0 mg/dL and only increased in 14 patients (maximum increase 0.9 mg/dL). Median pre-op and discharge eGFR was 61 mL/minute (28-137 mL/minute/1.73 m2) and 67 mL/minute (32-138 mL/minute/1.73 m2), respectively (P < .5). Cr and eGFR in the 2 patients with a Cr of >2.0 mg/dL remained unchanged post-op. Only 2 patients with a Cr of <2.0 mg/dL had a post-op Cr >2.0 mg/dL and both returned to normal by day 3 post-op. Thirty-six patients have been followed for more than a year (median 34.5 months, maximum 144 months) and Cr has remained stable in all but 2 patients. These 2 patients, both with a pre-op Cr of 1.5 mg/dL, subsequently developed Cr levels of 2.1 mg/dL and 2.4 mg/dL but maintained baseline Cr levels for 25 and 34 months, respectively, before demonstrating these elevated levels which have proven to be unrelated to renal vein ligation. Hematuria and flank pain have never been recorded after discharge. Restoration of left renal vein continuity after LRVDAL may be unnecessary since renal compromise and hematuria was not encountered in this long-term analysis.

Effect of compression pressure on inhalation grade lactose as carrier for dry powder inhalations

PubMed Central

Raut, Neha Sureshrao; Jamaiwar, Swapnil; Umekar, Milind Janrao; Kotagale, Nandkishor Ramdas

2016-01-01

Introduction: This study focused on the potential effects of compression forces experienced during lactose (InhaLac 70, 120, and 230) storage and transport on the flowability and aerosol performance in dry powder inhaler formulation. Materials and Methods: Lactose was subjected to typical compression forces 4, 10, and 20 N/cm2. Powder flowability and particle size distribution analysis of un-compressed and compressed lactose was evaluated by Carr's index, Hausner's ratio, the angle of repose and by laser diffraction method. Aerosol performance of un-compressed and compressed lactose was assessed in dispersion studies using glass twin-stage-liquid-impenger at flow rate 40-80 L/min. Results: At compression forces, the flowability of compressed lactose was observed same or slightly improved. Furthermore, compression of lactose caused a decrease in in vitro aerosol dispersion performance. Conclusion: The present study illustrates that, as carrier size increases, a concurrent decrease in drug aerosolization performance was observed. Thus, the compression of the lactose fines onto the surfaces of the larger lactose particles due to compression pressures was hypothesized to be the cause of these observed performance variations. The simulations of storage and transport in an industrial scale can induce significant variations in formulation performance, and it could be a source of batch-to-batch variations. PMID:27014618

Surgical and medical management of a uterine spindle cell tumor in an African hedgehog (Atelerix albiventris).

PubMed

Done, Lisa B; Deem, Sharon L; Fiorello, Christine V

2007-12-01

A 5-yr-old female African hedgehog (Ateleris albiventris) presented with hematuria. Vulvar culture results revealed a 4+ growth of Enterococcus sp. and gamma-Streptococcus sp. susceptible to trimethoprim sulfa and enrofloxacin. Ultrasound evaluation of the abdomen revealed an unidentifiable tubular structure in the region of the reproductive tract. An exploratory laparotomy and ovariohysterectomy were performed. Pathologic studies of the uterus showed a uterine spindle cell tumor, uterine endometrial polyp, uterine adenomyosis, and a possible acute infarct resulting in uterine wall necrosis. Hematuria did not reoccur, and the hedgehog lived for another 19 mo until she died from an oral squamous cell carcinoma. To date, this is the first report of a uterine spindle cell tumor in an African hedgehog.

Mechanical compression insults induce nanoscale changes of membrane-skeleton arrangement which could cause apoptosis and necrosis in dorsal root ganglion neurons.

PubMed

Quan, Xin; Guo, Kai; Wang, Yuqing; Huang, Liangliang; Chen, Beiyu; Ye, Zhengxu; Luo, Zhuojing

2014-01-01

In a primary spinal cord injury, the amount of mechanical compression insult that the neurons experience is one of the most critical factors in determining the extent of the injury. The ultrastructural changes that neurons undergo when subjected to mechanical compression are largely unknown. In the present study, using a compression-driven instrument that can simulate mechanical compression insult, we applied mechanical compression stimulation at 0.3, 0.5, and 0.7 MPa to dorsal root ganglion (DRG) neurons for 10 min. Combined with atomic force microscopy, we investigated nanoscale changes in the membrane-skeleton, cytoskeleton alterations, and apoptosis induced by mechanical compression injury. The results indicated that mechanical compression injury leads to rearrangement of the membrane-skeleton compared with the control group. In addition, mechanical compression stimulation induced apoptosis and necrosis and also changed the distribution of the cytoskeleton in DRG neurons. Thus, the membrane-skeleton may play an important role in the response to mechanical insults in DRG neurons. Moreover, sudden insults caused by high mechanical compression, which is most likely conducted by the membrane-skeleton, may induce necrosis, apoptosis, and cytoskeletal alterations.

Neurogenic Thoracic Outlet Syndrome Caused by Vascular Compression of the Brachial Plexus: A Report of Two Cases

PubMed Central

Hanna, Amgad; Bodden, Larry O'Neil; Siebiger, Gabriel R. L.

2018-01-01

Thoracic outlet syndrome (TOS) is caused by compression of the brachial plexus and/or subclavian vessels as they pass through the cervicothoracobrachial region, exiting the chest. There are three main types of TOS: neurogenic TOS, arterial TOS, and venous TOS. Neurogenic TOS accounts for approximately 95% of all cases, and it is usually caused by physical trauma (posttraumatic etiology), chronic repetitive motion (functional etiology), or bone or muscle anomalies (congenital etiology). We present two cases in which neurogenic TOS was elicited by vascular compression of the inferior portion of the brachial plexus. PMID:29497457

Working memory, age, and hearing loss: susceptibility to hearing aid distortion.

PubMed

Arehart, Kathryn H; Souza, Pamela; Baca, Rosalinda; Kates, James M

2013-01-01

Hearing aids use complex processing intended to improve speech recognition. Although many listeners benefit from such processing, it can also introduce distortion that offsets or cancels intended benefits for some individuals. The purpose of the present study was to determine the effects of cognitive ability (working memory) on individual listeners' responses to distortion caused by frequency compression applied to noisy speech. The present study analyzed a large data set of intelligibility scores for frequency-compressed speech presented in quiet and at a range of signal-to-babble ratios. The intelligibility data set was based on scores from 26 adults with hearing loss with ages ranging from 62 to 92 years. The listeners were grouped based on working memory ability. The amount of signal modification (distortion) caused by frequency compression and noise was measured using a sound quality metric. Analysis of variance and hierarchical linear modeling were used to identify meaningful differences between subject groups as a function of signal distortion caused by frequency compression and noise. Working memory was a significant factor in listeners' intelligibility of sentences presented in babble noise and processed with frequency compression based on sinusoidal modeling. At maximum signal modification (caused by both frequency compression and babble noise), the factor of working memory (when controlling for age and hearing loss) accounted for 29.3% of the variance in intelligibility scores. Combining working memory, age, and hearing loss accounted for a total of 47.5% of the variability in intelligibility scores. Furthermore, as the total amount of signal distortion increased, listeners with higher working memory performed better on the intelligibility task than listeners with lower working memory did. Working memory is a significant factor in listeners' responses to total signal distortion caused by cumulative effects of babble noise and frequency compression implemented with sinusoidal modeling. These results, together with other studies focused on wide-dynamic range compression, suggest that older listeners with hearing loss and poor working memory are more susceptible to distortions caused by at least some types of hearing aid signal-processing algorithms and by noise, and that this increased susceptibility should be considered in the hearing aid fitting process.

Obstructing urethral calculus in a woman revealed to be the cause of chronic pelvic pain.

PubMed

Thomas, J S; Crew, J

2012-10-01

Urethral calculi are extremely rarely reported in Caucasian females and are usually associated with an anatomical abnormality such as a diverticulum or a stricture. Ureteric calculi can move to become lodged in the urethra, although this is rare in women because of their short urethral length. We present a case of a 55-year-old woman presenting with urinary retention secondary to an obstructing upper tract calculus that had moved into the urethra. Four years previously, the patient had been diagnosed with chronic pelvic pain following a primary posterior vaginal wall repair. Following treatment of the obstructing calculus, her symptoms of pelvic pain completely resolved. We report a very unusual case that highlights the importance of investigating chronic pelvic pain. This patient's symptom of vaginal pain, though highly localized, was caused by pathology elsewhere in the pelvis. Alternative diagnoses should be sought for such patients and investigation performed to detect any nonvisible hematuria.

Prevalence and Risk Factors of CKD in Chinese Patients with Periodontal Disease

PubMed Central

Chen, Wei; Liang, Mengjun; Luo, Wei; Wu, Xianfeng; Ruan, Yiping; Wang, Jie; Xu, Ricong; Zhan, Xiaojiang; Yu, Jianwen; Tan, Jiaqing; Dong, Xiuqing; Zhang, Jincai; Yu, Xueqing

2013-01-01

Background Periodontal disease is common among adults and is associated with an increasing risk of chronic kidney disease (CKD). We aimed to investigate the prevalence and risk factors of CKD in patients with periodontal disease in China. Methods In the current cross-sectional study, patients with periodontal disease were included from Guangdong Provincial Stomatological Hospital between March 2011 and August 2011. CKD was defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2, the presence of albuminuria, or hematuria. All patients with periodontal disease underwent a periodontal examination, including periodontal probing pocket depth, gingival recession, and clinical attachment level by Florida Probe. They completed a questionnaire and had blood and urine samples taken. The adjusted prevalence of indicators of kidney damage was calculated and risk factors associated with CKD were analyzed. Results A total of 1392 patients with periodontal disease were invited to participate this study and 1268 completed the survey and examination. After adjusting for age and sex, the prevalence of reduced eGFR, albuminuria, and hematuria was 2.7% (95% CI 1.7–3.7), 6.7% (95% CI 5.5–8.1) and 10.9% (95% CI 9.2–12.5), respectively. The adjusted prevalence of CKD was 18.2% (95% CI 16.2–20.3). Age, male, diabetes, hypertension, history of CKD, hyperuricemia, and interleukin-6 levels (≥7.54 ng/L) were independent risk factors for reduced eGFR. Female, diabetes, hypertension, history of CKD, hyperuricemia, high level of cholesterol, and high sensitivity C-reactive protein (hsCRP) (≥1.03 mg/L) and TNF-α levels (≥1.12 ng/L) were independently associated with an increased risk of albuminuria. Female, lower education (

Orbital compressed air and petroleum injury mimicking necrotizing fasciitis.

PubMed

Mellington, Faye E; Bacon, Annette S; Abu-Bakra, Mohammed A J; Martinez-Devesa, Pablo; Norris, Jonathan H

2014-09-01

Orbital injury secondary to petroleum-based products is rare. We report the first case, to our knowledge, of a combined compressed air and chemical orbital injury, which mimicked necrotizing fasciitis. A 58-year-old man was repairing his motorcycle engine when a piston inadvertently fired, discharging compressed air and petroleum-based carburetor cleaner into his left eye. He developed surgical emphysema, skin necrosis, and a chemical cellulitis, causing an orbital compartment syndrome. He was treated initially with antibiotics and subsequently with intravenous steroid and orbital decompression surgery. There was almost complete recovery by 4 weeks postsurgery. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Petroleum-based products can cause severe skin irritation and necrosis. Compressed air injury can cause surgical emphysema. When these two mechanisms of injury are combined, the resulting orbitopathy and skin necrosis can mimic necrotizing fasciitis and cause diagnostic confusion. A favorable outcome is achievable with aggressive timely management. Copyright © 2014 Elsevier Inc. All rights reserved.

Successful Treatment with Microvascular Decompression Surgery of a Patient with Hemiparesis Caused by Vertebral Artery Compression of the Medulla Oblongata: Case Report and Review of the Literature.

PubMed

Ren, Jibin; Sun, Hongtao; Diao, Yunfeng; Niu, Xuegang; Wang, Hang; Wei, Zhengjun; Yuan, Fei

2017-12-01

There are few reports on hemiparesis caused by vascular medullary compression, which can occur because of dolichoectasia of the vertebrobasilar arterial system. In this article, we report a case of vertebral artery compression of the medulla oblongata in a 67-year-old woman. The patient was hypertensive, and she developed hemiparesis and intermittent spasms over 5 years. These spasms had worsened during the last year. Cranial nerve magnetic resonance imaging showed compression of the medulla oblongata by the left vertebral artery. A motor evoked potential (MEP) examination showed abnormal conduction of MEPs of bilateral toe abductors. The patient underwent microvascular decompression surgery under general anesthesia through a retrosigmoid keyhole approach. This operation led to relief of vascular compression and symptomatic improvement. Our case suggests that detailed history, imaging studies, and electrophysiologic studies help lead to a correct and early diagnosis of hemiparesis caused by vascular compression of the rostral ventrolateral medulla. Microvascular decompression surgery improves patient symptoms, and intraoperative electrophysiologic monitoring helps to avoid injury to important adjacent nerves. Copyright © 2017 Elsevier Inc. All rights reserved.

Implementation of the first wellness-fitness evaluation for the Dallas Fire-Rescue Department

PubMed Central

Seals, Norman; Martin, JoAnn; Russell, Bryan

2010-01-01

More than 100 firefighters lose their lives in the line of duty each year; many of these deaths are caused by cardiovascular events and underlying coronary heart disease. In addition, firefighters are at higher-than-normal risk of developing certain types of cancer. To improve health and fitness among its firefighters, the Dallas Fire-Rescue Department developed and implemented an annual wellness-fitness program in 2008. The program detected and addressed medical issues including coronary disease, hypertension, high triglyceride levels, high cholesterol, high blood glucose levels, and hematuria. Prostate, thyroid, breast, kidney, and bladder cancers were also detected. By identifying these issues, engaging the firefighters' personal physicians, and recommending individualized treatment plans, this program may have extended lives and improved the quality of life for the firefighters. PMID:20671818

Implementation of the first wellness-fitness evaluation for the Dallas Fire-Rescue Department.

PubMed

Winter, F David; Seals, Norman; Martin, Joann; Russell, Bryan

2010-07-01

More than 100 firefighters lose their lives in the line of duty each year; many of these deaths are caused by cardiovascular events and underlying coronary heart disease. In addition, firefighters are at higher-than-normal risk of developing certain types of cancer. To improve health and fitness among its firefighters, the Dallas Fire-Rescue Department developed and implemented an annual wellness-fitness program in 2008. The program detected and addressed medical issues including coronary disease, hypertension, high triglyceride levels, high cholesterol, high blood glucose levels, and hematuria. Prostate, thyroid, breast, kidney, and bladder cancers were also detected. By identifying these issues, engaging the firefighters' personal physicians, and recommending individualized treatment plans, this program may have extended lives and improved the quality of life for the firefighters.

Bracken fern poisoning

USDA-ARS?s Scientific Manuscript database

Bracken fern (Pteridium aquilinum) is found throughout the world and enzootic hematuria, bright blindness, and bracken staggers. This chapter reviews the plant, the various poisoning syndrome that it produces, the current strategies to prevent poisoning, and recommended treatments....

Schistosoma haematobium Infection That Mimics Bladder Cancer in a 66-Year-Old Ethnic Egyptian Man.

PubMed

Zepeda, Celenne Morfin; Coffey, Kristen H

2015-01-01

66-year-old ethnic Egyptian man. Hematuria. The patient had a history of multiple episodes of gross hematuria for the past 5 years. Because the hematuria usually resolved on its own, he did not seek medical attention during that time. Bladder cancer was suspected. The patient had a history of coronary artery disease, hypertension, nephrolithiasis, congestive heart failure, lifelong smoking, and ischemic cardiomyopathy. He has been taking the anticoagulants clopidogrel (Plavix) and warfarin (Coumadin). The patient is originally from Egypt and has been living in the United States for the past 10 years. A complete blood count showed a hemoglobin of 13.0 g per dL (reference range, 14.0 to 18.0 g per dL), hematocrit 40% (40% to 54%), red blood cell count (RBC) 4.65 × 10(9) per L (4.60 to 6.00), and platelet count 179 × 10(9) per L (150 to 450). The urinalysis results showed 3+ protein, 4+ blood, and urine RBC of greater than 100 per high power field (hpf). The urinalysis results did not indicate the presence of parasitic ova or adult parasites. Based on these results, the physician ordered cystoscopic testing, suspecting bladder cancer. Analysis of the bladder tissue showed inflammation (Image 1) and several ova that were consistent with developing Schistosoma (Image 2). Many of the ova were calcified and surrounded by severely inflamed tissue (Image 3). Copyright© by the American Society for Clinical Pathology (ASCP).

Renal related disorders in concomitant Schistosoma haematobium-Plasmodium falciparum infection among children in a rural community of Nigeria.

PubMed

Morenikeji, Olajumoke A; Eleng, Ituna E; Atanda, Omotayo S; Oyeyemi, Oyetunde T

2016-01-01

Schistosomiasis and malaria are two common parasitic diseases that are co-endemic in resource-poor communities of sub-Saharan Africa. This study aims to assess the effects of single and concomitant Plasmodium falciparum and Schistosoma haematobium infections on two indicators of renal injury in school children in a rural community of Nigeria. A cross-sectional epidemiological survey was carried out on a total of 173 schoolchildren between ages 6 and 18 years (mean age 11.4±2.6 years). Urine and blood samples were collected by standard methods for concurrent microscopic diagnosis of S. haematobium and P. falciparum infections. Urinary blood (hematuria) and protein were determined using a urinalysis dipstick. The prevalence of single infections was 75.1% and 78.2% for S. haematobium and P. falciparum, respectively. A total of 57.1% individuals were infected with the two parasites. The prevalence of hematuria was significantly higher in the co-infection status (63.8%) than in single S. haematobium (52.2%) and P. falciparum (43.7%) infection statuses (p=0.04), while no significant variation was recorded in proteinuria in the three infection statuses (p=0.53). The proportion of children with renal injury associated with the co-infection of these parasites is very high, particularly in young children, who seem to have a higher prevalence of hematuria. Copyright © 2015 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

Calcium-creatinine ratio in a morning urine sample for the estimation of hypercalciuria associated with non-glomerular hematuria observed in children and adolescents.

PubMed

Quiñones-Vázquez, Susana; Liriano-Ricabal, María Del Rosario; Santana-Porbén, Sergio; Salabarría-González, José Reinaldo

2018-01-01

Hypercalciuria might be revealed during the differential diagnosis of hematuria accompanying renal lithiasis (RL). In spite of this, diagnostic accuracy of calcium urinary excretion might be affected by incomplete 24-hour urine collections. In the present study, the diagnostic utility of calcium/creatinine (ICaCre) index for determining hypercalciuria associated with non-glomerular hematuria (NGH) and RL was assessed. ICaCre (mg/mg) index was calculated from calcium (mmol/l) and creatinine (µmol/l) concentrations in an aliquot from a 24-hour urine collection in 169 children and adolescents with NGH or RL. Calciuria values > 4.0 mg/kg in 24 hours were distributed according to the presence of NGH or RL. Mean ICaCre index was 0.2 ± 0.1 mg/mg. Calciuria values estimated from ICaCre were statistically higher to those from 24-hour urine collection (p < 0.05). The frequency of hypercalciuria was independent from the measurement method (estimated from ICaCre 39.5% vs. 24 h collection 32.1%; p > 0.05). Hypercalciuria distribution was as follows: no NGH + no RL: 59.0%; no NGH + RL: 60.0% (∆ = +1.0%); NGH + no RL: 68.2% (∆ = +9.2%); NGH + RL: 73.3% (∆ = +14.4%). The use of ICaCre index for determining calcium urine excretion might be effective in the study of hypercalciuria associated with NGH and RL. Copyright: © 2018 Permanyer.

Screening for kidney disease in children on World Kidney Day in Jalisco, Mexico.

PubMed

Koshy, Susan M; Garcia-Garcia, Guillermo; Pamplona, Jacob Sandoval; Renoirte-Lopez, Karina; Perez-Cortes, Gustavo; Gutierrez, Ma Luisa Salazar; Hemmelgarn, Brenda; Lloyd, Anita; Tonelli, Marcello

2009-06-01

World Kidney Day (WKD) is intended to raise awareness and increase detection of chronic kidney disease (CKD), but most emphasis is placed on adults rather than children. We examined yield of screening for CKD and hypertension among poor children in Mexico. On WKD (2006, 2007), children (age < 18 years) without known CKD were invited to participate at two screening stations. We measured body mass index (BMI), blood pressure, and serum creatinine, and performed dipstick urinalysis. The Schwartz equation was used to estimate glomerular filtration rate (GFR; reduced GFR defined as < 60 ml/min per 1.73 m(2)). Proteinuria and hematuria were defined by a reading of >or= 1+ protein or blood on dipstick. Hypertension was defined by gender, age, and height-specific norms. In total, 240 children were screened (mean age 8.9 +/- 4.1 years; 44.2% male). Proteinuria and hematuria were detected in 38 (16.1%) and 41 (17.5%), respectively; 15% had BMI > 95th percentile for age. Reduced GFR was detected in four (1.7%) individuals. Systolic hypertension was more prevalent in younger children (age 0-8 years, 19.6%; age 9-13 years, 7.1%; age 14-17 years, 5.3%) suggesting a possible white-coat effect. Hematuria, proteinuria, hypertension and obesity were frequently detected among children in a community based screening program in Mexico. This form of screening might be useful in identifying children with CKD and hypertension in developing nations.

Urinalysis in children and adolescents.

PubMed

Utsch, Boris; Klaus, Günter

2014-09-12

Urinalysis is the most commonly performed biochemical test in infancy and early childhood. The urine sample should be correctly obtained, age-specific aspects should be considered, and age-dependent reference values should be used. This review is based on a selective literature search in electronic databases, textbooks, and guidelines from Germany and abroad on the acquisition of urine samples and the performance of urinalysis in infancy and early childhood. The timing and mode of acquisition of the urine sample affect the assessment of hematuria, proteinuria, leukocyturia, nitrituria, and the uropathogenic bacterial colony count in the urine culture. Dipstick tests can be used for targeted screening for these features. The test results should be interpreted together with the findings of urine microscopy, the medical history, and the physical examination. Proteinuria should be quantified and differentiated; both of these things can be done either from collected urine or (especially in infants and young children) from a spontaneously voided urine sample, by determination of the protein/creatinine quotient. Orthostatic proteinuria in an adolescent requires no further evaluation or treatment. Hematuria should be characterized as either glomerular or non-glomerular erythrocyturia. Asymptomatic, isolated microhematuria in childhood is not uncommon and often transient; in the absence of a family history, it usually does not require an extensive work-up. Proteinuria combined with hematuria should arouse the suspicion of glomerulonephritis. Urinalysis in infancy and early childhood is a simple and informative diagnostic test as long as the urine sample has been obtained properly and the results are interpreted appropriately for this age group.

Effect of tranexamic acid on gross hematuria: A pilot randomized clinical trial study.

PubMed

Moharamzadeh, Payman; Ojaghihaghighi, Seyedhossein; Amjadi, Mohsen; Rahmani, Farzad; Farjamnia, Arezoo

2017-12-01

Local forms of the tranexamic acid have been effective in treating many haemorrhagic cases. So that the aim of the current study is to assess the effectiveness of local tranexamic acid in controlling painless hematuria in patients referred to the emergency department. This is a randomized, double-blind clinical trial study, which was conducted on 50 patients with complaints of painless lower urinary tract bleeding during June 2014 and August 2015. The patients were randomly divided into two groups of 25 people each, one group receiving tranexamic acid and the other given a placebo. During bladder irrigation, local tranexamic acid and the placebo were injected into the bladder via Foley catheter. Patients were examined over 24h in terms of the amount of normal saline serum used for irrigation, level of hemoglobin, and blood in urine. In this study it was observed that consumption of tranexamic acid significantly decreased the volume of used serum for bladder irrigation (P=0.041) and the microscopic status of urine decreased significantly in terms of the hematuria after 24h (P=0.026). However, the rate of packed cell transfusion and drop in hemoglobin levels showed no significant difference in both groups of patients (P˃0.05). The results of this study showed that tranexamic acid could significantly reduce the volume of required serum for bladder irrigation to clear urine, but it had no significant effect on the drop in serum hemoglobin levels. Copyright © 2017 Elsevier Inc. All rights reserved.

[Psychogenic purpura with hematuria and sexual pain disorder: a case report].

PubMed

Ozyildirim, Ilker; Yücel, Başak; Aktan, Melih

2010-01-01

Psychogenic purpura (Gardner-Diamond syndrome) is the occurrence and spontaneous recurrence of painful ecchymosis following emotional stress and minor trauma. Although the exact mechanism of this syndrome remains unknown, apart from skin lesions, different types of hemorrhaging have been reported, such as epistaxis, gastrointestinal bleeding, and bleeding from the ear canals and eyes. We report a psychogenic purpura case that presented with hematuria in addition to skin lesions. Based on the psychiatric evaluation she was diagnosed with major depressive disorder, generalized anxiety disorder, and obsessive-compulsive disorder. Additionally, sexual pain disorder accompanied these disorders. With the help of antidepressant and supportive psychotherapy, the patient's ecchymosis and bleeding disappeared. During 8 months of follow-up the symptoms did not return. Vaginismus has not been reported in patients with psychogenic purpura. The presence of vaginismus, which is seen more frequently in eastern cultures and is thought to be related to sociocultural determinants, suggests that some cultural factors may be common to both psychogenic purpura and vaginismus. The aim of this case report was to call attention to a syndrome that is rarely seen and diagnosed, and to discuss its relationship to psychosocial factors. This syndrome should be considered in the differential diagnosis of not only ecchymotic lesions, but also various types of bleeding, including hematuria. Despite the fact that its etiology and treatment are not clearly understood, it should be noted that psychological factors play a role in this disease and therefore, psychopharmacological and psychotherapeutic approaches can be effective.

The effect of rectal Foley catheterization on rectal bleeding rates after transrectal ultrasound-guided prostate biopsy.

PubMed

Kilciler, Mete; Erdemir, Fikret; Demir, Erkan; Güven, Oğuz; Avci, Ali

2008-09-01

To assess whether Foley catheterization of the rectum after transrectal ultrasound (TRUS)-guided prostate biopsy decreases complication rates. Between June 2000 and September 2006, 275 consecutive patients were evaluated after undergoing TRUS-guided prostate biopsy. All procedures were performed on an outpatient basis. Patients were divided into two groups. In the first group (n = 134), a Foley catheter was inserted into the rectum and inflated to 50 cm(3) after TRUS-guided biopsy. In the second group (n = 141), catheterization was performed without balloon placement. Rectal bleeding, hematuria, hematospermia, infection, and acute urinary retention rates were compared between groups. The mean ages of the patients were 63.3 years +/- 5.6 and 62.1 years +/- 7.2 years in the Foley catheter group and control group, respectively (P = .112). Hematuria, hematospermia, infection, and rectal bleeding occurred in 31 (23.1%), 30 (22.4), nine (6.7%), and two patients (1.5%), respectively, in the Foley catheter group; and in 36 (25.5%), 36 (25.5%), 11 (7.8%), and 25 patients (17.7%), respectively, in the control group. The incidences of infection, hematuria, and hematospermia were not significantly different between groups (P > .05). In contrast, the rectal bleeding rate was significantly lower in the Foley catheter group (1.5%) than in the control group (17.7%; P = .001). Although it has no effect on other complications, TRUS-guided prostate biopsy with rectal Foley catheterization is a useful, practical method to decrease or prevent rectal bleeding.

Identification of 47 novel mutations in patients with Alport syndrome and thin basement membrane nephropathy.

PubMed

Weber, Stefanie; Strasser, Katja; Rath, Sabine; Kittke, Achim; Beicht, Sonja; Alberer, Martin; Lange-Sperandio, Bärbel; Hoyer, Peter F; Benz, Marcus R; Ponsel, Sabine; Weber, Lutz T; Klein, Hanns-Georg; Hoefele, Julia

2016-06-01

Alport syndrome (ATS) is a progressive hereditary nephropathy characterized by hematuria and proteinuria. It can be associated with extrarenal manifestations. In contrast, thin basement membrane nephropathy (TBMN) is characterized by microscopic hematuria, is largely asymptomatic, and is rarely associated with proteinuria and end-stage renal disease. Mutations have been identified in the COL4A5 gene in ATS and in the COL4A3 and COL4A4 genes in ATS and TBMN. To date, more than 1000 different mutations in COL4A5, COL4A3, and COL4A4 are known. In this study mutational analysis by exon sequencing and multiplex ligation-dependent probe amplification was performed in a large European cohort of families with ATS and TBMN. Molecular diagnostic testing of 216 individuals led to the detection of 47 novel mutations, thereby expanding the spectrum of known mutations causing ATS and TBMN by up to 10 and 6%, respectively, depending on the database. Remarkably, a high number of ATS patients with only single mutations in COL4A3 and COL4A4 were identified. Additionally, three ATS patients presented with synonymous sequence variants that possible affect correct mRNA splicing, as suggested by in silico analysis. The results of this study clearly broaden the genotypic spectrum of known mutations for ATS and TBMN, which will in turn now facilitate future studies into genotype-phenotype correlations. Further studies should also examine the significance of single heterozygous mutations in COL4A3 and COL4A4 and of synonymous sequence variants associated with ATS.

Coexistence of Anti-Glomerular Basement Membrane Glomerulonephritis and Membranous Nephropathy in a Female Patient with Preserved Renal Function.

PubMed

Ogawara, Aoi; Harada, Makoto; Ichikawa, Tohru; Fujii, Kazuaki; Ehara, Takashi; Kobayashi, Mamoru

2017-12-01

Renal prognosis for anti-glomerular basement membrane (GBM) glomerulonephritis is poor. The greater the amount of anti-GBM antibody binding the antigen (type IV collagen of the glomerular basement membrane), the greater the number of crescents that develop in glomeruli, resulting in progression of renal impairment. Immunofluorescence staining reveals linear IgG depositions on glomerular capillary walls. Membranous nephropathy (MN) is one of the most common causes of nephrotic syndrome in middle-aged to elderly patients. Immune complex is deposited in the sub-epithelial space of the glomerulus resulting in the development of a membranous lesion. Immunofluorescence staining reveals granular IgG depositions on glomerular capillary walls. Coexisting anti-GBM glomerulonephritis and MN are rare and, here we report a case of coexisting anti-GBM glomerulonephritis and MN with preserved renal function. There are some cases of coexisting anti-GBM glomerulonephritis and MN do not show severely decreased renal function. A 76-year-old Japanese woman presented with nephrotic syndrome, microscopic hematuria, and was positive for anti-GBM antibody. Kidney biopsy revealed linear and granular IgG depositions in glomerular capillary walls, crescent formations, and electron-dense deposits in the sub-epithelial space. She was diagnosed with anti-GBM glomerulonephritis and MN. Steroid and cyclosporine therapy achieved complete remission, and kidney function was preserved. In conclusion, coexisting anti-GBM glomerulonephritis and MN can have preserved renal function. IgG subclass of deposited anti-GBM antibody may be associated with the severity of anti-GBM glomerulonephritis. In addition, in the case of nephrotic syndrome with hematuria, we should consider the possibility of coexisting anti-GBM glomerulonephritis and MN.

Bracken fern poisoning

USDA-ARS?s Scientific Manuscript database

Bracken fern (Pteridium aquilinum) has worldwide distribution and in some areas dominated plant communities replacing desirable forages. Poisoning is identified as enzootic hematuria, bright blindness, and bracken staggers. This chapter reviews updates new information on the plant, the various poi...

Pulmonary atelectasis from compression of the left main bronchus by an aortic aneurysm.

PubMed

Yap, K H; Sulaiman, S

2009-07-01

Pulmonary atelectasis may be caused by endobronchial lesions or by extrinsic compression of the bronchus. However, lung collapse due to compression from a thoracic aneurysm is uncommon. We report a 76-year-old hypertensive female patient who has pulmonary atelectasis due to an extrinsic compression from a descending thoracic aortic aneurysm, and discuss possible treatment options.

Sciatica caused by lumbar epidural gas.

PubMed

Belfquih, Hatim; El Mostarchid, Brahim; Akhaddar, Ali; gazzaz, Miloudi; Boucetta, Mohammed

2014-01-01

Gas production as a part of disc degeneration can occur but rarely causes nerve compression syndromes. The clinical features are similar to those of common sciatica. CT is very useful in the detection of epidural gas accumulation and nerve root compression. We report a case of symptomatic epidural gas accumulation originating from vacuum phenomenon in the intervertebral disc, causing lumbo-sacral radiculopathy. A 45-year-old woman suffered from sciatica for 9 months. The condition worsened in recent days. Computed tomography (CT) demonstrated intradiscal vacuum phenomenon, and accumulation of gas in the lumbar epidural space compressing the dural sac and S1 nerve root. After evacuation of the gas, her pain resolved without recurrence.

An audit of pressure sores caused by intermittent compression devices used to prevent venous thromboembolism.

PubMed

Skillman, Joanna; Thomas, Sunil

2011-12-01

When intermittent compression devices (ICDs) are used to prevent venous thromboembolism (VTE) they can cause pressure sores in a selected group of women, undergoing long operations. A prospective audit pre and post intervention showed a reduced risk with an alternative device, without increasing the risk of VTE.

Clinical effectiveness of hyperbaric oxygen therapy for BK-virus-associated hemorrhagic cystitis after allogeneic bone marrow transplantation.

PubMed

Savva-Bordalo, J; Pinho Vaz, C; Sousa, M; Branca, R; Campilho, F; Resende, R; Baldaque, I; Camacho, O; Campos, A

2012-08-01

Late-onset hemorrhagic cystitis (HC) after allogeneic hematopoietic stem cell transplantation (HSCT) has been associated with BK virus (BKV). Antiviral drugs are of limited efficacy and the optimal treatment for HC has not yet been established. Hyperbaric oxygen (HBO) may benefit these patients. We, therefore, retrospectively evaluated the effectiveness of HBO therapy in 16 patients with HC after allogeneic HSCT. All 16 patients had macroscopic hematuria and BKV infection. Patients received 100% oxygen in a hyperbaric chamber at 2.1 atmospheres for 90 min, 5 days per week, with a median 13 treatments (range, 4-84). Fifteen patients (94%) showed complete resolution of hematuria. Median urinary DNA BKV titers declined after HBO (P<0.05). Patients started on HBO earlier after diagnosis of HC responded sooner (P<0.05). HBO was generally well tolerated and proved to be a reliable option for this difficult to manage condition.

My Personal Journey With Ovarian Cancer Treatment: Caring and Chemotherapy Tips.

PubMed

Decker, Kim A

2016-12-01

Six years ago, I was diagnosed with stage IIIA ovarian low malignant cell potential cancer. It was the most shocking situation I have ever experienced. I didn't realize I had any symptoms, except occasional back pain, which I attributed to starting a new workout program. I had scheduled an abdominal computerized tomography (CT) scan for recurrent microscopic hematuria, which my internist wanted to check. I was told I would hear the results in two days. Two hours after my CT scan, while I was eating ice cream and watching television, an on-call genitourinary doctor (who I did not personally know) called to tell me the good news-that I had kidney stones, thus the microscopic hematuria. However, the bad news was that I had ovarian cancer that had spread to my omentum. He said he would call my gynecologist right away.

Transitional cell carcinomas in four fishing cats (Prionailurus viverrinus).

PubMed

Sutherland-Smith, Meg; Harvey, Catherine; Campbell, Mark; McAloose, Denise; Rideout, Bruce; Morris, Patrick

2004-09-01

Transitional cell carcinomas (TCC) of the urinary bladder were diagnosed in four related fishing cats (Prionailurus viverrinus). The major clinical sign in each case was persistent hematuria unresponsive to medical therapy. Cystotomy and biopsy provided an antemortem diagnosis in three of the fishing cats before euthanasia because of progression of clinical signs. The diagnosis was made in the fourth cat after euthanasia because of renal failure. Hematuria improved temporarily in one of the cats diagnosed antemortem and treated with piroxicam and carboplatin. Attempts to isolate a herpesvirus in two of the cats failed. Histopathologic appearance of the TCC was similar to that described for other species. TCC metastasis to the lungs was noted at necropsy in one cat; metastatic disease was not noted in the other fishing cats on gross or histopathologic examination. TCC of the urinary bladder appears to be more prevalent in fishing cats than in other species of domestic or nondomestic felids.

Microscopic or occult hematuria, when reflex testing is not good laboratory practice.

PubMed

Froom, Paul; Barak, Mira

2010-01-01

Consensus opinion suggests that hematuria found by dipstick and not confirmed on microscopic examination (<2 erythrocytes per high power field) signifies a false-positive reagent strip test result. Standard practice is to repeat the dipstick test several days later and if still positive to confirm by microscopic examination. If discordant results are obtained, experts recommend reflex testing for urinary myoglobin and hemoglobin concentrations. The question is whether or not this approach represents good laboratory practice. These recommendations are not evidence based. We conclude that the reference range for red blood cells on the reagent strip should be increased to 25x10(6) cells/L for young men, and 50x10(6) cells/L for the rest of the adult population, ranges consistent with flow cytometry reports. Confirmation reflex testing using tests that have inferior sensitivity, precision and probably accuracy is not recommended.

Pelvic fracture and injury to the lower urinary tract.

PubMed

Spirnak, J P

1988-10-01

The presence of a urologic injury must be considered in all patients with pelvic fracture. Uroradiographic evaluation starting with retrograde urethrography is indicated in all male patients with concomitant gross hematuria, bloody urethral discharge, scrotal or perineal ecchymosis, a nonpalpable prostate on rectal examination, or an inability to urinate. If the urethra is normal, a catheter may be passed, and in the presence of gross hematuria, a cystogram must be performed. Female patients rarely suffer urethral lacerations. The urethra is examined, and a Foley catheter may be passed without a urethrogram. The immediate management of associated urologic injuries continues to evolve and evoke controversy. Selected cases of extraperitoneal bladder perforation may be safely managed solely by catheter drainage. Intraperitoneal perforations require surgical exploration and repair. Urethral disruption (partial or complete) may be safely managed by primary cystostomy drainage with management of potential complications (stricture, impotence, incontinence) in 4 to 6 months.

Prevalence of extraforaminal nerve root compression below lumbosacral transitional vertebrae.

PubMed

Porter, Neil A; Lalam, Radhesh K; Tins, Bernhard J; Tyrrell, Prudencia N M; Singh, Jaspreet; Cassar-Pullicino, Victor N

2014-01-01

Although pathology at the first mobile segment above a lumbosacral transitional vertebra (LSTV) is a known source of spinal symptoms, nerve root compression below an LSTV, has only sporadically been reported. Our objective was to assess the prevalence of nerve root entrapment below an LSTV, review the causes of entrapment, and correlate with presenting symptoms. A retrospective review of MR and CT examinations of the lumbar spine was performed over a 5.5-year period in which the words "transitional vertebra" were mentioned in the report. Nerve root compression below an LSTV was assessed as well as the subtype of transitional vertebra. Correlation with clinical symptoms at referral was made. MR and CT examinations were also reviewed to exclude any other cause of symptoms above the LSTV. One hundred seventy-four patients were included in the study. Neural compression by new bone formation below an LSTV was demonstrated in 23 patients (13%). In all of these patients, there was a pseudarthrosis present on the side of compression due to partial sacralization with incomplete fusion. In three of these patients (13%), there was symptomatic correlation with no other cause of radiculopathy demonstrated. A further 13 patients (57%) had correlating symptoms that may in part be attributable to compression below an LSTV. Nerve root compression below an LSTV occurs with a prevalence of 13% and can be symptomatic in up to 70% of these patients. This region should therefore be carefully assessed in all symptomatic patients with an LSTV.

Compressive myelopathy of the cervical spine in Komodo dragons (Varanus komodoensis).

PubMed

Zimmerman, Dawn M; Douglass, Michael; Sutherland-Smith, Meg; Aguilar, Roberto; Schaftenaar, Willem; Shores, Andy

2009-03-01

Cervical subluxation and compressive myelopathy appears to be a cause of morbidity and mortality in captive Komodo dragons (Varanus komodoensis). Four cases of cervical subluxation resulting in nerve root compression or spinal cord compression were identified. Three were presumptively induced by trauma, and one had an unknown inciting cause. Two dragons exhibited signs of chronic instability. Cervical vertebrae affected included C1-C4. Clinical signs on presentation included ataxia, ambulatory paraparesis or tetraparesis to tetraplegia, depression to stupor, cervical scoliosis, and anorexia. Antemortem diagnosis of compression was only confirmed with magnetic resonance imaging or computed tomography. Treatment ranged from supportive care to attempted surgical decompression. All dragons died or were euthanatized, at 4 days to 12 mo postpresentation. Studies to define normal vertebral anatomy in the species are necessary to determine whether the pathology is linked to cervical malformation, resulting in ligament laxity, subsequent instability, and subluxation.

Hyperbaric oxygen therapy (HBOT) in case of hemorrhagic cystitis after radiotherapy

PubMed Central

Klejnotowska, Alicja; Matuszewski, Marcin; Sicko, Zdzislaw; Markuszewski, Marcin; Krajka, Kazimierz

2012-01-01

Introduction We present the effect of hyperbaric oxygen therapy (HBOT) after radiotherapy for cancer in the pelvic cavity resulting in hematuria. Increasing the pressure of oxygen (PO2) in ischemic tissues favors the formation of new blood vessels and increases the secretion of collagen. Material and methods We evaluated 10 patients who were treated with HBOT from October 2006 to December 2010 due to persistent radiation damage to the lining of the bladder leading to recurrent hematuria. The study group was comprised of seven men and three women. In the case of cervical and endometrial cancers, 30 Gy of brachytherapy with 45-50 Gy of teleradiotherapy were used. In prostate cancer (PCa), we applied 50 Gy of teleradiotherapy with an additional dose of 20-24 Gy, and in the case of bladder cancer (BCa), 50 Gy of teleradiotherapy was applied with an additional dose of 16 Gy. HBOT consisted of 60 HBO2 treatments, in which patients were administered 100% oxygen at a pressure of 2.5 atm. Results The group effect of total or partial resolution was observed in six patients. In one case, treatment was discontinued due to an increase in hematuria and the consequent suspicion of bladder tumor recurrence. While in and additional three cases, the treatment did not produce the desired result. Conclusions Treatment of hemorrhagic cystitis is a difficult therapeutic challenge. One possible method is the implementation of HBOT. In very difficult cases, HBO2 treatment appears to be effective in giving more than half of patients a chance of getting better. PMID:24578962

Isomorphic red blood cells using automated urine flow cytometry is a reliable method in diagnosis of bladder cancer.

PubMed

Muto, Satoru; Sugiura, Syo-Ichiro; Nakajima, Akiko; Horiuchi, Akira; Inoue, Masahiro; Saito, Keisuke; Isotani, Shuji; Yamaguchi, Raizo; Ide, Hisamitsu; Horie, Shigeo

2014-10-01

We aimed to identify patients with a chief complaint of hematuria who could safely avoid unnecessary radiation and instrumentation in the diagnosis of bladder cancer (BC), using automated urine flow cytometry to detect isomorphic red blood cells (RBCs) in urine. We acquired urine samples from 134 patients over the age of 35 years with a chief complaint of hematuria and a positive urine occult blood test or microhematuria. The data were analyzed using the UF-1000i (®) (Sysmex Co., Ltd., Kobe, Japan) automated urine flow cytometer to determine RBC morphology, which was classified as isomorphic or dysmorphic. The patients were divided into two groups (BC versus non-BC) for statistical analysis. Multivariate logistic regression analysis was used to determine the predictive value of flow cytometry versus urine cytology, the bladder tumor antigen test, occult blood in urine test, and microhematuria test. BC was confirmed in 26 of 134 patients (19.4 %). The area under the curve for RBC count using the automated urine flow cytometer was 0.94, representing the highest reference value obtained in this study. Isomorphic RBCs were detected in all patients in the BC group. On multivariate logistic regression analysis, only isomorphic RBC morphology was significantly predictive for BC (p < 0.001). Analytical parameters such as sensitivity, specificity, positive predictive value, and negative predictive value of isomorphic RBCs in urine were 100.0, 91.7, 74.3, and 100.0 %, respectively. Detection of urinary isomorphic RBCs using automated urine flow cytometry is a reliable method in the diagnosis of BC with hematuria.

Urinary retention: benefit of gradual bladder decompression - myth or truth? A randomized controlled trial.

PubMed

Boettcher, S; Brandt, A S; Roth, S; Mathers, M J; Lazica, D A

2013-01-01

Urinary retention is a common emergency requiring immediate catheterization. Gradual decompression (GD) of the extended bladder is believed to minimize the risk of complications such as bleeding or circulatory collapse, but to date it has not been compared with rapid decompression (RD) in controlled trials. Male patients presenting with urinary retention (n = 294) were randomized to rapid or gradual catheterization. For the latter, the transurethral catheter was clamped for 5 min after every 200-ml outflow until the bladder was completely empty. Patients were monitored for at least 30 min thereafter with regular checks of vital signs and presence of macroscopic hematuria. Of 294 patients, 142 (48.3%) were randomized to the GD and 152 (51.7%) to the RD group. Both groups showed no statistically significant difference with regard to age, anticoagulation treatment, catheter size and material, or volume retained. Hematuria occurred in 16 (11.3%) of the GD and 16 (10.5%) of the RD group; 6 patients in the former and 4 in the latter required further treatment. No circulatory collapse occurred. We noted a decrease in the previously raised blood pressure and heart rate in both groups, although without clinical significance. In this first randomized trial, no statistically significant difference was noted between gradual and rapid emptying of the bladder for urinary retention. Gradual emptying did not reduce the risk of hematuria or circulatory collapse. Therefore, there is no need to prefer gradual over rapid emptying, which is both easy and safe. © 2013 S. Karger AG, Basel.

Glomerulonephritis in the acute phase of Ross River virus disease (epidemic polyarthritis).

PubMed

Fraser, J R; Cunningham, A L; Muller, H K; Sinclair, R A; Standish, H G

1988-03-01

Hematuria and proteinuria were detected at the peak of symptoms in a case of Ross River virus (RRV) disease. No other infective cause was identified. A renal biopsy 28 days after the onset of nephritis showed mild mesangial proliferative changes and one segmental sclerotic lesion. Immunofluorescence showed widespread linear deposition of IgG in glomerular capillary walls with similar but weak staining for IgM, complement (C3) and fibrinogen; granular deposits of IgM and C3 in several arterioles; and IgM in a few mesangial cells. No electron-dense deposits were detected, nor was RRV antigen found in the renal tissue. Anti-glomerular basement membrane antibodies were not detected in the serum. Recovery from the renal disturbance was complete within three months although rheumatic symptoms persisted for 30 months.

[Clinical characteristics and prognosis of secondary amyloidosis in patients with rheumatoid arthritis--renal involvement and therapy].

PubMed

Sakai, M; Eguchi, K; Tezuka, H; Yamashita, I; Nakashima, M; Ida, H; Origuchi, T; Shimada, H; Kawabe, Y; Fukuda, T

1992-10-01

Secondary amyloidosis is an important complication that may have a strong influence on the prognosis of patients with rheumatoid arthritis (RA). We studied 21 RA patients with secondary amyloidosis. The two major initial signs were gastrointestinal symptoms and renal involvement. When 15 of the 21 patients were diagnosed as having secondary amyloidosis, they displayed renal involvement including proteinuria, hematuria and hypercreatininemia. The 15 patients with amyloidosis were either subjected to dialysis or died within 35 months on the average. The causes of death in 13 patients were cardiac failure, gastrointestinal bleeding and infection, which were strongly implicated with renal failure. Dialysis was applied to seven patients. Three of them were maintained with chronic dialysis. We discussed the induction-time and the method of dialysis in patients with amyloidosis secondary to RA.

Unusual presentations of BK virus infections in pediatric renal transplant recipients.

PubMed

Drake, Keri A; Najera, Lydia; Reed, Robyn C; Verghese, Priya S

2013-02-01

BKV has emerged as a significant pathogen in the field of transplantation, predominantly causing BKV nephropathy in renal transplant recipients and hemorrhagic cystitis in HSCT recipients. However, case reports describe more diverse complications, and we too present three unusual cases of BKV infections in pediatric renal transplant recipients. First, we describe a case of biopsy-proven renal damage secondary to BKV prior to the onset of viremia, demonstrating that BKV nephropathy can occur without preceding viremia. We also present two renal transplant recipients with persistent BK viruria, one with BKV-associated hemorrhagic cystitis and the other with microscopic hematuria. Therefore, we conclude that BKV manifestations may be more diverse than previously thought and suggest clinical utility in urine BKV qPCR testing in specific transplant recipients. © 2012 John Wiley & Sons A/S.

Bladder Involvement in Stage I Endometriosis.

PubMed

Brady, Paula C; Missmer, Stacey A; Laufer, Marc R

2017-08-01

Endometriosis-the ectopic implantation of endometrial-like tissue-affects 10% of adolescent females and adults. Bladder involvement, causing dysuria and hematuria, occurs in a very small number of endometriosis patients. The patient presented at age 12 years with dysuria and pelvic pain. Laparoscopy revealed stage I endometriosis. Postoperatively, she reported persistent dysuria and passage of tissue in her urine. Cystoscopy showed diffuse erythema; urine cytology revealed glandular and spindle cells suggestive of endometriosis. She was transitioned from oral contraceptives to an intranasal gonadotropin-releasing hormone agonist, with symptom resolution. Intravesicular endometriosis coinciding with stage I disease supports a mechanism of endometriosis dissemination other than direct bladder infiltration. Patients with endometriosis who complain of urinary symptoms warrant assessment, because intravesicular bladder involvement cannot be excluded using pelviscopy. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Bladder rupture caused by postpartum urinary retention.

PubMed

Dueñas-García, Omar Felipe; Rico, Hugo; Gorbea-Sanchez, Viridiana; Herrerias-Canedo, Tomas

2008-08-01

Postpartum bladder rupture is an uncommon surgical emergency and a diagnostic challenge. A primigravida delivered a healthy newborn without complications at 39.4 weeks of gestation. The patient was admitted 80 hours postpartum with abdominal pain, oliguria, hematuria, and pain that worsened during the previous 4 hours. An inserted Foley catheter drained only a small amount of urine, and serum creatinine was elevated (3.5 mg/dL). A laparotomy was performed and revealed a 10-cm hole in the urinary bladder. The bladder was repaired and the patient was discharged 15 days after surgery. The follow-up cystoscopy revealed adequate healing of the bladder. Urinary retention can lead to serious complications, including bladder rupture. Postpartum bladder rupture due to urinary retention should be ruled out if there is a history of abdominal pain, oliguria, and elevated of serum creatinine.

A New Challenge for Compression Algorithms: Genetic Sequences.

ERIC Educational Resources Information Center

Grumbach, Stephane; Tahi, Fariza

1994-01-01

Analyzes the properties of genetic sequences that cause the failure of classical algorithms used for data compression. A lossless algorithm, which compresses the information contained in DNA and RNA sequences by detecting regularities such as palindromes, is presented. This algorithm combines substitutional and statistical methods and appears to…

Rupture of esophagus by compressed air.

PubMed

Wu, Jie; Tan, Yuyong; Huo, Jirong

2016-11-01

Currently, beverages containing compressed air such as cola and champagne are widely used in our daily life. Improper ways to unscrew the bottle, usually by teeth, could lead to an injury, even a rupture of the esophagus. This letter to editor describes a case of esophageal rupture caused by compressed air.

Renal cell metastases versus liver hemangioma.

PubMed

Mydlo, J H; Shore, N; Herr, H W

1991-03-01

We present the case of a man with presumed metastatic renal cell carcinoma based on radiologic examination and weight loss, who refused treatment of any kind for one year. A surgical exploration to control hematuria revealed a Stage I tumor.

[Thoracic spinal cord compression at two levels due to ligamentum flavum calcification. Case report].

PubMed

Gondim, J; Ramos Júnior, F

1998-06-01

Calcification and/or ossification of the ligamenta flava is a well reported clinicopathologic entity causing narrowing of the spinal canal cord compression. It has been described almost exclusively in Japanese people. The authors present the case of a non Japanese patient with thoracic myelopathy caused by ossification of the ligamentum flavum.

Transconjunctival orbital emphysema caused by compressed air injury: a case report.

PubMed

Mathew, Sunu; Vasu, Usha; Francis, Febson; Nazareth, Colin

2008-01-01

Orbital emphysema following conjunctival tear in the absence of orbital wall fracture, caused by air under pressure is rare. Usually orbital emphysema is seen in facial trauma associated with damage to the adjacent paranasal sinuses or facial bones. To the best of our knowledge, there have been only eight reports of orbital emphysema following use of compressed air during industrial work. The air under pressure is pushed through the subconjunctival space into the subcutaneous and retrobulbar spaces. We present here a rare cause of orbital emphysema in a young man working with compressed air gun. Although the emphysema was severe, there were no orbital bone fracture and the visual recovery of the patient was complete without attendant complications.

Transconjunctival orbital emphysema caused by compressed air injury: A case report

PubMed Central

Vasu, Usha; Francis, Febson; Nazareth, Colin

2008-01-01

Orbital emphysema following conjunctival tear in the absence of orbital wall fracture, caused by air under pressure is rare. Usually orbital emphysema is seen in facial trauma associated with damage to the adjacent paranasal sinuses or facial bones. To the best of our knowledge, there have been only eight reports of orbital emphysema following use of compressed air during industrial work. The air under pressure is pushed through the subconjunctival space into the subcutaneous and retrobulbar spaces. We present here a rare cause of orbital emphysema in a young man working with compressed air gun. Although the emphysema was severe, there were no orbital bone fracture and the visual recovery of the patient was complete without attendant complications. PMID:18417833

Preliminary investigation of biological resistance, water absorption and swelling of thermally compressed pine wood panels

Treesearch

Oner Unsal; S. Nami Kartal; Zeki Candan; Rachel Arango; Carol A. Clausen; Frederick Green

2008-01-01

Wood can be modified by compressive, thermal and chemical treatments. Compression of wood under thermal conditions is resulted in densification of wood. This study evaluated decay and termite resistance of thermally compressed pine wood panels at either 5 or 7 MPa and at either 120 or 150°C for one hour. The process caused increases in density and decreases in...

Application of Compressive Sensing to Gravitational Microlensing Experiments

NASA Technical Reports Server (NTRS)

Korde-Patel, Asmita; Barry, Richard K.; Mohsenin, Tinoosh

2016-01-01

Compressive Sensing is an emerging technology for data compression and simultaneous data acquisition. This is an enabling technique for significant reduction in data bandwidth, and transmission power and hence, can greatly benefit spaceflight instruments. We apply this process to detect exoplanets via gravitational microlensing. We experiment with various impact parameters that describe microlensing curves to determine the effectiveness and uncertainty caused by Compressive Sensing. Finally, we describe implications for spaceflight missions.

Compressive residual strength of graphite/epoxy laminates after impact

NASA Technical Reports Server (NTRS)

Guy, Teresa A.; Lagace, Paul A.

1992-01-01

The issue of damage tolerance after impact, in terms of the compressive residual strength, was experimentally examined in graphite/epoxy laminates using Hercules AS4/3501-6 in a (+ or - 45/0)(sub 2S) configuration. Three different impactor masses were used at various velocities and the resultant damage measured via a number of nondestructive and destructive techniques. Specimens were then tested to failure under uniaxial compression. The results clearly show that a minimum compressive residual strength exists which is below the open hole strength for a hole of the same diameter as the impactor. Increases in velocity beyond the point of minimum strength cause a difference in the damage produced and cause a resultant increase in the compressive residual strength which asymptotes to the open hole strength value. Furthermore, the results show that this minimum compressive residual strength value is independent of the impactor mass used and is only dependent upon the damage present in the impacted specimen which is the same for the three impactor mass cases. A full 3-D representation of the damage is obtained through the various techniques. Only this 3-D representation can properly characterize the damage state that causes the resultant residual strength. Assessment of the state-of-the-art in predictive analysis capabilities shows a need to further develop techniques based on the 3-D damage state that exists. In addition, the need for damage 'metrics' is clearly indicated.

Cardiovascular causes of airway compression.

PubMed

Kussman, Barry D; Geva, Tal; McGowan, Francis X

2004-01-01

Compression of the paediatric airway is a relatively common and often unrecognized complication of congenital cardiac and aortic arch anomalies. Airway obstruction may be the result of an anomalous relationship between the tracheobronchial tree and vascular structures (producing a vascular ring) or the result of extrinsic compression caused by dilated pulmonary arteries, left atrial enlargement, massive cardiomegaly, or intraluminal bronchial obstruction. A high index of suspicion of mechanical airway compression should be maintained in infants and children with recurrent respiratory difficulties, stridor, wheezing, dysphagia, or apnoea unexplained by other causes. Prompt diagnosis is required to avoid death and minimize airway damage. In addition to plain chest radiography and echocardiography, diagnostic investigations may consist of barium oesophagography, magnetic resonance imaging (MRI), computed tomography, cardiac catheterization and bronchoscopy. The most important recent advance is MRI, which can produce high quality three-dimensional reconstruction of all anatomic elements allowing for precise anatomic delineation and improved surgical planning. Anaesthetic technique will depend on the type of vascular ring and the presence of any congenital heart disease or intrinsic lesions of the tracheobronchial tree. Vascular rings may be repaired through a conventional posterolateral thoracotomy, or utilizing video-assisted thoracoscopic surgery (VATS) or robotic endoscopic surgery. Persistent airway obstruction following surgical repair may be due to residual compression, secondary airway wall instability (malacia), or intrinsic lesions of the airway. Simultaneous repair of cardiac defects and vascular tracheobronchial compression carries a higher risk of morbidity and mortality.

Kyphosis

MedlinePlus

... age, and the cause and effects of the curvature. Symptoms Mild kyphosis may produce no noticeable signs ... or crushed vertebrae (compression fractures) can result in curvature of the spine. Mild compression fractures often don' ...

Intramedullary cyst formation after removal of multiple intradural spinal arachnoid cysts: A case report

PubMed Central

Zekaj, Edvin; Saleh, Christian; Servello, Domenico

2016-01-01

Background: A rare cause of spinal cord compression is spinal arachnoid cysts. Symptoms are caused by spinal cord compression, however, asymptomatic patients have been also reported. Treatment options depend upon symptom severity and clinical course. Case Description: We report the case of a 47-year-old patient who developed an intramedullary arachnoid cyst after removal of an intradural extramedullary cyst. Conclusion: Surgery should be considered early in a symptomatic disease course. Longstanding medullary compression may reduce the possibility of neurological recovery as well as secondary complications such as intramedullary cyst formation. PMID:27512608

Cardiac compression due to gastric volvulus: an unusual cause of chest pain.

PubMed

Brown, Alex; Austin, David; Kanakala, Venkatesh

2017-05-22

A 42-year-old man was admitted to coronary care for assessment with severe retrosternal chest pain. Echocardiography showed significant external compression of the left atrium. A subsequent CT scan revealed him to have a large hiatus hernia, with most of his stomach herniating into his thorax causing left atrial compression and gastric volvulus. He subsequently underwent successful emergency decompression of the gastric volvulus and repair of his hiatus hernia. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

[Neurovascular compression of the medulla oblongata: a rare cause of secondary hypertension].

PubMed

Nádas, Judit; Czirják, Sándor; Igaz, Péter; Vörös, Erika; Jermendy, György; Rácz, Károly; Tóth, Miklós

2014-05-25

Compression of the rostral ventrolateral medulla oblongata is one of the rarely identified causes of refractory hypertension. In patients with severe, intractable hypertension caused by neurovascular compression, neurosurgical decompression should be considered. The authors present the history of a 20-year-old man with severe hypertension. After excluding other possible causes of secondary hypertension, the underlying cause of his high blood pressure was identified by the demonstration of neurovascular compression shown by magnetic resonance angiography and an increased sympathetic activity (sinus tachycardia) during the high blood pressure episodes. Due to frequent episodes of hypertensive crises, surgical decompression was recommended, which was performed with the placement of an isograft between the brainstem and the left vertebral artery. In the first six months after the operation, the patient's blood pressure could be kept in the normal range with significantly reduced doses of antihypertensive medication. Repeat magnetic resonance angiography confirmed the cessation of brainstem compression. After six months, increased blood pressure returned periodically, but to a smaller extent and less frequently. Based on the result of magnetic resonance angiography performed 22 months after surgery, re-operation was considered. According to previous literature data long-term success can only be achieved in one third of patients after surgical decompression. In the majority of patients surgery results in a significant decrease of blood pressure, an increased efficiency of antihypertensive therapy as well as a decrease in the frequency of highly increased blood pressure episodes. Thus, a significant improvement of the patient's quality of life can be achieved. The case of this patient is an example of the latter scenario.

Anterior urethral valves: an uncommon cause of obstructive uropathy in children.

PubMed

Kibar, Yusuf; Coban, Hidayet; Irkilata, H Cem; Erdemir, Fikret; Seckin, Bedrettin; Dayanc, Murat

2007-10-01

Anterior urethral valves (AUV) are rare entities generally described in case reports. They are an uncommon cause of lower urinary tract obstruction in children and can be difficult to diagnose. In the present study, we present our experience in four children with AUV along with a literature review. We retrospectively identified four children with AUV presented between 1998 and 2005 at age 4-9 years. Hematuria, urinary tract infection and weak voiding stream were the most common symptoms. Voiding cystourethrography (VCUG) confirmed the diagnosis of AUV. On cystourethroscopy, cusp-like valves in the anterior urethra were seen in all children. Transurethral endoscopic resection of the valves was carried out in three children using a pediatric resectoscope. In one child with a massive anterior urethral diverticulum, open resection of the valve, diverticulectomy and urethroplasty were performed. All patients were cured, none had complications as a result of surgery, and all reported a normal urinary stream at follow-up. Children with poor stream and recurrent infections should be evaluated carefully and anterior urethral valves should be considered in differential diagnosis of obstructive lesions.

Compressing Perceived Distance with Remote Tool-Use: Real, Imagined, and Remembered

ERIC Educational Resources Information Center

Davoli, Christopher C.; Brockmole, James R.; Witt, Jessica K.

2012-01-01

Reaching for an object with a tool has been shown to cause a compressed perception of space just beyond arm's reach. It is not known, however, whether tools that have distal, detached effects at far distances can cause this same perceptual distortion. We examined this issue in the current study with targets placed up to 30m away. Participants who…

Application of Compressive Sensing to Gravitational Microlensing Experiments

NASA Astrophysics Data System (ADS)

Korde-Patel, Asmita; Barry, Richard K.; Mohsenin, Tinoosh

2017-06-01

Compressive Sensing is an emerging technology for data compression and simultaneous data acquisition. This is an enabling technique for significant reduction in data bandwidth, and transmission power and hence, can greatly benefit space-flight instruments. We apply this process to detect exoplanets via gravitational microlensing. We experiment with various impact parameters that describe microlensing curves to determine the effectiveness and uncertainty caused by Compressive Sensing. Finally, we describe implications for space-flight missions.

Tracheal Compression Caused by a Mediastinal Hematoma After Interrupted Aortic Arch Surgery.

PubMed

Hua, Qingwang; Lin, Zhiyong; Hu, Xingti; Zhao, Qifeng

2017-08-03

Congenital abnormalities of the aortic arch include interrupted aortic arch (IAA), coarctation of the aorta (CoA), and double aortic arch (DAA). Aortic arch repair is difficult and postoperative complications are common. However, postoperative tracheobronchial stenosis with respiratory insufficiency is an uncommon complication and is usually caused by increased aortic anastomotic tension. We report here a case of tracheal compression by a mediastinal hematoma following IAA surgery. The patient underwent a repeat operation to remove the hematoma and was successfully weaned off the ventilator.In cases of tracheobronchial stenosis after aortic arch surgery, airway compression by increased aortic anastomotic tension is usually the first diagnosis considered by clinicians. Other causes, such as mediastinal hematomas, are often ignored. However, the severity of symptoms with mediastinal hematomas makes this an important entity.

Breaking of rod-shaped model material during compression

NASA Astrophysics Data System (ADS)

Lukas, Kulaviak; Vera, Penkavova; Marek, Ruzicka; Miroslav, Puncochar; Petr, Zamostny; Zdenek, Grof; Frantisek, Stepanek; Marek, Schongut; Jaromir, Havlica

2017-06-01

The breakage of a model anisometric dry granular material caused by uniaxial compression was studied. The bed of uniform rod-like pasta particles (8 mm long, aspect ratio 1:8) was compressed (Gamlen Tablet Press) and their size distribution was measured after each run (Dynamic Image Analysing). The compression dynamics was recorded and the effect of several parameters was tested (rate of compression, volume of granular bed, pressure magnitude and mode of application). Besides the experiments, numerical modelling of the compressed breakable material was performed as well, employing the DEM approach (Discrete Element Method). The comparison between the data and the model looks promising.

Urethral cavernous hemangioma in a female patient: a rare entity

PubMed Central

Bolat, Mustafa Suat; Yüzüncü, Kubilay; Akdeniz, Ekrem; Demirdoven, Ayse Nurten

2015-01-01

Genitourinary hemangiomas are rare entities of the urinary system. We reported a female patient who suffered dyspareunia and intermitant hematuria that was proved as urethral cavernous hemangioma. Despite its benign nature, hemangiomas may recur due to incomplet excision. PMID:26985270

Effects of Initial Graft Tension on the Tibiofemoral Compressive Forces and Joint Position Following ACL Reconstruction

PubMed Central

Brady, Mark F.; Bradley, Michael P.; Fleming, Braden C.; Fadale, Paul D.; Hulstyn, Michael J.; Banerjee, Rahul

2007-01-01

Background The initial tension applied to an ACL graft at the time of fixation modulates knee motion and the tibiofemoral compressive loads. Purpose To establish the relationships between initial graft tension, tibiofemoral compressive force, and the neutral tibiofemoral position in the cadaver knee. Study Design Controlled Laboratory Study. Methods The tibiofemoral compressive forces and joint positions were determined in the ACL-intact knee at 0°, 20° and 90° knee flexion. The ACL was excised and reconstructed with a patellar tendon graft using graft tensions of 1, 15, 30, 60 and 90 N applied at 0°, 20° and 90° knee flexion. The compressive forces and neutral positions were compared between initial tension conditions and the ACL-intact knee. Results Increasing initial graft tension increased the tibiofemoral compressive forces. The forces in the medial compartment were 1.8 times those in the lateral compartment. The compressive forces were dependent on the knee angle at which the tension was applied. The greatest compressive forces occurred when the graft was tensioned with the knee in extension. An increase in initial graft tension caused the tibia to rotate externally compared to the ACL-intact knee. Increases in initial graft tension also caused a significant posterior translation of the tibia relative to the femur. Conclusions Different initial graft tension protocols produced predictable changes in the tibiofemoral compressive forces and joint positions. Clinical Relevance The tibiofemoral compressive force and neutral joint position were best replicated with a low graft tension (1–15 N) when using a patellar tendon graft. PMID:17218659

Noncontact Measurement Of Critical Current In Superconductor

NASA Technical Reports Server (NTRS)

Israelsson, Ulf E.; Strayer, Donald M.

1992-01-01

Critical current measured indirectly via flux-compression technique. Magnetic flux compressed into gap between superconductive hollow cylinder and superconductive rod when rod inserted in hole in cylinder. Hall-effect probe measures flux density before and after compression. Method does not involve any electrical contact with superconductor. Therefore, does not cause resistive heating and consequent premature loss of superconductivity.

Effects of water during cure on the properties of a carbon/phenolic system

NASA Technical Reports Server (NTRS)

Penn, B. G.; Clemons, J. M.; Ledbetter, F. E., III; Daniels, J. G.; Thompson, L. M.

1984-01-01

The effects of prepreg water contamination on interlaminar shear strength, tranverse compressive strength, and longitudinal compressive strength were determined. Decreases in these properties due to water contamination were sugstantial: 28 percent for the interlaminar shear strength, 21 percent for the transverse compressive strength and 31 percent for the longitudinal compressive strength. Since voids were not detected by X-ray analysis, the most likely cause for these results is fiber-matrix debounding in the laminate.

Viscoelastic behavior of basaltic ash from Stromboli volcano inferred from intermittent compression experiments

NASA Astrophysics Data System (ADS)

Kurokawa, A. K.; Miwa, T.; Okumura, S.; Uesugi, K.

2017-12-01

After ash-dominated Strombolian eruption, considerable amount of ash falls back to the volcanic conduit forming a dense near-surface region compacted by weights of its own and other fallback clasts (Patrick et al., 2007). Gas accumulation below this dense cap causes a substantial increase in pressure within the conduit, causing the volcanic activity to shift to the preliminary stages of a forthcoming eruption (Del Bello et al., 2015). Under such conditions, rheology of the fallback ash plays an important role because it controls whether the fallback ash can be the cap. However, little attention has been given to the point. We examined the rheology of ash collected at Stromboli volcano via intermittent compression experiments changing temperature and compression time/rate. The ash deformed at a constant rate during compression process, and then it was compressed without any deformation during rest process. The compression and rest processes repeated during each experiment to see rheological variations with progression of compaction. Viscoelastic changes during the experiment were estimated by Maxwell model. The results show that both elasticity and viscosity increases with decreasing porosity. On the other hand, the elasticity shows strong rate-dependence in the both compression and rest processes while the viscosity dominantly depends on the temperature, although the compression rate also affects the viscosity in the case of the compression process. Thus, the ash behaves either elastically or viscously depending on experimental process, temperature, and compression rate/time. The viscoelastic characteristics can be explained by magnitude relationships between the characteristic relaxation times and times for compression and rest processes. This indicates that the balance of the time scales is key to determining the rheological characteristics and whether the ash behaves elastically or viscously may control cyclic Strombolian eruptions.

Melatonin treatment further improves adipose-derived mesenchymal stem cell therapy for acute interstitial cystitis in rat.

PubMed

Chen, Yen-Ta; Chiang, Hsin-Ju; Chen, Chih-Hung; Sung, Pei-Hsun; Lee, Fan-Yen; Tsai, Tzu-Hsien; Chang, Chia-Lo; Chen, Hong-Hwa; Sun, Cheuk-Kwan; Leu, Steve; Chang, Hsueh-Wen; Yang, Chih-Chao; Yip, Hon-Kan

2014-10-01

This study tests the hypothesis that combined melatonin and adipose-derived mesenchymal stem cell (ADMSC, 1.2 × 10(6) given intravenously) treatment offer superior protection against cyclophosphamide (CYP 150 mg/kg)-induced acute interstitial cystitis (AIC) in rats. Male adult Sprague-Dawley rats were treated as follows: sham controls, AIC alone, AIC + melatonin, AIC + ADMSC, and AIC + melatonin +ADMSC. When melatonin was used, it was given as follows: 20 mg/kg at 30 min after CYP and 50 mg/kg at 6 and 18 hr after CYP. Twenty-four-hour urine volume, urine albumin level, and severity of hematuria were highest in AIC rats and lowest in the controls; likewise urine volume was higher in AIC + melatonin rats than in AIC + ADMSC and AIC + melatonin + ADMSC treated rats; in all cases, P < 0.001. The numbers of CD14+, CD74+, CD68+, MIP+, Cox-2+, substance P+, cells and protein expression of IL-6, IL-12, RANTES, TNF-α, NF-κB, MMP-9, iNOS (i.e. inflammatory biomarkers), glycosaminoglycan level, expression of oxidized protein, and protein expression of reactive oxygen species (NOX-1, NOX-2, NOX-4) in the bladder tissue exhibited an identical pattern compared with that of hematuria among the five groups (all P < 0.0001). The integrity of epithelial layer and area of collagen deposition displayed an opposite pattern compared to that of hematuria among all groups (P < 0.0001). The cellular expressions of antioxidants (GR, GPx, HO-1, NQO 1) showed a significant progressive increase form controls to AIC + melatonin + ADMSC (all P < 0.0001). Combined regimen of melatonin and ADMSC was superior to either alone in protecting against CYP-induced AIC. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Bilateral Renal Anastomosing Hemangiomas: A Tale of Two Kidneys

PubMed Central

Abboudi, Hamid; Tschobotko, Benjamin; Carr, Christopher

2017-01-01

Abstract Background: Renal anastomosing hemangioma (RAH) is an extremely rare benign vascular tumor first described in 2009. Making this diagnosis is fraught with challenges. Radiologically they share features consistent with renal cell carcinomas (RCCs). Their vascular nature poses risks if considering preoperative biopsy and histologically they share characteristics akin to angiosarcomas. The few reports published in the literature suggest presentation with hematuria, flank pain, and polycythemia although the majority are diagnosed at postnephrectomy histologic examination. This case represents the first metachronous RAH in the literature, and is the first RAH presenting with severe hemorrhage. Case Presentation: A 62-year-old woman of Albanian heritage presented to urology with visible hematuria and positive urine cytology. Three years before this presentation, she had undergone an elective radical right-sided nephrectomy for a suspected RCC detected on magnetic resonance imaging, which proved to be an RAH after postoperative histologic examination of the specimen. The patient was investigated with cystoscopy and ureteroscopy for this new hematuria presentation, both of which were unremarkable. Fourteen hours post ureteroscopy, the patient became severely hypotensive and developed acute kidney injury. A CT scan indicated a large left-sided renal subcapsular and retroperitoneal hematoma that was actively bleeding. The patient was hemodynamically unstable and, therefore, required an emergency open left-sided nephrectomy, rendering her anephric and dialysis dependent. Postoperative histologic examination proved that the left kidney also contained an RAH. Conclusion: The anastomosing hemangioma is an important subtype to differentiate from angiosarcoma before and after a nephrectomy. Urologists should carefully consider invasive tests in patients with previously diagnosed vascular lesions as there may be an increased risk of bleeding. Patients with a previously diagnosed anastomosing hemangioma may require surveillance of the contralateral kidney. PMID:29279869

A Prospective Blinded Evaluation of Urine-DNA Testing for Detection of Urothelial Bladder Carcinoma in Patients with Gross Hematuria.

PubMed

Dahmcke, Christina M; Steven, Kenneth E; Larsen, Louise K; Poulsen, Asger L; Abdul-Al, Ahmad; Dahl, Christina; Guldberg, Per

2016-12-01

Retrospective studies have provided proof of principle that bladder cancer can be detected by testing for the presence of tumor DNA in urine. We have conducted a prospective blinded study to determine whether a urine-based DNA test can replace flexible cystoscopy in the initial assessment of gross hematuria. A total of 475 consecutive patients underwent standard urological examination including flexible cystoscopy and computed tomography urography, and provided urine samples immediately before (n=461) and after (n=444) cystoscopy. Urine cells were collected using a filtration device and tested for eight DNA mutation and methylation biomarkers. Clinical evaluation identified 99 (20.8%) patients with urothelial bladder tumors. With this result as a reference and based on the analysis of all urine samples, the DNA test had a sensitivity of 97.0%, a specificity of 76.9%, a positive predictive value of 52.5%, and a negative predictive value of 99.0%. In three patients with a positive urine-DNA test without clinical evidence of cancer, a tumor was detected at repeat cystoscopy within 16 mo. Our results suggest that urine-DNA testing can be used to identify a large subgroup of patients with gross hematuria in whom cystoscopy is not required. We tested the possibility of using a urine-based DNA test to check for bladder cancer in patients with visible blood in the urine. Our results show that the test efficiently detects bladder cancer and therefore may be used to greatly reduce the number of patients who would need to undergo cystoscopy. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Bilateral Renal Anastomosing Hemangiomas: A Tale of Two Kidneys.

PubMed

Abboudi, Hamid; Tschobotko, Benjamin; Carr, Christopher; DasGupta, Ranan

2017-01-01

Background: Renal anastomosing hemangioma (RAH) is an extremely rare benign vascular tumor first described in 2009. Making this diagnosis is fraught with challenges. Radiologically they share features consistent with renal cell carcinomas (RCCs). Their vascular nature poses risks if considering preoperative biopsy and histologically they share characteristics akin to angiosarcomas. The few reports published in the literature suggest presentation with hematuria, flank pain, and polycythemia although the majority are diagnosed at postnephrectomy histologic examination. This case represents the first metachronous RAH in the literature, and is the first RAH presenting with severe hemorrhage. Case Presentation: A 62-year-old woman of Albanian heritage presented to urology with visible hematuria and positive urine cytology. Three years before this presentation, she had undergone an elective radical right-sided nephrectomy for a suspected RCC detected on magnetic resonance imaging, which proved to be an RAH after postoperative histologic examination of the specimen. The patient was investigated with cystoscopy and ureteroscopy for this new hematuria presentation, both of which were unremarkable. Fourteen hours post ureteroscopy, the patient became severely hypotensive and developed acute kidney injury. A CT scan indicated a large left-sided renal subcapsular and retroperitoneal hematoma that was actively bleeding. The patient was hemodynamically unstable and, therefore, required an emergency open left-sided nephrectomy, rendering her anephric and dialysis dependent. Postoperative histologic examination proved that the left kidney also contained an RAH. Conclusion: The anastomosing hemangioma is an important subtype to differentiate from angiosarcoma before and after a nephrectomy. Urologists should carefully consider invasive tests in patients with previously diagnosed vascular lesions as there may be an increased risk of bleeding. Patients with a previously diagnosed anastomosing hemangioma may require surveillance of the contralateral kidney.

Impact of hydrophilic catheters on urinary tract infections in people with spinal cord injury: systematic review and meta-analysis of randomized controlled trials.

PubMed

Li, Li; Ye, Wenqin; Ruan, Hong; Yang, Baoyan; Zhang, Shuqi; Li, Li

2013-04-01

To identify randomized controlled trials comparing the use of hydrophilic and nonhydrophilic catheters for intermittent catheterization (IC) in patients with spinal cord injury (SCI), and to perform a meta-analysis evaluating the occurrence of hematuria and urinary tract infection (UTI). We searched the following electronic databases to identify studies: EMBASE (1991 to August 2011), PubMed (1991 to August 2011), Cochrane Library (no date restriction), China National Knowledge Infrastructure (no date restriction), and the Chinese Biomedical Literature Database (no date restriction). Randomized controlled trials, parallel-control, crossover-control, and prospective cohort studies that assessed morbidity associated with the use of hydrophilic catheters and nonhydrophilic catheters in patients after SCI were included. Data extraction was performed using standardized forms of the Cochrane Collaboration. Methodologic quality was independently assessed by 2 reviewers using the Downs and Black instrument. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for dichotomous data. Five studies involving 508 subjects; 462 subjects completed the study and were included in this meta-analysis. There was a significantly lower incidence (OR=.36; 95% CI, 24%-54%; P<.0001) of reported UTIs in the hydrophilic-treated group compared with the nonhydrophilic-treated group. Hematuria was also reported significantly less in the hydrophilic catheter group than in the nonhydrophilic catheter group (OR=.57; 95% CI, 35%-92%; P=.001). This meta-analysis found UTIs and hematuria less frequently associated with the use of hydrophilic-coated catheters for IC in patients with SCI. These findings support the use of hydrophilic catheters in this patient population. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Early initiation of aspirin after prostate and transurethral bladder surgeries is not associated with increased incidence of postoperative bleeding: a prospective, randomized trial.

PubMed

Ehrlich, Y; Yossepowitch, O; Margel, D; Lask, D; Livne, P M; Baniel, J

2007-08-01

Lower urinary tract operations are being increasingly performed in elderly patients, in whom aspirin intake is common for preventing cardiovascular disease. We determined the safety of early aspirin re-initiation after lower urinary tract surgeries. A randomized, open label clinical trial was done. The study cohort included patients referred for transurethral prostatectomy, open prostatectomy and transurethral resection of bladder tumor while receiving aspirin prophylaxis. After controlling for surgical modality patients were randomized into 2 arms, including aspirin treatment initiation 24 hours after discontinuing of bladder irrigation (early treatment group) and aspirin treatment initiation 3 weeks after surgery (late treatment group). Primary end points were pre-discharge hematuria necessitating the restoration of bladder irrigation or the cessation of aspirin treatment and late hematuria treated in an urgent care setting, requiring hospital admission or compelling the cessation of aspirin treatment. A total of 120 patients were enrolled, including 60 per treatment group. There were no significant differences between the groups in surgery related factors that could have affected postoperative bleeding. Primary end points were attained by 16 of the 120 patients (13.6%), including 10 of the 60 (16.7%) in the early treatment group and 6 (10%) in the late treatment group (p = 0.28). Time to catheter removal and persistent hematuria duration were similar in the 2 groups. Cardiovascular morbidity was noted in 3 of 120 patients, of whom all were assigned to the early treatment group. Early aspirin initiation after lower urinary tract surgeries does not appear to carry an increased risk of postoperative bleeding. Thus, it may be considered in patients at high risk for cardiovascular morbidity.

Visually guided male urinary catheterization: a feasibility study.

PubMed

Willette, Paul A; Banks, Kevin; Shaffer, Lynn

2013-01-01

Ten percent to 15% of urinary catheterizations involve complications. New techniques to reduce risks and pain are indicated. This study examines the feasibility and safety of male urinary catheterization by nursing personnel using a visually guided device in a clinical setting. The device, a 0.6-mm fiber-optic bundle inside a 14F triple-lumen flexible urinary catheter with a lubricious coating, irrigation port, and angled tip, connects to a camera, allowing real-time viewing of progress on a color monitor. Two emergency nurses were trained to use the device. Male patients 18 years or older presenting to the emergency department with an indication for urinary catheterization using a standard Foley or Coudé catheter were eligible to participate in the study. Exclusion criteria were a current suprapubic tube or gross hematuria prior to the procedure. Twenty-five patients were enrolled. Data collected included success of placement, total procedure time, pre-procedure pain and maximum pain during the procedure, gross hematuria, abnormalities or injuries identified if catheterization failed, occurrence of and reason for equipment failures, and number of passes required for placement. All catheters were successfully placed. The median number of passes required was 1. For all but one patient, procedure time was ≤ 17 minutes. A median increase in pain scores of 1 point from baseline to the maximum was reported. Gross hematuria was observed in 2 patients. The success rate for placement of a Foley catheter with the visually guided device was 100%, indicating its safety, accuracy, and feasibility in a clinical setting. Minimal pain was associated with the procedure. Copyright © 2013 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

Multilevel thoracic hemangioma with spinal cord compression in a pediatric patient: case report and review of the literature.

PubMed

Cherian, Jacob; Sayama, Christina M; Adesina, Adekunle M; Lam, Sandi K; Luerssen, Thomas G; Jea, Andrew

2014-09-01

Vertebral hemangiomas are common benign vascular tumors of the spine. It is very rare for these lesions to symptomatically compress neural elements. If spinal cord compression does occur, it usually involves only a single level. Multilevel vertebral hemangiomas causing symptomatic spinal cord compression have never been reported in the pediatric population to the best of our knowledge. We report the case of a 15-year-old boy presenting with progressive paraparesis due to thoracic spinal cord compression from a multilevel thoracic hemangioma (T5-T10) with epidural extension. Because of his progressive neurological deficit, he was initially treated with urgent multilevel decompressive laminectomies from T4 to T11. This was to be followed by radiotherapy for residual tumor, but the patient was unfortunately lost to follow-up. He re-presented 3 years later with recurrent paraparesis and progressive disease. This was treated with urgent radiotherapy with good response. As of 6 months follow-up, he has made an excellent neurological recovery. In this report, we present the first case of a child with multilevel vertebral hemangiomas causing symptomatic spinal cord compression and review the literature to detail the pathophysiology, management, and treatment of other cases of spinal cord compression by vertebral hemangiomas.

Intrinsic Compressive Stress in Polycrystalline Films is Localized at Edges of the Grain Boundaries.

PubMed

Vasco, Enrique; Polop, Celia

2017-12-22

The intrinsic compression that arises in polycrystalline thin films under high atomic mobility conditions has been attributed to the insertion or trapping of adatoms inside grain boundaries. This compression is a consequence of the stress field resulting from imperfections in the solid and causes the thermomechanical fatigue that is estimated to be responsible for 90% of mechanical failures in current devices. We directly measure the local distribution of residual intrinsic stress in polycrystalline thin films on nanometer scales, using a pioneering method based on atomic force microscopy. Our results demonstrate that, at odds with expectations, compression is not generated inside grain boundaries but at the edges of gaps where the boundaries intercept the surface. We describe a model wherein this compressive stress is caused by Mullins-type surface diffusion towards the boundaries, generating a kinetic surface profile different from the mechanical equilibrium profile by the Laplace-Young equation. Where the curvatures of both profiles differ, an intrinsic stress is generated in the form of Laplace pressure. The Srolovitz-type surface diffusion that results from the stress counters the Mullins-type diffusion and stabilizes the kinetic surface profile, giving rise to a steady compression regime. The proposed mechanism of competition between surface diffusions would explain the flux and time dependency of compressive stress in polycrystalline thin films.

Intrinsic Compressive Stress in Polycrystalline Films is Localized at Edges of the Grain Boundaries

NASA Astrophysics Data System (ADS)

Vasco, Enrique; Polop, Celia

2017-12-01

The intrinsic compression that arises in polycrystalline thin films under high atomic mobility conditions has been attributed to the insertion or trapping of adatoms inside grain boundaries. This compression is a consequence of the stress field resulting from imperfections in the solid and causes the thermomechanical fatigue that is estimated to be responsible for 90% of mechanical failures in current devices. We directly measure the local distribution of residual intrinsic stress in polycrystalline thin films on nanometer scales, using a pioneering method based on atomic force microscopy. Our results demonstrate that, at odds with expectations, compression is not generated inside grain boundaries but at the edges of gaps where the boundaries intercept the surface. We describe a model wherein this compressive stress is caused by Mullins-type surface diffusion towards the boundaries, generating a kinetic surface profile different from the mechanical equilibrium profile by the Laplace-Young equation. Where the curvatures of both profiles differ, an intrinsic stress is generated in the form of Laplace pressure. The Srolovitz-type surface diffusion that results from the stress counters the Mullins-type diffusion and stabilizes the kinetic surface profile, giving rise to a steady compression regime. The proposed mechanism of competition between surface diffusions would explain the flux and time dependency of compressive stress in polycrystalline thin films.

Tensile and compressive failure modes of laminated composites loaded by fatigue with different mean stress

NASA Technical Reports Server (NTRS)

Rotem, Assa

1990-01-01

Laminated composite materials tend to fail differently under tensile or compressive load. Under tension, the material accumulates cracks and fiber fractures, while under compression, the material delaminates and buckles. Tensile-compressive fatigue may cause either of these failure modes depending on the specific damage occurring in the laminate. This damage depends on the stress ratio of the fatigue loading. Analysis of the fatigue behavior of the composite laminate under tension-tension, compression-compression, and tension-compression had led to the development of a fatigue envelope presentation of the failure behavior. This envelope indicates the specific failure mode for any stress ratio and number of loading cycles. The construction of the fatigue envelope is based on the applied stress-cycles to failure (S-N) curves of both tensile-tensile and compressive-compressive fatigue. Test results are presented to verify the theoretical analysis.

Hereditary xanthinuria and urolithiasis in a domestic shorthair cat

PubMed Central

Furman, E.; Hooijberg, E.H.; Leidinger, E.; Zedinger, C.; Giger, U.; Leidinger, J.

2015-01-01

A 2-year-old domestic shorthair cat was presented with a history of hematuria, stranguria and intermittent urethral obstruction. Urine sediment showed hematuria, pyuria, and yellow-brown, amorphous and spherical crystals. Upon surgical correction of the obstructed urethra by perineal urethrostomy, many dark yellow to grey, irregular, gravel-like to millet grain-sized uroliths, consisting of 100% xanthine by crystallography were found. The urinary xanthine concentration was high. The cat subsequently developed bilateral nephroliths, recurrent urinary tract infection, and chronic kidney failure. Dietary management with a low-purine diet failed in part due to poor compliance, and the cat was euthanized at 6 years of age. Xanthinuria is rare inborn error of metabolism in cats and other species but should be considered as a differential diagnosis in cases of feline urolithiasis. No associated molecular genetic defect has been elucidated, and management of these cases is difficult. In the absence of calculi for analysis, measuring urinary xanthine concentration can help in diagnosing this metabolic defect. PMID:26478726

[The profile urological emergencies at the Conakry University Teaching Hospital, Guinea].

PubMed

Bobo Diallo, A; Bah, I; Diallo, T M O; Bah, O R; Amougou, B; Bah, M D; Guirassy, S; Bobo Diallo, M

2010-03-01

To stick out the profile urological emergencies at the Conakry University Teaching Hospital, Guinea. This retrospective study, carried out over a period of 3 years (January 2005-December 2007), included 757 urological emergencies admitted to the urology department of the university hospital of Conakry, Guinea. The mean age of patients was 56 years. These patients had an age equal to or higher than 60 years in 58% of the cases. The sex ratio (M/F) was 16.6. According to the social profession, the farmer (40,6%) and workers (21%) were the dominant patients. The most frequent illness was vesical urinary retention (73.9%), hematuria (9.6%) and genito-urinary system trauma (7%). The most performed procedures were the installation of a urethral catheter (55.25%) and the installation of a suprapubic catheter (24.14%). The most frequent urological emergency in our country was vesical urinary retention, the hematuria and genito-urinary system trauma are not rare there. Copyright 2009 Elsevier Masson SAS. All rights reserved.

Migration of luque rods through a laminectomy defect causing spinal cord compression.

PubMed

Quint, D J; Salton, G

1993-01-01

Internal fixation of traumatic spinal injuries has been associated with spinal canal stenosis, spinal cord compression, and nerve root impingement. We present a case of spinal cord/cauda equina compression due to migration of intact, anchored thoracolumbar Luque rods into the spinal canal through a laminectomy defect, leading to neurologic complications 10 years after the original operation.

Coronary artery compression by teflon pledget granuloma following aortic valve replacement.

PubMed

Cohle, S D; Delavan, J W

1997-09-01

We describe a massive fatal posterior myocardial infarct resulting from compression of the right coronary artery by a Teflon pledget granuloma in a patient who had undergone aortic valve replacement six months before death. Other iatrogenic causes of coronary artery occlusion or compression are discussed in this paper. To our knowledge this is the first report of this surgical complication.

Stiffness and Poisson ratio in longitudinal compression of fiber yarns in meso-FE modelling of composite reinforcement forming

NASA Astrophysics Data System (ADS)

Wang, D.; Naouar, N.; Vidal-Salle, E.; Boisse, P.

2018-05-01

In meso-scale finite element modeling, the yarns of the reinforcement are considered to be solids made of a continuous material in contact with their neighbors. The present paper consider the mechanical behavior of these yarns that can happen for some loadings of the reinforcement. The yarns present a specific mechanical behavior when under longitudinal compression because they are made up of a large number of fibers, Local buckling of the fibers causes the compressive stiffness of the continuous material representing the yarn to be much weaker than when under tension. In addition, longitudinal compression causes an important transverse expansion. It is shown that the transverse expansion can be depicted by a Poisson ratio that remained roughly constant when the yarn length and the compression strain varied. Buckling of the fibers significantly increases the transverse dimensions of the yarn which leads to a large Poisson ratio (up to 12 for a yarn analyzed in the present study). Meso-scale finite element simulations of reinforcements with binder yarns submitted to longitudinal compression showed that these improvements led to results in good agreement with micro-CT analyses.

First case of Propionibacterium acnes urinary tract infection in a dog.

PubMed

Harada, Kazuki; Shimizu, Takae; Tsuka, Takeshi; Imagawa, Tomohiro; Takeuchi, Takashi

2015-12-21

Propionibacterium acnes has been rarely isolated as a commensal from dogs, but there is little evidence of pathogenicity. Urinary tract infections are common in dogs and are typically caused by various commensal bacteria. Here we present the first case report of a urinary tract infection caused by P. acnes. A 6-year-old female Japanese Shiba Inu was hospitalized for polyuria, polydipsia, and severe hematuria. At admission, blood tests revealed leukocytosis, slight anemia, decreased albumin, and slightly elevated blood urea nitrogen. Computerized tomography showed gas accumulation on the inner side of the bladder wall. Urinalysis revealed proteinuria and bilirubinuria without glycosuria. The urine sediment contained large numbers of erythrocytes and leukocytes. Additionally, rod-shaped bacteria were detected by Diff-Quik staining. Enrofloxacin and metronidazole were administered empirically; however, the renal function declined sharply and the patient died 2 days later. Bacteriological examination revealed that the causative agent was Propionibacterium acnes, which was identified as sequence type 53 via multilocus sequence typing. This isolate showed high susceptibility to ampicillin, amoxicillin/clavulanic acid, cefoxitin, imipenem, clindamycin, tetracycline, chloramphenicol, and enrofloxacin, but was resistant to metronidazole. To the best of our knowledge, this is the first case report of a dog with urinary tract infection caused by P. acnes.

Modelling the Impact of Fractionation on Late Urinary Toxicity After Postprostatectomy Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fiorino, Claudio, E-mail: fiorino.claudio@hsr.it; Cozzarini, Cesare; Rancati, Tiziana

2014-12-01

Purpose: To fit urinary toxicity data of patients treated with postprostatectomy radiation therapy with the linear quadratic (LQ) model with/without introducing a time factor. Methods and Materials: Between 1993 and 2010, 1176 patients were treated with conventional fractionation (1.8 Gy per fraction, median 70.2 Gy, n=929) or hypofractionation (2.35-2.90 Gy per fraction, n=247). Data referred to 2004-2010 (when all schemes were in use, n=563; conventional fractionation: 316; hypofractionation: 247) were fitted as a logit function of biological equivalent dose (BED), according to the LQ model with/without including a time factor γ (fixing α/β = 5 Gy). The 3-year risks of severe urethral stenosis, incontinence, and hematuriamore » were considered as endpoints. Best-fit parameters were derived, and the resulting BEDs were taken in multivariable backward logistic models, including relevant clinical variables, considering the whole population. Results: The 3-year incidences of severe stenosis, incontinence, and hematuria were, respectively, 6.6%, 4.8%, and 3.3% in the group treated in 2004-2010. The best-fitted α/β values were 0.81 Gy and 0.74 Gy for incontinence and hematuria, respectively, with the classic LQ formula. When fixing α/β = 5 Gy, best-fit values for γ were, respectively, 0.66 Gy/d and 0.85 Gy/d. Sensitivity analyses showed reasonable values for γ (0.6-1.0 Gy/d), with comparable goodness of fit for α/β values between 3.5 and 6.5 Gy. Likelihood ratio tests showed that the fits with/without including γ were equivalent. The resulting multivariable backward logistic models in the whole population included BED, pT4, and use of antihypertensives (area under the curve [AUC] = 0.72) for incontinence and BED, pT4, and year of surgery (AUC = 0.80) for hematuria. Stenosis data could not be fitted: a 4-variable model including only clinical factors (acute urinary toxicity, pT4, year of surgery, and use of antihypertensives) was suggested (AUC = 0.73). Conclusions: The unexpected impact of moderate hypofractionation on severe incontinence and hematuria after postprostatectomy radiation therapy may be explained by a bladder α/β value <1 Gy or, radiobiologically more plausible, by introducing a time factor likely to represent a previously hypothesized consequential component of late effect.« less

[Pediatric orbital emphysema caused by a compressed-air pistol shot: a case report].

PubMed

Navarro-Mingorance, A; Reyes-Dominguez, S B; León-León, M C

2014-09-01

We report the case of a 2 year-old child with orbital emphysema secondary to a compressed-air gun shot in the malar region, with no evidence of orbital wall fracture. Conservative treatment was applied, and no complications were observed. Orbital emphysema in the absence of an orbital wall fracture is a rare situation. Orbital emphysema is usually seen in facial trauma associated with damage to the adjacent paranasal sinuses or facial bones. To our knowledge there have been very few reports of orbital emphysema caused by a compressed-air injury. Copyright © 2012 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

Safety and Immunogenicity of Adenovirus 35 Tuberculosis Vaccine Candidate in Adults with Active or Previous Tuberculosis. A Randomized Trial.

PubMed

van Zyl-Smit, Richard N; Esmail, Aliasgar; Bateman, Mary E; Dawson, Rodney; Goldin, Jonathan; van Rikxoort, Eva; Douoguih, Macaya; Pau, Maria Grazia; Sadoff, Jerald C; McClain, J Bruce; Snowden, Margaret Ann; Benko, Jacqueline; Hokey, David A; Rutkowski, Kathryn Tucker; Graves, Andrew; Shepherd, Barbara; Ishmukhamedov, Sadritdin; Kagina, Benjamin M N; Abel, Brian; Hanekom, Willem A; Scriba, Thomas J; Bateman, Eric D

2017-05-01

Administration of tuberculosis (TB) vaccines in participants with previous or current pulmonary TB may have the potential for causing harmful postvaccination immunologic (Koch-type) reactions. To assess the safety and immunogenicity of three dose levels of the AERAS-402 live, replication-deficient adenovirus 35-vectored TB candidate vaccine, containing three mycobacterial antigens, in individuals with current or previous pulmonary TB. We performed a phase II randomized, placebo-controlled, double-blinded dose-escalation study in an HIV-negative adult South African cohort (n = 72) with active pulmonary TB (on treatment for 1-4 mo) or pulmonary TB treated at least 12 months before study entry and considered cured. Safety endpoints included clinical assessment, flow volume curves, diffusing capacity of the lung for carbon monoxide, pulse oximetry, chest radiograph, and high-resolution thoracic computerized tomography scans. Cytokine expression by CD4 and CD8 T cells, after stimulation with Ag85A, Ag85B, and TB10.4 peptide pools, was examined by intracellular cytokine staining. No apparent temporal or dose-related changes in clinical status (specifically acute, Koch phenomenon-like reactions), lung function, or radiology attributable to vaccine were observed. Injection site reactions were mild or moderate. Hematuria (by dipstick only) occurred in 25 (41%) of 61 AERAS-402 recipients and 3 (27%) of 11 placebo recipients, although no gross hematuria was reported. AERAS-402 induced robust CD8 + and moderate CD4 + T-cell responses, mainly to Ag85B in both vaccine groups. Administration of the AERAS-402 candidate TB vaccine to participants with current or previous pulmonary TB induced a robust immune response and is not associated with clinically significant pulmonary complications. Clinical trial registered with www.clinicaltrials.gov (NCT 02414828) and in the South African National Clinical Trials Register ( www.sanctr.gov.za DOH 27-0808-2060).

Iliac Artery-Uretero-Colonic Fistula Presenting as Gastrointestinal Hemorrhage and Hematuria: A Case Report.

PubMed

Kurata, Saya; Tobu, Shohei; Udo, Kazuma; Noguchi, Mitsuru

2018-01-01

Background: The experience with uretero-arterial fistulas has been limited. However, the aggressive treatment of pelvic tumors with surgical resection and radiotherapy, along with liberal use of ureteral catheters, has been attributed to an increase in their incidence. Unless they are promptly diagnosed and treated, uretero-arterial fistulas are associated with considerably high rates of morbidity and mortality. Urologists need maintain a high degree of suspicion for uretero-arterial fistula in high-risk patients. We herein present the clinical course of an iliac artery-uretero-colonic fistula. Case Presentation: A 67-year-old woman with a history of colon cancer who underwent laparoscopic high anterior resection in July 2010. A ureteral stent inserted to right ureteral stricture, which developed as a result of local recurrence of the tumor in September 2010. She had undergone chemoradiotherapy, but the lesion had slowly increased in size. During the replacement of the ureteral stent in April 2016, she immediately experienced bladder tamponade, bloody bowel discharge, and hypotension. Contrast CT revealed a complex fistula between the right distal ureter and the right internal iliac artery. Furthermore, contrast medium flowed into the intestinal tract through the tumor. The patient was therefore diagnosed with internal iliac artery-uretero-colonic fistula. Arteriography revealed a right uretero-internal iliac artery fistula, and the embolization of the right internal iliac artery was performed. The right ureteral stent was removed. Her hematuria and bloody bowel discharge disappeared, but right nephrostomy was performed because she presented with acute pyelonephritis to ureteral obstruction. Conclusion: In the present case, the uretero-arterial fistula was caused by the long use of an indwelling stent, chemoradiotherapy, infection, and an increase in the size of the lesion. When a suspected uretero-arterial fistula is accompanied by bloody bowel discharge, we should consider the possibility of traffic to the intestinal tract.

Decay and termite resistance, water absorption and swelling of thermally compressed wood panels

Treesearch

Oner Unsal; S. Nami Kartal; Zeki Candan; Rachel A. Arango; Carol A. Clausen; Frederick Green

2009-01-01

This study evaluated decay and termite resistance of thermally compressed pine wood panels under pressure at either 5 or 7 MPa and either 120 or 150 °C for 1 h. Wood specimens from the panels were exposed to laboratory decay resistance by using the wood degrading fungi, Gloeophyllum trabeum and Trametes versicolor. The thermal compression process caused increases in...

Traverse Focusing of Intense Charged Particle Beams with Chromatic Effects for Heavy Ion Fusion

DOE Office of Scientific and Technical Information (OSTI.GOV)

James M. Mitrani, Igor D. Kaganovich, Ronald C. Davidson

A fi nal focusing scheme designed to minimize chromatic effects is discussed. The Neutralized Drift Compression Experiment-II (NDCX-II) will apply a velocity tilt for longitudinal bunch compression, and a fi nal focusing solenoid (FFS) for transverse bunch compression. In the beam frame, neutralized drift compression causes a suffi ciently large spread in axial momentum, pz , resulting in chromatic effects to the fi nal focal spot during transverse bunch compression. Placing a weaker solenoid upstream of a stronger fi nal focusing solenoid (FFS) mitigates chromatic effects and improves transverse focusing by a factor of approximately 2-4 for appropriate NDCX-II parameters.

Neurovascular compression of the trigeminal and glossopharyngeal nerve: three case reports

PubMed Central

Childs, A; Meaney, J; Ferrie, C; Holland, P

2000-01-01

Trigeminal neuralgia (TN) is a frequent cause of paroxysmal facial pain and headache in adults. Glossopharyngeal neuralgia (GPN) is less common, but can cause severe episodic pain in the ear and throat. Neurovascular compression of the appropriate cranial nerve as it leaves the brain stem is responsible for the symptoms in many patients, and neurosurgical decompression of the nerve is now a well accepted treatment in adults with both TN and GPN who fail to respond to drug therapy. Neither TN nor GPN are routinely considered in the differential diagnosis when assessing children with paroxysmal facial or head pain, as they are not reported to occur in childhood. Case reports of three children with documented neurovascular compression causing severe neuralgic pain and disability are presented. The fact that these conditions do occur in the paediatric population, albeit rarely, is highlighted, and appropriate investigation and management are discussed.

 PMID:10735840

Fecal Impaction Causing Pelvic Venous Compression and Edema.

PubMed

Naramore, Sara; Aziz, Faisal; Alexander, Chandran Paul; Methratta, Sosamma; Cilley, Robert; Rocourt, Dorothy

2015-09-28

Chronic constipation is a common condition which may result in fecal impaction. A 13-year-old male with chronic constipation and encopresis presented with fecal impaction for three weeks. The impaction caused abdominal pain, distension, encopresis, and decreased oral intake. He was found in severe distress with non-pitting edema of his feet and ankles along with perineal edema. The pedal edema worsened after receiving a fluid bolus, so concern arose for venous compression or a thrombus. A Duplex Ultrasound demonstrated changes in the venous waveforms of the bilateral external iliac and common femoral veins without thrombosis. Manual disimpaction and polyethylene glycol 3350 with electrolytes resolved the pedal and perineal edema. Four months later, he had soft bowel movements without recurrence of the edema. A repeat Duplex Ultrasound was normal. We present a child in whom severe fecal impaction caused pelvic venous compression resulting in bilateral pedal and perineal edema.

Fecal Impaction Causing Pelvic Venous Compression and Edema

PubMed Central

Naramore, Sara; Aziz, Faisal; Alexander, Chandran Paul; Methratta, Sosamma; Cilley, Robert; Rocourt, Dorothy

2015-01-01

Chronic constipation is a common condition which may result in fecal impaction. A 13-year-old male with chronic constipation and encopresis presented with fecal impaction for three weeks. The impaction caused abdominal pain, distension, encopresis, and decreased oral intake. He was found in severe distress with non-pitting edema of his feet and ankles along with perineal edema. The pedal edema worsened after receiving a fluid bolus, so concern arose for venous compression or a thrombus. A Duplex Ultrasound demonstrated changes in the venous waveforms of the bilateral external iliac and common femoral veins without thrombosis. Manual disimpaction and polyethylene glycol 3350 with electrolytes resolved the pedal and perineal edema. Four months later, he had soft bowel movements without recurrence of the edema. A repeat Duplex Ultrasound was normal. We present a child in whom severe fecal impaction caused pelvic venous compression resulting in bilateral pedal and perineal edema. PMID:26500749

Multiple locations of nerve compression: an unusual cause of persistent lower limb paresthesia.

PubMed

Ang, Chia-Liang; Foo, Leon Siang Shen

2014-01-01

A paucity of appreciation exists that the "double crush" phenomenon can account for persistent leg symptoms even after spinal neural decompression surgery. We present an unusual case of multiple locations of nerve compression causing persistent lower limb paresthesia in a 40-year old male patient. The patient's lower limb paresthesia was persistent after an initial spinal surgery to treat spinal lateral recess stenosis thought to be responsible for the symptoms. It was later discovered that he had peroneal muscle herniations that had caused superficial peroneal nerve entrapments at 2 separate locations. The patient obtained much symptomatic relief after decompression of the peripheral nerve. The "double crush" phenomenon and multiple levels of nerve compression should be considered when evaluating lower limb neurogenic symptoms, especially after spinal nerve root surgery. Copyright © 2014 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Intravesical instillation of Formalin for hemorrhagic cystitis secondary to radiation for gynecologic malignancies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Behnam, K.; Patil, U.B.; Mariano, E.

Our experience with the use of Formalin instillation in intractable gross hematuria secondary to radiation cystitis in patients with gynecological malignancies is reported. This study indicates coagulative effect of low concentration of Formalin with minimal side effects as a method to control hemorrhage.

Robotic management of pheochromocytoma of the vesicoureteric junction.

PubMed

Nayyar, Rishi; Singh, Prabhjot; Gupta, Narmada P

2010-01-01

Pheochromocytoma of the urinary bladder is rare, presenting usually with hypertension, hematuria and syncopal attacks. Such cases have usually been managed with open or laparoscopic partial cystectomy. We present a case of bladder pheochromocytoma that had unusual presenting symptoms, a paraneoplastic manifestation and was successfully managed with robotic technique.

Endovascular treatment of arterio-ureteral fistulae with covered stents: Case series and review of the literature.

PubMed

Patel, Dhruv; Kumar, Abhishek; Ranganath, Praveen; Contractor, Sohail

2014-01-01

Arterio-ureteral fistulae are abnormal connections between an artery and the ureter and carry a high mortality. We present two cases of arterio-ureteral fistulae that presented with life-threatening hematuria. Both patients were treated with endovascular covered stent placement.

Endovascular treatment of arterio-ureteral fistulae with covered stents: Case series and review of the literature

PubMed Central

Patel, Dhruv; Ranganath, Praveen; Contractor, Sohail

2014-01-01

Arterio-ureteral fistulae are abnormal connections between an artery and the ureter and carry a high mortality. We present two cases of arterio-ureteral fistulae that presented with life-threatening hematuria. Both patients were treated with endovascular covered stent placement. PMID:27489652

Vulnerability of the Superficial Zone of Immature Articular Cartilage to Compressive Injury

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rolauffs, R.; Muehleman, C; Li, J

The zonal composition and functioning of adult articular cartilage causes depth-dependent responses to compressive injury. In immature cartilage, shear and compressive moduli as well as collagen and sulfated glycosaminoglycan (sGAG) content also vary with depth. However, there is little understanding of the depth-dependent damage caused by injury. Since injury to immature knee joints most often causes articular cartilage lesions, this study was undertaken to characterize the zonal dependence of biomechanical, biochemical, and matrix-associated changes caused by compressive injury. Disks from the superficial and deeper zones of bovine calves were biomechanically characterized. Injury to the disks was achieved by applying amore » final strain of 50% compression at 100%/second, followed by biomechanical recharacterization. Tissue compaction upon injury as well as sGAG density, sGAG loss, and biosynthesis were measured. Collagen fiber orientation and matrix damage were assessed using histology, diffraction-enhanced x-ray imaging, and texture analysis. Injured superficial zone disks showed surface disruption, tissue compaction by 20.3 {+-} 4.3% (mean {+-} SEM), and immediate biomechanical impairment that was revealed by a mean {+-} SEM decrease in dynamic stiffness to 7.1 {+-} 3.3% of the value before injury and equilibrium moduli that were below the level of detection. Tissue areas that appeared intact on histology showed clear textural alterations. Injured deeper zone disks showed collagen crimping but remained undamaged and biomechanically intact. Superficial zone disks did not lose sGAG immediately after injury, but lost 17.8 {+-} 1.4% of sGAG after 48 hours; deeper zone disks lost only 2.8 {+-} 0.3% of sGAG content. Biomechanical impairment was associated primarily with structural damage. The soft superficial zone of immature cartilage is vulnerable to compressive injury, causing superficial matrix disruption, extensive compaction, and textural alteration, which results in immediate loss of biomechanical function. In conjunction with delayed superficial sGAG loss, these changes may predispose the articular surface to further softening and tissue damage, thus increasing the risk of development of secondary osteoarthritis.« less

Can lumbar hemorrhagic synovial cyst cause acute radicular compression? Case report

PubMed Central

Timbó, Luciana Sátiro; Rosemberg, Laercio Alberto; Brandt, Reynaldo André; Peres, Ricardo Botticini; Nakamura, Olavo Kyosen; Guimarães, Juliana Frota

2014-01-01

Lumbar synovial cysts are an uncommon cause of back pain and radiculopathy, usually manifesting with gradual onset of symptoms, secondary to involvement of the spinal canal. Rarely, intracyst hemorrhage occurs, and may acutely present as radicular - or even spinal cord - compression syndrome. Synovial cysts are generally associated with degenerative facets, although the pathogenesis has not been entirely established. We report a case of bleeding complication in a synovial cyst at L2-L3, adjacent to the right interfacet joint, causing acute pain and radiculopathy in a patient on anticoagulation therapy who required surgical resection. PMID:25628207

Buckling Behavior of Compression-Loaded Composite Cylindrical Shells With Reinforced Cutouts

NASA Technical Reports Server (NTRS)

Hilburger, Mark W.; Sarnes, James H., Jr.

2004-01-01

Results from a numerical study of the response of thin-walled compression-loaded quasi-isotropic laminated composite cylindrical shells with unreinforced and reinforced square cutouts are presented. The effects of cutout reinforcement orthotropy, size, and thickness on the nonlinear response of the shells are described. A nonlinear analysis procedure has been used to predict the nonlinear response of the shells. The results indicate that a local buckling response occurs in the shell near the cutout when subjected to load and is caused by a nonlinear coupling between local shell-wall deformations and in-plane destabilizing compression stresses near the cutout. In general, reinforcement around a cutout in a compression-loaded shell is shown to retard or eliminate the local buckling response near the cutout and increase the buckling load of the shell. However, some results show that certain reinforcement configurations can cause an unexpected increase in the magnitude of local deformations and stresses in the shell and cause a reduction in the buckling load. Specific cases are presented that suggest that the orthotropy, thickness, and size of a cutout reinforcement in a shell can be tailored to achieve improved buckling response characteristics.

Investigation of low compressive strengths of concrete in paving, precast and structural concrete

DOT National Transportation Integrated Search

2000-08-01

This research examines the causes for a high incidence of catastrophically low compressive strengths, primarily on structural concrete, during the 1997 construction season. The source for the low strengths was poor aggregate-paste bond associated wit...

Large Hiatal Hernia Compressing the Heart.

PubMed

Matar, Andrew; Mroue, Jad; Camporesi, Enrico; Mangar, Devanand; Albrink, Michael

2016-02-01

We describe a 41-year-old man with De Mosier's syndrome who presented with exercise intolerance and dyspnea on exertion caused by a giant hiatal hernia compressing the heart with relief by surgical treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

A Rare Cause of Hemifacial Spasm: Papillary Oncocytic Cystadenoma

PubMed Central

Erol, Ozan; Aydın, Erdinç

2016-01-01

Background: Hemifacial spasm is a sudden, involuntary and synchronous spasm of the facial muscles. The most frequent cause of this condition is compression of the facial nerves due to vascular pathologies. The most commonly used method of treatment is Botulinum toxin injection. However, the gold standard treatment is surgical treatment. Case Report: A 64-year-old male patient with hemifacial spasms, which had occurred due to a rare parotid mass that had been surgically treated, is presented in this case. Conclusion: This case report demonstrates that longstanding parotid gland masses may compress the facial nerves and cause demyelination in the nerve and thus may cause spasms in the facial muscles. PMID:27761290

Diagnostic examination of the child with urolithiasis or nephrocalcinosis.

PubMed

Hoppe, Bernd; Kemper, Markus J

2010-03-01

Urolithiasis and nephrocalcinosis are more frequent in children then currently anticipated, but still remain under- or misdiagnosed in a significant proportion of patients, since symptoms and signs may be subtle or misleading. All children with colicky abdominal pain or macroscopic hematuria should be examined thoroughly for urolithiasis. Also, other, more general, abdominal manifestations can be the first symptoms of renal stones. The patients and their family histories, as well as physical examination, are important initial steps for diagnostic evaluation. Thereafter, diagnostic imaging should be aimed at the location of calculi but also at identification of urinary tract anomalies or acute obstruction due to stone disease. This can often be accomplished by ultrasound examination alone, but sometimes radiological methods such as plain abdominal films or more sensitive non-enhanced computed tomography are necessary. Since metabolic causes are frequent in children, diagnostic evaluation should be meticulous so that metabolic disorders that cause recurrent urolithiasis or even renal failure, such as the primary hyperoxalurias and others, can be ruled out. The stone is not the disease itself; it is only one serious sign! Therefore, thorough and early diagnostic examination is mandatory for every infant and child with the first stone event, or with nephrocalcinosis.

A lesson from kidney transplantation among identical twins: Case report and literature review.

PubMed

Rao, Zhengsheng; Huang, Zhongli; Song, Turun; Lin, Tao

2015-09-01

There continues to be disagreement related to the appropriate therapeutic regimen to be used when the donor and the recipient in kidney transplant operations are identical twins. Here we present two cases of kidney transplantation between identical twins. Both recipients had end-stage renal disease (ESRD) caused by primary nephropathy. We also present information gleaned from a literature review of similar cases. The first recipient was a 26-year-old man who experienced biopsy-proven IgA nephropathy 10 months post-transplantation. Mycophenolate mofetil (MMF), angiotensin receptor blockers (ARBs), and steroids were used to reverse this pathologic condition. Till now, 76 months post-transplantation, the patient is stable, and the new kidney is functioning well. The second recipient was a 20-year-old woman who had hematuria and proteinuria 3 months post-transplantation, and crescent glomerulonephritis with mild to moderate interstitial injury was proven by biopsy 11 months postoperatively. This patient did not respond to various treatments and resumed hemodialysis 15 months post-transplantation. These case studies show that immunosuppressive therapy should be maintained in kidney transplant recipients who are identical twins with ESRD caused by initial nephropathy. Copyright © 2015 Elsevier B.V. All rights reserved.

A founder mutation in COL4A3 causes autosomal recessive Alport syndrome in the Ashkenazi Jewish population.

PubMed

Webb, B D; Brandt, T; Liu, L; Jalas, C; Liao, J; Fedick, A; Linderman, M D; Diaz, G A; Kornreich, R; Trachtman, H; Mehta, L; Edelmann, L

2014-08-01

Alport syndrome is an inherited progressive nephropathy arising from mutations in the type IV collagen genes, COL4A3, COL4A4, and COL4A5. Symptoms also include sensorineural hearing loss and ocular lesions. We determined the molecular basis of Alport syndrome in a non-consanguineous Ashkenazi Jewish family with multiple affected females using linkage analysis and next generation sequencing. We identified a homozygous COL4A3 mutation, c.40_63del, in affected individuals with mutant alleles inherited from each parent on partially conserved haplotypes. Large-scale population screening of 2017 unrelated Ashkenazi Jewish samples revealed a carrier frequency of 1 in 183 indicating that COL4A3 c.40_63del is a founder mutation which may be a common cause of Alport syndrome in this population. Additionally, we determined that heterozygous mutation carriers in this family do not meet criteria for a diagnosis of Thin Basement Membrane Nephropathy and concluded that carriers of c.40_63del are not likely to develop benign familial hematuria. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Systemic Epstein-Barr virus infection associated with membranous nephropathy in children.

PubMed

Araya, C E; González-Peralta, R P; Skoda-Smith, S; Dharnidharka, V R

2006-03-01

Epstein-Barr virus (EBV) infection can cause diverse renal manifestations ranging from microscopic hematuria to acute renal failure. Membranous nephropathy (MN) is an uncommon and usually secondary cause of nephrotic syndrome in children, and has been reported after chronic infections and antigenemia. We report two pediatric cases of secondary MN associated with acute and chronic systemic EBV infection. Patient 1 had a liver transplant for cirrhosis due to biliary atresia and developed chronic EB viremia. Membranous nephropathy occurred 3 years later and with aggressive therapy has partially subsided, in temporal association with a drop in blood EBV PCR levels. The other patient had a primary immunodeficiency and developed a lymphoproliferative disorder attributed to EBV. Nephrotic syndrome developed at initial presentation and was associated with MN on biopsy. The patient cleared the virus from blood, which was associated with eventual resolution of the MN. We postulate that EB viremia in patients lacking a fully competent immune system, but without a renal allograft, may create a susceptible environment for chronic systemic EB antigenemia that can then lead to immune-complex MN in the kidney. The association of EBV with renal histological changes consistent with MN has been suggested but not directly described before.

FATAL HONEY POISONING IN SOUTHWEST CHINA: A CASE SERIES OF 31 CASES.

PubMed

Zhang, Qiang; Chen, Xinguang; Chen, Shunan; Ye, Yinlong; Luo, Jiancheng; Li, Juanjuan; Yu, Siyang; Liu, Hui; Liu, Zhitao

2017-01-01

Honey poisoning cases occur in southwestern China. In this case series, we attempted to determine the symptoms and causes of honey poisoning from 2007 to 2012 in southwestern China. We also conducted a quantitative melissopalynological analysis of honey samples. During the study period, 31 honey poisoning cases occurred in the study location, all during July to August. All the cases occurred after consuming at least 100 grams of honey. The most frequent symptoms were nausea and vomiting (100%), abdominal pain (90.3%), diarrhea (74.2%), palpitations (61.3%), dizziness (54.8%), chest congestion (48.4%) and dyspnea (48.4%). Severe cases developed oliguria/anuria, twitch, hematuria, ecchymosis or hematochezia. The median time from ingestion to onset of symptoms was 29 hours. Eight patients died (mortality rate: 25.8%). The pollen of Tripterygium hypoglaucum (a plant with poisonous nectar and pollen) was detected in 22 of 29 honey samples examined (75.9%). The results of pollen analysis were consistent with the clinical findings of previous cases. T. hypoglaucum appears to be the cause of honey poisoning in southwestern China. Honey poisoning should be included in the differential diagnosis of patients who consume honey in this region and develop symptoms of food poisoning.

[Bladder rupture caused by spontaneous perforation of an infected urachal cyst].

PubMed

Maruschke, M; Kreutzer, H J; Seiter, H

2003-06-01

Anomalies of the fetal urachus are rare. Normally, the postnatal urachus presents as a fibrous band extending from the bladder to the umbilicus. Urachal cysts may occur in postnatal life. Spontaneous perforation of urachal cysts is a very rare condition, which clinically may not be distinguishable from other acute abdominal conditions. We report a case of a 63-year-old male with a history of recurrent urinary tract infections and a bladder rupture caused by a spontaneous perforation of an infected urachal cyst. The symptomatology showed abdominal rigidity and pain, a palpable mass in the lower abdomen, and hematuria. Laboratory findings showed leukocytosis and an increased CRP level. The bladder rupture was confirmed by cystography. Bacteriologic examination identified Proteus vulgaris, Corynebacterium species, and Klebsiella pneumoniae. Most of the published cases in the literature report about intraperitoneal perforation of infected urachal cysts. In the present case, we found a spontaneous perforation of an infected urachal cyst leading to an extraperitoneal bladder rupture with an extraperitoneal limitation of the infection. The definitive therapy was complete surgical excision including a cuff of the bladder, drainage, and systemic broad-spectrum and local application of antibiotics. The further course was uneventful.

Multiple Myeloma and Epidural Spinal Cord Compression : Case Presentation and a Spine Surgeon's Perspective

PubMed Central

Ha, Kee-Yong; Kim, Hyun-Woo

2013-01-01

Multiple myeloma, a multicentric hematological malignancy, is the most common primary tumor of the spine. As epidural myeloma causing spinal cord compression is a rare condition, its therapeutic approach and clinical results have been reported to be diverse, and no clear guidelines for therapeutic decision have been established. Three patients presented with progressive paraplegia and sensory disturbance. Image and serological studies revealed multiple myeloma and spinal cord compression caused by epidural myeloma. Emergency radiotherapy and steroid therapy were performed in all three cases. However, their clinical courses and results were distinctly different. Following review of our cases and the related literature, we suggest a systematic therapeutic approach for these patients to achieve better clinical results. PMID:24175035

Low-molecular-weight heparin and mortality in acutely ill medical patients.

PubMed

Kakkar, Ajay K; Cimminiello, Claudio; Goldhaber, Samuel Z; Parakh, Rajiv; Wang, Chen; Bergmann, Jean-François

2011-12-29

Although thromboprophylaxis reduces the incidence of venous thromboembolism in acutely ill medical patients, an associated reduction in the rate of death from any cause has not been shown. We conducted a double-blind, placebo-controlled, randomized trial to assess the effect of subcutaneous enoxaparin (40 mg daily) as compared with placebo--both administered for 10±4 days in patients who were wearing elastic stockings with graduated compression--on the rate of death from any cause among hospitalized, acutely ill medical patients at participating sites in China, India, Korea, Malaysia, Mexico, the Philippines, and Tunisia. Inclusion criteria were an age of at least 40 years and hospitalization for acute decompensated heart failure, severe systemic infection with at least one risk factor for venous thromboembolism, or active cancer. The primary efficacy outcome was the rate of death from any cause at 30 days after randomization. The primary safety outcome was the rate of major bleeding during and up to 48 hours after the treatment period. A total of 8307 patients were randomly assigned to receive enoxaparin plus elastic stockings with graduated compression (4171 patients) or placebo plus elastic stockings with graduated compression (4136 patients) and were included in the intention-to-treat population. The rate of death from any cause at day 30 was 4.9% in the enoxaparin group as compared with 4.8% in the placebo group (risk ratio, 1.0; 95% confidence interval [CI], 0.8 to 1.2; P=0.83). The rate of major bleeding was 0.4% in the enoxaparin group and 0.3% in the placebo group (risk ratio, 1.4; 95% CI, 0.7 to 3.1; P=0.35). The use of enoxaparin plus elastic stockings with graduated compression, as compared with elastic stockings with graduated compression alone, was not associated with a reduction in the rate of death from any cause among hospitalized, acutely ill medical patients. (Funded by Sanofi; LIFENOX ClinicalTrials.gov number, NCT00622648.).

Mechanical characterization of diesel soot nanoparticles: in situ compression in a transmission electron microscope and simulations

NASA Astrophysics Data System (ADS)

Jenei, Istvan Zoltan; Dassenoy, Fabrice; Epicier, Thierry; Khajeh, Arash; Martini, Ashlie; Uy, Dairene; Ghaednia, Hamed; Gangopadhyay, Arup

2018-02-01

Incomplete fuel burning inside an internal combustion engine results in the creation of soot in the form of nanoparticles. Some of these soot nanoparticles (SNP) become adsorbed into the lubricating oil film present on the cylinder walls, which adversely affects the tribological performance of the lubricant. In order to better understand the mechanisms underlying the wear caused by SNPs, it is important to understand the behavior of SNPs and to characterize potential changes in their mechanical properties (e.g. hardness) caused by (or during) mechanical stress. In this study, the behavior of individual SNPs originating from diesel engines was studied under compression. The experiments were performed in a transmission electron microscope using a nanoindentation device. The nanoparticles exhibited elasto-plastic behavior in response to consecutive compression cycles. From the experimental data, the Young’s modulus and hardness of the SNPs were calculated. The Young’s modulus and hardness of the nanoparticles increased with the number of compression cycles. Using an electron energy loss spectroscopy technique, it was shown that the sp2/sp3 ratio within the compressed nanoparticle decreases, which is suggested to be the cause of the increase in elasticity and hardness. In order to corroborate the experimental findings, molecular dynamics simulations of a model SNP were performed. The SNP model was constructed using carbon and hydrogen atoms with morphology and composition comparable to those observed in the experiment. The model SNP was subjected to repeated compressions between two virtual rigid walls. During the simulation, the nanoparticle exhibited elasto-plastic behavior like that in the experiments. The results of the simulations confirm that the increase in the elastic modulus and hardness is associated with a decrease in the sp2/sp3 ratio.

Mechanical characterization of diesel soot nanoparticles: in situ compression in a transmission electron microscope and simulations.

PubMed

Jenei, Istvan Zoltan; Dassenoy, Fabrice; Epicier, Thierry; Khajeh, Arash; Martini, Ashlie; Uy, Dairene; Ghaednia, Hamed; Gangopadhyay, Arup

2018-02-23

Incomplete fuel burning inside an internal combustion engine results in the creation of soot in the form of nanoparticles. Some of these soot nanoparticles (SNP) become adsorbed into the lubricating oil film present on the cylinder walls, which adversely affects the tribological performance of the lubricant. In order to better understand the mechanisms underlying the wear caused by SNPs, it is important to understand the behavior of SNPs and to characterize potential changes in their mechanical properties (e.g. hardness) caused by (or during) mechanical stress. In this study, the behavior of individual SNPs originating from diesel engines was studied under compression. The experiments were performed in a transmission electron microscope using a nanoindentation device. The nanoparticles exhibited elasto-plastic behavior in response to consecutive compression cycles. From the experimental data, the Young's modulus and hardness of the SNPs were calculated. The Young's modulus and hardness of the nanoparticles increased with the number of compression cycles. Using an electron energy loss spectroscopy technique, it was shown that the sp 2 /sp 3 ratio within the compressed nanoparticle decreases, which is suggested to be the cause of the increase in elasticity and hardness. In order to corroborate the experimental findings, molecular dynamics simulations of a model SNP were performed. The SNP model was constructed using carbon and hydrogen atoms with morphology and composition comparable to those observed in the experiment. The model SNP was subjected to repeated compressions between two virtual rigid walls. During the simulation, the nanoparticle exhibited elasto-plastic behavior like that in the experiments. The results of the simulations confirm that the increase in the elastic modulus and hardness is associated with a decrease in the sp 2 /sp 3 ratio.

Development, characterization, and modeling of ballistic impact on composite laminates under compressive pre-stress

NASA Astrophysics Data System (ADS)

Kerr-Anderson, Eric

Structural composite laminates were ballistically impacted while under in-plane compressive pre-stress. Residual properties, damage characterization, and energy absorption were compared to determine synergistic effects of in-plane compressive pre-stress and impact velocity. A fixture was developed to apply in-plane compressive loads up to 30 tons to structural composites during an impact event using a single-stage light-gas gun. Observed failure modes included typical conical delamination, the development of an impact initiated shear crack (IISC), and the shear failure of a pre-stressed composite due to impact. It was observed that the compressive failure threshold quadratically decreased in relation to the impact velocity up to velocities that caused partial penetration. For all laminates impacted at velocities causing partial or full penetration up to 350 ms-1, the failure threshold was consistent and used as an experimental normalization. Samples impacted below 65% of the failure threshold witnessed no significant change in damage morphology or residual properties when compared to typical conical delamination. Samples impacted above 65% of the failure threshold witnessed additional damage in the form of a shear crack extending perpendicular to the applied load from the point of impact. The presence of an IISC reduced the residual properties and even caused failure upon impact at extreme combinations. Four failure envelopes have been established as: transient failure, steady state failure, impact initiated shear crack, and conical damage. Boundaries and empirically based equations for residual compressive strength have been developed for each envelope with relation to two E-glass/vinyl ester laminate systems. Many aspects of pre-stressed impact have been individually examined, but there have been no comprehensive examinations of pre-stressed impact. This research has resulted in the exploration and characterization of compressively pre-stressed damage for impact velocities resulting in reflection, partial penetration, and penetration at pre-stress levels resulting in conical damage, shear cracking, and failure.

A rare cause of late onset neurological deficit in post tuberculous kyphotic deformity—case report

PubMed Central

Shetty, Ajoy Prasad; Kanna, Rishi M.; Rajasekaran, Shanmuganathan

2017-01-01

Late onset neurological deficit is a rare complication of spinal tuberculosis. Reactivation of the disease and compression by internal gibbus are the common causes for late onset neurological deficit. We report a rare cause of late onset paraplegia in a patient with post tubercular kyphotic deformity. The late onset neurological deficit was due to the adjacent segment degeneration proximal to the kyphotic deformity. Posterior hypertrophied ligamentum flavum and anterior disc osteophyte complex caused the cord compression. The increased stress for prolonged period at the end of the deformity was the reason for the accelerated degeneration. Patient underwent posterior decompression, posterolateral and interbody fusion. Deformity correction was not done. To our best knowledge, this is only the second report of this unusual cause of late onset paraplegia. PMID:29354759

A rare cause of late onset neurological deficit in post tuberculous kyphotic deformity-case report.

PubMed

Subramani, Suresh; Shetty, Ajoy Prasad; Kanna, Rishi M; Rajasekaran, Shanmuganathan

2017-12-01

Late onset neurological deficit is a rare complication of spinal tuberculosis. Reactivation of the disease and compression by internal gibbus are the common causes for late onset neurological deficit. We report a rare cause of late onset paraplegia in a patient with post tubercular kyphotic deformity. The late onset neurological deficit was due to the adjacent segment degeneration proximal to the kyphotic deformity. Posterior hypertrophied ligamentum flavum and anterior disc osteophyte complex caused the cord compression. The increased stress for prolonged period at the end of the deformity was the reason for the accelerated degeneration. Patient underwent posterior decompression, posterolateral and interbody fusion. Deformity correction was not done. To our best knowledge, this is only the second report of this unusual cause of late onset paraplegia.

Traumatic Pancreatitis: A Rare Complication of Cardiopulmonary Resuscitation.

PubMed

Aziz, Muhammad

2017-08-17

An elderly gentleman was successfully revived after undergoing cardiopulmonary resuscitation (CPR) for cardiac arrest. Post CPR, the patient developed acute pancreatitis which was likely complication of inappropriately delivered chest compressions which caused further complications and resulted in the death of the patient. This case underlines the importance of quality chest compressions that includes correct placement of hands by the operator giving chest compressions to avoid lethal injuries to the receiver.

Enhanced Pulse Compression in Nonlinear Fiber by a WDM Optical Pulse

NASA Technical Reports Server (NTRS)

Yeh, C.; Bergman, L.

1997-01-01

A new way to compress an optical pulse in a single-mode fiber is presented in this paper. By the use of the cross phase modulation (CPM) effect caused by the nonlinearity of the optical fiber, a shepherd pulse propagating on a different wavelength beam in a wavelength division multiplexed (WDM) single-mode fiber system can be used to enhance the pulse compression of a co-propagating primary pulse.

Use of a biodegradable, oversized stent in a child with tracheomalacia secondary to vascular external compression.

PubMed

Di Dedda, Giovanni; Mirabile, Cristian

2017-01-01

We describe the implantation of an absorbable, custom-made stent of polydioxanone to treat tracheomalacia in a 5-month-old patient with extrinsic compression by a double aortic arch. The use of an absorbable, oversized stent treated the tracheal collapse caused by vascular compression, avoided removal procedures, and allowed the infant's growth. The use of an oversized stent prevented stent migration and gave minimal problems of granulation.

Static compression down-regulates N-cadherin expression and facilitates loss of cell phenotype of nucleus pulposus cells in a disc perfusion culture.

PubMed

Zhou, Haibo; Shi, Jianmin; Zhang, Chao; Li, Pei

2018-02-28

Mechanical compression often induces degenerative changes of disc nucleus pulposus (NP) tissue. It has been indicated that N-cadherin (N-CDH)-mediated signaling helps to preserve the NP cell phenotype. However, N-CDH expression and the resulting NP-specific phenotype alteration under the static compression and dynamic compression remain unclear. To study the effects of static compression and dynamic compression on N-CDH expression and NP-specific phenotype in an in vitro disc organ culture. Porcine discs were organ cultured in a self-developed mechanically active bioreactor for 7 days and subjected to static or dynamic compression (0.4 MPa for 2 h once per day). The noncompressed discs were used as controls. Compared with the dynamic compression, static compression significantly down-regulated the expression of N-CDH and NP-specific markers (laminin, brachyury, and keratin 19); decreased the Alcian Blue staining intensity, glycosaminoglycan and hydroxyproline contents; and declined the matrix macromolecule (aggrecan and collagen II) expression. Compared with the dynamic compression, static compression causes N-CDH down-regulation, loss of NP-specific phenotype, and the resulting decrease in NP matrix synthesis. © 2018 The Author(s).

Dissolution of infection-induced struvite bladder stones by using a noncalculolytic diet and antibiotic therapy

PubMed Central

2004-01-01

Abstract An 8-year-old, female spayed miniature schnauzer was presented for pollakiuria and gross hematuria. Infection-induced struvite urolithiasis with concurrent bacterial urinary tract infection was diagnosed. The treatment is described, followed by a brief discussion of struvite stones and their medical management. PMID:15532883

A unique evolution of the kidney phenotype in a patient with autosomal recessive Alport syndrome.

PubMed

Vischini, Gisella; Kapp, Meghan E; Wheeler, Ferrin C; Hopp, Laszlo; Fogo, Agnes B

2018-03-09

Alport syndrome is due to mutations in one of the genes encoding (α3,4,5) type IV collagen resulting in defective type IV collagen, a key component of the glomerular basement membrane (GBM). The GBM is initially thin, and with ongoing remodeling, develops a thickened basket-woven appearance. We report a unique case of a 9-year-old boy who was biopsied for hematuria and proteinuria, diagnosed as IgA nephropathy, with normal GBM appearance and thickness. Due to a family history of hematuria and chronic kidney disease, he subsequently underwent genetic evaluation and a mutation of α3 type IV collagen (COL4A3) was detected. Additional studies of the initial biopsy demonstrated abnormal type IV collagen immunostaining. A repeat biopsy 4years later showed characteristic glomerular basement membrane morphology of Alport syndrome, and scarring consistent with sequelae of IgA nephropathy. This is the first description of this unusual transition from an initial normal appearance of the glomerular basement membrane to the classic Alport phenotype. Copyright © 2018. Published by Elsevier Inc.

Evaluation of the ameliorative effects of immunosuppressants on crescentic glomerulonephritis in SCG/Kj mice.

PubMed

Saiga, Kan; Yoshida, Minako; Nakamura, Iwao; Toyoda, Eriko; Tokunaka, Kazuhiro; Morohashi, Hirohisa; Abe, Fuminori; Nemoto, Kyuichi; Nose, Masato

2008-09-01

The therapeutic efficacy of immunosuppressants for treating rapidly progressive glomerulonephritis (RPGN) with crescent formation remains controversial. SCG/Kj mice spontaneously develop RPGN-like symptoms, characteristic of crescentic glomerulonephritis and systemic small vessel vasculitis, associated with the presence of anti-neutrophil cytoplasmic antibodies (ANCA). We evaluated the "ameliorative", not prophylactic, effects of immunosuppressive agents, deoxyspergualin (DSG), cyclophosphamide (CYC) and prednisolone (PDN), on RPGN in these mice. DSG at intraperitoneal doses of 3 and 6 mg/kg, CYC at an oral dose of 12 mg/kg, or PDN at an intraperitoneal dose of 120 mg/kg was administered once a day for 21 days to female mice "at the onset of hematuria". A set of control SCG/Kj mice received only saline injections. DSG and CYC significantly prolonged survival, improved the proteinuria, hematuria and hyperuremia, and decreased the serum level of myeloperoxidase-ANCA. Moreover, DSG significantly suppressed the formation of crescents in glomeruli. PDN failed to affect any of the parameters. DSG might be useful for inducing remission in crescentic glomerulonephritis involved in RPGN.

Eosinophilic cystitis with recurrent urinary retention: case report.

PubMed

Park, Hongzoo

2017-01-01

Eosinophilic cystitis is a rare inflammatory disease of the bladder whose origin, pathogenesis, and treatment are unknown. Frequency, dysuria, and hematuria are frequent symptoms. Here, we report a rare occurrence of recurrent urinary retention and repetitive catheterization. A 67-year-old male presented with acute urinary retention and intermittent gross hematuria of 2 weeks duration. Urethral catheterization followed by a trial without catheter, was successful. Complete blood count showed presence of eosinophils (eosinophilia) and computed tomography of kidneys, ureter and bladder with contrast showed thickened bladder wall and small prostate. Cystoscopy revealed an erythematous lesion over the anterior wall. The rest of the mucosa was normal. Transurethral biopsies of the lesion were performed and histologic examination showed features of eosinophilic cystitis. Despite multiple medication regimens containing corticosteroids and antihistamines, he presented with recurrent urinary retention, approximately once every month. After 6 months, he was started on bethanechol, which led to no catheterization for up to 2 years. To the best of our knowledge, this is the first report on the successful use of bethanechol as a treatment for eosinophilic cystitis with recurrent urinary retention.

Complications of acucise endopyelotomy.

PubMed

Kim, F J; Herrell, S D; Jahoda, A E; Albala, D M

1998-10-01

Endoscopic management of ureteropelvic junction (UPJ) obstruction has a success rate of 80% to 86%. We have been performing a ureteral cutting balloon procedure under fluoroscopic control (Acucise endopyelotomy) for UPJ obstruction at Loyola University Medical Center since 1991. The overall success rate in 77 patients was 78%. All patients had a preoperative intravenous urogram or a retrograde pyelogram, but none had vascular imaging studies. Acucise endopyelotomy consisted of a posterolateral incision of the UPJ and placement of an endopyelotomy or double-J stent. Foley catheter placement at the end of the procedure demonstrated significant gross hematuria in three patients (4%). All three remained hemodynamically stable but with significant drops in postprocedure hemoglobin levels, which necessitated blood transfusion. Aggressive management included angiographic studies and embolization of lower-pole branching arteries in two patients (3%). One patient stopped bleeding after being given two units of blood. None of the patients required an open exploratory procedure. Although the risk of vascular injury is low with Acucise endopyelotomy, prolonged postoperative gross hematuria does mandate investigation and observation. Angiographic embolization appears to be the therapeutic modality of choice for patients with hemorrhagic complications after an Acucise endopyelotomy.

Buckling Behavior of Compression-Loaded Composite Cylindrical Shells with Reinforced Cutouts

NASA Technical Reports Server (NTRS)

Hilburger, Mark W.; Starnes, James H., Jr.

2002-01-01

Results from a numerical study of the response of thin-wall compression-loaded quasi-isotropic laminated composite cylindrical shells with reinforced and unreinforced square cutouts are presented. The effects of cutout reinforcement orthotropy, size, and thickness on the nonlinear response of the shells are described. A high-fidelity nonlinear analysis procedure has been used to predict the nonlinear response of the shells. The analysis procedure includes a nonlinear static analysis that predicts stable response characteristics of the shells and a nonlinear transient analysis that predicts unstable dynamic buckling response characteristics. The results illustrate how a compression-loaded shell with an unreinforced cutout can exhibit a complex nonlinear response. In particular, a local buckling response occurs in the shell near the cutout and is caused by a complex nonlinear coupling between local shell-wall deformations and in-plane destabilizing compression stresses near the cutout. In general, the addition of reinforcement around a cutout in a compression-loaded shell can retard or eliminate the local buckling response near the cutout and increase the buckling load of the shell, as expected. However, results are presented that show how certain reinforcement configurations can actually cause an unexpected increase in the magnitude of local deformations and stresses in the shell and cause a reduction in the buckling load. Specific cases are presented that suggest that the orthotropy, thickness, and size of a cutout reinforcement in a shell can be tailored to achieve improved response characteristics.

VINSON/AUTOVON Interface Applique for the Modem, Digital Data, AN/GSC-38

DTIC Science & Technology

1980-11-01

Measurement Indication Result Before Step 6 None Noise and beeping are heard in handset After Step 7 None Noise and beepi ng disappear Condition Measurement...linear range due to the compression used. Lowering the levels below the compression range may give increased linearity, but may cause signal-to- noise ...are encountered where the bit error rate at 16 KB/S results is objectionable audio noise or causes the KY-58 to squelch. On these channels the bit

Assessing the Effects of Data Compression in Simulations Using Physically Motivated Metrics

DOE PAGES

Laney, Daniel; Langer, Steven; Weber, Christopher; ...

2014-01-01

This paper examines whether lossy compression can be used effectively in physics simulations as a possible strategy to combat the expected data-movement bottleneck in future high performance computing architectures. We show that, for the codes and simulations we tested, compression levels of 3–5X can be applied without causing significant changes to important physical quantities. Rather than applying signal processing error metrics, we utilize physics-based metrics appropriate for each code to assess the impact of compression. We evaluate three different simulation codes: a Lagrangian shock-hydrodynamics code, an Eulerian higher-order hydrodynamics turbulence modeling code, and an Eulerian coupled laser-plasma interaction code. Wemore » compress relevant quantities after each time-step to approximate the effects of tightly coupled compression and study the compression rates to estimate memory and disk-bandwidth reduction. We find that the error characteristics of compression algorithms must be carefully considered in the context of the underlying physics being modeled.« less

Optic nerve compression as a late complication of a hydrogel explant with silicone encircling band.

PubMed

Crama, Niels; Kluijtmans, Leo; Klevering, B Jeroen

2018-06-01

To present a complication of compressive optic neuropathy caused by a swollen hydrogel explant and posteriorly displaced silicone encircling band. A 72-year-old female patient presented with progressive visual loss and a tilted optic disc. Her medical history included a retinal detachment in 1993 that was treated with a hydrogel explant under a solid silicone encircling band. Visual acuity had decreased from 6/10 to 6/20 and perimetry showed a scotoma in the temporal superior quadrant. On Magnetic Resonance Imaging (MRI), compression of the optic nerve by a displaced silicone encircling band inferior nasally in combination with a swollen episcleral hydrogel explant was observed. Surgical removal of the hydrogel explant and silicone encircling band was uneventful and resulted in improvement of visual acuity and visual field loss. This is the first report on compressive optic neuropathy caused by swelling of a hydrogel explant resulting in a dislocated silicone encircling band. The loss of visual function resolved upon removal of the explant and encircling band.

In-situ neutron diffraction of LaCoO3 perovskite under uniaxial compression. I. Crystal structure analysis and texture development

DOE Office of Scientific and Technical Information (OSTI.GOV)

Aman, Amjad; Chen, Yan; Lugovy, Mykola

2014-01-01

The dynamics of texture formation, changes in crystal structure and stress accommodation mechanisms are studied in R3c rhombohedral LaCoO3 perovskite during in-situ uniaxial compression experiment by neutron diffraction. The neutron diffraction revealed the complex crystallographic changes causing the texture formation and significant straining along certain crystallographic directions during in-situ compression, which are responsible for the appearance of hysteresis and non-linear ferroelastic deformation in LaCoO3 perovskite. The irreversible strain after the first loading was connected with the appearance of non-recoverable changes in the intensity ratio of certain crystallographic peaks, causing non-reversible texture formation. However in the second loading/unloading cycle the hysteresismore » loop was closed and no irreversible strain appears after deformation. The significant texture formation is responsible for increase in the Young s modulus of LaCoO3 at high compressive loads, where the reported values of Young s modulus increase from 76 GPa measured at the very beginning of the loading to 194 GPa at 900 MPa applied compressive stress measured at the beginning of the unloading curve.« less

Symmetry compression method for discovering network motifs.

PubMed

Wang, Jianxin; Huang, Yuannan; Wu, Fang-Xiang; Pan, Yi

2012-01-01

Discovering network motifs could provide a significant insight into systems biology. Interestingly, many biological networks have been found to have a high degree of symmetry (automorphism), which is inherent in biological network topologies. The symmetry due to the large number of basic symmetric subgraphs (BSSs) causes a certain redundant calculation in discovering network motifs. Therefore, we compress all basic symmetric subgraphs before extracting compressed subgraphs and propose an efficient decompression algorithm to decompress all compressed subgraphs without loss of any information. In contrast to previous approaches, the novel Symmetry Compression method for Motif Detection, named as SCMD, eliminates most redundant calculations caused by widespread symmetry of biological networks. We use SCMD to improve three notable exact algorithms and two efficient sampling algorithms. Results of all exact algorithms with SCMD are the same as those of the original algorithms, since SCMD is a lossless method. The sampling results show that the use of SCMD almost does not affect the quality of sampling results. For highly symmetric networks, we find that SCMD used in both exact and sampling algorithms can help get a remarkable speedup. Furthermore, SCMD enables us to find larger motifs in biological networks with notable symmetry than previously possible.

Damage Tolerance of Pre-Stressed Composite Panels Under Impact Loads

NASA Astrophysics Data System (ADS)

Johnson, Alastair F.; Toso-Pentecôte, Nathalie; Schueler, Dominik

2014-02-01

An experimental test campaign studied the structural integrity of carbon fibre/epoxy panels preloaded in tension or compression then subjected to gas gun impact tests causing significant damage. The test programme used representative composite aircraft fuselage panels composed of aerospace carbon fibre toughened epoxy prepreg laminates. Preload levels in tension were representative of design limit loads for fuselage panels of this size, and maximum compression preloads were in the post-buckle region. Two main impact scenarios were considered: notch damage from a 12 mm steel cube projectile, at velocities in the range 93-136 m/s; blunt impact damage from 25 mm diameter glass balls, at velocities 64-86 m/s. The combined influence of preload and impact damage on panel residual strengths was measured and results analysed in the context of damage tolerance requirements for composite aircraft panels. The tests showed structural integrity well above design limit loads for composite panels preloaded in tension and compression with visible notch impact damage from hard body impact tests. However, blunt impact tests on buckled compression loaded panels caused large delamination damage regions which lowered plate bending stiffness and reduced significantly compression strengths in buckling.

Mediastinal tuberculous lymphadenitis presenting as an esophageal intramural tumor: A very rare but important cause for dysphagia

PubMed Central

Pimenta, APA; Preto, JR; Gouveia, AMF; Fonseca, E; Pimenta, MML

2007-01-01

Dysphagia associated with esophageal mechanical obstruction is usually related to malignant esophageal diseases. Benign lesions are rarely a cause for this type of dysphagia, and usually occur either as an intramural tumor or as an extrinsic compression. Mediastinal tuberculous lymphadenitis is rare in adults, and even more rarely causes dysphagia. We report two cases of dysphagia in adult patients caused by mediastinal tuberculous lymphadenitis, presenting radiologically and endoscopically as an esophageal submucosal tumor. Based on the clinical and imaging diagnosis, the patients underwent a right thoracotomy, and excision of the mass attached to and compressing the esophagus. Pathological examination of the specimens showed a chronic granulomatous inflammation with caseous necrosis, which was consistent with tuberculous lymphadenitis. PMID:18023110

Airway obstruction due to tracheomalacia caused by innominate artery compression and a kyphotic cervical spine.

PubMed

Liu, Chia-Hsin; Huang, Wen-Sheng; Wang, Hong-Hau; Wu, Chin-Pyng; Chian, Chih-Feng; Perng, Wann-Cherng; Tsai, Chen-Liang

2015-02-01

Tracheomalacia can cause variable degrees of intrathoracic airway obstruction and is an easily overlooked cause of respiratory distress in adults. Here, we report a case of acute respiratory failure in which subglottic stenosis was accidentally identified during endotracheal intubation. Subsequent bronchoscopy and computed tomography of the thorax and neck revealed tracheal compression with tracheomalacia caused by a tortuous innominate artery and a kyphotic cervical spine. The patient underwent rigid bronchoscopy with metal stent implantation, and her symptoms were alleviated. These findings outline the importance of precise diagnosis and interventions for preventing recurrent life-threatening respiratory failure in such cases. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Monitoring compaction and compressibility changes in offshore chalk reservoirs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dean, G.; Hardy, R.; Eltvik, P.

1994-03-01

Some of the North Sea's largest and most important oil fields are in chalk reservoirs. In these fields, it is important to measure reservoir compaction and compressibility because compaction can result in platform subsidence. Also, compaction drive is a main drive mechanism in these fields, so an accurate reserves estimate cannot be made without first measuring compressibility. Estimating compaction and reserves is difficult because compressibility changes throughout field life. Installing of accurate, permanent downhole pressure gauges on offshore chalk fields makes it possible to use a new method to monitor compressibility -- measurement of reservoir pressure changes caused by themore » tide. This tidal-monitoring technique is an in-situ method that can greatly increase compressibility information. It can be used to estimate compressibility and to measure compressibility variation over time. This paper concentrates on application of the tidal-monitoring technique to North Sea chalk reservoirs. However, the method is applicable for any tidal offshore area and can be applied whenever necessary to monitor in-situ rock compressibility. One such application would be if platform subsidence was expected.« less

Which pediatric blunt trauma patients do not require pelvic imaging?

PubMed

Haasz, Maya; Simone, Laura A; Wales, Paul W; Stimec, Jennifer; Stephens, Derek; Beno, Suzanne; Schuh, Suzanne

2015-11-01

This study aimed to develop a tool in identifying traumatized children at low risk of pelvic fracture and to determine the sensitivity of this low-risk model for pelvic fractures. We hypothesized that the proportion of children without predictors with pelvic fracture is less than 1%. This is a retrospective trauma registry analysis of previously healthy children 1 year to 17 years old presenting to the pediatric emergency department with blunt trauma. Postulated predictors of pelvic fracture on radiograph or computed tomography included pain/abnormal examination result of the pelvis/hip, femur deformity, hematuria, abdominal pain/tenderness, Glasgow Coma Scale (GCS) score of 13 or lower, and hemodynamic instability. We used multivariable logistic regression to identify independent predictors of fracture. Of 1,121 eligible patients (mean [SD] age, 8.5 [4.6] years), 87 (7.8%) had pelvic fracture. Independent predictors included pain/abnormal examination result of the pelvis/hip (odds ratio [OR], 16.7; 95% confidence interval [CI], 9.6-29.1), hematuria (OR, 6.6; 95% CI, 3.0-14.6), femoral deformity (OR, 5.9; 95% CI, 3.1-11.3), GCS score of 13 or lower (OR, 2.4; 95% CI, 1.3-4.3), and hemodynamic instability (OR, 3.4; 95% CI, 1.7-6.9). One of 590 children (0.2%; 95% CI, 0-0.5%) without predictors had pelvic fractures versus 86 (16.2%) of 531 in those with one or more predictors (OR, 119; 95% CI, 16.6-833). One of 87 children with pelvic fractures had no predictors (1.1%; 95% CI, 0-3%). When assuming a 100% radiography rate, this tool saves 53% pelvic radiographs. Children with multiple blunt trauma without pain/abnormal examination result of the pelvis/hip, femur deformity, hematuria, abdominal pain/tenderness, GCS score of 13 or lower, or hemodynamic instability constitute a low-risk population for pelvic fracture, with less than 0.5% risk rate. This population does not require routine pelvic imaging. Therapeutic study, level IV.

Simultaneous Median and Ulnar Compression Neuropathy Secondary to a Giant Palmar Lipoma: A Case Report and Review of the Literature

PubMed Central

Unal, Melih; Demirayak, Engin; Acar, Baver

2018-01-01

Lipomas are benign tumors that rarely settle in the hand. They usually present with mass, pain, and nerve compression symptoms. Although isolated median or ulnar nerve compression neuropathy secondary to a lipoma of the hand has been widely reported, simultaneous median and ulnar nerve compression neuropathy are exceedingly rare and there are only three reported cases in the current literature to date. Herein, a case of a 50-year-old woman with a giant palmar lipoma that caused median and ulnar compression neuropathy is presented. The removal of the tumor resulted in the complete recovery of the patient’s symptoms. A deep-seated palmar lipoma should be kept in mind in patients with unilateral compression neuropathy symptoms with a palmar mass. PMID:29666776

The humeral origin of the brachioradialis muscle: an unusual site of high radial nerve compression.

PubMed

Cherchel, A; Zirak, C; De Mey, A

2013-11-01

Radial nerve compression is seldom encountered in the upper arm, and most commonly described compression syndromes have their anatomical cause in the forearm. The teres major, the triceps muscle, the intermuscular septum region and the space between the brachialis and brachioradialis muscles have all been identified as radial nerve compression sites above the elbow. We describe the case of a 38-year-old male patient who presented with dorso-lateral forearm pain and paraesthesias without neurological deficit. Surgical exploration revealed radial nerve compression at the humeral origin of the brachioradialis muscle. Liberation of the nerve at this site was successful at relieving the symptoms. To our knowledge, this compression site has not been described in the literature. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

A functional variant in NEPH3 gene confers high risk of renal failure in primary hematuric glomerulopathies. Evidence for predisposition to microalbuminuria in the general population

PubMed Central

Voskarides, Konstantinos; Stefanou, Charalambos; Pieri, Myrtani; Demosthenous, Panayiota; Felekkis, Kyriakos; Arsali, Maria; Athanasiou, Yiannis; Xydakis, Dimitris; Stylianou, Kostas; Daphnis, Eugenios; Goulielmos, Giorgos; Loizou, Petros; Savige, Judith; Höhne, Martin; Völker, Linus A.; Benzing, Thomas; Maxwell, Patrick H.; Gale, Daniel P.; Gorski, Mathias; Böger, Carsten; Kollerits, Barbara; Kronenberg, Florian; Paulweber, Bernhard; Zavros, Michalis; Pierides, Alkis; Deltas, Constantinos

2017-01-01

Background Recent data emphasize that thin basement membrane nephropathy (TBMN) should not be viewed as a form of benign familial hematuria since chronic renal failure (CRF) and even end-stage renal disease (ESRD), is a possible development for a subset of patients on long-term follow-up, through the onset of focal and segmental glomerulosclerosis (FSGS). We hypothesize that genetic modifiers may explain this variability of symptoms. Methods We looked in silico for potentially deleterious functional SNPs, using very strict criteria, in all the genes significantly expressed in the slit diaphragm (SD). Two variants were genotyped in a cohort of well-studied adult TBMN patients from 19 Greek-Cypriot families, with a homogeneous genetic background. Patients were categorized as “Severe” or “Mild”, based on the presence or not of proteinuria, CRF and ESRD. A larger pooled cohort (HEMATURIA) of 524 patients, including IgA nephropathy patients, was used for verification. Additionally, three large general population cohorts [Framingham Heart Study (FHS), KORAF4 and SAPHIR] were used to investigate if the NEPH3-V353M variant has any renal effect in the general population. Results and conclusions Genotyping for two high-scored variants in 103 TBMN adult patients with founder mutations who were classified as mildly or severely affected, pointed to an association with variant NEPH3-V353M (filtrin). This promising result prompted testing in the larger pooled cohort (HEMATURIA), indicating an association of the 353M variant with disease severity under the dominant model (p = 3.0x10-3, OR = 6.64 adjusting for gender/age; allelic association: p = 4.2x10-3 adjusting for patients’ kinships). Subsequently, genotyping 6,531 subjects of the Framingham Heart Study (FHS) revealed an association of the homozygous 353M/M genotype with microalbuminuria (p = 1.0x10-3). Two further general population cohorts, KORAF4 and SAPHIR confirmed the association, and a meta-analysis of all three cohorts (11,258 individuals) was highly significant (p = 1.3x10-5, OR = 7.46). Functional studies showed that Neph3 homodimerization and Neph3-Nephrin heterodimerization are disturbed by variant 353M. Additionally, 353M was associated with differential activation of the unfolded protein response pathway, when overexpressed in stressed cultured undifferentiated podocyte cells, thus attesting to its functional significance. Genetics and functional studies support a “rare variant-strong effect” role for NEPH3-V353M, by exerting a negative modifier effect on primary glomerular hematuria. Additionally, genetics studies provide evidence for a role in predisposing homozygous subjects of the general population to micro-albuminuria. PMID:28334007

Study on the Aging Behaviors of Rubber Materials in Tension and Compression Loads

NASA Astrophysics Data System (ADS)

Jiang, Can; Wang, Hongyu; Ma, Xiaobing

Rubber materials are widely used in aviation, aerospace, shipbuilding, automobile and other military field. However, rubber materials are easy to aging, which largely restricts its using life. In working environment, due to the combined effect of heat and oxygen, vulcanized rubber will undergo degradation and crosslinking reaction which will cause elasticity decease and permanent deformation, so mostly rubber products are used under stress state. Due to the asymmetric structure and asymmetric stress distribution, mechanical stress may cause serious damage to molecular structure; therefore, this paper is aimed to analyze the aging behavior of rubber materials under tensile and compressive loadings, through analyzing experiment data, and adopting Gauss function to describe stress relaxation coefficient, to build an aging equation containing compression ratio parameter and aging time.

Rheology of the lithosphere and the folding caused by horizontal compression

NASA Astrophysics Data System (ADS)

Birger, B. I.

2015-05-01

The laboratory tests of rock specimens show that transient creep, at which deformations increase with time whereas strain rate decreases occurs when creep strains are sufficiently small. Since plate tectonics only permits small deformations in the lithospheric plates, the creep of the lithosphere is transient (non-steady-state). In this work, we study how the rheology of the lithosphere that possesses elasticity, brittleness (pseudo-plasticity), and creep affects the folding in the Earth's crust. Folding is caused by horizontal compression that results from the collision between the lithospheric plates. The effective viscosity characterizing the transient creep is lower than in the case of a steady-state creep and depends on the characteristic time of the considered process. The allowance for transient creep gives the distribution of the rheological properties of the horizontally compressed lithosphere in which the upper crust is brittle, whereas the lower crust and mantle lithosphere are dominated by transient creep. It is shown that the flows that arise in the lithosphere due to the instability under horizontal compression and cause folding are small-scale. These flows are concentrated in the upper brittle crust, they determine the short-wave Earth's surface topography, penetrate into the lower, creep-dominated crust to a shallow depth, and do not penetrate into the mantle. Therefore, these flows do not deform the Moho.

Experimental Study on Properties of Methane Diffusion of Coal Block under Triaxial Compressive Stress

PubMed Central

Zhao, Hong-Bao

2014-01-01

Taking the standard size coal block samples defined by ISRM as research objects, both properties of methane diffusion of coal block under triaxial compressive stress and characteristic influences caused by methane pressure were systematically studied with thermo-fluid-solid coupling with triaxial servocontrolled seepage equipment of methane-containing coal. The result shows the methane diffusion property of coal block under triaxial compressive stress was shown in four-stage as follow, first is sharply reduce stage, second is hyperbolic reduce stage, third is close to a fixed value stage, fourth stage is 0. There is a special point making the reduced rate of characteristic curve of methane diffusion speed become sharply small; the influences of shape of methane diffusion speed characteristic curve caused by methane pressure are not obvious, which only is shown in numerical size of methane diffusion speed. Test time was extended required by appear of the special point makes the reduce rate of methane diffusion speed become sharply small. The fitting four-phase relation of methane diffusion of coal block under triaxial compressive stress was obtained, and the idea is proposed that influences of the fitting four-phase relation caused by methane pressure were only shown in value of fitting parameters. PMID:25531000

Effect of adding acid solution on setting time and compressive strength of high calcium fly ash based geopolymer

NASA Astrophysics Data System (ADS)

Antoni, Herianto, Jason Ghorman; Anastasia, Evelin; Hardjito, Djwantoro

2017-09-01

Fly ash with high calcium oxide content when used as the base material in geopolymer concrete could cause flash setting or rapid hardening. However, it might increase the compressive strength of geopolymer concrete. This rapid hardening could cause problems if the geopolymer concrete is used on a large scale casting that requires a long setting time. CaO content can be indicated by pH values of the fly ash, while higher pH is correlated with the rapid setting time of fly ash-based geopolymer. This study investigates the addition of acid solution to reduce the initial pH of the fly ash and to prolong the setting time of the mixture. The acids used in this study are hydrochloric acid (HCl), sulfuric acid (H2 SO4), nitric acid (HNO3) and acetic acid (CH3 COOH). It was found that the addition of acid solution in fly ash was able to decrease the initial pH of fly ash, however, the initial setting time of geopolymer was not reduced. It was even faster than that of the control mixture. The acid type causes various influence, depending on the fly ash properties. In addition, the use of acid solution in fly ash reduces the compressive strength of geopolymer mortar. It is concluded that the addition of acid solution cannot prolong the rapid hardening of high calcium fly ash geopolymer, and it causes adverse effect on the compressive strength.

Hydronephrosis in the course of ureteropelvic junction obstruction: An underestimated problem? Current opinions on the pathogenesis, diagnosis and treatment.

PubMed

Krajewski, Wojciech; Wojciechowska, Joanna; Dembowski, Janusz; Zdrojowy, Romuald; Szydełko, Tomasz

2017-08-01

Ureteropelvic junction obstruction (UPJO) causes a reduction in the urine flow from the renal pelvis into the ureter. Untreated UPJO may cause hydronephrosis, chronic infection or urolithiasis and will often result in progressive deterioration of renal function. Most cases of UPJO are congenital; however, the disease can be clinically silent until adulthood. Other causes, both intrinsic and extrinsic, are acquired and include urolithiasis, post-operative/inflammatory/ischemic stricture, fibroepithelial polyps, adhesions and malignancy. In the past, the most frequent symptom of UPJO in neonates and infants was a palpable flank mass. Nowadays, thanks to the widespread use of maternal and prenatal ultrasound examinations, asymptomatic hydronephrosis is diagnosed very early. In adults and older children symptoms may include intermittent abdominal or flank pain, nausea, vomiting and hematuria. In addition to high specificity and sensitivity in detecting UPJO, modern technologically advanced equipment such as ultrasound, magnetic resonance imaging and computed tomography provides a lot of information about the function of the affected kidney and the anatomy of the surrounding tissues. Treatment options for UPJO include a wide spectrum of approaches, from active surveillance or minimally invasive endourologic techniques to open, laparoscopic or robotic pyeloplasty. The main goal of therapy is to relieve symptoms and maintain or improve renal function, but it is difficult to define treatment success after UPJO therapy.

Effects of dynamic range compression on spatial selective auditory attention in normal-hearing listeners.

PubMed

Schwartz, Andrew H; Shinn-Cunningham, Barbara G

2013-04-01

Many hearing aids introduce compressive gain to accommodate the reduced dynamic range that often accompanies hearing loss. However, natural sounds produce complicated temporal dynamics in hearing aid compression, as gain is driven by whichever source dominates at a given moment. Moreover, independent compression at the two ears can introduce fluctuations in interaural level differences (ILDs) important for spatial perception. While independent compression can interfere with spatial perception of sound, it does not always interfere with localization accuracy or speech identification. Here, normal-hearing listeners reported a target message played simultaneously with two spatially separated masker messages. We measured the amount of spatial separation required between the target and maskers for subjects to perform at threshold in this task. Fast, syllabic compression that was independent at the two ears increased the required spatial separation, but linking the compressors to provide identical gain to both ears (preserving ILDs) restored much of the deficit caused by fast, independent compression. Effects were less clear for slower compression. Percent-correct performance was lower with independent compression, but only for small spatial separations. These results may help explain differences in previous reports of the effect of compression on spatial perception of sound.

Primary pelvic hydatid cyst with sciatic compression.

PubMed

Nouira, F; Chouikh, T; Charieg, A; Ghorbel, S; Jlidi, S; Chaouachi, B

2011-01-01

Hydatid cysts are endemic in certain regions of the world and particulary in North Africa. They are usually located in the liver, lung, and spleen, though many uncommon locations have been reported. This is the first report of a child with primary pelvic hydatid disease causing a sciatic compression.

Phase transitions during compression and decompression of clots from platelet-poor plasma, platelet-rich plasma and whole blood.

PubMed

Liang, Xiaojun; Chernysh, Irina; Purohit, Prashant K; Weisel, John W

2017-09-15

Blood clots are required to stem bleeding and are subject to a variety of stresses, but they can also block blood vessels and cause heart attacks and ischemic strokes. We measured the compressive response of human platelet-poor plasma (PPP) clots, platelet-rich plasma (PRP) clots and whole blood clots and correlated these measurements with confocal and scanning electron microscopy to track changes in clot structure. Stress-strain curves revealed four characteristic regions, for compression-decompression: (1) linear elastic region; (2) upper plateau or softening region; (3) non-linear elastic region or re-stretching of the network; (4) lower plateau in which dissociation of some newly made connections occurs. Our experiments revealed that compression proceeds by the passage of a phase boundary through the clot separating rarefied and densified phases. This observation motivates a model of fibrin mechanics based on the continuum theory of phase transitions, which accounts for the pre-stress caused by platelets, the adhesion of fibrin fibers in the densified phase, the compression of red blood cells (RBCs), and the pumping of liquids through the clot during compression/decompression. Our experiments and theory provide insights into the mechanical behavior of blood clots that could have implications clinically and in the design of fibrin-based biomaterials. The objective of this paper is to measure and mathematically model the compression behavior of various human blood clots. We show by a combination of confocal and scanning electron microscopy that compression proceeds by the passage of a front through the sample that separates a densified region of the clot from a rarefied region, and that the compression/decompression response is reversible with hysteresis. These observations form the basis of a model for the compression response of clots based on the continuum theory of phase transitions. Our studies may reveal how clot rheology under large compression in vivo due to muscle contraction, platelet retraction and hydrodynamic flow varies under various pathophysiological conditions and could inform the design of fibrin based biomaterials. Copyright © 2017 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Severe Hemolytic Jaundice in a Neonate with a Novel COL4A1 Mutation.

PubMed

Tomotaki, Seiichi; Mizumoto, Hiroshi; Hamabata, Takayuki; Kumakura, Akira; Shiota, Mitsutaka; Arai, Hiroshi; Haginoya, Kazuhiro; Hata, Daisuke

2016-12-01

We report our experience with a preterm infant with severe hemolytic jaundice who required exchange transfusion just after birth. The patient was negative for alloimmune hemolysis as a result of maternal-fetal blood type incompatibility, and tests for inherited defects in erythrocyte metabolism, membrane function, and hemoglobin synthesis were normal. We also performed a bone marrow examination, but could not identify the cause of hemolysis. The patient had several other complications, including porencephaly, epilepsy, elevated serum levels of creatine kinase, and persistent microscopic hematuria. Later, we detected a genetic mutation in COL4A1, which was recently found to be associated with hemolytic anemia. We therefore believe that all of the patient's clinical features, including hemolytic anemia, were due to the mutation in COL4A1. Genetic testing for COL4A1 mutations is recommended in neonates who exhibit hemolytic disease of unknown etiology, especially when other complications compatible with COL4A1-related disorders are present. Copyright © 2014. Published by Elsevier B.V.

Renal, auricular, and ocular outcomes of Alport syndrome and their current management.

PubMed

Zhang, Yanqin; Ding, Jie

2017-09-01

Alport syndrome is a hereditary glomerular basement membrane disease caused by mutations in the COL4A3/4/5 genes encoding the type IV collagen alpha 3-5 chains. Most cases of Alport syndrome are inherited as X-linked dominant, and some as autosomal recessive or autosomal dominant. The primary manifestations are hematuria, proteinuria, and progressive renal failure, whereas some patients present with sensorineural hearing loss and ocular abnormalities. Renin-angiotensin-aldosterone system blockade is proven to delay the onset of renal failure by reducing proteinuria. Renal transplantation is a curative treatment for patients who have progressed to end-stage renal disease. However, only supportive measures can be used to improve hearing loss and visual loss. Although both stem cell therapy and gene therapy aim to repair the basement membrane defects, technical difficulties require more research in Alport mice before clinical studies. Here, we review the renal, auricular, and ocular manifestations and outcomes of Alport syndrome and their current management.

Dysregulated LIGHT expression on T cells mediates intestinal inflammation and contributes to IgA nephropathy

PubMed Central

Wang, Jing; Anders, Robert A.; Wu, Qiang; Peng, Dacheng; Cho, Judy H.; Sun, Yonglian; Karaliukas, Reda; Kang, Hyung-Sik; Turner, Jerrold R.; Fu, Yang-Xin

2004-01-01

Whether and how T cells contribute to the pathogenesis of immunoglobulin A nephropathy (IgAN) has not been well defined. Here, we explore a murine model that spontaneously develops T cell–mediated intestinal inflammation accompanied by pathological features similar to those of human IgAN. Intestinal inflammation mediated by LIGHT, a ligand for lymphotoxin β receptor (LTβR), not only stimulates IgA overproduction in the gut but also results in defective IgA transportation into the gut lumen, causing a dramatic increase in serum polymeric IgA. Engagement of LTβR by LIGHT is essential for both intestinal inflammation and hyperserum IgA syndrome in our LIGHT transgenic model. Impressively, the majority of patients with inflammatory bowel disease showed increased IgA-producing cells in the gut, elevated serum IgA levels, and severe hematuria, a hallmark of IgAN. These observations indicate the critical contributions of dysregulated LIGHT expression and intestinal inflammation to the pathogenesis of IgAN. PMID:15067315

Type I female genital mutilation: a cause of completely closed vagina.

PubMed

Rouzi, Abdulrahim A; Sahly, Nora; Alhachim, Estabraq; Abduljabbar, Hassan

2014-09-01

Female genital mutilation (FGM) ranges in severity from a nick of the clitoris to partial or total removal of the external genitalia. Sexual complications after FGM include sexual dysfunction, difficult intercourse, and dyspareunia. We report a case of Type I FGM presenting as complete vaginal closure and urinary retention. A 16-year-old adolescent was referred for obliterated vagina and urinary retention. She had recurrent urinary tract infections, difficulty in voiding, and cyclic hematuria. At the age of 1 year she had been taken by her mother to a pediatric surgeon to have a Type I FGM procedure. On examination, the urethral meatus and vaginal orifices were completely closed by the FGM scar. She underwent uneventful surgical opening of the vagina. A normal vaginal orifice was created and normal flow of urine and menses occurred. Type I FGM can present as complete vaginal closure and urinary retention. Proper diagnosis and treatment are of paramount importance. © 2014 International Society for Sexual Medicine.

Advances in Therapeutic Development for Radiation Cystitis.

PubMed

Rajaganapathy, Bharathi Raja; Jayabalan, Nirmal; Tyagi, Pradeep; Kaufman, Jonathan; Chancellor, Michael B

2014-01-01

Radiation treatment for pelvic malignancies is typically associated with radiation injury to urinary bladder that can ultimately lead to radiation cystitis (RC). The late sequelae of radiation therapy may take many years to develop and include bothersome storage symptoms such as hematuria, which may be life-threatening in severe cases of hemorrhagic cystitis. Although no definitive treatment is currently available, various interventions are used for radiation and hemorrhagic cystitis including blood transfusion, bladder irrigation, intravesical instillation of substances such as alum, silver nitrate, prostaglandins or formalin, and fulguration of intravesical bleeding sites and surgery options such as supravesical urinary diversions and cystectomy. Effects of non-surgical treatments for radiation and hemorrhagic cystitis are of modest success and studies are lacking to control the effects caused by RC. When such measures have proven ineffective, use of bladder botulinum toxin injection has been reported. New therapy, such as intravesical immunosuppression with local tacrolimus formulation is being developed for the treatment of radiation hemorrhagic cystitis. © 2013 Wiley Publishing Asia Pty Ltd.

Identification of a Novel GLA Mutation (L206 P) in a Patient with Fabry Disease.

PubMed

Kim, Ji-Hoon; Kim, Gee-Hee; Park, Hoon-Suk; Choi, Jin-A; Bae, Jung-Min; Cho, Uiju

2017-03-01

We report a new α-Galactosidase A (αGal-A) mutation in a 39-year-old Korean born, male Fabry disease patient. Fabry disease is a devastating, progressive inborn error of metabolism caused by X-linked genetic mutations. In this case, the first clinical symptom to occur was in childhood consisting of a burning pain originating in the extremities then radiating inwards to the limbs. This patient also stated to have ringing in his ears, angiokeratomas on his trunk, and cornea verticillata. He visited an outpatient cardiologist due to intermittent and atypical chest discomfort at the age of 39. Electrocardiographic and echocardiographic examination showed left ventricular hypertrophy. A physical examination revealed proteinuria without hematuria. The patient's plasma αGal-A activity was markedly lower than the mean value of the controls. After genetic counseling and obtaining written informed consent, we identified one hemizygous mutation in exon 4 of galactosidase alpha, c.617T>C (p.Leu206 Pro). He was eventually diagnosed as having Fabry disease.

Evaluation of Immunological Disorders of T Lymphocytes and Endocrinological Disorders as Pathogen Factors in Patients With Metaplasia of Urinary Bladder

ClinicalTrials.gov

2014-03-19

The Follow-up Duration Was 1-8 Years.; The Main Reasons Behind Visiting the Hospital Were Recurrent Urinary Tract Infection,; Urinary Urgencies, Pollakiuria, Difficulty in Initiating Micturition, Pain in Hypogastrium,; Night Wetting and Day Wetting, Menstruation's Disorders, Urolithiasis, Defects of Urinary; System and Hematuria.

Hypertrophic osteopathy associated with renal pelvis transitional cell carcinoma in a dog

PubMed Central

Grillo, Thais P.; Brandão, Cláudia V.S.; Mamprim, Maria J.; de Jesus, Carlos M.N.; Santos, Taizha C.; Minto, Bruno W.

2007-01-01

A 6-year-old male, Belgian shepherd dog was presented with lethargy, oliguria, hematuria, and reluctance to move. The dog developed hypertrophic osteopathy secondary to renal pelvis transitional cell carcinoma. A nephrectomy was performed and after a year, the dog was completely asymptomatic, and no evidence of metastatic disease was present. PMID:17824162

Blepharitis

MedlinePlus

... base of the eyelashes as well. Causes The exact cause of blepharitis is unknown. It is thought ... day. After the warm compresses, gently rub a solution of warm water and no-tears baby shampoo ...

Three-dimensional numerical simulation for plastic injection-compression molding

NASA Astrophysics Data System (ADS)

Zhang, Yun; Yu, Wenjie; Liang, Junjie; Lang, Jianlin; Li, Dequn

2018-03-01

Compared with conventional injection molding, injection-compression molding can mold optical parts with higher precision and lower flow residual stress. However, the melt flow process in a closed cavity becomes more complex because of the moving cavity boundary during compression and the nonlinear problems caused by non-Newtonian polymer melt. In this study, a 3D simulation method was developed for injection-compression molding. In this method, arbitrary Lagrangian- Eulerian was introduced to model the moving-boundary flow problem in the compression stage. The non-Newtonian characteristics and compressibility of the polymer melt were considered. The melt flow and pressure distribution in the cavity were investigated by using the proposed simulation method and compared with those of injection molding. Results reveal that the fountain flow effect becomes significant when the cavity thickness increases during compression. The back flow also plays an important role in the flow pattern and redistribution of cavity pressure. The discrepancy in pressures at different points along the flow path is complicated rather than monotonically decreased in injection molding.

Analysis of the operation of the SCD Response intermittent compression system.

PubMed

Morris, Rh J; Griffiths, H; Woodcock, J P

2002-01-01

The work assessed the performance of the Kendall SCD Response intermittent pneumatic compression system for deep vein thrombosis prophylaxis, which claimed to set its cycle according to the blood flow characteristics of individual patient limbs. A series of tests measured the system response in various situations, including application to the limbs of healthy volunteers, and to false limbs. Practical experimentation and theoretical analysis were used to investigate influences on the system functioning other than blood flow. The system tested did not seem to perform as claimed, being unable to distinguish between real and fake limbs. The intervals between compressions were set to times unrealistic for venous refill, with temperature changes in the cuff the greatest influence on performance. Combining the functions of compression and the measurement of the effects of compression in the same air bladder makes temperature artefacts unavoidable and can cause significant errors in the inter-compression interval.

Ultrasonic scissors-assisted 'open-book' thyroidectomy in massive goiter compressing airway and causing unilateral vocal cord paralysis.

PubMed

M, Irfan; Yaroko, Ali Ango; S M, Najeb; Periasamy, Centilnathan

2013-04-01

A massive goiter may constrict the trachea resulting in shortness of breath. Recurrent laryngeal nerve compression may cause vocal cord paralysis. We highlight a case of a 62- year-old female with a 30 year history of an anterior neck swelling gradually increasing in size. She presented with acute symptoms of upper airway obstruction and voice changes. Emergency thyroidectomy was performed by dividing the middle part of the gland using ultrasonic scissors. The recovery was uneventful and the patient regained normal vocal cord function post operatively.

Glaucoma (image)

MedlinePlus

Glaucoma is a condition of increased fluid pressure inside the eye. The increased pressure causes compression of ... nerve which can eventually lead to nerve damage. Glaucoma can cause partial vision loss, with blindness as ...

The Significance of Education for Mortality Compression in the United States*

PubMed Central

Brown, Dustin C.; Hayward, Mark D.; Montez, Jennifer Karas; Humme, Robert A.; Chiu, Chi-Tsun; Hidajat, Mira M.

2012-01-01

Recent studies of old-age mortality trends assess whether longevity improvements over time are linked to increasing compression of mortality at advanced ages. The historical backdrop of these studies is the long-term improvements in a population's socioeconomic resources that fueled longevity gains. We extend this line of inquiry by examining whether socioeconomic differences in longevity within a population are accompanied by old-age mortality compression. Specifically, we document educational differences in longevity and mortality compression for older men and women in the United States. Drawing on the fundamental cause of disease framework, we hypothesize that both longevity and compression increase with higher levels of education and that women with the highest levels of education will exhibit the greatest degree of longevity and compression. Results based on the Health and Retirement Study and the National Health Interview Survey Linked Mortality File confirm a strong educational gradient in both longevity and mortality compression. We also find that mortality is more compressed within educational groups among women than men. The results suggest that educational attainment in the United States maximizes life chances by delaying the biological aging process. PMID:22556045

The Influence of Compression Stocking on Jumping Performance of Athlete

NASA Astrophysics Data System (ADS)

Salleh, M. N.; Lazim, H. M.; Lamsali, H.; Salleh, A. F.

2018-05-01

Evidence of compression stocking effectiveness are mixed, with some researchers suggests that the stocking can enhance performance while others dispute the finding. One of the factors that are thought to cause the mixed results is level of pressure used in their studies. This research had organized a test on fourteen athletes. Their body was scanned and a customized compression stocking which can exert pressure correspond to the intended one was developed. An experiment was conducted to measure the effect of wearing compression stocking on jumping performance. The results show mixed outcomes. For the female athlete, there is a significant difference between wearing and not wearing compression stocking (p<0.05) on knee power. However, there is no significant difference for male athletes whether wearing or not.

Turbulence intensity and spatial integral scale during compression and expansion strokes in a four-cycle reciprocating engine

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ikegami, M.; Shioji, M.; Nishimoto, K.

1987-01-01

A laser homodyne technique is applied to measure turbulence intensities and spatial scales during compression and expansion strokes in a non-fired engine. By using this technique, relative fluid motion in a turbulent flow is detected directly without cyclic variation biases caused by fluctuation in the main flow. Experiments are performed at different engine speeds, compression ratios, and induction swirl ratios. In no-swirl cases the turbulence field near the compression end is almost uniform, whereas in swirled cases both the turbulence intensity and the scale near the cylinder axis are higher than those in the periphery. In addition, based on themore » measured results, the k-epsilon two-equation turbulence model under the influence of compression is discussed.« less

[Experimental study on establishment of a simple model of rats crush injury-crush syndrome].

PubMed

Chen, Xi; Liu, Yuehong; Xu, Wei; Qin, Tingwu; Zhao, Luping; Liu, Shuping; Zhang, Yi; Tan, Hong; Zhou, Yu

2013-01-01

To establish a repeatable, simple, and effective model of rat crush injury and crush syndrome. A total of 42 female Sprague Dawley rats (2-month-old, (CS) so as to lay a foundation for further study on CS. weighing 160-180 g) were divided randomly into the control group (n=6) and experimental group (n=36). The rats of the experimental group were used to establish the crush injury and CS model in both lower limbs by self-made crush injury mould. The survival rate and hematuria rate were observed after decompression. The biochemical indexes of blood were measured at 2, 4, 8, 12, 24, and 48 hours after decompression. The samples of muscle, kidney, and heart were harvested for morphological observation. There was no treatment in the control group, and the same tests were performed. Seven rats died and 15 rats had hematuria during compression in the experimental group. Swelling of the lower limb and muscle tissue was observed in the survival rats after reperfusion. The liver function test results showed that the levels of alanine transaminase and aspartate aminotransferase in the experimental group were significantly higher than those in the control group (P < 0.05). The renal function test results showed that blood urea nitrogen level increased significantly after 2 hours of decompression in the experimental group, showing significant difference when compared with that in the control group at 12, 24, and 48 hours after decompression (P < 0.05); the creatinine level of the experimental group was higher than that of the control group at 4, 8, 12, and 24 hours, showing significant difference at 8, 12, and 24 hours (P < 0.05). The serum K+ concentration of the experimental group was higher than that of the control group at all time, showing significant difference at the other time (P < 0.05) except at 2 hours. The creatine kinase level showed an increasing tendency in the experimental group, showing significant difference when compared with the level of the control group at 4, 8, 12, and 24 hours (P < 0.05). The histological examination of the experimental group showed that obvious edema and necrosis of the muscle were observed at different time points; glomeruli congestion and swelling, renal tubular epithelial cell degeneration, edema, necrosis, and myoglobin tube type were found in the kidneys; and myocardial structure had no obvious changes. The method of the crush injury and CS model by self-made crush injury mould is a simple and effective procedure and the experimental result is stable. It is a simple method to establish an effective model of rats crush injury and CS.

Bending cyclic load test for crystalline silicon photovoltaic modules

NASA Astrophysics Data System (ADS)

Suzuki, Soh; Doi, Takuya; Masuda, Atsushi; Tanahashi, Tadanori

2018-02-01

The failures induced by thermomechanical fatigue within crystalline silicon photovoltaic modules are a common issue that can occur in any climate. In order to understand these failures, we confirmed the effects of compressive or tensile stresses (which were cyclically loaded on photovoltaic cells and cell interconnect ribbons) at subzero, moderate, and high temperatures. We found that cell cracks were induced predominantly at low temperatures, irrespective of the compression or tension applied to the cells, although the orientation of cell cracks was dependent on the stress applied. The fracture of cell interconnect ribbons was caused by cyclical compressive stress at moderate and high temperatures, and this failure was promoted by the elevation of temperature. On the basis of these results, the causes of these failures are comprehensively discussed in relation to the viscoelasticity of the encapsulant.

Combined preoperative traction with instrumented posterior occipitocervical fusion for severe ventral brainstem compression secondary to displaced os odontoideum: technical report of 2 cases.

PubMed

Abd-El-Barr, Muhammad M; Snyder, Brian D; Emans, John B; Proctor, Mark R; Hedequist, Daniel

2016-12-01

Severe os odontoideum causing ventral brainstem compression is a rare and difficult entity to treat. It is generally accepted that severe os odontoideum causing ventral brainstem compression and neurological deficits warrants surgical treatment. This often requires both anterior and posterior procedures. Anterior approaches to the craniocervical junction are fraught with complications, including infection and risk of injury to neurovascular structures. External traction systems traditionally require long-term bedrest. The authors report 2 cases of severe ventral brainstem compression secondary to displaced os odontoideum and describe their use of extended preoperative halo vest traction to reduce the severe kyphosis and improve neurological function, followed by posterior occipitocervical fusion. Postoperatively both patients showed remarkable improvements in their neurological function and kyphotic deformity. Preoperative halo vest traction combined with posterior occipitocervical fusion appears to be a safe and effective method to treat brainstem compression by severe os odontoideum. It allows for adequate decompression of ventral neural structures and improvement of neurological function, but it is not hindered by the risks of anterior surgical approaches and does not restrict patients to strict bedrest as traditional traction systems. This method of halo vest traction and posterior-only approaches may be transferable to other cervical instability issues with both anterior and posterior pathologies.

Tension and Compression Creep Apparatus for wood-Plastic Composites

Treesearch

Scott E. Hamel; John C. Hermanson; Steven M. Cramer

2011-01-01

Design of structural members made of wood-plastic composites (WPC) is not possible without accurate test data for tension and compression. The viscoelastic behavior of these materials means that these data are required for both the quasi-static stress-strain response, and the long-term creep response. Their relative incompressibility causes inherent difficulties in...

A rare case of large isolated internal iliac artery aneurysm with ureteral obstruction and hydronephrosis: Compression symptoms are limitation for endovascular procedures.

PubMed

Nenezic, Dragoslav; Tanaskovic, Slobodan; Gajin, Predrag; Ilijevski, Nenad; Novakovic, Aleksandra; Radak, Djordje

2015-04-01

In this report, we aim to present a rare case of isolated internal iliac artery aneurysm with associated left ureteric obstruction and consequent hydronephrosis. A 66-year-old male patient was admitted for occasional pain in the lower back that appeared one month earlier. CT arteriography revealed isolated internal iliac artery (diameter 99 mm) with ureteral obstruction, hydroureter and left kidney hydronephrosis occurrence. Aneurysm was resected, after six months the patient was doing well. Bearing in mind that 77% of the patients with isolated internal iliac artery have symptoms caused by aneurysmal compression on adjacent organs, we wanted to highlight that despite the amazing expansion of endovascular procedures in the last decades, its therapeutic effect in isolated internal iliac artery's treatment is to a great extent limited since compression symptoms cannot be solved. Open surgery remains the gold standard for isolated internal iliac artery's treatment considering significant limitations of endovascular procedures due to the inability to eliminate problems caused by compression. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Rupture of sigmoid colon caused by compressed air.

PubMed

Yin, Wan-Bin; Hu, Ji-Lin; Gao, Yuan; Zhang, Xian-Xiang; Zhang, Mao-Shen; Liu, Guang-Wei; Zheng, Xue-Feng; Lu, Yun

2016-03-14

Compressed air has been generally used since the beginning of the 20(th) century for various applications. However, rupture of the colon caused by compressed air is uncommon. We report a case of pneumatic rupture of the sigmoid colon. The patient was admitted to the emergency room complaining of abdominal pain and distention. His colleague triggered a compressed air nozzle against his anus as a practical joke 2 h previously. On arrival, his pulse rate was 126 beats/min, respiratory rate was 42 breaths/min and blood pressure was 86/54 mmHg. Physical examination revealed peritoneal irritation and the abdomen was markedly distended. Computed tomography of the abdomen showed a large volume of air in the abdominal cavity. Peritoneocentesis was performed to relieve the tension pneumoperitoneum. Emergency laparotomy was done after controlling shock. Laparotomy revealed a 2-cm perforation in the sigmoid colon. The perforation was sutured and temporary ileostomy was performed as well as thorough drainage and irrigation of the abdominopelvic cavity. Reversal of ileostomy was performed successfully after 3 mo. Follow-up was uneventful. We also present a brief literature review.

Rupture of sigmoid colon caused by compressed air

PubMed Central

Yin, Wan-Bin; Hu, Ji-Lin; Gao, Yuan; Zhang, Xian-Xiang; Zhang, Mao-Shen; Liu, Guang-Wei; Zheng, Xue-Feng; Lu, Yun

2016-01-01

Compressed air has been generally used since the beginning of the 20th century for various applications. However, rupture of the colon caused by compressed air is uncommon. We report a case of pneumatic rupture of the sigmoid colon. The patient was admitted to the emergency room complaining of abdominal pain and distention. His colleague triggered a compressed air nozzle against his anus as a practical joke 2 h previously. On arrival, his pulse rate was 126 beats/min, respiratory rate was 42 breaths/min and blood pressure was 86/54 mmHg. Physical examination revealed peritoneal irritation and the abdomen was markedly distended. Computed tomography of the abdomen showed a large volume of air in the abdominal cavity. Peritoneocentesis was performed to relieve the tension pneumoperitoneum. Emergency laparotomy was done after controlling shock. Laparotomy revealed a 2-cm perforation in the sigmoid colon. The perforation was sutured and temporary ileostomy was performed as well as thorough drainage and irrigation of the abdominopelvic cavity. Reversal of ileostomy was performed successfully after 3 mo. Follow-up was uneventful. We also present a brief literature review. PMID:26973403

Late-onset renal vein thrombosis: A case report and review of the literature

PubMed Central

Hogan, Jessica L.; Rosenthal, Stanton J.; Yarlagadda, Sri G.; Jones, Jill A.; Schmitt, Timothy M.; Kumer, Sean C.; Kaplan, Bruce; Deas, Shenequa L.; Nawabi, Atta M.

2014-01-01

INTRODUCTION Renal vein thrombosis, a rare complication of renal transplantation, often causes graft loss. Diagnosis includes ultrasound with Doppler, and it is often treated with anticoagulation or mechanical thrombectomy. Success is improved with early diagnosis and institution of treatment. PRESENTATION OF CASE We report here the case of a 29 year-old female with sudden development of very late-onset renal vein thrombosis after simultaneous kidney pancreas transplant. This resolved initially with thrombectomy, stenting and anticoagulation, but thrombosis recurred, necessitating operative intervention. Intraoperatively the renal vein was discovered to be compressed by a large ovarian cyst. DISCUSSION Compression of the renal vein by a lymphocele or hematoma is a known cause of thrombosis, but this is the first documented case of compression and thrombosis due to an ovarian cyst. CONCLUSION Early detection and treatment of renal vein thrombosis is paramount to restoring renal allograft function. Any woman of childbearing age may have thrombosis due to compression by an ovarian cyst, and screening for this possibility may improve long-term graft function in this population. PMID:25528029

Late-onset renal vein thrombosis: A case report and review of the literature.

PubMed

Hogan, Jessica L; Rosenthal, Stanton J; Yarlagadda, Sri G; Jones, Jill A; Schmitt, Timothy M; Kumer, Sean C; Kaplan, Bruce; Deas, Shenequa L; Nawabi, Atta M

2015-01-01

Renal vein thrombosis, a rare complication of renal transplantation, often causes graft loss. Diagnosis includes ultrasound with Doppler, and it is often treated with anticoagulation or mechanical thrombectomy. Success is improved with early diagnosis and institution of treatment. We report here the case of a 29 year-old female with sudden development of very late-onset renal vein thrombosis after simultaneous kidney pancreas transplant. This resolved initially with thrombectomy, stenting and anticoagulation, but thrombosis recurred, necessitating operative intervention. Intraoperatively the renal vein was discovered to be compressed by a large ovarian cyst. Compression of the renal vein by a lymphocele or hematoma is a known cause of thrombosis, but this is the first documented case of compression and thrombosis due to an ovarian cyst. Early detection and treatment of renal vein thrombosis is paramount to restoring renal allograft function. Any woman of childbearing age may have thrombosis due to compression by an ovarian cyst, and screening for this possibility may improve long-term graft function in this population. Published by Elsevier Ltd.

Physeal growth arrest by excessive compression: histological, biochemical, and micro-CT observations in rabbits.

PubMed

Yoo, Won Joon; Cheon, Jung-Eun; Lee, Hye Ran; Cho, Tae-Joon; Choi, In Ho

2011-12-01

Compressive force across the growth plate may cause retardation and even arrest of physeal growth. The purpose of this study was to investigate histologic changes, metabolic changes in terms of glycosaminoglycan (GAG) concentration, and contrast-enhanced micro-computed tomography (CEMCT) findings of physeal cartilage in a rabbit model of physeal damage caused by excessive compression. Compressive forces were applied via external fixators for two weeks to the growth plates of distal femurs and proximal tibiae of right hind-legs in 8-week-old rabbits. Left hind-legs remained intact and were used as controls. Forty-four bone specimens containing growth plates of distal femurs or proximal tibiae were harvested one week (n = 12) and four weeks (n = 32) after surgery, and examined for histologic findings (H&E staining) and GAGs quantification in physeal cartilage. After incubation in an ionic contrast material for 48 hours, specimens were scanned by CEMCT, and the pixel values of physeal cartilage were measured. CEMCT showed a thin, highly attenuated line parallel to the growth plate in compressed specimens harvested at four weeks after surgery, which was found to be transversely connected trabecular bone. In these specimens, GAG content in physeal cartilage was significantly lower, and CEMCT pixel values of physeal cartilage were significantly higher than in the specimens from the contralateral control side. Excessive compressive force applied to growth plates produces altered histologic features and metabolic function in terms of decreased GAG content in physeal cartilage, changes that can be demonstrated by CEMCT.

Knee joint passive stiffness and moment in sagittal and frontal planes markedly increase with compression.

PubMed

Marouane, H; Shirazi-Adl, A; Adouni, M

2015-01-01

Knee joints are subject to large compression forces in daily activities. Due to artefact moments and instability under large compression loads, biomechanical studies impose additional constraints to circumvent the compression position-dependency in response. To quantify the effect of compression on passive knee moment resistance and stiffness, two validated finite element models of the tibiofemoral (TF) joint, one refined with depth-dependent fibril-reinforced cartilage and the other less refined with homogeneous isotropic cartilage, are used. The unconstrained TF joint response in sagittal and frontal planes is investigated at different flexion angles (0°, 15°, 30° and 45°) up to 1800 N compression preloads. The compression is applied at a novel joint mechanical balance point (MBP) identified as a point at which the compression does not cause any coupled rotations in sagittal and frontal planes. The MBP of the unconstrained joint is located at the lateral plateau in small compressions and shifts medially towards the inter-compartmental area at larger compression forces. The compression force substantially increases the joint moment-bearing capacities and instantaneous angular rigidities in both frontal and sagittal planes. The varus-valgus laxities diminish with compression preloads despite concomitant substantial reductions in collateral ligament forces. While the angular rigidity would enhance the joint stability, the augmented passive moment resistance under compression preloads plays a role in supporting external moments and should as such be considered in the knee joint musculoskeletal models.

[Selective preimplantation pathological evaluation in renal transplantation: a single center's experience].

PubMed

Peng, F H; Chen, J J; Peng, L K; Xie, X B; Lan, G B; Yu, S J; Wang, Y; Tang, X T; Dai, H L; Gao, C; Fang, C H

2018-01-16

Objective: To summarize the clinical data of pre-implantation biopsy donors in our hospital and explore the clinical characteristics of those donors in pathological high-risk, and to provide references for the selective histological evaluation of extended criteria donor kidneys. Methods: We retrospectively reviewed the clinical data and pre-implantation renal pathologic score of donors from January 1, 2015 to May 1, 2017.During this period, 247 cases of donation after citizen's death (DCD) occurred.After clinical evaluation and selective machine perfusion( Lifeport) evaluation, 30 cases of pre-implantation pathological evaluation were performed.According to Remuzzi scores, donors were divided into low-risk and high-risk group.Nine cases of low-risk group (bilateral kidney's Remuzzi score ≤3) and 16 cases of high-risk group (bilateral or unilateral kidney's Remuzzi score ≥4, severe glomerular micro-thrombi or severe tubular necrosis) were included.Five cases of donors were excluded due to only unilateral renal pathological result available.Both high-risk and low-risk groups' clinical data, including sex, age, height, body weight, body mass index, proteinuria, hematuria, urinary glucose, baseline or admission serum creatinine, serum creatinine before procurement, history of hypertension and/or diabetes mellitus, cardiopulmonary resuscitation or not, with or without the history of shock, urine output prior to acquisition, macroscopical manifestations of donor kidney, cause of death were statistically analyzed. Results: The donors' baseline serum creatinine/upper limit of normal serum creatinine range in high-risk group were significantly higher than that in low-risk group [(129.8±42.2)% vs(92.4±30.5)%, P =0.029]. The poor macroscopical manifestations of donor kidneys were significantly more frequent in high-risk group than that in low-risk group (12/16 vs 0/9, P = 0). No significant differences between two groups were found regarding their age, height, weight, BMI, proteinuria, hematuria, urine glucose, pre-procure creatinine level, history of hypertension and/or diabetes mellitus, cause of death and so on ( P >0.05). Conclusions: After clinical evaluation and selective Lifeport evaluation, donor grafts of whose baseline serum creatinine levels increased beyond normal range and of whose grafts' macroscopical manifestations were poor, should undergo pre-implantation pathological evaluation further.Also, it is reasonable to perform pre-implantation biopsy in cases of equivocal results after Lifeport evaluation.This will be beneficial to identify histological high-risk donors and also be predictive to allocate the grafts.

Inflammatory cascades mediate synapse elimination in spinal cord compression

PubMed Central

2014-01-01

Background Cervical compressive myelopathy (CCM) is caused by chronic spinal cord compression due to spondylosis, a degenerative disc disease, and ossification of the ligaments. Tip-toe walking Yoshimura (twy) mice are reported to be an ideal animal model for CCM-related neuronal dysfunction, because they develop spontaneous spinal cord compression without any artificial manipulation. Previous histological studies showed that neurons are lost due to apoptosis in CCM, but the mechanism underlying this neurodegeneration was not fully elucidated. The purpose of this study was to investigate the pathophysiology of CCM by evaluating the global gene expression of the compressed spinal cord and comparing the transcriptome analysis with the physical and histological findings in twy mice. Methods Twenty-week-old twy mice were divided into two groups according to the magnetic resonance imaging (MRI) findings: a severe compression (S) group and a mild compression (M) group. The transcriptome was analyzed by microarray and RT-PCR. The cellular pathophysiology was examined by immunohistological analysis and immuno-electron microscopy. Motor function was assessed by Rotarod treadmill latency and stride-length tests. Results Severe cervical calcification caused spinal canal stenosis and low functional capacity in twy mice. The microarray analysis revealed 215 genes that showed significantly different expression levels between the S and the M groups. Pathway analysis revealed that genes expressed at higher levels in the S group were enriched for terms related to the regulation of inflammation in the compressed spinal cord. M1 macrophage-dominant inflammation was present in the S group, and cysteine-rich protein 61 (Cyr61), an inducer of M1 macrophages, was markedly upregulated in these spinal cords. Furthermore, C1q, which initiates the classical complement cascade, was more upregulated in the S group than in the M group. The confocal and electron microscopy observations indicated that classically activated microglia/macrophages had migrated to the compressed spinal cord and eliminated synaptic terminals. Conclusions We revealed the detailed pathophysiology of the inflammatory response in an animal model of chronic spinal cord compression. Our findings suggest that complement-mediated synapse elimination is a central mechanism underlying the neurodegeneration in CCM. PMID:24589419

Mammographic compression in Asian women.

PubMed

Lau, Susie; Abdul Aziz, Yang Faridah; Ng, Kwan Hoong

2017-01-01

To investigate: (1) the variability of mammographic compression parameters amongst Asian women; and (2) the effects of reducing compression force on image quality and mean glandular dose (MGD) in Asian women based on phantom study. We retrospectively collected 15818 raw digital mammograms from 3772 Asian women aged 35-80 years who underwent screening or diagnostic mammography between Jan 2012 and Dec 2014 at our center. The mammograms were processed using a volumetric breast density (VBD) measurement software (Volpara) to assess compression force, compression pressure, compressed breast thickness (CBT), breast volume, VBD and MGD against breast contact area. The effects of reducing compression force on image quality and MGD were also evaluated based on measurement obtained from 105 Asian women, as well as using the RMI156 Mammographic Accreditation Phantom and polymethyl methacrylate (PMMA) slabs. Compression force, compression pressure, CBT, breast volume, VBD and MGD correlated significantly with breast contact area (p<0.0001). Compression parameters including compression force, compression pressure, CBT and breast contact area were widely variable between [relative standard deviation (RSD)≥21.0%] and within (p<0.0001) Asian women. The median compression force should be about 8.1 daN compared to the current 12.0 daN. Decreasing compression force from 12.0 daN to 9.0 daN increased CBT by 3.3±1.4 mm, MGD by 6.2-11.0%, and caused no significant effects on image quality (p>0.05). Force-standardized protocol led to widely variable compression parameters in Asian women. Based on phantom study, it is feasible to reduce compression force up to 32.5% with minimal effects on image quality and MGD.

[Compression of the sciatic nerve in uremic tumor calcinosis].

PubMed

García, S; Cofán, F; Combalia, A; Casas, A; Campistol, J M; Oppenheimer, F

1999-02-01

Tumoral calcinosis is an uncommon and benign condition characterized by the presence of slow-growing calcified periarticular soft tissue masses of varying size. They are usually asymptomatic and nerve compression is rare. We describe the case of a 54-year-old female patient on long-term hemodialysis for chronic renal failure presenting sciatica in the left lower limb secondary to an extensive uremic tumoral calcinosis that affected the hip and thigh. The pathogenesis of uremic tumoral calcinosis as well as the treatment and clinical outcome are analyzed. The uncommon nerve compression due to tumoral calcinosis are reviewed. In conclusion, uremic tumoral calcinosis is a not previously reported infrequent cause of sciatic nerve compression.

Inelastic response of silicon to shock compression.

PubMed

Higginbotham, A; Stubley, P G; Comley, A J; Eggert, J H; Foster, J M; Kalantar, D H; McGonegle, D; Patel, S; Peacock, L J; Rothman, S D; Smith, R F; Suggit, M J; Wark, J S

2016-04-13

The elastic and inelastic response of [001] oriented silicon to laser compression has been a topic of considerable discussion for well over a decade, yet there has been little progress in understanding the basic behaviour of this apparently simple material. We present experimental x-ray diffraction data showing complex elastic strain profiles in laser compressed samples on nanosecond timescales. We also present molecular dynamics and elasticity code modelling which suggests that a pressure induced phase transition is the cause of the previously reported 'anomalous' elastic waves. Moreover, this interpretation allows for measurement of the kinetic timescales for transition. This model is also discussed in the wider context of reported deformation of silicon to rapid compression in the literature.

Rectal perforation by compressed air

PubMed Central

2017-01-01

As the use of compressed air in industrial work has increased, so has the risk of associated pneumatic injury from its improper use. However, damage of large intestine caused by compressed air is uncommon. Herein a case of pneumatic rupture of the rectum is described. The patient was admitted to the Emergency Room complaining of abdominal pain and distension. His colleague triggered a compressed air nozzle over his buttock. On arrival, vital signs were stable but physical examination revealed peritoneal irritation and marked distension of the abdomen. Computed tomography showed a large volume of air in the peritoneal cavity and subcutaneous emphysema at the perineum. A rectal perforation was found at laparotomy and the Hartmann procedure was performed. PMID:28706893

Rectal perforation by compressed air.

PubMed

Park, Young Jin

2017-07-01

As the use of compressed air in industrial work has increased, so has the risk of associated pneumatic injury from its improper use. However, damage of large intestine caused by compressed air is uncommon. Herein a case of pneumatic rupture of the rectum is described. The patient was admitted to the Emergency Room complaining of abdominal pain and distension. His colleague triggered a compressed air nozzle over his buttock. On arrival, vital signs were stable but physical examination revealed peritoneal irritation and marked distension of the abdomen. Computed tomography showed a large volume of air in the peritoneal cavity and subcutaneous emphysema at the perineum. A rectal perforation was found at laparotomy and the Hartmann procedure was performed.

Renal Denervation in Patients With Loin Pain Hematuria Syndrome.

PubMed

Prasad, Bhanu; Giebel, Shelley; Garcia, Francisco; Goyal, Kunal; St Onge, Jennifer Rose

2017-01-01

Loin pain hematuria syndrome (LPHS) is a painful and incapacitating condition that typically affects young women. Treatment options, including opiates and/or surgical denervation of the renal nerves by autotransplantation, have variable success. In this report, we describe the successful use of endovascular renal nerve ablation in this population. Four women with LPHS and intractable pain unresponsive to conservative measures underwent endovascular ablation of the renal nerves between July and November 2015 using the Vessix renal denervation system. The number and frequency of pain medications and responses to the EQ-5D, McGill Pain Questionnaire, Geriatric Depression Score, 36-Item Short-Form Health Survey, and Oswestry Disability Index were measured at baseline and 3 and 6 months postprocedure to evaluate changes in pain, disability, quality of life, and mood. There were improvements in pain, disability, and quality of life from baseline to 6 months postprocedure. By 6 months, 2 of 4 patients had discontinued all pain medications, whereas the other 2 had reduced their doses of these medications by 75%. These results suggest that percutaneous catheter-based renal nerve ablation with radiofrequency energy may be a treatment option for some patients with LPHS. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

Spontaneous puerperal extraperitoneal bladder wall rupture in young woman with diagnostic dilemma

PubMed Central

Sabat, Debabrat Kumar; Panigrahi, Pradeep Kumar; Sahoo, Ranjan Kumar; Acharya, Mousumi; Sahu, Mahesh Ch

2015-01-01

A young female presented with an acute abdominal pain and oliguria for 1 week following normal vaginal delivery. No history of hematuria was present. Patient was having lochia rubra. Sealed uterine rupture was suspected clinically. Initial ultrasound of the patient showed distended urinary bladder containing Foley catheter ballon with clamping of Foley catheter and particulate ascites. Abdominal paracentesis revealed hemorrhagic fluid. Contrast-enhanced computed tomography of abdomen revealed ascites, distended urinary bladder and no extraluminal contrast extravasation in delayed scan. As patient condition deteriorated, repeat ultrasound guided abdominal paracentesis was done which revealed transudative peritoneal collection with distended bladder. Cystoscopy revealed urinary bladder ruptures with exudate sealing the rupture site. Exploratory laparotomy was done and a diagnosis of extraperitoneal bladder rupture was confirmed. The rent was repaired in layers. She was put on continuous bladder drainage for 3 weeks followed by bladder training. It presented in a unique way as there was hemorrhagic peritoneal tap, no macroscopic hematuria and urinary bladder was distended in spite of urinary bladder wall rupture which delayed the diagnosis and treatment. Complete emptying of urinary bladder before second stage of labor and during postpartum period with perineal repair is mandatory to prevent urinary bladder rupture. PMID:26985426

Spontaneous puerperal extraperitoneal bladder wall rupture in young woman with diagnostic dilemma.

PubMed

Sabat, Debabrat Kumar; Panigrahi, Pradeep Kumar; Sahoo, Ranjan Kumar; Acharya, Mousumi; Sahu, Mahesh Ch

2015-01-01

A young female presented with an acute abdominal pain and oliguria for 1 week following normal vaginal delivery. No history of hematuria was present. Patient was having lochia rubra. Sealed uterine rupture was suspected clinically. Initial ultrasound of the patient showed distended urinary bladder containing Foley catheter ballon with clamping of Foley catheter and particulate ascites. Abdominal paracentesis revealed hemorrhagic fluid. Contrast-enhanced computed tomography of abdomen revealed ascites, distended urinary bladder and no extraluminal contrast extravasation in delayed scan. As patient condition deteriorated, repeat ultrasound guided abdominal paracentesis was done which revealed transudative peritoneal collection with distended bladder. Cystoscopy revealed urinary bladder ruptures with exudate sealing the rupture site. Exploratory laparotomy was done and a diagnosis of extraperitoneal bladder rupture was confirmed. The rent was repaired in layers. She was put on continuous bladder drainage for 3 weeks followed by bladder training. It presented in a unique way as there was hemorrhagic peritoneal tap, no macroscopic hematuria and urinary bladder was distended in spite of urinary bladder wall rupture which delayed the diagnosis and treatment. Complete emptying of urinary bladder before second stage of labor and during postpartum period with perineal repair is mandatory to prevent urinary bladder rupture.

Accidental genital trauma in the female children in Jordan and the role of forensic medicine.

PubMed

Al-Abdallat, Emad M; Al-Ali, Rayyan A; Salameh, Ghada A

2013-10-01

To evaluate the frequency and the nature of genital trauma in female children in Jordan, and to stress the role of forensics. This is a cross-sectional study conducted between March 2008 and December 2011 in Jordan University Hospital, Amman, Jordan. Sixty-three female children were examined for genital trauma after immediate admission. The mechanism of injury was categorized and reported by the examiners as either straddle, non-straddle blunt, or penetrating. Straddle injury was the cause of injuries in 90.5% of patients, and contusions were the significant type of injury in 34% of patients, followed by abrasions in both labia majora and labia minora. Only one case suffered from non-intact hymen and 2 had hematuria. These 3 cases (4.7%) required surgical intervention and follow-up after 2 weeks. Straddle injuries were the main cause of genital trauma and rarely affect the hymen; however, due to the sensitivity of the subject and the severity of the traumas, forensic physicians should provide consultation and cooperate with gynecologists to exclude or confirm hymenal injuries, where empathy is necessary to mitigate tension associated with such injuries for the sake of the child and the parents as well, along with good management of the injury type.

High-pressure structural, elastic, and thermodynamic properties of zircon-type HoPO 4 and TmPO 4

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gomis, O.; Lavina, B.; Rodríguez-Hernández, P.

2017-01-20

Zircon-type holmium phosphate (HoPO 4) and thulium phosphate (TmPO 4) have been studied by single-crystal x-ray diffraction and ab initio calculations. We report on the influence of pressure on the crystal structure, and on the elastic and thermodynamic properties. The equation of state for both compounds is accurately determined. We have also obtained information on the polyhedral compressibility which is used to explain the anisotropic axial compressibility and the bulk compressibility. Both compounds are ductile and more resistive to volume compression than to shear deformation at all pressures. Furthermore, the elastic anisotropy is enhanced upon compression. Finally, the calculations indicatemore » that the possible causes that make the zircon structure unstable are mechanical instabilities and the softening of a silent B 1u mode.« less

Effectiveness of an association of a cranberry dry extract, D-mannose, and the two microorganisms Lactobacillus plantarum LP01 and Lactobacillus paracasei LPC09 in women affected by cystitis: a pilot study.

PubMed

Vicariotto, Franco

2014-01-01

Urinary tract infections (UTIs) are the most common bacterial infection in women. Most UTIs are acute uncomplicated cystitis caused by Escherichia coli (86%). This study was undertaken to assess the effectiveness of an association of a cranberry dry extract, D-mannose, a gelling complex composed of the exopolysaccharides produced by Streptococcus thermophilus ST10 (DSM 25246) and tara gum, as well as the 2 microorganisms Lactobacillus plantarum LP01 (LMG P-21021) and Lactobacillus paracasei LPC09 (DSM 24243) in women affected by acute uncomplicated cystitis. Thirty-three premenopausal, nonpregnant women diagnosed with acute uncomplicated cystitis were enrolled in a pilot prospective study and completed the treatment protocol. Subjects were instructed to take 2 doses per day during the first month, and then to continue with 1 sachet per day until the sixtieth day. Nitrites and leukocyte esterase on urine dipstick testing were used as indicators of cystitis, with analysis performed at enrollment, after 30 and 60 days, and after 1 month of follow-up. Typical UTI symptoms, namely dysuria, frequent voiding of small volumes, urinary urgency, suprapubic pain, and gross hematuria were scored 0 to 3 and evaluated at each visit. Positive results for the presence of nitrites and leukocyte esterase were found in 14 and 20 subjects after 30 days and in 9 and 14 women after 60 days, respectively (P<0.001). At the end of the follow-up period, positive results for nitrites and leukocyte esterase were recorded in only 4 and 3 of 24 and 19 subjects (16.7%, P=0.103; 15.8%, P=0.325, respectively), with negative results after 60 days. Typical symptoms of cystitis, specifically dysuria, frequent voiding, urgency, and suprapubic pain were significantly improved as well. No significant differences were recorded in the incidence and severity of hematuria at any visit. The long-term ability of an association of cranberry, D-mannose, an innovative gelling complex, and the 2 microorganisms tested to significantly improve the uncomfortable symptoms reported by women with acute cystitis has been suggested.

Extracranial internal carotid artery dissection caused by compression from a giant osteophyte due to atlantoaxial osteoarthritis: case report.

PubMed

Ikedo, Taichi; Nakamura, Kazuhito; Sano, Noritaka; Nagata, Manabu; Okada, Yumiko; Kawakami, Taichiro; Murata, Takaho

2017-10-01

Deformed osseous structures have been reported as rare causes of extracranial internal carotid artery (ICA) dissection, including the styloid process and the hyoid bone. Here, the authors describe the first known case of symptomatic ICA dissection caused by a giant osteophyte due to atlantoaxial osteoarthritis. The left ICA was fixed at the skull base and at the ICA portion compressed by the osteophyte, and it was highly stretched and injured between the two portions during neck rotation. The patient was successfully treated with ligation of the affected ICA following balloon test occlusion. Atlantoaxial osteoarthritis should be considered in the differential diagnosis of ICA dissection in patients with a severely deformed cervical spine.

Varicocoele caused by a pancreatic pseudocyst.

PubMed Central

Dixon, J M; Armstrong, C P; Eremin, O

1983-01-01

Pseudocysts of the pancreas, when large, can compress adjacent structures giving rise to a series of clinical symptoms and signs. We present a patient whose pseudocyst compressed the left renal and testicular veins, resulting in a left sided varicocoele. We can find no evidence of such a complication having been previously reported. Images Fig. 1 Fig. 2 PMID:6840618

The effect of pressure on Cu-btc: framework compression vs. guest inclusion.

PubMed

Graham, Alexander J; Tan, Jin-Chong; Allan, David R; Moggach, Stephen A

2012-02-01

Here we present detailed structural data on the effect of high pressure on Cu-btc. Application of pressure causes solvent to be squeezed into the pores until a phase transition occurs, driven by the sudden compression and expansion of equatorial and axial Cu-O bonds. This journal is © The Royal Society of Chemistry 2012

Squamous cell carcinoma causing dorsal atlantoaxial spinal cord compression in a dog

PubMed Central

Miyazaki, Yuta; Aikawa, Takeshi; Nishimura, Masaaki; Iwata, Munetaka; Kagawa, Yumiko

2016-01-01

A 12-year-old Chihuahua dog was presented for cervical pain and progressive tetraparesis. Magnetic resonance imaging revealed spinal cord compression due to a mass in the dorsal atlantoaxial region. Surgical treatment was performed. The mass was histopathologically diagnosed as a squamous cell carcinoma. The dog recovered to normal neurologic status after surgery. PMID:27708441

Pelvic crescent fractures: variations in injury mechanism and radiographic pattern.

PubMed

Gehlert, Rick J; Xing, Zhiqing; DeCoster, Thomas A

2014-01-01

Pelvic crescent fracture, also known as sacroiliac fracture-dislocation, is traditionally considered as a lateral compression injury and a vertically stable injury. Thirty consecutive cases were analyzed and it was found that 63% of cases were caused by lateral compression (LC), 27% by anteroposterior compression (APC), and 10% by vertical shear (VS). APC and VS injuries cause significant displacement of the anterior iliac fragment, but 21% of LC injury cases showed minimal displacement and were treated successfully with nonoperative treatment. Different injury mechanisms also produce different types of pelvic instability. More important, different injury mechanisms produce distinct radiographic fracture patterns regarding the obliquity of the fracture line and fracture surface. These differences in the fracture pattern will influence the decision of internal fixation options. Therefore, treatment of pelvic crescent fractures should be based on individual analysis of injury mechanism and radiographic fracture pattern.

Magnetic power piston fluid compressor

NASA Technical Reports Server (NTRS)

Gasser, Max G. (Inventor)

1994-01-01

A compressor with no moving parts in the traditional sense having a housing having an inlet end allowing a low pressure fluid to enter and an outlet end allowing a high pressure fluid to exit is described. Within the compressor housing is at least one compression stage to increase the pressure of the fluid within the housing. The compression stage has a quantity of magnetic powder within the housing, is supported by a screen that allows passage of the fluid, and a coil for selectively providing a magnetic field across the magnetic powder such that when the magnetic field is not present the individual particles of the powder are separated allowing the fluid to flow through the powder and when the magnetic field is present the individual particles of the powder pack together causing the powder mass to expand preventing the fluid from flowing through the powder and causing a pressure pulse to compress the fluid.

Trigeminal neuralgia caused by an anomalous posterior inferior cerebellar artery from the primitive trigeminal artery: case report.

PubMed

Lee, Seung Hwan; Koh, Jun Seok; Lee, Cheol Young

2011-06-01

A 61-year-old woman presented with typical trigeminal neuralgia (TN), caused by an aberrant posterior inferior cerebellar artery (PICA) associated with the primitive trigeminal artery (PTA). Magnetic resonance angiography and digital subtraction angiography clearly showed an anomalous artery directly originating from the PTA and coursing into the PICA territory at the cerebellum. During microvascular decompression (MVD), we confirmed and decompressed vascular compression of the trigeminal nerve by this anomalous, PICA-variant type of PTA. The PTA did not conflict with the trigeminal nerve, and the anomalous PICA only compressed the caudolateral part of the trigeminal nerve, without the more common compression at its root entry zone. This case is informative due not only to its very unusual angioanatomical variation but also to its helpfulness for surgeons preparing a MVD for a TN associated with such a rare vascular anomaly.

Development of real time abdominal compression force monitoring and visual biofeedback system

NASA Astrophysics Data System (ADS)

Kim, Tae-Ho; Kim, Siyong; Kim, Dong-Su; Kang, Seong-Hee; Cho, Min-Seok; Kim, Kyeong-Hyeon; Shin, Dong-Seok; Suh, Tae-Suk

2018-03-01

In this study, we developed and evaluated a system that could monitor abdominal compression force (ACF) in real time and provide a surrogating signal, even under abdominal compression. The system could also provide visual-biofeedback (VBF). The real-time ACF monitoring system developed consists of an abdominal compression device, an ACF monitoring unit and a control system including an in-house ACF management program. We anticipated that ACF variation information caused by respiratory abdominal motion could be used as a respiratory surrogate signal. Four volunteers participated in this test to obtain correlation coefficients between ACF variation and tidal volumes. A simulation study with another group of six volunteers was performed to evaluate the feasibility of the proposed system. In the simulation, we investigated the reproducibility of the compression setup and proposed a further enhanced shallow breathing (ESB) technique using VBF by intentionally reducing the amplitude of the breathing range under abdominal compression. The correlation coefficient between the ACF variation caused by the respiratory abdominal motion and the tidal volume signal for each volunteer was evaluated and R 2 values ranged from 0.79 to 0.84. The ACF variation was similar to a respiratory pattern and slight variations of ACF ranges were observed among sessions. About 73-77% average ACF control rate (i.e. compliance) over five trials was observed in all volunteer subjects except one (64%) when there was no VBF. The targeted ACF range was intentionally reduced to achieve ESB for VBF simulation. With VBF, in spite of the reduced target range, overall ACF control rate improved by about 20% in all volunteers except one (4%), demonstrating the effectiveness of VBF. The developed monitoring system could help reduce the inter-fraction ACF set up error and the intra fraction ACF variation. With the capability of providing a real time surrogating signal and VBF under compression, it could improve the quality of respiratory tumor motion management in abdominal compression radiation therapy.

Fractured Rock Permeability as a Function of Temperature and Confining Pressure

NASA Astrophysics Data System (ADS)

Alam, A. K. M. Badrul; Fujii, Yoshiaki; Fukuda, Daisuke; Kodama, Jun-ichi; Kaneko, Katsuhiko

2015-10-01

Triaxial compression tests were carried out on Shikotsu welded tuff, Kimachi sandstone, and Inada granite under confining pressures of 1-15 MPa at 295 and 353 K. The permeability of the tuff declined monotonically with axial compression. The post-compression permeability became smaller than that before axial compression. The permeability of Kimachi sandstone and Inada granite declined at first, then began to increase before the peak load, and showed values that were almost constant in the residual strength state. The post-compression permeability of Kimachi sandstone was higher than that before axial compression under low confining pressures, but lower under higher confining pressures. On the other hand, the permeability of Inada granite was higher than that before axial compression regardless of the confining pressure values. For the all rock types, the post-compression permeability at 353 K was lower than at 295 K and the influence of the confining pressure was less at 353 K than at 295 K. The above temperature effects were observed apparently for Inada granite, only the latter effect was apparent for Shikotsu welded tuff, and they were not so obvious for Kimachi sandstone. The mechanisms causing the variation in rock permeability and sealability of underground openings were discussed.

Coil Compression for Accelerated Imaging with Cartesian Sampling

PubMed Central

Zhang, Tao; Pauly, John M.; Vasanawala, Shreyas S.; Lustig, Michael

2012-01-01

MRI using receiver arrays with many coil elements can provide high signal-to-noise ratio and increase parallel imaging acceleration. At the same time, the growing number of elements results in larger datasets and more computation in the reconstruction. This is of particular concern in 3D acquisitions and in iterative reconstructions. Coil compression algorithms are effective in mitigating this problem by compressing data from many channels into fewer virtual coils. In Cartesian sampling there often are fully sampled k-space dimensions. In this work, a new coil compression technique for Cartesian sampling is presented that exploits the spatially varying coil sensitivities in these non-subsampled dimensions for better compression and computation reduction. Instead of directly compressing in k-space, coil compression is performed separately for each spatial location along the fully-sampled directions, followed by an additional alignment process that guarantees the smoothness of the virtual coil sensitivities. This important step provides compatibility with autocalibrating parallel imaging techniques. Its performance is not susceptible to artifacts caused by a tight imaging fieldof-view. High quality compression of in-vivo 3D data from a 32 channel pediatric coil into 6 virtual coils is demonstrated. PMID:22488589

Dual pathology proximal median nerve compression of the forearm.

PubMed

Murphy, Siun M; Browne, Katherine; Tuite, David J; O'Shaughnessy, Michael

2013-12-01

We report an unusual case of synchronous pathology in the forearm- the coexistence of a large lipoma of the median nerve together with an osteochondroma of the proximal ulna, giving rise to a dual proximal median nerve compression. Proximal median nerve compression neuropathies in the forearm are uncommon compared to the prevalence of distal compression neuropathies (eg Carpal Tunnel Syndrome). Both neural fibrolipomas (Refs. 1,2) and osteochondromas of the proximal ulna (Ref. 3) in isolation are rare but well documented. Unlike that of a distal compression, a proximal compression of the median nerve will often have a definite cause. Neural fibrolipoma, also called fibrolipomatous hamartoma are rare, slow-growing, benign tumours of peripheral nerves, most often occurring in the median nerve of younger patients. To our knowledge, this is the first report of such dual pathology in the same forearm, giving rise to a severe proximal compression of the median nerve. In this case, the nerve was being pushed anteriorly by the osteochondroma, and was being compressed from within by the intraneural lipoma. This unusual case highlights the advantage of preoperative imaging as part of the workup of proximal median nerve compression. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Study on data compression algorithm and its implementation in portable electronic device for Internet of Things applications

NASA Astrophysics Data System (ADS)

Asilah Khairi, Nor; Bahari Jambek, Asral

2017-11-01

An Internet of Things (IoT) device is usually powered by a small battery, which does not last long. As a result, saving energy in IoT devices has become an important issue when it comes to this subject. Since power consumption is the primary cause of radio communication, some researchers have proposed several compression algorithms with the purpose of overcoming this particular problem. Several data compression algorithms from previous reference papers are discussed in this paper. The description of the compression algorithm in the reference papers was collected and summarized in a table form. From the analysis, MAS compression algorithm was selected as a project prototype due to its high potential for meeting the project requirements. Besides that, it also produced better performance regarding energy-saving, better memory usage, and data transmission efficiency. This method is also suitable to be implemented in WSN. MAS compression algorithm will be prototyped and applied in portable electronic devices for Internet of Things applications.

Tension band wiring of the olecranon: is it really a dynamic principle of osteosynthesis?

PubMed

Brink, P R G; Windolf, M; de Boer, P; Brianza, S; Braunstein, V; Schwieger, K

2013-04-01

The tension band principle as applied to transverse olecranon fractures fixed by tension band wiring is based on the premise that distraction forces on the outer cortex of the ulna during elbow flexion are converted to compression forces on the articular surface of the olecranon at the fracture site. In view of some clinical outcomes, where hardware failure and secondary dislocations occur, the question arises if the dynamic compression theory is correct. Compressive forces during active flexion and extension after tension band wiring of a transverse osteotomy of the olecranon were measured in 6 fresh frozen human cadaveric models using a pressure-sensor in the osteotomy gap. We could collect 30 measurements during active flexion and 30 during active extension. Active flexion did not cause any compressive forces in the osteotomy gap. Extension with the humerus in an upright position and the elbow actively extended causes some compression (0.37-0.51 MPa) at the articular surface comparing with active flexion (0.2 MPa) due to gravity forces. Posterior, there was no significant pressure difference observed (0.41-0.45 versus 0.36-0.32 MPa) between active flexion and extension. The tension band wiring principle only exists during active extension in a range of 30-120° of flexion of the elbow. Postoperative exercise programs should be modified in order to prevent loss of compression at the fracture site of transverse olecranon fractures, treated with tension band wiring when the elbow is mobilised. Copyright © 2012 Elsevier Ltd. All rights reserved.

An Observational Epidemiological Study of Exercise-induced Rhabdomyolysis Causing Acute Kidney Injury: A Single-center Experience.

PubMed

Jabur, W L; Nasa, P; Mohammed, K A; Kulkarni, A; Tomaraei, S N

2018-01-01

Exercise-induced rhabdomyolysis (EIR) is an uncommon cause of severe rhabdomyolysis and a very rare cause of acute kidney injury (AKI). A prospective observational study of 25 patients diagnosed with EIR was conducted in a multispecialty hospital in Dubai, from 2009 to 2015. Five out of 25 patients experienced AKI necessitating temporary renal replacement therapy. The initial presentation, biochemical parameters, and clinical course of patients were monitored, to understand epidemiology and risk factors for the development of AKI. There was male preponderance (4 out of 5 patients), higher rate of systemic symptoms (all 5 patients) versus 60% in NRAKI), oligo-anuria (all 5 patients), compartment syndrome (3 out \\of 5) and severe dehydration seen in patients with RAKI group. On laboratory evaluation, there was higher rise in creatinine kinase (CK) enzyme, serum and urine myoglobin levels impaired renal function on presentation, hyperuricemia, high D-dimer level, PCV of more than 55%, found to be associated with RAKI as compared to NRAKI group. Hematuria by positive urine dipstick with absent red blood cells on urinalysis, is an insensitive tool as was present in only 62% and 43% of RAKI and NRAKI groups, respectively. It was also observed that delayed pesentation for medical care, metabolic acidosis, were commonly associated with AKI. All patients with RAKI required RRT for a comparable period of time (3-4 weeks). In all of them, no deterioration or relapse reported on follow-up of 3 months.

Inelastic response of silicon to shock compression

DOE PAGES

Higginbotham, Andrew; Stubley, P. G.; Comley, A. J.; ...

2016-04-13

The elastic and inelastic response of [001] oriented silicon to laser compression has been a topic of considerable discussion for well over a decade, yet there has been little progress in understanding the basic behaviour of this apparently simple material. We present experimental x-ray diffraction data showing complex elastic strain profiles in laser compressed samples on nanosecond timescales. We also present molecular dynamics and elasticity code modelling which suggests that a pressure induced phase transition is the cause of the previously reported ‘anomalous’ elastic waves. Moreover, this interpretation allows for measurement of the kinetic timescales for transition. Lastly, this modelmore » is also discussed in the wider context of reported deformation of silicon to rapid compression in the literature.« less

Inelastic response of silicon to shock compression

PubMed Central

Higginbotham, A.; Stubley, P. G.; Comley, A. J.; Eggert, J. H.; Foster, J. M.; Kalantar, D. H.; McGonegle, D.; Patel, S.; Peacock, L. J.; Rothman, S. D.; Smith, R. F.; Suggit, M. J.; Wark, J. S.

2016-01-01

The elastic and inelastic response of [001] oriented silicon to laser compression has been a topic of considerable discussion for well over a decade, yet there has been little progress in understanding the basic behaviour of this apparently simple material. We present experimental x-ray diffraction data showing complex elastic strain profiles in laser compressed samples on nanosecond timescales. We also present molecular dynamics and elasticity code modelling which suggests that a pressure induced phase transition is the cause of the previously reported ‘anomalous’ elastic waves. Moreover, this interpretation allows for measurement of the kinetic timescales for transition. This model is also discussed in the wider context of reported deformation of silicon to rapid compression in the literature. PMID:27071341

Esophageal achalasia compressing left atrium diagnosed by echocardiography using a liquid containing carbon dioxide in a 21-year-old woman with Turner syndrome.

PubMed

Park, Man Je; Song, Bong Gun; Lee, Hyoun Soo; Kim, Ki Hoon; Ok, Hea Sung; Kim, Byeong Ki; Park, Yong Hwan; Kang, Gu Hyun; Chun, Woo Jung; Oh, Ju Hyeon

2012-01-01

Extrinsic compression of the left atrium by the esophagus, the stomach, or both is an uncommon but important cause of hemodynamic compromise. Achalasia is a motility disorder characterized by impaired relaxation of the lower esophageal sphincter and dilatation of the distal two thirds of the esophagus. Echocardiographic imaging after oral ingestion of liquid containing carbon dioxide allowed for differentiation between a compressive vascular structure and the esophagus. We report a rare case of esophageal achalasia compressing the left atrium diagnosed by echocardiography using a liquid containing carbon dioxide in a 21-year-old woman with Turner syndrome. Copyright © 2012 Elsevier Inc. All rights reserved.

Buckling and Failure of Compression-loaded Composite Cylindrical Shells with Reinforced Cutouts

NASA Technical Reports Server (NTRS)

Hilburger, Mark W.; Nemeth, Michael P.

2005-01-01

Results from a numerical and experimental study that illustrate the effects of selected cutout reinforcement configurations on the buckling and failure response of compression-loaded composite cylindrical shells with a cutout are presented. The effects of reinforcement size, thickness, and orthotropy on the overall response of compression-loaded shells are described. In general, reinforcement around a cutout in a compression-loaded shell can retard or eliminate the local buckling response and material failure near the cutout and increase the buckling load of the shell. However, some results show that certain reinforcement configurations can cause a significant increase in the local interlaminar failures that can accumulate near the free edges of a cutout during a local buckling event.

Relationship between weight of rescuer and quality of chest compression during cardiopulmonary resuscitation

PubMed Central

2014-01-01

Background According to the guidelines for cardiopulmonary resuscitation (CPR), the rotation time for chest compression should be about 2 min. The quality of chest compressions is related to the physical fitness of the rescuer, but this was not considered when determining rotation time. The present study aimed to clarify associations between body weight and the quality of chest compression and physical fatigue during CPR performed by 18 registered nurses (10 male and 8 female) assigned to light and heavy groups according to the average weight for each sex in Japan. Methods Five-minute chest compressions were then performed on a manikin that was placed on the floor. Measurement parameters were compression depth, heart rate, oxygen uptake, integrated electromyography signals, and rating of perceived exertion. Compression depth was evaluated according to the ratio (%) of adequate compressions (at least 5 cm deep). Results The ratio of adequate compressions decreased significantly over time in the light group. Values for heart rate, oxygen uptake, muscle activity defined as integrated electromyography signals, and rating of perceived exertion were significantly higher for the light group than for the heavy group. Conclusion Chest compression caused increased fatigue among the light group, which consequently resulted in a gradual fall in the quality of chest compression. These results suggested that individuals with a lower body weight should rotate at 1-min intervals to maintain high quality CPR and thus improve the survival rates and neurological outcomes of victims of cardiac arrest. PMID:24957919

Transcatheter Embolization of a Large Symptomatic Pelvic Arteriovenous Malformation with Glubran 2 Acrylic Glue

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gandini, R.; Angelopoulos, G., E-mail: giorginos78@msn.com; Konda, D.

A young patient affected by a pelvic arteriovenous malformation (pAVM) with recurrent episodes of hematuria following exercise, underwent transcatheter embolization using Glubran 2 acrylic glue (GEM, Viareggio, Italy). All branches of the pAVM were successfully occluded. The patient showed prompt resolution of symptoms and persistent occlusion of the pAVM at the 6 month follow-up.

Compression asphyxia from a human pyramid.

PubMed

Tumram, Nilesh Keshav; Ambade, Vipul Namdeorao; Biyabani, Naushad

2015-12-01

In compression asphyxia, respiration is stopped by external forces on the body. It is usually due to an external force compressing the trunk such as a heavy weight on the chest or abdomen and is associated with internal injuries. In present case, the victim was trapped and crushed under the falling persons from a human pyramid formation for a "Dahi Handi" festival. There was neither any severe blunt force injury nor any significant pathological natural disease contributing to the cause of death. The victim was unable to remove himself from the situation because his cognitive responses and coordination were impaired due to alcohol intake. The victim died from asphyxia due to compression of his chest and abdomen. Compression asphyxia resulting from the collapse of a human pyramid and the dynamics of its impact force in these circumstances is very rare and is not reported previously to the best of our knowledge. © The Author(s) 2015.

Histopathological spectrum of childhood nephrotic syndrome in Indian children.

PubMed

Kumar, Jitendra; Gulati, Sanjeev; Sharma, Ajay Prakash; Sharma, Raj Kumar; Gupta, Ramesh Kumar

2003-07-01

Nephrotic syndrome in children is a clinical manifestation of different histopathological subtypes. There is a paucity of recent large studies dealing with the histopathological spectrum from developing countries. A prospective study was performed from January 1990 to December 2000 at our center, involving 600 children (with age of onset up to 16 years) with idiopathic nephrotic syndrome (INS). The objectives were: (1) to study the histopathological distribution of different subtypes of INS and (2) to compare the clinical and biochemical parameters at the time of diagnosis of minimal change disease (MCD) with non-MCD subtypes. For the purpose of this study we analyzed only those children with INS who underwent biopsies. The study group included 290 children in which adequate biopsy reports were available. There were 213 males and 77 females. Mean age at onset of INS was 7.9+5.1 years. Facial edema was found in 286 (98.6%), microhematuria in 120 (41.3%), gross hematuria in 7 (2.5%), and hypertension in 77(26.8%) patients. All patients of the study group were seronegative for HBsAg and HIV. Focal and segmental glomerulosclerosis (FSGS) was the most common histopathological subtype, occurring in 110 of 290 children (38%). Other subtypes included MCD in 95 children (32%), membranoproliferative glomerulonephritis (MPGN) in 44 children (15%), mesangioproliferative glomerulonephritis in 33 children (11%), membranous glomerulonephritis in 5 children (2%), and diffuse mesangial sclerosis in 3 children (1%). In children under 8 years of age, MCD was the most common entity, whereas FSGS predominated in children with age at onset greater than 8 years. The age at onset of nephrotic syndrome was significantly higher in the non-MCD group than the MCD group. The incidence of hypertension, microhematuria, and gross hematuria was significantly lower in the MCD group. MCD remains the most common histopathological subtype in Indian children with INS and onset under 8 years of age. The incidence of MPGN continues to be high. MCD can be differentiated from non-MCD subtype by younger age at onset, absence of hypertension, and absence of microscopic hematuria.

Transurethral resection of the prostate (TURP) - Series (image)

MedlinePlus

The prostate gland is an organ that surrounds the urinary urethra in men. It secretes fluid that mixes with ... An enlarged prostate gland compresses the urethra, causing problems with ... is caused by prostate gland overgrowth (benign prostatic ...

Preparation of graphite dispersed copper composite with intruding graphite particles in copper plate

NASA Astrophysics Data System (ADS)

Noor, Abdul Muizz Mohd; Ishikawa, Yoshikazu; Yokoyama, Seiji

2017-01-01

In this study, it was attempted that copper-graphite composite was prepared locally on the surface of a copper plate with using a spot welding machine. Experiments were carried out with changing the compressive load, the repetition number of the compression and the electrical current in order to study the effect of them on carbon content and Vickers hardness on the copper plate surface. When the graphite was pushed into copper plate only with the compressive load, the composite was mainly hardened by the work hardening. The Vickers hardness increased linearly with an increase in the carbon content. When an electrical current was energized through the composite at the compression, the copper around the graphite particles were heated to the temperature above approximately 2100 K and melted. The graphite particles partially or entirely dissolved into the melt. The graphite particles were precipitated from the melt under solidification. In addition, this high temperature caused the improvement of wetting of copper to graphite. This high temperature caused the annealing, and reduced the Vickers hardness. Even in this case, the Vickers hardness increased with an increase in the carbon content. This resulted from the dispersion hardening.

Edema: diagnosis and management.

PubMed

Trayes, Kathryn P; Studdiford, James S; Pickle, Sarah; Tully, Amber S

2013-07-15

Edema is an accumulation of fluid in the interstitial space that occurs as the capillary filtration exceeds the limits of lymphatic drainage, producing noticeable clinical signs and symptoms. The rapid development of generalized pitting edema associated with systemic disease requires timely diagnosis and management. The chronic accumulation of edema in one or both lower extremities often indicates venous insufficiency, especially in the presence of dependent edema and hemosiderin deposition. Skin care is crucial in preventing skin breakdown and venous ulcers. Eczematous (stasis) dermatitis can be managed with emollients and topical steroid creams. Patients who have had deep venous thrombosis should wear compression stockings to prevent postthrombotic syndrome. If clinical suspicion for deep venous thrombosis remains high after negative results are noted on duplex ultrasonography, further investigation may include magnetic resonance venography to rule out pelvic or thigh proximal venous thrombosis or compression. Obstructive sleep apnea may cause bilateral leg edema even in the absence of pulmonary hypertension. Brawny, nonpitting skin with edema characterizes lymphedema, which can present in one or both lower extremities. Possible secondary causes of lymphedema include tumor, trauma, previous pelvic surgery, inguinal lymphadenectomy, and previous radiation therapy. Use of pneumatic compression devices or compression stockings may be helpful in these cases.

A database for assessment of effect of lossy compression on digital mammograms

NASA Astrophysics Data System (ADS)

Wang, Jiheng; Sahiner, Berkman; Petrick, Nicholas; Pezeshk, Aria

2018-03-01

With widespread use of screening digital mammography, efficient storage of the vast amounts of data has become a challenge. While lossless image compression causes no risk to the interpretation of the data, it does not allow for high compression rates. Lossy compression and the associated higher compression ratios are therefore more desirable. The U.S. Food and Drug Administration (FDA) currently interprets the Mammography Quality Standards Act as prohibiting lossy compression of digital mammograms for primary image interpretation, image retention, or transfer to the patient or her designated recipient. Previous work has used reader studies to determine proper usage criteria for evaluating lossy image compression in mammography, and utilized different measures and metrics to characterize medical image quality. The drawback of such studies is that they rely on a threshold on compression ratio as the fundamental criterion for preserving the quality of images. However, compression ratio is not a useful indicator of image quality. On the other hand, many objective image quality metrics (IQMs) have shown excellent performance for natural image content for consumer electronic applications. In this paper, we create a new synthetic mammogram database with several unique features. We compare and characterize the impact of image compression on several clinically relevant image attributes such as perceived contrast and mass appearance for different kinds of masses. We plan to use this database to develop a new objective IQM for measuring the quality of compressed mammographic images to help determine the allowed maximum compression for different kinds of breasts and masses in terms of visual and diagnostic quality.

The impact of hazardous waste leachate on performance of clay liners.

PubMed

Mosavat, Nasim; Nalbantoglu, Zalihe

2013-02-01

Penetration of hazardous liquids through waste containment barriers exerts contamination and considerable alterations in geotechnical properties of clay liners. In general, these changes are attributed to the variation of the dielectric constant and the chemistry of the pore fluids which cause changes in soil structure. In the present study, a series of laboratory tests were performed on natural and contaminated clay soil permeated with different hazardous liquids: ethylene glycol and toluene which are generally found in petroleum-contaminated sites, possessing intermediate and low dielectric constants. Toluene was used in its pure form and ethylene glycol was used at various percentages of 0, 20, 40 and 60% by the volume of distilled water. In addition, natural sea water was also utilized as an inorganic fluid for permeation and salinization of the clay soil. The overall test results indicated that plasticity, sedimentation time, unconfined compressive strength, swell and compressibility generally decreased with increasing organic fluid/water concentration, while a slight increase in the permeability values was observed. Pure toluene resulted in diminution of plasticity and considerable flocculation of the particles which caused the soil to become granular. Sea water also caused particle flocculation and reduction in plasticity, swell potential and unconfined compressive strength, although it was noted that compressibility properties remained unchanged compared to distilled water. Finally, the correlation between the electrical resistivity and plasticity index values suggested that the electrical resistivity measurements can be used as a detecting technique for subsurface soil and waste barrier contamination.

Clinical approach to optic neuropathies

PubMed Central

Behbehani, Raed

2007-01-01

Optic neuropathy is a frequent cause of vision loss encountered by ophthalmologist. The diagnosis is made on clinical grounds. The history often points to the possible etiology of the optic neuropathy. A rapid onset is typical of demyelinating, inflammatory, ischemic and traumatic causes. A gradual course points to compressive, toxic/nutritional and hereditary causes. The classic clinical signs of optic neuropathy are visual field defect, dyschromatopsia, and abnormal papillary response. There are ancillary investigations that can support the diagnosis of optic neuropathy. Visual field testing by either manual kinetic or automated static perimetry is critical in the diagnosis. Neuro-imaging of the brain and orbit is essential in many optic neuropathies including demyelinating and compressive. Newer technologies in the evaluation of optic neuropathies include multifocal visual evoked potentials and optic coherence tomography. PMID:19668477

[Extrinsic compression of the hepatocholedocus caused by cavernomatosis of the portal vein. Report of a case].

PubMed

Carpani, M; Guma, C I; Casal, M A

1982-01-01

The extrinsic compression of the hepatocholedochus by a cavernomatosis of the portal vein, is an unusual pathology. The present case begun clinically as an obstructive jaundice, assuming that the vascular origin of the compression increased the litiasic biliary disease. The percutaneous transhepatic cholangiography was the diagnostic method that suggested a double illness of the biliary system. The surgery and the pathology certificated the diagnosis. The correct treatment once confirmed the obstructive trial, must be: the extraction of the biliary gallstones and the bile-digestive derivation (preferently the hepatic-jejunum anastomosis in Y of Roux).

Electrical conductivity of SiO2 at extreme conditions and planetary dynamos

PubMed Central

Scipioni, Roberto; Stixrude, Lars; Desjarlais, Michael P.

2017-01-01

Ab intio molecular dynamics simulations show that the electrical conductivity of liquid SiO2 is semimetallic at the conditions of the deep molten mantle of early Earth and super-Earths, raising the possibility of silicate dynamos in these bodies. Whereas the electrical conductivity increases uniformly with increasing temperature, it depends nonmonotonically on compression. At very high pressure, the electrical conductivity decreases on compression, opposite to the behavior of many materials. We show that this behavior is caused by a novel compression mechanism: the development of broken charge ordering, and its influence on the electronic band gap. PMID:28784773

Internal loading of an inhomogeneous compressible Earth with phase boundaries

NASA Technical Reports Server (NTRS)

Defraigne, P.; Dehant, V.; Wahr, J. M.

1996-01-01

The geoid and the boundary topography caused by mass loads inside the earth were estimated. It is shown that the estimates are affected by compressibility, by a radially varying density distribution, and by the presence of phase boundaries with density discontinuities. The geoid predicted in the chemical boundary case is 30 to 40 percent smaller than that predicted in the phase case. The effects of compressibility and radially varying density are likely to be small. The inner core-outer core topography for loading inside the mantle and for loading inside the inner core were computed.

Percutaneous Coronary Intervention for a Patient with Left Main Coronary Compression Syndrome.

PubMed

Ikegami, Ryutaro; Ozaki, Kazuyuki; Ozawa, Takuya; Hirono, Satoru; Ito, Masahiro; Minamino, Tohru

2018-05-15

Left main coronary compression syndrome rarely occurs in patients with severe pulmonary hypertension. A 65-year-old woman with severe pulmonary hypertension due to an atrial septal defect suffered from angina on effort. Cardiac computed-tomography and coronary angiography revealed considerable stenosis of the left main coronary artery (LMA) caused by compression between the dilated main pulmonary artery trunk and the sinus of valsalva. Stenting of the LMA under intravascular ultrasound imaging was effective for the treatment of angina. We herein report the diagnosis and management of this condition with a brief literature review.

Marked Increase in Flow Velocities During Deep Expiration: A Duplex Doppler Sign of Celiac Artery Compression Syndrome

DOE Office of Scientific and Technical Information (OSTI.GOV)

Erden, Ayse; Yurdakul, Mehmet; Cumhur, Turhan

1999-07-15

Symptoms of chronic mesenteric ischemia develop when the celiac artery is constricted by the median arcuate ligament of the diaphragm. Lateral aortography is the primary modality for diagnosing ligamentous compression of the celiac artery. However, duplex Doppler sonography performed during deep expiration can cause a marked increase in flow velocities at the compressed region of the celiac artery and suggest the diagnosis of celiac arterial constriction due to the diaphragmatic ligament. RID='''' ID='''' Correspondence to: A. Erden, M.D., Hafta sokak. 23/6, Gaziosmanpasa, 06700 Ankara, Turkey.

Effects of environmental gas compression on the multiphase ISM and star formation . The Virgo spiral galaxies NGC 4501 and NGC 4567/68

NASA Astrophysics Data System (ADS)

Nehlig, F.; Vollmer, B.; Braine, J.

2016-03-01

The cluster environment can affect galaxy evolution in different ways: via ram pressure stripping or by gravitational perturbations caused by galactic encounters. Both kinds of interactions can lead to the compression of the interstellar medium (ISM) and its associated magnetic fields, causing an increase in the gas surface density and the appearance of asymmetric ridges of polarized radio continuum emission. New IRAM 30m HERA CO(2-1) data of NGC 4501, a Virgo spiral galaxy currently experiencing ram pressure stripping, and NGC 4567/68, an interacting pair of galaxies in the Virgo cluster, are presented. We find an increase in the molecular fraction where the ISM is compressed. The gas is close to self-gravitation in compressed regions. This leads to an increase in gas pressure and a decrease in the ratio between the molecular fraction and total ISM pressure. The overall Kennicutt Schmidt relation based on a pixel-by-pixel analysis at ~1.5 kpc resolution is not significantly modified by compression. However, we detected continuous regions of low molecular star formation efficiencies in the compressed parts of the galactic gas disks. The data suggest that a relation between the molecular star formation efficiency SFEH2 = SFR/M(H2) and gas self-gravitation (Rmol/Ptot and Toomre Q parameter) exists. Both systems show spatial variations in the star formation efficiency with respect to the molecular gas that can be related to environmental compression of the ISM. An analytical model was used to investigate the dependence of SFEH2 on self-gravitation. The model correctly reproduces the correlations between Rmol/Ptot, SFEH2, and Q if different global turbulent velocity dispersions are assumed for the three galaxies. We found that variations in the NH2/ICO conversion factor can mask most of the correlation between SFEH2 and the Toomre Q parameter. Dynamical simulations were used to compare the effects of ram pressure and tidal ISM compression. These models give direct access to the volume density. We conclude that a gravitationally induced ISM compression has the same consequences as ram pressure compression: (I) an increasing gas surface density; (II) an increasing molecular fraction; and (III) a decreasing Rmol/Ptot in the compressed region due to the presence of nearly self-gravitating gas. The response of SFEH2 to compression is more complex. While in the violent ISM-ISM collisions (e.g., Taffy galaxies and NGC 4438) the interaction makes star formation drop by an order of magnitude, we only detect an SFEH2 variation of ~50% in the compressed regions of the three galaxies. We suggest that the decrease in star formation depends on the ratio between the compression timescale and the turbulent dissipation timescale. In NGC 4501 and NGC 4567/68 the compression timescale is comparable to the turbulent dissipation timescale and only leads to minor changes in the molecular star formation efficiency.

Branchial cleft cyst encircling the hypoglossal nerve

PubMed Central

Long, Kristin L.; Spears, Carol; Kenady, Daniel E.

2013-01-01

Branchial cleft anomalies are a common cause of lateral neck masses and may present with infection, cyst enlargement or fistulas. They may affect any of the nearby neck structures, causing compressive symptoms or vessel thrombosis. We present a case of a branchial cleft cyst in a 10-year-old boy who had been present for 1year. At the time of operation, the cyst was found to completely envelop the hypoglossal nerve. While reports of hypoglossal nerve palsies due to external compression from cysts are known, we believe this to be the first report of direct nerve involvement by a branchial cleft cyst. PMID:24963902

True aneurysm of the proximal occipital artery: Case report.

PubMed

Illuminati, Giulio; Cannistrà, Marco; Pizzardi, Giulia; Pasqua, Rocco; Frezzotti, Francesca; Calio', Francesco G

2018-01-01

True aneurysms of the proximal occipital artery are rare, may cause neurological symptoms due to compression of the hypoglossal nerve and their resection may be technically demanding. The case of an aneurysm of the proximal occipital artery causing discomfort and tongue deviation by compression on the hypoglossal nerve is reported. Postoperative course after resection was followed by complete regression of symptoms. Surgical resection, as standard treatment of aneurysms of the occipital artery, with the eventual technical adjunct of intubation by the nose is effective in durably relieving symptoms and preventing aneurysm-related complication. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

A molecular dynamics and ab initio analysis of the electronic structure of single-walled carbon nanotubes adhered to a substrate

NASA Astrophysics Data System (ADS)

Van Der Geest, A. G.; Lu, Z.; Lusk, M. T.; Dunn, M. L.

2011-04-01

Single-wall nanotubes can adhere to planar surfaces via van der Waals forces, and this causes the tubes to deform. We use classical molecular dynamics to estimate this deformation and density functional theory to quantify its impact on electronic band structure. For (n,0) tubes, adhesion causes the maximum bandgap to rise more rapidly with diameter, but the value of the maximum is not affected. The influence of adhesion forces on bandgap was found to correlate with that associated with lateral, uniaxial compression for moderate values of adhesion energy and compressive distortion.

Common peroneal neuropathy related to cryotherapy and compression in a footballer.

PubMed

Babwah, Terence

2011-01-01

This report describes the effect of excessive cooling with ice, and compression with a plastic wrap on the common peroneal nerve (CPN) for 90 minutes in a professional footballer, which led to a common peroneal nerve palsy and a resulting footdrop. It highlights the need to be cautious with regards to the duration and frequency of icing as well as the choice of anchoring material when applying ice to injured areas that have superficial nerves passing nearby. Full recovery of the CPN function occurred in this athlete after five weeks. The major causes of footdrop and common causes of common peroneal neuropathy are discussed.

Intractable occipital neuralgia caused by an entrapment in the semispinalis capitis.

PubMed

Son, Byung-Chul; Kim, Deok-Ryeong; Lee, Sang-Won

2013-09-01

Occipital neuralgia is a rare pain syndrome characterized by periodic lancinating pain involving the occipital nerve complex. We present a unique case of entrapment of the greater occipital nerve (GON) within the semispinalis capitis, which was thought to be the cause of occipital neuralgia. A 66-year-old woman with refractory left occipital neuralgia revealed an abnormally low-loop of the left posterior inferior cerebellar artery on the magnetic resonance imaging, suggesting possible vascular compression of the upper cervical roots. During exploration, however, the GON was found to be entrapped at the perforation site of the semispinalis capitis. There was no other compression of the GON or of C1 and C2 dorsal roots in their intracranial course. Postoperatively, the patient experienced almost complete relief of typical neuralgic pain. Although occipital neuralgia has been reported to occur by stretching of the GON by inferior oblique muscle or C1-C2 arthrosis, peripheral compression in the transmuscular course of the GON in the semispinalis capitis as a cause of refractory occipital neuralgia has not been reported and this should be considered when assessing surgical options for refractory occipital neuralgia.

Intractable Occipital Neuralgia Caused by an Entrapment in the Semispinalis Capitis

PubMed Central

Kim, Deok-ryeong; Lee, Sang-won

2013-01-01

Occipital neuralgia is a rare pain syndrome characterized by periodic lancinating pain involving the occipital nerve complex. We present a unique case of entrapment of the greater occipital nerve (GON) within the semispinalis capitis, which was thought to be the cause of occipital neuralgia. A 66-year-old woman with refractory left occipital neuralgia revealed an abnormally low-loop of the left posterior inferior cerebellar artery on the magnetic resonance imaging, suggesting possible vascular compression of the upper cervical roots. During exploration, however, the GON was found to be entrapped at the perforation site of the semispinalis capitis. There was no other compression of the GON or of C1 and C2 dorsal roots in their intracranial course. Postoperatively, the patient experienced almost complete relief of typical neuralgic pain. Although occipital neuralgia has been reported to occur by stretching of the GON by inferior oblique muscle or C1-C2 arthrosis, peripheral compression in the transmuscular course of the GON in the semispinalis capitis as a cause of refractory occipital neuralgia has not been reported and this should be considered when assessing surgical options for refractory occipital neuralgia. PMID:24278663

Deformation behavior of open-cell dry natural rubber foam: Effect of different concentration of blowing agent and compression strain rate

NASA Astrophysics Data System (ADS)

Samsudin, M. S. F.; Ariff, Z. M.; Ariffin, A.

2017-04-01

Compression and deformation behavior of partially open cell natural rubber (NR) foam produced from dry natural rubber (DNR), were investigated by performing compressive deformation at different strains and strain rates. Different concentrations of sodium bicarbonate as a blowing agent (BA) were utilized, from 4 to 16 phr in order to produce foams with range of cell size and morphology. Overall, increasing of blowing agent concentration had significantly changed relative foam density. Compression stress-strain curves of the foams exhibited that the compression behavior was directly correlated to the foam cells morphology and physical density. Pronounced changes were noticed for foams with bigger cells particularly at 4 phr concentration of BA where the compression stress at plateau region was greater compared to those with higher concentration of BA. Cell deformation progressive images confirmed that the foams demonstrated small degree of struts bending at 15% of strain and followed by continuous severe struts bending and elastic buckling up to 50% of strain. Compression test at different strain rates revealed that the strain rate factor only affected the foams with 4 phr of BA by causing immediate increment in the compression stress value when higher strain rate was applied.

Nonsurgical management of an extensive spontaneous spinal epidural hematoma causing quadriplegia and respiratory distress in a choledocholithiasis patient

PubMed Central

Raasck, Kyle; Khoury, Jason; Aoude, Ahmed; Abduljabbar, Fahad; Jarzem, Peter

2017-01-01

Abstract Rationale: Spontaneous spinal epidural hematoma (SSEH) manifests from blood accumulating in the epidural space, compressing the spinal cord, and leading to acute neurological deficits. The disease's cloudy etiology and rarity contribute to dangerously suboptimal therapeutic principles. These neural deficits can be permanent, even fatal, if the SSEH is not treated in a timely and appropriate manner. Standard therapy is decompressive laminectomy, though nonsurgical management is a viable course of action for patients who meet a criterion that is continuously being refined. Patient concerns: A 76-year-old woman on warfarin for a past pulmonary embolism presented to the emergency room with jaundice, myalgia, hematuria, neck pain, and an International Normalized Ratio (INR) of 14. Upon admission, she rapidly developed quadriplegia and respiratory distress that necessitated intubation. Diagnoses: T2-weighted magnetic resonance imaging (MRI) revealed an epidural space-occupying hyperintensity from C2 to S5 consistent with a spinal epidural hematoma. An incidental finding of dilated intrahepatic and common bile ducts prompted an endoscopic retrograde cholangiopancreatography, which demonstrated choledocholithiasis. Interventions: The patient's INR was normalized with Vitamin K and Beriplex. Upon transfer to the surgical spine team for assessment of a possible intervention, the patient began to demonstrate recovery of neural functions. The ensuing sustained motor improvement motivated the team's preference for close neurologic monitoring and continued medical therapy over surgery. Thirteen hours after the onset of her symptoms, the patient was extubated. A sphincterotomy was later performed, removing 81 common bile duct stones. Outcomes: MRI demonstrated complete resorption of the SSEH and the patient maintained full neurological function at final follow-up. Lessons: Nonsurgical management of SSEH should be considered in the context of early and sustained recovery. Severe initial neural deficit does not necessitate surgical decompression. Choledocholithiasis and subsequent Vitamin K deficiency, particularly when coupled with anticoagulant use, can increase INR and is a novel proposed risk factor for SSEH. Furthermore, coagulopathies should be medically corrected before surgical intervention within a given timeframe, as spontaneous recovery may manifest. This should be favored over surgery in patients demonstrating early and sustained recovery, as nonsurgical management is 25% more effective in achieving full recovery. PMID:29390530

Nonsurgical management of an extensive spontaneous spinal epidural hematoma causing quadriplegia and respiratory distress in a choledocholithiasis patient: A case report.

PubMed

Raasck, Kyle; Khoury, Jason; Aoude, Ahmed; Abduljabbar, Fahad; Jarzem, Peter

2017-12-01

Spontaneous spinal epidural hematoma (SSEH) manifests from blood accumulating in the epidural space, compressing the spinal cord, and leading to acute neurological deficits. The disease's cloudy etiology and rarity contribute to dangerously suboptimal therapeutic principles. These neural deficits can be permanent, even fatal, if the SSEH is not treated in a timely and appropriate manner. Standard therapy is decompressive laminectomy, though nonsurgical management is a viable course of action for patients who meet a criterion that is continuously being refined. A 76-year-old woman on warfarin for a past pulmonary embolism presented to the emergency room with jaundice, myalgia, hematuria, neck pain, and an International Normalized Ratio (INR) of 14. Upon admission, she rapidly developed quadriplegia and respiratory distress that necessitated intubation. T2-weighted magnetic resonance imaging (MRI) revealed an epidural space-occupying hyperintensity from C2 to S5 consistent with a spinal epidural hematoma. An incidental finding of dilated intrahepatic and common bile ducts prompted an endoscopic retrograde cholangiopancreatography, which demonstrated choledocholithiasis. The patient's INR was normalized with Vitamin K and Beriplex. Upon transfer to the surgical spine team for assessment of a possible intervention, the patient began to demonstrate recovery of neural functions. The ensuing sustained motor improvement motivated the team's preference for close neurologic monitoring and continued medical therapy over surgery. Thirteen hours after the onset of her symptoms, the patient was extubated. A sphincterotomy was later performed, removing 81 common bile duct stones. MRI demonstrated complete resorption of the SSEH and the patient maintained full neurological function at final follow-up. Nonsurgical management of SSEH should be considered in the context of early and sustained recovery. Severe initial neural deficit does not necessitate surgical decompression. Choledocholithiasis and subsequent Vitamin K deficiency, particularly when coupled with anticoagulant use, can increase INR and is a novel proposed risk factor for SSEH. Furthermore, coagulopathies should be medically corrected before surgical intervention within a given timeframe, as spontaneous recovery may manifest. This should be favored over surgery in patients demonstrating early and sustained recovery, as nonsurgical management is 25% more effective in achieving full recovery. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Using a visual discrimination model for the detection of compression artifacts in virtual pathology images.

PubMed

Johnson, Jeffrey P; Krupinski, Elizabeth A; Yan, Michelle; Roehrig, Hans; Graham, Anna R; Weinstein, Ronald S

2011-02-01

A major issue in telepathology is the extremely large and growing size of digitized "virtual" slides, which can require several gigabytes of storage and cause significant delays in data transmission for remote image interpretation and interactive visualization by pathologists. Compression can reduce this massive amount of virtual slide data, but reversible (lossless) methods limit data reduction to less than 50%, while lossy compression can degrade image quality and diagnostic accuracy. "Visually lossless" compression offers the potential for using higher compression levels without noticeable artifacts, but requires a rate-control strategy that adapts to image content and loss visibility. We investigated the utility of a visual discrimination model (VDM) and other distortion metrics for predicting JPEG 2000 bit rates corresponding to visually lossless compression of virtual slides for breast biopsy specimens. Threshold bit rates were determined experimentally with human observers for a variety of tissue regions cropped from virtual slides. For test images compressed to their visually lossless thresholds, just-noticeable difference (JND) metrics computed by the VDM were nearly constant at the 95th percentile level or higher, and were significantly less variable than peak signal-to-noise ratio (PSNR) and structural similarity (SSIM) metrics. Our results suggest that VDM metrics could be used to guide the compression of virtual slides to achieve visually lossless compression while providing 5-12 times the data reduction of reversible methods.

Impact of multilayered compression bandages on sub-bandage interface pressure: a model.

PubMed

Al Khaburi, J; Nelson, E A; Hutchinson, J; Dehghani-Sanij, A A

2011-03-01

Multi-component medical compression bandages are widely used to treat venous leg ulcers. The sub-bandage interface pressures induced by individual components of the multi-component compression bandage systems are not always simply additive. Current models to explain compression bandage performance do not take account of the increase in leg circumference when each bandage is applied, and this may account for the difference between predicted and actual pressures. To calculate the interface pressure when a multi-component compression bandage system is applied to a leg. Use thick wall cylinder theory to estimate the sub-bandage pressure over the leg when a multi-component compression bandage is applied to a leg. A mathematical model was developed based on thick cylinder theory to include bandage thickness in the calculation of the interface pressure in multi-component compression systems. In multi-component compression systems, the interface pressure corresponds to the sum of the pressures applied by individual bandage layers. However, the change in the limb diameter caused by additional bandage layers should be considered in the calculation. Adding the interface pressure produced by single components without considering the bandage thickness will result in an overestimate of the overall interface pressure produced by the multi-component compression systems. At the ankle (circumference 25 cm) this error can be 19.2% or even more in the case of four components bandaging systems. Bandage thickness should be considered when calculating the pressure applied using multi-component compression systems.

Dilatation-dissipation corrections for advanced turbulence models

NASA Technical Reports Server (NTRS)

Wilcox, David C.

1992-01-01

This paper analyzes dilatation-dissipation based compressibility corrections for advanced turbulence models. Numerical computations verify that the dilatation-dissipation corrections devised by Sarkar and Zeman greatly improve both the k-omega and k-epsilon model predicted effect of Mach number on spreading rate. However, computations with the k-gamma model also show that the Sarkar/Zeman terms cause an undesired reduction in skin friction for the compressible flat-plate boundary layer. A perturbation solution for the compressible wall layer shows that the Sarkar and Zeman terms reduce the effective von Karman constant in the law of the wall. This is the source of the inaccurate k-gamma model skin-friction predictions for the flat-plate boundary layer. The perturbation solution also shows that the k-epsilon model has an inherent flaw for compressible boundary layers that is not compensated for by the dilatation-dissipation corrections. A compressibility modification for k-gamma and k-epsilon models is proposed that is similar to those of Sarkar and Zeman. The new compressibility term permits accurate predictions for the compressible mixing layer, flat-plate boundary layer, and a shock separated flow with the same values for all closure coefficients.

Testing, Selection, and Implementation of Random Number Generators

DTIC Science & Technology

2008-07-01

Complexity and Lempel - Ziv Compression tests. This causes concern for cryptographic use but is not relevant for our applications. In fact, the features of...Linear Complexity, Lempel - Ziv Compression , and Matrix Rank test failures excluded. The Mersenne Twister is widely accepted by the community; in fact...searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection information. Send comments

Blunt trauma to large vessels: a mathematical study

PubMed Central

Ismailov, Rovshan M; Shevchuk, Nikolai A; Schwerha, Joseph; Keller, Lawrence; Khusanov, Higmat

2004-01-01

Background Blunt trauma causes short-term compression of some or all parts of the chest, abdomen or pelvis and changes hemodynamics of the blood. Short-term compression caused by trauma also results in a short-term decrease in the diameter of blood vessels. It has been shown that with a sudden change in the diameter of a tube or in the direction of the flow, the slower-moving fluid near the wall stops or reverses direction, which is known as boundary layer separation (BLS). We hypothesized that a sudden change in the diameter of elastic vessel that results from compression may lead not only to BLS but also to other hemodynamic changes that can damage endothelium. Methods We applied Navier-Stokes, multiphase and boundary layer equations to examine such stress. The method of approximation to solve the BL equations was used. Experiments were conducted in an aerodynamic tube, where incident flow velocity and weight of carriage with particles before and after blowing were measured. Results We found that sudden compression resulting from trauma leads to (1) BLS on the curved surface of the vessel wall; (2) transfer of laminar boundary layer into turbulent boundary layer. Damage to the endothelium can occur if compression is at least 25% and velocity is greater than 2.4 m/s or if compression is at least 10% and velocity is greater than 2.9 m/s. Conclusion Our research may point up new ways of reducing the damage from blunt trauma to large vessels. It has the potential for improvement of safety features of motor vehicles. This work will better our understanding of the precise mechanics and critical variables involved in diagnosis and prevention of blunt trauma to large vessels. PMID:15153246

Renal hemangiopericytoma: case report and literature review.

PubMed

Vetorazzo Filho, José Eduardo; Bahia, Leandro Augusto Costa; Esteves, Paulo Ebert; Maron, Paulo Eduardo Goulart; Vedovato, Bruno César; Fernandes, Roni de Carvalho; Perez, Marjo Deninson Cardenuto

2015-01-01

Hemangioperycytoma is a rare perivascular tumor that seldom involves the urogenital system. This tumor often appears with an unspecific clinical picture, and sometimes is associated with hematuria or hypertension. Diagnosis is based on a combination of histological and immunohistological findings. We report a case of a 52-year-old patient with renal hemangiopericytoma who underwent surgical treatment at our service. This report also includes a literature review on the subject.

Renal hemangiopericytoma: case report and literature review

PubMed Central

Vetorazzo, José Eduardo; Bahia, Leandro Augusto Costa; Esteves, Paulo Ebert; Maron, Paulo Eduardo Goulart; Vedovato, Bruno César; Fernandes, Roni de Carvalho; Perez, Marjo Deninson Cardenuto

2015-01-01

Hemangioperycytoma is a rare perivascular tumor that seldom involves the urogenital system. This tumor often appears with an unspecific clinical picture, and sometimes is associated with hematuria or hypertension. Diagnosis is based on a combination of histological and immunohistological findings. We report a case of a 52-year-old patient with renal hemangiopericytoma who underwent surgical treatment at our service. This report also includes a literature review on the subject. PMID:25946050

Treatment of radiation-induced cystitis with hyperbaric oxygen

DOE Office of Scientific and Technical Information (OSTI.GOV)

Weiss, J.P.; Boland, F.P.; Mori, H.

The effects of hyperbaric oxygen on radiation cystitis have been documented in 3 patients with radiation-induced hemorrhagic cystitis refractory to conventional therapy. Cessation of gross hematuria and reversal of cystoscopic bladder changes were seen in response to a series of hyperbaric oxygen treatments of 2 atmosphere absolute pressure for 2 hours. To our knowledge this is the first report of cystoscopically documented healing of radiation-induced bladder injury.

Renal artery and vein injury following blunt trauma.

PubMed Central

Sturm, J T; Perry, J F; Cass, A S

1975-01-01

Blunt injuries of the renal vascular pedicle occur infrequently. The experience with fourteen cases of blunt renal vascular trauma is presented. Most patients were injured in motor vehicle accidents. The diagnosis was made immediately after admission in 6 patients, delayed in 5, and at autopsy in 3. Most patients presented with gross or microscopic hematuria. The diagnosis of renal vascular injury was suggested by IVP in most instances. Surgical management was used in the 6 patients in whom the immediate diagnosis of renal pedicle injury was made; primary vascular repair was carried out in 4 patients and nephrectomy in two. Conservative management was used in 4 of the 5 patients with delayed diagnosis, and nephrectomy was required in the fifth. Three patients received no treatment as two were dead on arrival and one die during laparotomy. Seven patients died (50%). One of the 7 survivors has a functioning kidney following repair of a renal vein laceration. Three patients with devascularized kidneys have been followed long term and have not developed hypertension. An IVP should be mandatory following severe blunt trauma, especially when hematuria is present. Renal arteriography is indicated with distortion of calyces, extravasation or nonfunction seen on IVP and allows a definitive diagnosis of renal vessel injury to be made. PMID:1190872

Important medical decisions: Using brief motivational interviewing to enhance patients' autonomous decision-making.

PubMed

Pantalon, Michael V; Sledge, William H; Bauer, Stephen F; Brodsky, Beth; Giannandrea, Stephanie; Kay, Jerald; Lazar, Susan G; Mellman, Lisa A; Offenkrantz, William C; Oldham, John; Plakun, Eric M; Rockland, Lawrence H

2013-03-01

The use of motivational interviewing (MI) when the goals of patient and physician are not aligned is examined. A clinical example is presented of a patient who, partly due to anxiety and fear, wants to opt out of further evaluation of his hematuria while the physician believes that the patient must follow up on the finding of hematuria. As patients struggle in making decisions about their medical care, physician interactions can become strained and medical care may become compromised. Physicians sometimes rely on their authority within the doctor-patient relationship to assist patients in making decisions. These methods may be ineffective when there is a conflict in motivations or goals, such as with patient ambivalence and resistance. Furthermore, the values of patient autonomy may conflict with the values of beneficence. A patient simulation exercise is used to demonstrate the value of MI in addressing the motivations of a medical patient when autonomy is difficult to realize because of a high level of resistance to change due to fear. The salience of MI in supporting the value of patient autonomy without giving up the value of beneficence is discussed by providing a method of evaluating the patient's best interests by psychotherapeutically addressing his anxious, fear-based ambivalence.

How safe is 1% alum irrigation in controlling intractable vesical hemorrhage?

PubMed

Goswami, A K; Mahajan, R K; Nath, R; Sharma, S K

1993-02-01

A prospective study was done to evaluate the efficacy and safety of intravesical instillation of 1% alum solution in 12 cases of hematuria of vesical origin, uncontrolled by saline irrigation for 24 hours via a 3-way Foley catheter. There were 10 cases of transitional cell carcinoma and 2 of radiation cystitis. Complete response was noted in 6 patients and a partial response in 4. Local side effects included suprapubic pain and vesical tenesmus, which were controlled by antispasmodic and/or analgesic drugs. Transient low grade pyrexia (maximum up to 38.2C) was noted in 4 patients. Among the other various clinical and biochemical parameters, serum aluminum level and prothrombin time showed statistically highly significant changes. Serum aluminum increased from an average baseline value of 1.68 to 3.36 mumol./l. without clinical evidence of aluminum toxicity and with levels well below the recommended safe limit. Prothrombin time increased parallel with the increase in serum aluminum level to a maximum of 1 1/2 times the control. Prothrombin values, therefore, can be used clinically, since they are readily obtainable whereas serum aluminum levels are not. Vesical irrigation with 1% alum solution is a safe method to control hematuria of vesical origin in properly selected cases.

Bladder perforation owing to a unipolar coagulating device.

PubMed

Pakter, J; Budnick, L D

1981-09-15

A report on a patient who sustained a burn and perforation of the urinary bladder from visible sparks emanating from a unipolar coagulating device during the couse of laparoscopic sterilization is presented. It is the first report of urinary bladder burns using a unipolar coagulating device. A 24-year-old woman, gravida 10, para 3, abortus 7, underwent a laparoscopic sterilization with a unipolar coagulating device. As the physician was finishing the coagulation, a spark from the device caused a 1-2 cm burn with a central area of perforation into the urinary bladder. Conservative treatment was recommended, and consisted of Foley catheterization and drainage for 5 days. Initial urine culture revealed Klebsiella species, and oral ampicillin was prescribed. Hematuria was noted throughout the patient's hospitalization, and blood clots were present in the urine on Day 2 postoperation. The patient had no abdominal or flank pain, was afebrile, and had a stable hemoglobin level during the hospital stay. Cystography was performed on Day 5 postoperatively and demonstrated no perforation. Foley catheter was removed. Patient was discharged 2 days later and remains in good health 3 months postoperatively.

Chronic copper toxicosis in sheep following the use of copper sulfate as a fungicide on fruit trees.

PubMed

Oruc, Hasan H; Cengiz, Murat; Beskaya, Atilla

2009-07-01

Between January and October 2006, 15 Chios sheep died in a field located near a factory in Orhangazi, Bursa, Turkey. In addition, in May 2007, 2 ewes died after aborting in the same field. Clinical signs in affected animals prior to death were anorexia, hematuria, icterus, incoordination, and ptyalism. Postmortem findings included generalized icterus; yellow, friable livers; distended gallbladders with dense, dark bile; and dark, hypertrophic kidneys with hemorrhage. Copper (Cu) concentrations were measured in multiple specimens of the following: 9 sera, 3 livers, 3 kidneys, 4 plants (including 2 artichoke leaf specimens), 3 soil samples, and 1 drinking water sample. High Cu concentrations were present in the livers, kidneys, and sera of dead sheep, as well as in the vegetation and soil samples from the field. Chronic Cu toxicosis was confirmed as the cause of death attributed primarily to the use of copper sulfate as a fungicide for fruit trees within the field. In addition, factory dust containing Cu might have been an additional factor in the toxicosis.

Warm Water Compress as an Alternative for Decreasing the Degree of Phlebitis.

PubMed

Annisa, Fitri; Nurhaeni, Nani; Wanda, Dessie

Intravenous fluid therapy is an invasive procedure which may increase the risk of patient complications. One of the most common of these is phlebitis, which may cause discomfort and tissue damage. Therefore, a nursing intervention is needed to effectively treat phlebitis. The purpose of this study was to investigate the effectiveness of applying a warm compression intervention to reduce the degree of phlebitis. A quasi-experimental pre-test and post-test design was used, with a non-equivalent control group. The total sample size was 32 patients with degrees of phlebitis ranging from 1 to 4. The total sample was divided into 2 interventional groups: those patients that were given 0.9% NaCl compresses and those given warm water compresses. The results showed that both compresses were effective in reducing the degree of phlebitis, with similar p values (p = .000). However, there was no difference in the average reduction score between the two groups (p = .18). Therefore, a warm water compress is valuable in the treatment of phlebitis, and could decrease the degree of phlebitis both effectively and inexpensively.

Modeling Two-Stage Bunch Compression With Wakefields: Macroscopic Properties And Microbunching Instability

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bosch, R.A.; Kleman, K.J.; /Wisconsin U., SRC

2011-09-08

In a two-stage compression and acceleration system, where each stage compresses a chirped bunch in a magnetic chicane, wakefields affect high-current bunches. The longitudinal wakes affect the macroscopic energy and current profiles of the compressed bunch and cause microbunching at short wavelengths. For macroscopic wavelengths, impedance formulas and tracking simulations show that the wakefields can be dominated by the resistive impedance of coherent edge radiation. For this case, we calculate the minimum initial bunch length that can be compressed without producing an upright tail in phase space and associated current spike. Formulas are also obtained for the jitter in themore » bunch arrival time downstream of the compressors that results from the bunch-to-bunch variation of current, energy, and chirp. Microbunching may occur at short wavelengths where the longitudinal space-charge wakes dominate or at longer wavelengths dominated by edge radiation. We model this range of wavelengths with frequency-dependent impedance before and after each stage of compression. The growth of current and energy modulations is described by analytic gain formulas that agree with simulations.« less

Hollow microgels squeezed in overcrowded environments

NASA Astrophysics Data System (ADS)

Scotti, A.; Brugnoni, M.; Rudov, A. A.; Houston, J. E.; Potemkin, I. I.; Richtering, W.

2018-05-01

We study how a cavity changes the response of hollow microgels with respect to regular ones in overcrowded environments. The structural changes of hollow poly(N-isopropylacrylamide) microgels embedded within a matrix of regular ones are probed by small-angle neutron scattering with contrast variation. The form factors of the microgels at increasing compressions are directly measured. The decrease of the cavity size with increasing concentration shows that the hollow microgels have an alternative way with respect to regular cross-linked ones to respond to the squeezing due to their neighbors. The structural changes under compression are supported by the radial density profiles obtained with computer simulations. The presence of the cavity offers to the polymer network the possibility to expand toward the center of the microgels in response to the overcrowded environment. Furthermore, upon increasing compression, a two step transition occurs: First the microgels are compressed but the internal structure is unchanged; then, further compression causes the fuzzy shell to collapse completely and reduce the size of the cavity. Computer simulations also allow studying higher compression degrees than in the experiments leading to the microgel's faceting.

Foamed concrete containing rice husk ash as sand replacement: an experimental study on compressive strength

NASA Astrophysics Data System (ADS)

Rum, R. H. M.; Jaini, Z. M.; Boon, K. H.; Khairaddin, S. A. A.; Rahman, N. A.

2017-11-01

This study presents the utilization of rice husk ash (RHA) as sand replacement in foamed concrete. The study focuses on the effect of RHA on the compressive strength of foamed concrete. RHA contains high pozzolanic material that reacts with cementitious to enhance the strength and durability of foamed concrete. RHA also acts as filler causing the foamed concrete to become denser while retaining its unique low density. A total 243 cube specimens was prepared for the compression test. Two sets of mix design were employed at water-cement (W/C) ratio of 0.55, 0.60 and cement-sand ratio of 0.50, 0.33. The results revealed that the presence of RHA as sand replacement resulted in an increase in the compressive strength of foamed concrete. Moreover, 30% to 40% RHA was the optimum content level, contributing to the compressive strength of 18.1 MPa to 22.4 MPa. The W/C ratio and superplasticiser dosage play small roles in improving workability. In contrast, density governs the compressive strength of foamed concrete.

The Effect of Coloring and Compacting Pressure Paving Block by Adding 5 Wt.% Fly Ash in The Compressive Strength

NASA Astrophysics Data System (ADS)

Nurzal; Nursyuhada, Aries

2017-12-01

This research aims based on SNI 03-0691-1996 to investigate the effect of coloring and compacting pressure with the addition of 5 wt.% fly ash (Fa) on compressive strength. Fa derived from waste material coal-fired Sijantang Sawahlunto thermal power plant. The growing production of Fa caused negative environmental impact. So, one of the solutions to overcome that effects is to use the Fa as a raw material for paving block mixture that can reduce the cost of raw material and increase its strength. Paving blocks are gray and red with 0 wt.%, 5 wt.% Fa + Pb composition. Compaction pressure variations 55, 65, 75, 85 and 95 Kg/cm2. The drying time for 35 days. Specimens were produced in the form of rectangular bar (length, L = 20 cm, width, B = 10 cm, thickness, W = 6 cm). The test results showed that the addition of 5 wt% FA has a compressive strength value higher than 0 wt%. The red color has a compressive strength lower than the gray color paving block caused the red color (Iron Oxide) is less binding at the time of mixing the material. Gray and red Paving blocks both increase in each additional compaction pressure, because the higher the compaction pressure will increase the bond between the particles so porosity is reduced increased compressive strength. The overall data, the gray paving block with the composition of 5 wt% FA at compaction pressure 95 kg/cm2 with the optimal compressive strength value of 36.1 MPa and the lowest value is found in the red color paving block at 0 wt% FA at a pressure of 55 kg/cm2 with a value of 6.5 MPa. Gray and red Color paving blocks has a compressive strength quality based on SNI 03-0691-1996.

Case report and systematic literature review of a novel etiology of sinistral portal hypertension presenting with UGI bleeding: Left gastric artery pseudoaneurysm compressing the splenic vein treated by embolization of the pseudoaneurysm.

PubMed

Hakim, Seifeldin; Bortman, Jared; Orosey, Molly; Cappell, Mitchell S

2017-03-01

A novel case is reported of upper gastrointestinal (UGI) bleeding from sinistral portal hypertension, caused by a left gastric artery (LGA) pseudoaneurysm (PA) compressing the splenic vein (SV) that was successfully treated with PA embolization. A 41-year-old man with previous medical history of recurrent, alcoholic pancreatitis presented with several episodes of hematemesis and abdominal pain for 48 hours. Physical examination revealed a soft abdomen, with no abdominal bruit, no pulsatile abdominal mass, and no stigmata of chronic liver disease. The hemoglobin declined acutely from 12.3 to 9.3 g/dL. Biochemical parameters of liver function and routine coagulation profile were entirely within normal limits. Abdominal CT revealed a 5-cm-wide peripancreatic mass compressing the stomach and constricting the SV. Esophagogastroduodenoscopy showed blood oozing from portal hypertensive gastropathy, small nonbleeding gastric cardial and fundal varices, gastric compression from the extrinsic mass, and no esophageal varices. MRCP and angiography showed that the mass was vascular, arose from the LGA, compressed the mid SV without SV thrombosis, and caused sinistral portal hypertension. At angiography, the PA was angioembolized and occluded. The patient has been asymptomatic with no further bleeding and a stable hemoglobin level during 8 weeks of follow-up. Literature review of the 14 reported cases of LGA PA revealed that this report of acute UGI bleeding from sinistral portal hypertension from a LGA PA constricting the SV is novel; one previously reported patient had severe anemia without acute UGI bleeding associated with sinistral portal hypertension from a LGA PA. A patient presented with UGI bleeding from sinistral portal hypertension from a LGA PA compressing the SV that was treated by angiographic obliteration of the PA which relieved the SV compression and arrested the UGI bleeding. Primary therapy for this syndrome should be addressed to obliterate the PA and not the secondarily constricted SV.

Vasovagal reflex emergency caused by Riedel's thyroiditis: A case report and review of the literature.

PubMed

Cai, Wei; Kang, Hua; Hai, Tao

2016-01-01

Riedel's thyroiditis is a rare type of chronic thyroiditis, associated with fibroinflammatory process and invasion into surrounding tissues, leading to compressive symptoms. A 45-year-old man had a left thyroid mass, presenting with hypotension and bradycardia many times. He was diagnosed with vasovagal reflex caused by cervical vessel compression due to a thyroid lesion. We performed the emergency operation, and most of the left thyroid was removed to relieve the compression on cervical vessels. The result of pathology proved to be Riedel's thyroiditis. The vasovagal reflex did not occur any more during the 28-month follow up, except on the 3(rd) day after the surgery. Six months after the thyroidectomy, the patient was found to have retroperitoneal fibrosis, diagnosed by biopsy during a laparotomy for biliary disease. Riedel's thyroiditis can lead to a vasovagal episode and might not be a primary thyroid disease but rather a manifestation of the systemic disorder, multifocal fibrosclerosis. Copyright © 2013. Published by Elsevier Taiwan.

Wearing graduated compression stockings augments cutaneous vasodilation in heat-stressed resting humans.

PubMed

Fujii, Naoto; Nikawa, Toshiya; Tsuji, Bun; Kondo, Narihiko; Kenny, Glen P; Nishiyasu, Takeshi

2017-05-01

We investigated whether graduated compression induced by stockings enhances cutaneous vasodilation in passively heated resting humans. Nine habitually active young men were heated at rest using water-perfusable suits, resulting in a 1.0 °C increase in body core temperature. Heating was repeated twice on separate occasions while wearing either (1) stockings that cause graduated compression (pressures of 26.4 ± 5.3, 17.5 ± 4.4, and 6.1 ± 2.0 mmHg at the ankle, calf, and thigh, respectively), or (2) loose-fitting stockings without causing compression (Control). Forearm vascular conductance during heating was evaluated by forearm blood flow (venous occlusion plethysmography) divided by mean arterial pressure to estimate heat-induced cutaneous vasodilation. Body core (esophageal), skin, and mean body temperatures were measured continuously. Compared to the Control, forearm vascular conductance during heating was higher with graduated compression stockings (e.g., 23.2 ± 5.5 vs. 28.6 ± 5.8 units at 45 min into heating, P = 0.001). In line with this, graduated compression stockings resulted in a greater sensitivity (27.5 ± 8.3 vs. 34.0 ± 9.4 units °C -1 , P = 0.02) and peak level (25.5 ± 5.8 vs. 29.7 ± 5.8 units, P = 0.004) of cutaneous vasodilation as evaluated from the relationship between forearm vascular conductance with mean body temperature. In contrast, the mean body temperature threshold for increases in forearm vascular conductance did not differ between the Control and graduated compression stockings (36.5 ± 0.1 vs. 36.5 ± 0.2 °C, P = 0.85). Our results show that graduated compression associated with the use of stockings augments cutaneous vasodilation by modulating sensitivity and peak level of cutaneous vasodilation in relation to mean body temperature. However, the effect of these changes on whole-body heat loss remains unclear.

Peripheral Neuropathy and Nerve Compression Syndromes in Burns.

PubMed

Strong, Amy L; Agarwal, Shailesh; Cederna, Paul S; Levi, Benjamin

2017-10-01

Peripheral neuropathy and nerve compression syndromes lead to substantial morbidity following burn injury. Patients present with pain, paresthesias, or weakness along a specific nerve distribution or experience generalized peripheral neuropathy. The symptoms manifest at various times from within one week of hospitalization to many months after wound closure. Peripheral neuropathy may be caused by vascular occlusion of vasa nervorum, inflammation, neurotoxin production leading to apoptosis, and direct destruction of nerves from the burn injury. This article discusses the natural history, diagnosis, current treatments, and future directions for potential interventions for peripheral neuropathy and nerve compression syndromes related to burn injury. Copyright © 2017 Elsevier Inc. All rights reserved.

Composite self-expanding bioresorbable prototype stents with reinforced compression performance for congenital heart disease application: Computational and experimental investigation.

PubMed

Zhao, Fan; Xue, Wen; Wang, Fujun; Liu, Laijun; Shi, Haoqin; Wang, Lu

2018-08-01

Stents are vital devices to treat vascular stenosis in pediatric patients with congenital heart disease. Bioresorbable stents (BRSs) have been applied to reduce challenging complications caused by permanent metal stents. However, it remains almost a total lack of BRSs with satisfactory compression performance specifically for children with congenital heart disease, leading to importantly suboptimal effects. In this work, composite bioresorbable prototype stents with superior compression resistance were designed by braiding and annealing technology, incorporating poly (p-dioxanone) (PPDO) monofilaments and polycaprolactone (PCL) multifilament. Stent prototype compression properties were investigated. The results revealed that novel composite prototype stents showed superior compression force compared to the control ones, as well as recovery ability. Furthermore, deformation mechanisms were analyzed by computational simulation, which revealed bonded interlacing points among yarns play an important role. This research presents important clinical implications in bioresorbable stent manufacture and provides further study with an innovative stent design. Copyright © 2018 Elsevier Ltd. All rights reserved.

Lossless compression of AVIRIS data: Comparison of methods and instrument constraints

NASA Technical Reports Server (NTRS)

Roger, R. E.; Arnold, J. F.; Cavenor, M. C.; Richards, J. A.

1992-01-01

A family of lossless compression methods, allowing exact image reconstruction, are evaluated for compressing Airborne Visible/Infrared Imaging Spectrometers (AVIRIS) image data. The methods are used on Differential Pulse Code Modulation (DPCM). The compressed data have an entropy of order 6 bits/pixel. A theoretical model indicates that significantly better lossless compression is unlikely to be achieved because of limits caused by the noise in the AVIRIS channels. AVIRIS data differ from data produced by other visible/near-infrared sensors, such as LANDSAT-TM or SPOT, in several ways. Firstly, the data are recorded at a greater resolution (12 bits, though packed into 16-bit words). Secondly, the spectral channels are relatively narrow and provide continuous coverage of the spectrum so that the data in adjacent channels are generally highly correlated. Thirdly, the noise characteristics of the AVIRIS are defined by the channels' Noise Equivalent Radiances (NER's), and these NER's show that, at some wavelengths, the least significant 5 or 6 bits of data are essentially noise.

Full myeloablative conditioning and an unrelated HLA mismatched donor increase the risk for BK virus-positive hemorrhagic cystitis in allogeneic hematopoetic stem cell transplanted patients.

PubMed

Dalianis, Tina; Ljungman, Per

2011-03-01

BK virus (BKV)-associated hemorrhagic cystitis (HC), varying from mild hematuria with or without dysuria to life-threating bleeding and clots that may cause urinary obstruction and renal failure, causes significant morbidity and mortality in haematopoetic stem cell transplanted (HSCT) patients. Unfortunately, its development is difficult to predict since BK viruria is very common after HSCT and can be present in patients with and without HC. There is therefore the need to identify risk factors that may increase the risk of developing HC after HSCT. The viral load of BK-viruria, as well as BK viremia, has been monitored for this purpose. Moreover, having full myeoblative conditioning (MC) versus reduced intensity conditioning (RIC) prior to HSCT and an HLA-matched or -mismatched graft from an unrelated donor in contrast to an HLA-matched graft from a related donor have been studied as risk factors for HC. In addition, graft versus host disease has been examined, but has not been defined as a definite risk factor for HC. We conclude that the present evidence suggests that HSCT patients with BK viruria, receiving MC and an unrelated donor graft that is HLA-mismatched have an increased risk for developing HC in comparison to patients receiving RIC and an HLA-matched related donor graft.

Posterior tibial vein aneurysm presenting as tarsal tunnel syndrome.

PubMed

Ayad, Micheal; Whisenhunt, Anumeha; Hong, EnYaw; Heller, Josh; Salvatore, Dawn; Abai, Babak; DiMuzio, Paul J

2015-06-01

Tarsal tunnel syndrome is a compressive neuropathy of the posterior tibial nerve within the tarsal tunnel. Its etiology varies, including space occupying lesions, trauma, inflammation, anatomic deformity, iatrogenic injury, and idiopathic and systemic causes. Herein, we describe a 46-year-old man who presented with left foot pain. Work up revealed a venous aneurysm impinging on the posterior tibial nerve. Following resection of the aneurysm and lysis of the nerve, his symptoms were alleviated. Review of the literature reveals an association between venous disease and tarsal tunnel syndrome; however, this report represents the first case of venous aneurysm causing symptomatic compression of the nerve. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Buckling Analysis of Single and Multi Delamination In Composite Beam Using Finite Element Method

NASA Astrophysics Data System (ADS)

Simanjorang, Hans Charles; Syamsudin, Hendri; Giri Suada, Muhammad

2018-04-01

Delamination is one type of imperfection in structure which found usually in the composite structure. Delamination may exist due to some factors namely in-service condition where the foreign objects hit the composite structure and creates inner defect and poor manufacturing that causes the initial imperfections. Composite structure is susceptible to the compressive loading. Compressive loading leads the instability phenomenon in the composite structure called buckling. The existence of delamination inside of the structure will cause reduction in buckling strength. This paper will explain the effect of delamination location to the buckling strength. The analysis will use the one-dimensional modelling approach using two- dimensional finite element method.

[Cockett's syndrome, May-Thurner syndrome, or iliac vein compression syndrome].

PubMed

Gil Martín, A R; Carreras Aja, M; Arrieta Ardieta, I; Labayen Azparren, I

2014-01-01

Iliac vein compression syndrome (also known as May-Thurner syndrome or Cockett's syndrome) is a rare clinical entity in which the left common iliac vein is compressed when it passes between the right common iliac artery and the spine. The sustained compression and trauma caused by the pulsatile force of the artery on the vein damage the intima and lead to the formation of membranes or bands in the vascular lumen that hinder or obstruct the flow of blood in the vein, favoring thrombus formation. The current treatment strategy of choice is endovascular vein patch angioplasty and stenting with the aim of improving the caliber of the lumen and enabling normal venous drainage. We present two cases of May-Thurner syndrome and review the clinical and CT findings. Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved.

The Effect of Grain Size on the Strain Hardening Behavior for Extruded ZK61 Magnesium Alloy

NASA Astrophysics Data System (ADS)

Zhang, Lixin; Zhang, Wencong; Chen, Wenzhen; Duan, Junpeng; Wang, Wenke; Wang, Erde

2017-12-01

The effects of grain size on the tensile and compressive strain hardening behaviors for extruded ZK61 alloys have been investigated by uniaxial tensile and compressive tests along the extrusion directions. Cylindrical tension and compression specimens of extruded ZK61 alloys with various sized grain were fabricated by annealing treatments. Tensile and compressive tests at ambient temperature were conducted at a strain rate of 0.5 × 10-3 s-1. The results indicate that both tensile strain hardening and compressive strain hardening of ZK61 alloys with different grain sizes have an athermal regime of dislocation accumulation in early deformation. The threshold stress value caused dynamic recovery is predominantly related to grain size in tensile strain hardening, but the threshold stress values for different grain sizes are almost identical in compressive strain hardening. There are obvious transition points on the tensile strain hardening curves which indicate the occurrence of dynamic recrystallization (DRX). The tensile strain hardening rate of the coarse-grained alloy obviously decreases faster than that of fine-grained alloys before DRX and the tensile strain hardening curves of different grain sizes basically tend to parallel after DRX. The compressive strain hardening rate of the fine-grained alloy obviously increases faster than that of coarse-grained alloy for twin-induced strain hardening, but compressive strain hardening curves also tend to parallel after twinning is exhausted.

Influence of video compression on the measurement error of the television system

NASA Astrophysics Data System (ADS)

Sotnik, A. V.; Yarishev, S. N.; Korotaev, V. V.

2015-05-01

Video data require a very large memory capacity. Optimal ratio quality / volume video encoding method is one of the most actual problem due to the urgent need to transfer large amounts of video over various networks. The technology of digital TV signal compression reduces the amount of data used for video stream representation. Video compression allows effective reduce the stream required for transmission and storage. It is important to take into account the uncertainties caused by compression of the video signal in the case of television measuring systems using. There are a lot digital compression methods. The aim of proposed work is research of video compression influence on the measurement error in television systems. Measurement error of the object parameter is the main characteristic of television measuring systems. Accuracy characterizes the difference between the measured value abd the actual parameter value. Errors caused by the optical system can be selected as a source of error in the television systems measurements. Method of the received video signal processing is also a source of error. Presence of error leads to large distortions in case of compression with constant data stream rate. Presence of errors increases the amount of data required to transmit or record an image frame in case of constant quality. The purpose of the intra-coding is reducing of the spatial redundancy within a frame (or field) of television image. This redundancy caused by the strong correlation between the elements of the image. It is possible to convert an array of image samples into a matrix of coefficients that are not correlated with each other, if one can find corresponding orthogonal transformation. It is possible to apply entropy coding to these uncorrelated coefficients and achieve a reduction in the digital stream. One can select such transformation that most of the matrix coefficients will be almost zero for typical images . Excluding these zero coefficients also possible reducing of the digital stream. Discrete cosine transformation is most widely used among possible orthogonal transformation. Errors of television measuring systems and data compression protocols analyzed In this paper. The main characteristics of measuring systems and detected sources of their error detected. The most effective methods of video compression are determined. The influence of video compression error on television measuring systems was researched. Obtained results will increase the accuracy of the measuring systems. In television image quality measuring system reduces distortion identical distortion in analog systems and specific distortions resulting from the process of coding / decoding digital video signal and errors in the transmission channel. By the distortions associated with encoding / decoding signal include quantization noise, reducing resolution, mosaic effect, "mosquito" effect edging on sharp drops brightness, blur colors, false patterns, the effect of "dirty window" and other defects. The size of video compression algorithms used in television measuring systems based on the image encoding with intra- and inter prediction individual fragments. The process of encoding / decoding image is non-linear in space and in time, because the quality of the playback of a movie at the reception depends on the pre- and post-history of a random, from the preceding and succeeding tracks, which can lead to distortion of the inadequacy of the sub-picture and a corresponding measuring signal.

Compressibility of the protein-water interface

NASA Astrophysics Data System (ADS)

Persson, Filip; Halle, Bertil

2018-06-01

The compressibility of a protein relates to its stability, flexibility, and hydrophobic interactions, but the measurement, interpretation, and computation of this important thermodynamic parameter present technical and conceptual challenges. Here, we present a theoretical analysis of protein compressibility and apply it to molecular dynamics simulations of four globular proteins. Using additively weighted Voronoi tessellation, we decompose the solution compressibility into contributions from the protein and its hydration shells. We find that positively cross-correlated protein-water volume fluctuations account for more than half of the protein compressibility that governs the protein's pressure response, while the self correlations correspond to small (˜0.7%) fluctuations of the protein volume. The self compressibility is nearly the same as for ice, whereas the total protein compressibility, including cross correlations, is ˜45% of the bulk-water value. Taking the inhomogeneous solvent density into account, we decompose the experimentally accessible protein partial compressibility into intrinsic, hydration, and molecular exchange contributions and show how they can be computed with good statistical accuracy despite the dominant bulk-water contribution. The exchange contribution describes how the protein solution responds to an applied pressure by redistributing water molecules from lower to higher density; it is negligibly small for native proteins, but potentially important for non-native states. Because the hydration shell is an open system, the conventional closed-system compressibility definitions yield a pseudo-compressibility. We define an intrinsic shell compressibility, unaffected by occupation number fluctuations, and show that it approaches the bulk-water value exponentially with a decay "length" of one shell, less than the bulk-water compressibility correlation length. In the first hydration shell, the intrinsic compressibility is 25%-30% lower than in bulk water, whereas its self part is 15%-20% lower. These large reductions are caused mainly by the proximity to the more rigid protein and are not a consequence of the perturbed water structure.

Compressibility of the protein-water interface.

PubMed

Persson, Filip; Halle, Bertil

2018-06-07

The compressibility of a protein relates to its stability, flexibility, and hydrophobic interactions, but the measurement, interpretation, and computation of this important thermodynamic parameter present technical and conceptual challenges. Here, we present a theoretical analysis of protein compressibility and apply it to molecular dynamics simulations of four globular proteins. Using additively weighted Voronoi tessellation, we decompose the solution compressibility into contributions from the protein and its hydration shells. We find that positively cross-correlated protein-water volume fluctuations account for more than half of the protein compressibility that governs the protein's pressure response, while the self correlations correspond to small (∼0.7%) fluctuations of the protein volume. The self compressibility is nearly the same as for ice, whereas the total protein compressibility, including cross correlations, is ∼45% of the bulk-water value. Taking the inhomogeneous solvent density into account, we decompose the experimentally accessible protein partial compressibility into intrinsic, hydration, and molecular exchange contributions and show how they can be computed with good statistical accuracy despite the dominant bulk-water contribution. The exchange contribution describes how the protein solution responds to an applied pressure by redistributing water molecules from lower to higher density; it is negligibly small for native proteins, but potentially important for non-native states. Because the hydration shell is an open system, the conventional closed-system compressibility definitions yield a pseudo-compressibility. We define an intrinsic shell compressibility, unaffected by occupation number fluctuations, and show that it approaches the bulk-water value exponentially with a decay "length" of one shell, less than the bulk-water compressibility correlation length. In the first hydration shell, the intrinsic compressibility is 25%-30% lower than in bulk water, whereas its self part is 15%-20% lower. These large reductions are caused mainly by the proximity to the more rigid protein and are not a consequence of the perturbed water structure.

Genetic variants in the LAMA5 gene in pediatric nephrotic syndrome.

PubMed

Braun, Daniela A; Warejko, Jillian K; Ashraf, Shazia; Tan, Weizhen; Daga, Ankana; Schneider, Ronen; Hermle, Tobias; Jobst-Schwan, Tilman; Widmeier, Eugen; Majmundar, Amar J; Nakayama, Makiko; Schapiro, David; Rao, Jia; Schmidt, Johanna Magdalena; Hoogstraten, Charlotte A; Hugo, Hannah; Bakkaloglu, Sevcan A; Kari, Jameela A; El Desoky, Sherif; Daouk, Ghaleb; Mane, Shrikant; Lifton, Richard P; Shril, Shirlee; Hildebrandt, Friedhelm

2018-03-09

Nephrotic syndrome (NS), a chronic kidney disease, is characterized by significant loss of protein in the urine causing hypoalbuminemia and edema. In general, ∼15% of childhood-onset cases do not respond to steroid therapy and are classified as steroid-resistant NS (SRNS). In ∼30% of cases with SRNS, a causative mutation can be detected in one of 44 monogenic SRNS genes. The gene LAMA5 encodes laminin-α5, an essential component of the glomerular basement membrane. Mice with a hypomorphic mutation in the orthologous gene Lama5 develop proteinuria and hematuria. To identify additional monogenic causes of NS, we performed whole exome sequencing in 300 families with pediatric NS. In consanguineous families we applied homozygosity mapping to identify genomic candidate loci for the underlying recessive mutation. In three families, in whom mutations in known NS genes were excluded, but in whom a recessive, monogenic cause of NS was strongly suspected based on pedigree information, we identified homozygous variants of unknown significance (VUS) in the gene LAMA5. While all affected individuals had nonsyndromic NS with an early onset of disease, their clinical outcome and response to immunosuppressive therapy differed notably. We here identify recessive VUS in the gene LAMA5 in patients with partially treatment-responsive NS. More data will be needed to determine the impact of these VUS in disease management. However, familial occurrence of disease, data from genetic mapping and a mouse model that recapitulates the NS phenotypes suggest that these genetic variants may be inherited factors that contribute to the development of NS in pediatric patients.

Functional and histological bladder damage in mice after photodynamic therapy: the influence of sensitiser dose and time of administration.

PubMed Central

Stewart, F. A.; Oussoren, Y.

1993-01-01

The bladders of anaesthetised mice were illuminated with red laser light (630 nm) at intervals of 1 day to 4 weeks after i.p. administration of Photofrin. Light was delivered intravesically by inserting a fibre optic, with a diffusing bulb tip, into the centre of fluid filled bladders. A single light dose of 11.3 J cm-2 applies 1 day after 10 mg kg-1 Photofrin caused a severe acute response, with increased urination frequency (five to seven times control) and hematuria. Recovery was good, however, and by 10 weeks only a mild (approximately two-fold) increase in frequency remained. There was no reduction in the amount of acute bladder damage or in the rate of healing when the interval between Photofrin and light was increased from 1 to 7 days but a 2 to 3 week interval lead to a significant reduction in damage. For an interval of 4 weeks there was only a mild (less than two-fold) increase in urination frequency during the first week. A drug dose of 2.5 mg kg-1 given 1 day before illumination caused transient haematuria but no increase in urination frequency. Doses of 5, 7.5 or 10 mg kg-1 all caused photosensitisation and the amount of bladder damage was drug dose dependent. The bladder seems to be well able to recover from severe acute damage induced by PDT. Occasional incidences of pyelonephritis were seen, however, suggesting that urinary tract infection during the acute period may lead to permanent renal damage. Images Figure 5 PMID:8398691

Vortex nozzle for segmenting and transporting metal chips from turning operations

DOEpatents

Bieg, L.F.

1993-04-20

Apparatus for collecting, segmenting and conveying metal chips from machining operations utilizes a compressed gas driven vortex nozzle for receiving the chip and twisting it to cause the chip to segment through the application of torsional forces to the chip. The vortex nozzle is open ended and generally tubular in shape with a converging inlet end, a constant diameter throat section and a diverging exhaust end. Compressed gas is discharged through angled vortex ports in the nozzle throat section to create vortex flow in the nozzle and through an annular inlet at the entrance to the converging inlet end to create suction at the nozzle inlet and cause ambient air to enter the nozzle. The vortex flow in the nozzle causes the metal chip to segment and the segments thus formed to pass out of the discharge end of the nozzle where they are collected, cleaned and compacted as needed.

Giant multilevel thoracic hemangioma with spinal cord compression in a patient with Klippel-Weber-Trenaunay syndrome: case report.

PubMed

Grau, Stefan J; Holtmannspoetter, Markus; Seelos, Klaus; Tonn, Joerg-Christian; Siefert, Axel

2009-06-15

Case report and clinical discussion. We intend to report a very rare case of a giant spinal hemangioma causing myelopathy. Multilevel symptomatic spinal hemangiomas causing acute neurologic symptoms are rare disorders. We found only sporadic reports in English literature. We describe a very rare case in which Klippel-Trenaunay-Weber syndrome is associated with a multisegmental vertebral hemangioma causing a rapidly progressing thoracic myelopathy. Because of the extension of the disease, surgical intervention was not feasible, the patient was treated by radiotherapy. The patient showed a complete regression of symptoms with stable condition after 3 months. In extensive spinal hemangiomas, radiotherapy may represent a safe treatment modality with rapid clinical improvement even in cases with spinal cord compression. This report contributes to a wide range of known vascular abnormalities in Klippel-Trenaunay-Weber syndrome and supports the need for a careful multisystemic evaluation of these patients.

Macrovascular Decompression of Facial Nerve With Anteromedial Transposition of a Dolichoectatic Vertebral Artery: 3-Dimensional Operative Video.

PubMed

Tabani, Halima; Yousef, Sonia; Burkhardt, Jan-Karl; Gandhi, Sirin; Benet, Arnau; Lawton, Michael T

2018-05-21

Most cranial nerve compression syndromes (ie, trigeminal neuralgia and hemifacial spasm) are caused by small arteries impinging on a nerve and are relieved by microvascular decompression. Rarely, cranial nerve compression syndromes can be caused by large artery impingement and can be relieved by macrovascular decompression. When present, this compression often occurs in association with degenerative atherosclerosis in the vertebral arteries (VA) and basilar artery. Conservative treatment is recommended for mild forms, but surgical transposition of the VA away from the root entry zone (REZ) can be considered. This video demonstrates macrovascular decompression of a dolichoectatic VA in a 74-yr-old female with refractory left hemifacial spasm. After obtaining IRB approval, patient consent was sought for the procedure. With the patient in three-quarter-prone position, a far-lateral craniotomy was performed. The dentate ligament was cut to free the VA, and the suprahypoglossal portion of the vagoaccessory triangle was widened. VA compressed the REZ of the facial nerve, but was mobilized anteromedially off the REZ. A muslin sling was wrapped around the VA and its tail brought down to the clival dura, which was punctured with a 19-gauge needle and enlarged with a dissector. The sling was pulled anteromedially to this puncture site and secured to the dura with an aneurysm clip, relieving the REZ of all compression. The patient tolerated the procedure with mild, transient hoarseness and her hemifacial spasm resolved completely. This case demonstrates the macrovascular decompression technique with anteromedial transposition of the vertebrobasilar artery, which can also be used for trigeminal neuralgia.

Spinal cord ischemia following thoracotomy without epidural anesthesia.

PubMed

Raz, Aeyal; Avramovich, Aharon; Saraf-Lavi, Efrat; Saute, Milton; Eidelman, Leonid A

2006-06-01

Paraplegia is an uncommon yet devastating complication following thoracotomy, usually caused by compression or ischemia of the spinal cord. Ischemia without compression may be a result of global ischemia, vascular injury and other causes. Epidural anesthesia has been implicated as a major cause. This report highlights the fact that perioperative cord ischemia and paraplegia may be unrelated to epidural intervention. A 71-yr-old woman was admitted for a left upper lobectomy for resection of a non-small cell carcinoma of the lung. The patient refused epidural catheter placement and underwent a left T5-6 thoracotomy under general anesthesia. During surgery, she was hemodynamically stable and good oxygen saturation was maintained. Several hours following surgery the patient complained of loss of sensation in her legs. Neurological examination disclosed a complete motor and sensory block at the T5-6 level. Magnetic resonance imaging (MRI) revealed spinal cord ischemia. The patient received iv steroid treatment, but remained paraplegic. Five months following the surgery there was only partial improvement in her motor symptoms. A follow-up MRI study was consistent with a diagnosis of spinal cord ischemia. In this case of paraplegia following thoracic surgery for lung resection, epidural anesthesia/analgesia was not used. The MRI demonstrated evidence of spinal cord ischemia, and no evidence of cord compression. This case highlights that etiologies other than epidural intervention, such as injury to the spinal segmental arteries during thoracotomy, should be considered as potential causes of cord ischemia and resultant paraplegia in this surgical population.

Significance of Compression in Binucleation while Differentiating Reactive Cellular Changes Between Human Papillomavirus and Candida Infections

PubMed Central

Okodo, Mitsuaki; Okayama, Kaori; Fukui, Tadasi; Shiina, Natsuko; Caniz, Timothy; Yabusaki, Hiromi; Fujii, Masahiko

2017-01-01

Purpose: Binucleation is a reactive cellular change (RCC) in Pap smears due to Candida infection. However, the origin of these binucleated cells as RCCs remains unclear. The purpose of this study was to examine binucleation in patients negative for intraepithelial lesion or malignancy (NILM) and infected with Candida and those infected with high-risk human papillomavirus (hr-HPV) and to clarify the origin of the binucleated cells. Methods: A total of 115 endocervical swab specimens with a combined diagnosis of NILM, Candida infection, and RCCs were used for this study. Pap smears were used to identify binucleated cells and then separate them into two groups, compression-positive and compression-negative. In addition, hr-HPV was detected using polymerase chain reaction (PCR) with a specific primer on the DNA extracted from the remaining residual cytology specimens. To make the hr-HPV-infected binucleated cells visible, an in situ PCR assay was performed on the Pap smear. Result: Of the 115 specimens, 69.6% contained binucleated cells, 26 (32.5%) showed only the compressed form, 35 (43.8%) showed only the non-compressed form, and 19 showed both the compressed and non-compressed forms of binucleated cells. Also, 34 specimens (29.6%) were positive for hr-HPV. The sensitivity and specificity of compression-positive binucleated cells were 91.2% and 82.7% (p < 0.001), but they were not significant in the compression-negative group (p = 0.156). Also, 34 cases with hr-HPV contained 99 compression-positive and 24 compression-negative cells. The hr-HPV-positive cells accounted for 68 (68.7%) of the 99 compression-positive and 2 (8.3%) of the 24 compression-negative binucleated cells as determined by an in situ PCR assay for hr-HPV. The relationship between compression and hr-HPV was statistically significant (p < 0.001). Conclusion: Compression-positive binucleated cells may be present as a result of hr-HPV infection and not RCC, which is caused due to inflammation in NILM cases infected with Candida. PMID:28952287

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lin, J.S.; Miyamoto, Y.

The fracture behavior of graded Al{sub 2}O{sub 3}/TiC/Ni materials with a symmetric structure was investigated using single-edge notch-bend (SENB) specimens with surface compression. The fracture toughness of the graded materials was determined according to ASTM Standard E399. The results show that the effective fracture toughness increases with an increase in notch depth in the compressive stress zone, and reaches the maximum of 39.2 MPa m{sup 1/2} at the interface of compressive/tensile stress zones. Finite elements analysis reveals that the surface compression will be intensified at the notch root once the specimen is edge-notched because of the stress concentration, and themore » digress of the compressive stress intensification increases with an increase in notch depth. The dependence of the effective fracture toughness of the graded materials on the notch depth shows a behavior similar to the R-curve that is usually associated with microstructural toughening mechanisms. This toughening behavior is caused by the intensification of the compressive stress concentration with the increase of the notch depth. A theoretical analysis based on fracture mechanics verifies that the mechanical reliability of brittle ceramics can be improved effectively by tailoring and controlling the internal stresses.« less

CT urography of urinary diversions with enhanced CT digital radiography: preliminary experience.

PubMed

Sudakoff, Gary S; Guralnick, Michael; Langenstroer, Peter; Foley, W Dennis; Cihlar, Krista L; Shakespear, Jonathan S; See, William A

2005-01-01

The purpose of this study was to determine if 3D-rendered CT urography (CTU) depicts both normal and abnormal findings in patients with urinary diversions and if the addition of contrast-enhanced CT digital radiography (CTDR) improves opacification of the urinary collecting system. Thirty CTU and contrast-enhanced CTDR examinations were performed in 24 patients who underwent cystectomy for bladder cancer. Indications for evaluation included hematuria, tumor surveillance, or suspected diversion malfunction. All examinations were evaluated without knowledge of the stage or grade of a patient's tumor and were compared with the clinical records. Opacification of the urinary collecting system was evaluated with 3D CTU alone, contrast-enhanced CTDR alone, and combined CTU and CTDR. Nine abnormalities were identified including distal ureteral strictures (n = 4), vascular compression of the mid left ureter (n = 1), scarring of the mid right pole infundibulum (n = 1), bilateral hydronephrosis and hydroureter (n = 1), urinary reservoir calculus (n = 1), and tumor recurrence invading the afferent limb of the neobladder (n = 1). Eight of the nine detected abnormalities were surgically or pathologically confirmed. All abnormalities were identified on all three imaging techniques but were best seen on 3D CTU and enhanced CTDR images. Incomplete opacification of the urinary collecting system occurred in 17 patients with CTU alone, 12 patients with contrast-enhanced CTDR alone, and nine patients with combined CTU and contrast-enhanced CTDR. Compared with CTU alone, the combined technique of 3D CTU and contrast-enhanced CTDR improved opacification by a statistically significant difference (p = 0.037). CTU with 3D rendering can accurately depict both normal and abnormal postoperative findings in patients with urinary diversions. Adding enhanced CTDR can improve visualization of the urinary collecting system.

Osteochondroma of the Scapula with Accessory Nerve (XI) Compression.

PubMed

Beauchamp-Chalifour, Philippe; Pelet, Stéphane

2018-01-01

Osteochondroma is the most common benign bone tumor and is characterized as a cartilage-capped bony stalk. This lesion usually develops from the growth plate of long bones. Most osteochondromas are asymptomatic. Neurovascular compressions or cosmetic issues can occur in specific locations. Malignant transformation is extremely rare, and MRI can help evaluate these lesions. Symptomatic mass and malignancy features are the main surgical indications. Uncommonly, an osteochondroma can develop from flat bones. We present the case of a 25-year-old patient with a right scapula osteochondroma causing an accessory nerve compression. The mass was surgically removed, and the diagnosis was confirmed. The patient fully recovered at the latest 3-year follow-up visit.

Secondary bladder amyloidosis with familial Mediterranean fever in a living donor kidney transplant recipient: a case report.

PubMed

Imamura, Sentaro; Narita, Shintaro; Nishikomori, Ryuta; Tsuruta, Hiroshi; Numakura, Kazuyuki; Maeno, Atsushi; Saito, Mitsuru; Inoue, Takamitsu; Tsuchiya, Norihiko; Nanjo, Hiroshi; Heike, Toshio; Satoh, Shigeru; Habuchi, Tomonori

2016-10-19

Secondary bladder amyloidosis is an extremely rare disease, resulting from a chronic systematic inflammatory disorder associated with amyloid deposits. Although uncommon in Japan, familial Mediterranean fever (FMF) is a hereditary autoinflammatory disease characterized by recurrent episodes of fever of short duration and serositis and is frequently associated with systemic amyloidosis. Here, we present a case of a Japanese patient complaining of fever and macroscopic hematuria after a living donor renal transplantation. Consequently, he was diagnosed with secondary bladder amyloidosis with FMF. A 64-year-old Japanese male received a living ABO-incompatible kidney transplant from his wife. The postoperative clinical course was normal, and the patient was discharged 21 days after the transplantation with a serum creatinine level of 0.78 mg/dl. The patient frequently complained of general fatigue and fever of unknown origin. Six months later, the patient presented with continuous general fatigue, macroscopic hematuria, and fever. Cystoscopic examination of the bladder showed an edematous region with bleeding, and a transurethral biopsy revealed amyloid deposits. His wife stated that the patient had a recurrent high fever since the age of 40 years and that his younger brother was suspected to have a familial autoinflammatory syndrome; thus, the patient was also suspected to have a familial autoinflammatory syndrome. Based on his brother's medical history and the genetic tests, which showed a homozygous mutation (M694V/M694V) for the Mediterranean fever protein, he was diagnosed with FMF. Although colchicine treatment for FMF was planned, the patient had an untimely death due to heart failure. We re-evaluated the pathological findings of the various tissue biopsies obtained during the treatment after the renal transplantation. Immunohistochemistry revealed amyloid deposits in the bladder region, renal allograft, and myocardium and the condition was diagnosed as AA amyloidosis associated with FMF. We presented a case of systemic amyloidosis with FMF, involving the bladder region, myocardium, and renal allograft, diagnosed after renal transplantation. Bladder amyloidosis should be considered in patients with macroscopic hematuria, particularly in the kidney transplant recipients with idiopathic chronic renal disease. Diagnosis of secondary bladder amyloidosis may result in the early detection of underlying diseases, which may contribute to patient prognosis.

Twinning behaviors of a rolled AZ31 magnesium alloy under multidirectional loading

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hou, Dewen

The microstructure and texture evolution of an AZ31 magnesium rolled sheet during quasi-static compression at strain rates of 10{sup −3} s{sup −1} has been investigated by in situ electron backscattered diffraction. The influence of the initial and pre-deformed texture on the predominant deformation mechanisms during compression has been examined. It has been found that extensive grain reorientation due to (10 − 12) tensile twinning appeared when compressed along transverse direction. Tensile twin variants were observed under this loading condition, and different variants will cause an effect to the following deformation. Several twinning modes occurred with continuative loading along rolling direction.more » - Highlights: •Twinning behaviors were investigated through in situ multidirectional compressive tests. •Deformation behavior was affected by the twin variants. •Four types of twinning behaviors were observed during deformation process.« less

A novel pulse compression algorithm for frequency modulated active thermography using band-pass filter

NASA Astrophysics Data System (ADS)

Chatterjee, Krishnendu; Roy, Deboshree; Tuli, Suneet

2017-05-01

This paper proposes a novel pulse compression algorithm, in the context of frequency modulated thermal wave imaging. The compression filter is derived from a predefined reference pixel in a recorded video, which contains direct measurement of the excitation signal alongside the thermal image of a test piece. The filter causes all the phases of the constituent frequencies to be adjusted to nearly zero value, so that on reconstruction a pulse is obtained. Further, due to band-limited nature of the excitation, signal-to-noise ratio is improved by suppressing out-of-band noise. The result is similar to that of a pulsed thermography experiment, although the peak power is drastically reduced. The algorithm is successfully demonstrated on mild steel and carbon fibre reference samples. Objective comparisons of the proposed pulse compression algorithm with the existing techniques are presented.

The Role of MRI in Diagnosing Neurovascular Compression of the Cochlear Nerve Resulting in Typewriter Tinnitus.

PubMed

Bae, Y J; Jeon, Y J; Choi, B S; Koo, J-W; Song, J-J

2017-06-01

Typewriter tinnitus, a symptom characterized by paroxysmal attacks of staccato sounds, has been thought to be caused by neurovascular compression of the cochlear nerve, but the correlation between radiologic evidence of neurovascular compression of the cochlear nerve and symptom presentation has not been thoroughly investigated. The purpose of this study was to examine whether radiologic evidence of neurovascular compression of the cochlear nerve is pathognomonic in typewriter tinnitus. Fifteen carbamazepine-responding patients with typewriter tinnitus and 8 control subjects were evaluated with a 3D T2-weighted volume isotropic turbo spin-echo acquisition sequence. Groups 1 (16 symptomatic sides), 2 (14 asymptomatic sides), and 3 (16 control sides) were compared with regard to the anatomic relation between the vascular loop and the internal auditory canal and the presence of neurovascular compression of the cochlear nerve with/without angulation/indentation. The anatomic location of the vascular loop was not significantly different among the 3 groups (all, P > .05). Meanwhile, neurovascular compression of the cochlear nerve on MR imaging was significantly higher in group 1 than in group 3 ( P = .032). However, considerable false-positive (no symptoms with neurovascular compression of the cochlear nerve on MR imaging) and false-negative (typewriter tinnitus without demonstrable neurovascular compression of the cochlear nerve) findings were also observed. Neurovascular compression of the cochlear nerve was more frequently detected on the symptomatic side of patients with typewriter tinnitus compared with the asymptomatic side of these patients or on both sides of control subjects on MR imaging. However, considering false-positive and false-negative findings, meticulous history-taking and the response to the initial carbamazepine trial should be regarded as more reliable diagnostic clues than radiologic evidence of neurovascular compression of the cochlear nerve. © 2017 by American Journal of Neuroradiology.

The importance of electrothermal terms in Ohm's law for magnetized spherical implosions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Davies, J. R., E-mail: jdav@lle.rochester.edu; Betti, R.; Chang, P.-Y.

2015-11-15

The magnetohydrodynamics (MHD) of magnetic-field compression in laser-driven spherical targets is considered. Magnetic-field evolution is cast in terms of an effective fluid velocity, a convective term resulting from resistivity gradients, a resistive diffusion term, and a source term. Effective velocity is the sum of fluid velocity, drift velocity, and heat-flux velocity, given by electron heat flux divided by electron enthalpy density, which has two components: the perpendicular or Nernst velocity and the cross-field velocity. The Nernst velocity compresses the magnetic field as the heat front moves into gas. The cross-field velocity leads to dynamo generation of an azimuthal magnetic field.more » It is proposed that the heat-flux velocity should be flux limited using a “Nernst” flux limiter independent of the thermal flux limiter but should not exceed it. The addition of the MHD routines to the 1D, Lagrangian hydrocode LILAC and the Eulerian version of the 2D hydrocode DRACO is described, and the codes are used to model a magnetized spherical compression on the OMEGA laser. Thermal flux limiting at a shock front is found to cause unphysical electron temperature gradients that lead to large, unphysical magnetic fields caused by the resistivity gradient, so thermal flux limiting in the gas is removed. The Nernst term reduces the benefits of magnetization in inertial fusion. A Nernst flux limiter ≤0.12 is required in the gas in order to agree with measured neutron yield and increases in the neutron-averaged ion temperature caused by magnetization. This corresponds to preventing the Nernst velocity from exceeding the shock velocity, which prevents significant decoupling of the magnetic field and gas compression.« less

Relaxation of the south flank after the 7.2-magnitude Kalapana earthquake, Kilauea Volcano, Hawaii

USGS Publications Warehouse

Dvorak, John J.; Klein, Fred W.; Swanson, Donald A.

1994-01-01

An M = 7.2 earthquake on 29 November 1975 caused the south flank of Kilauea Volcano, Hawaii, to move seaward several meters: a catastrophic release of compression of the south flank caused by earlier injections of magma into the adjacent segment of a rift zone. The focal mechanisms of the mainshock, the largest foreshock, and the largest aftershock suggest seaward movement of the upper block. The rate of aftershocks decreased in a familiar hyperbolic decay, reaching the pre-1975 rate of seismicity by the mid-1980s. Repeated rift-zone intrusions and eruptions after 1975, which occurred within 25 km of the summit area, compressed the adjacent portion of the south flank, apparently masking continued seaward displacement of the south flank. This is evident along a trilateration line that continued to extend, suggesting seaward displacement, immediately after the M = 7.2 earthquake, but then was compressed during a series of intrusions and eruptions that began in September 1977. Farther to the east, trilateration measurements show that the portion of the south flank above the aftershock zone, but beyond the area of compression caused by the rift-zone intrusions and eruptions, continued to move seaward at a decreasing rate until the mid-1980s, mimicking the decay in aftershock rate. Along the same portion of the south flank, the pattern of vertical surface displacements can be explained by continued seaward movement of the south flank and development of two eruptive fissures along the east rift zone, each of which extended from a depth of ∼3 km to the surface. The aftershock rate and continued seaward movement of the south flank are reminiscent of crustal response to other large earthquakes, such as the 1966 M = 6 Parkfield earthquake and the 1983 M = 6.5 Coalinga earthquake.

Time-Varying Distortions of Binaural Information by Bilateral Hearing Aids: Effects of Nonlinear Frequency Compression.

PubMed

Brown, Andrew D; Rodriguez, Francisco A; Portnuff, Cory D F; Goupell, Matthew J; Tollin, Daniel J

2016-10-03

In patients with bilateral hearing loss, the use of two hearing aids (HAs) offers the potential to restore the benefits of binaural hearing, including sound source localization and segregation. However, existing evidence suggests that bilateral HA users' access to binaural information, namely interaural time and level differences (ITDs and ILDs), can be compromised by device processing. Our objective was to characterize the nature and magnitude of binaural distortions caused by modern digital behind-the-ear HAs using a variety of stimuli and HA program settings. Of particular interest was a common frequency-lowering algorithm known as nonlinear frequency compression, which has not previously been assessed for its effects on binaural information. A binaural beamforming algorithm was also assessed. Wide dynamic range compression was enabled in all programs. HAs were placed on a binaural manikin, and stimuli were presented from an arc of loudspeakers inside an anechoic chamber. Stimuli were broadband noise bursts, 10-Hz sinusoidally amplitude-modulated noise bursts, or consonant-vowel-consonant speech tokens. Binaural information was analyzed in terms of ITDs, ILDs, and interaural coherence, both for whole stimuli and in a time-varying sense (i.e., within a running temporal window) across four different frequency bands (1, 2, 4, and 6 kHz). Key findings were: (a) Nonlinear frequency compression caused distortions of high-frequency envelope ITDs and significantly reduced interaural coherence. (b) For modulated stimuli, all programs caused time-varying distortion of ILDs. (c) HAs altered the relationship between ITDs and ILDs, introducing large ITD-ILD conflicts in some cases. Potential perceptual consequences of measured distortions are discussed. © The Author(s) 2016.

The mechanism of post-rift fault activities in Baiyun sag, Pearl River Mouth basin

NASA Astrophysics Data System (ADS)

Sun, Zhen; Xu, Ziying; Sun, Longtao; Pang, Xiong; Yan, Chengzhi; Li, Yuanping; Zhao, Zhongxian; Wang, Zhangwen; Zhang, Cuimei

2014-08-01

Post-rift fault activities were often observed in deepwater basins, which have great contributions to oil and gas migration and accumulation. The main causes for post-rift fault activities include tectonic events, mud or salt diapirs, and gravitational collapse. In the South China Sea continental margin, post-rift fault activities are widely distributed, especially in Baiyun sag, one of the largest deepwater sag with its main body located beneath present continental slope. During the post-rift stage, large population of faults kept active for a long time from 32 Ma (T70) till 5.5 Ma (T10). Seismic interpretation, fault analysis and analogue modeling experiments indicate that the post-rift fault activities in Baiyun sag between 32 Ma (T70) and 13.8 Ma (T30) was mainly controlled by gravity pointing to the Main Baiyun sag, which caused the faults extensive on the side facing Main Baiyun sag and the back side compressive. Around 32 Ma (T70), the breakup of the continental margin and the spreading of the South China Sea shed a combined effect of weak compression toward Baiyun sag. The gravity during post-rift stage might be caused by discrepant subsidence and sedimentation between strongly thinned sag center and wing areas. This is supported by positive relationship between sedimentation rate and fault growth index. After 13.8 Ma (T30), fault activity shows negative relationship with sedimentation rate. Compressive uplift and erosion in seismic profiles as well as negative tectonic subsiding rates suggest that the fault activity from 13.8 Ma (T30) to 5.5 Ma (T10) might be controlled by the subductive compression from the Philippine plate in the east.

The importance of electrothermal terms in Ohm's law for magnetized spherical implosions

DOE PAGES

Davies, J. R.; Betti, R.; Chang, P. -Y.; ...

2015-11-06

The magnetohydrodynamics (MHD) of magnetic-field compression in laser-driven spherical targets is considered. Magnetic-field evolution is cast in terms of an effective fluid velocity, a convective term resulting from resistivity gradients, a resistive diffusion term, and a source term. Effective velocity is the sum of fluid velocity, drift velocity, and heat-flux velocity, given by electron heat flux divided by electron enthalpy density, which has two components: the perpendicular or Nernst velocity and the cross-field velocity. The Nernst velocity compresses the magnetic field as a heat front moves into the gas. The cross-field velocity leads to dynamo generation of an azimuthal magneticmore » field. It is proposed that the heat-flux velocity should be flux limited using a “Nernst” flux limiter independent of the thermal flux limiter but should not exceed it. The addition of MHD routines to the 1-D, Lagrangian hydrocode LILAC and the Eulerian version of the 2-D hydrocode DRACO is described, and the codes are used to model a magnetized spherical compression on the OMEGA laser. Thermal flux limiting at a shock front is found to cause unphysical electron temperature gradients that lead to large, unphysical magnetic fields caused by the resistivity gradient, so thermal flux limiting in the gas is removed. The Nernst term reduces the benefits of magnetization in inertial fusion. In addition, a Nernst flux limiter ≤ 0.12 is required in the gas in order to agree with measured neutron yield and increases in the neutron-averaged ion temperature caused by magnetization. This corresponds to maintaining the Nernst velocity below the shock velocity, which prevents significant decoupling of the magnetic field and gas compression.« less

HIV, HBV, HCV and T. pallidum infections among blood donors and Transfusion-related complications among recipients at the Laquintinie hospital in Douala, Cameroon

PubMed Central

2014-01-01

Background Transfusion-transmissible infections (TTIs) pose a major health risk in Cameroon given the high prevalence of such pathogens and increased demands for blood donations in the local communities. This study aims at establishing the prevalence of commonly encountered TTIs among blood donors and transfusion-related complications among recipients in an urban center of Cameroon. Methods A total of 477 blood donors and 83 blood recipients were recruited by consecutive sampling at the Laquintinie Hospital in Douala (LHD), Cameroon. Serum samples from blood donors were tested by quantitative enzyme-linked immunosorbent assays (ELISA) and/or using various Rapid diagnostic test (RDT) for presence of Hepatits B (HBV) viral antigens, and antibodies to human immunodeficiency (HIV-1/2), Hepatits B (HCV) and Treponema pallidum. Recipient’s medical records were also analyzed for possible transfusion-associated complications. Results The male/female sex ratio of the blood donors was 4/1 with a mean age of 30.2 (Sd = 8.3) years. Of all blood donors, 64/467 (13.7%) were infected by at least one of the four TTIs. Infected volunteer donors represented 8.3% while infected family donors comprised 14.3% of the donor population. The prevalence of HCV, HIV, HBV and T. pallidum were 1.3%, 1.8%, 3.5%, and 8.1%, respectively. More than half of the blood recipients were female (78.3%) and the mean age was 20.6 (SD = 16.1) years. The causes of severe anemia indicative of transfusion in recipients varied with wards (postpartum hemorrhage, caesarean section, uterine or cervical lacerations, abortions, urinary tract infections, severe malaria, vaso-occlusive attacks, wounds and gastrointestinal bleeding). The most frequent complications were chills and hematuria, which represented 46.1% of all observed complications. Other complications such as nausea, vomiting, jaundice, sudden diarrhea, anxiety, tachycardia, or hyperthermia were also found in recipients. Three cases of deaths occurred during the study, including a girl of less than one year. Conclusion This study confirms the presence of blood-borne infectious diseases in blood donors at the LHD, identifying T. pallidum as the greatest threat to blood safety in the region, and hematuria as the most common immunological complications in blood recipients. PMID:24517107

Influence of chest compression artefact on capnogram-based ventilation detection during out-of-hospital cardiopulmonary resuscitation.

PubMed

Leturiondo, Mikel; Ruiz de Gauna, Sofía; Ruiz, Jesus M; Julio Gutiérrez, J; Leturiondo, Luis A; González-Otero, Digna M; Russell, James K; Zive, Dana; Daya, Mohamud

2018-03-01

Capnography has been proposed as a method for monitoring the ventilation rate during cardiopulmonary resuscitation (CPR). A high incidence (above 70%) of capnograms distorted by chest compression induced oscillations has been previously reported in out-of-hospital (OOH) CPR. The aim of the study was to better characterize the chest compression artefact and to evaluate its influence on the performance of a capnogram-based ventilation detector during OOH CPR. Data from the MRx monitor-defibrillator were extracted from OOH cardiac arrest episodes. For each episode, presence of chest compression artefact was annotated in the capnogram. Concurrent compression depth and transthoracic impedance signals were used to identify chest compressions and to annotate ventilations, respectively. We designed a capnogram-based ventilation detection algorithm and tested its performance with clean and distorted episodes. Data were collected from 232 episodes comprising 52 654 ventilations, with a mean (±SD) of 227 (±118) per episode. Overall, 42% of the capnograms were distorted. Presence of chest compression artefact degraded algorithm performance in terms of ventilation detection, estimation of ventilation rate, and the ability to detect hyperventilation. Capnogram-based ventilation detection during CPR using our algorithm was compromised by the presence of chest compression artefact. In particular, artefact spanning from the plateau to the baseline strongly degraded ventilation detection, and caused a high number of false hyperventilation alarms. Further research is needed to reduce the impact of chest compression artefact on capnographic ventilation monitoring. Copyright © 2017 Elsevier B.V. All rights reserved.

Primary epidural malignant hemangiopericytoma of thoracic spinal column causing cord compression: case report.

PubMed

Mohammadianpanah, Mohammad; Torabinejad, Simin; Bagheri, Mohammad Hadi; Omidvari, Shapour; Mosalaei, Ahmad; Ahmadloo, Niloofar

2004-09-02

Hemangiopericytoma is an uncommon mesenchymal neoplasm that rarely affects the spinal canal. Primary malignant hemangiopericytoma of the spinal column is extremely rare. We report on a case of primary epidural malignant hemangiopericytoma of the thoracic spinal column that invaded vertebral bone and caused spinal cord compression in a 21-year-old man. The patient presented with progressive back pain over a four-month period that progressed to paraparesis, bilateral leg paresthesia and urinary incontinence. The surgical intervention involved laminectomy and subtotal resection of the tumor, with posterior vertebral fixation. Postoperative involved-field radiotherapy was administered. A marked neurological improvement was subsequently observed. We describe the clinical, radiological, and histological features of this tumor and review the literature.

Fuel Vaporization and Its Effect on Combustion in a High-Speed Compression-Ignition Engine

NASA Technical Reports Server (NTRS)

Rothrock, A M; Waldron, C D

1933-01-01

The tests discussed in this report were conducted to determine whether or not there is appreciable vaporization of the fuel injected into a high-speed compression-ignition engine during the time available for injection and combustion. The effects of injection advance angle and fuel boiling temperature were investigated. The results show that an appreciable amount of the fuel is vaporized during injection even though the temperature and pressure conditions in the engine are not sufficient to cause ignition either during or after injection, and that when the conditions are such as to cause ignition the vaporization process affects the combustion. The results are compared with those of several other investigators in the same field.

Metastatic spinal cord compression from basal cell carcinoma of the skin treated with surgical decompression and vismodegib: case report and review of Hedgehog signalling pathway inhibition in advanced basal cell carcinoma.

PubMed

McGrane, J; Carswell, S; Talbot, T

2017-01-01

We report a case of a 66-year-old man with locally advanced and metastatic basal cell carcinoma (BCC) causing spinal cord compression, which was treated with spinal surgery and subsequent vismodegib. The patient presented with a large fungating chest wall lesion and a metastasis in T8 that was causing cord compression. He had neurosurgical decompression of the T8 lesion and fixation of the spine. Punch biopsy from the fungating chest wall lesion showed a BCC with some malignant squamous differentiation (basosquamous). Histopathological examination of the metastatic lesion in T8 at the time of surgical decompression identified features identical to the punch biopsy. The patient was referred to the oncology clinic for adjuvant treatment. In light of his metastatic disease and the large area over his chest wall that could not fully be covered by radiotherapy, he was treated with the novel oral Hedgehog signalling pathway (HHSP) inhibitor vismodegib, which led to marked improvement. © 2016 British Association of Dermatologists.

Aerodynamics inside a rapid compression machine

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mittal, Gaurav; Sung, Chih-Jen

2006-04-15

The aerodynamics inside a rapid compression machine after the end of compression is investigated using planar laser-induced fluorescence (PLIF) of acetone. To study the effect of reaction chamber configuration on the resulting aerodynamics and temperature field, experiments are conducted and compared using a creviced piston and a flat piston under varying conditions. Results show that the flat piston design leads to significant mixing of the cold vortex with the hot core region, which causes alternate hot and cold regions inside the combustion chamber. At higher pressures, the effect of the vortex is reduced. The creviced piston head configuration is demonstratedmore » to result in drastic reduction of the effect of the vortex. Experimental conditions are also simulated using the Star-CD computational fluid dynamics package. Computed results closely match with experimental observation. Numerical results indicate that with a flat piston design, gas velocity after compression is very high and the core region shrinks quickly due to rapid entrainment of cold gases. Whereas, for a creviced piston head design, gas velocity after compression is significantly lower and the core region remains unaffected for a long duration. As a consequence, for the flat piston, adiabatic core assumption can significantly overpredict the maximum temperature after the end of compression. For the creviced piston, the adiabatic core assumption is found to be valid even up to 100 ms after compression. This work therefore experimentally and numerically substantiates the importance of piston head design for achieving a homogeneous core region inside a rapid compression machine. (author)« less

[Late complication of selective renal arterial embolization after percutaneous surgery: renal "colic"].

PubMed

Savoie, Pierre-Henri; Lafolie, Trévor; Gabaudan, Charline; Biance, Nicolas; Avaro, Jean-Philippe; André, Marc; Bertrand, Serge; Balandraud, Paul

2007-06-01

Authors report a case of a 31 years old patient who eliminate a urinary stone which contains a platinium coil. Five years ago, this patient had a percutaneous nephrolithotomy. A persistent hematuria was successfully managed with angioembolization of a lower polar artery branch. One of the coils was deployed too distally. It was not efficient, it rolled itself up in the pseudoaneurysm cavity. Different physio pathological hypothesis are developed to explain this expulsion.

Anti-glomerular basement membrane disease and dual positivity for antineutrophil cytoplasmic antibody in a patient with membranous nephropathy.

PubMed

Meisels, I S; Stillman, I E; Kuhlik, A B

1998-10-01

We present the case of a 50-year-old man who underwent kidney biopsy for nephrotic syndrome. In addition to a membranous pattern, anti-glomerular basement membrane (anti-GBM) staining was noted before manifestations of anti-GBM disease. Hematuria and renal failure ensued 2 weeks later. In addition, he had simultaneous circulating levels of anti-GBM antibody and both perinuclear (P-) and cytoplasmic (C-) antineutrophil cytoplasmic antibody (ANCA).

[Clinical and pathological features of Alport syndrome in children].

PubMed

Zhu, Chun-Hua; Huang, Song-Ming; Wu, Hong-Mei; Bao, Hua-Ying; Chen, Ying; Han, Yuan; Zhao, Fei; Zhang, Ai-Hua; Zhang, Wei-Zhen

2010-03-01

To study the clinical and pathological features of Alport syndrome in children. The clinical and histopathological data of 10 hospitalized children with Alport syndrome from February 2007 to February 2009 were retrospectively reviewed. There were 7 males and 3 females, with the age ranging from 2 years to 6 years and 7 months (mean 3 years and 2 months). Five of 10 cases had positive family history. X-linked dominant inheritance Alport syndrome was diagnosed in 8 cases, and autosomal recessive inheritance Alport syndrome in 2 cases. Recurrent gross hematuria was found in 5 cases, hematuria and proteinuria in 3 cases, massive proteinuria in 1 case, and nephritic syndrome in 1 case. Under the light microscope, 8 cases presented with mesangial proliferation glomerulonephritis, and 2 cases with focal segmental glomerulosclerosis. Immunofluorescence assay showed that all cases had IgM deposition in glomerulus. Only 1 case showed typical glomerular basement membrane (GBM) pathological changes. All cases showed abnormal alpha-chain distribution in renal collagen IV. The children with Alport syndrome have diverse clinical manifestations. Characteristic histopathological presentations could not be found under a light microscope, mesangial proliferation glomerulonephritis is the dominant pathological change, and IgM deposition in glomerulus is common. The GBM pathological change in children is not common. Immunofluorescence assay of alpha-chain in collagen IV is needed for the diagnosis of Alport syndrome.

Predictors of relapses in ANCA-associated small vessel vasculitis with kidney involvement

PubMed Central

Iuliana, Andreiana; Simona, Stancu; Andreea, Avram; Ludmila, Taran; Gabriel, Mircescu

2014-01-01

Rationale: Almost half of the patients with anti-neutrophil cytoplasmic antibodies (ANCA) associated small vessel vasculitis relapse and their characteristics are still to be defined Objective: We aimed to evaluate the relapse rate and its determinants in a cohort of patients with ANCA associated vasculitis with severe kidney involvement. Methods and results: This is a retrospective study which included 100 patients consecutively admitted in a Nephrology Department with crescentic pauci-immune glomerulonephritis diagnosed by kidney biopsy. ANCAs were assessed by capture ELISA or indirect immunofluorescence (IFI). Patients were followed for a median period of 3.2 [0.1; 5.5] years. The median age was 61.6 years. The clinical condition at presentation was severe (median BVAS 16 and BVAS over 21 in one quarter of patients), mostly because of general, kidney and lung scores. Median creatinine was 5.7 mg/dL and 17% of the patients needed temporary dialysis. Eight patients relapsed (13.8%): one in the lung and seven in the kidney. The median time to relapse was 11.3 [9.2; 19.9] months. None of the investigated parameters allowed for differentiating patients who relapsed from those who did not, except higher hematuria in those who relapsed. Discussion: In our patients with ANCA vasculitis and severe kidney involvement, the relapse rate is low and hematuria but not ANCA specificity or clinical presentation allows the prediction of relapse. PMID:27057255

Kidney disease among children in sub-Saharan Africa: a systematic review

PubMed Central

Tallman, Jacob E.; Chu, Emily Y.; Fitzgerald, Daniel W.; Pain, Kevin J.; Peck, Robert N.

2015-01-01

The global burden of kidney disease is increasing, and several etiologies first begin in childhood. Risk factors for pediatric kidney disease are common in Africa, but data regarding its prevalence are lacking. We completed a systematic review of community-based studies describing the prevalence of proteinuria, hematuria, abnormal imaging, or kidney dysfunction among children in sub-Saharan Africa. Medline and Embase were searched. Five hundred twenty-three references were reviewed. Thirty-two references from 9 countries in sub-Saharan Africa were included in the qualitative synthesis. The degree of kidney damage and abnormal imaging varied widely: proteinuria 32.5% (2.2%-56.0%); hematuria 31.1% (0.6%-67.0%); hydronephrosis 11.3% (0.0%-38.0%), hydroureter 7.5% (0.0%-26.4%), major kidney abnormalities 0.1% (0.0%-0.8%). Serum creatinine was reported in four studies with insufficient detail to identify the prevalence renal dysfunction. A majority of the studies were performed in Schistosoma haematobium endemic areas. A lower prevalence of kidney disease was observed in the few studies from non-endemic areas. Published data on pediatric kidney disease in sub-Saharan Africa is highly variable and dependent on S. haematobium prevalence. More community-based studies are needed to describe the burden of pediatric kidney disease, particularly in regions where S. haematobium infection is non-endemic. PMID:25420180

Dioctophyma renale (Goeze, 1782) Infection in a Domestic Dog from Hamedan, Western Iran

PubMed Central

ZOLHAVARIEH, Seyed Masoud; NORIAN, Alireza; YAVARI, Morteza

2016-01-01

Dioctophyma renale infection is found in a wide range of mammalian species, typically in temperate areas of the world. Here, we report for the first time, the parasitism of a domestic dog by D. renale in Hamedan, Iran, a mountainous cold region, lacking significant amounts of rainfall, high humidity and temperature. A 2.5 yr old male mixed breed dog was presented with a two months history of progressive hematuria and muscle weakness. Complete blood count and serum biochemistry were performed with results indicating impaired renal function. Urinalysis, showed hematuria as well as parasitic eggs, suggestive of D. renale infection. Urinary system ultrasonography revealed a hypoecogenic tubular structure in the right kidney. The animal was treated with fenbendazole (45 mg/kg, PO, QD - five days) and ivermectin (0.02 mg/kg, SC, single dose). One week later, repeated laboratory examination confirmed presence of at least one alive worm in the affected kidney. A unilateral nephrectomy was performed; one female (60 × 5 cm) and one male (30 × 3.8 cm) live worm were taken out of the extremely thin walled right kidney. One month later, due to failure of the remained kidney and poor condition, the patient deceased. We conclude that dioctophymosis can be found in cold and or relatively dry area. Moreover, the results showed that the worm was not affected with common anthelmintic drugs. PMID:27095981

Dioctophyma renale (Goeze, 1782) Infection in a Domestic Dog from Hamedan, Western Iran.

PubMed

Zolhavarieh, Seyed Masoud; Norian, Alireza; Yavari, Morteza

2016-01-01

Dioctophyma renale infection is found in a wide range of mammalian species, typically in temperate areas of the world. Here, we report for the first time, the parasitism of a domestic dog by D. renale in Hamedan, Iran, a mountainous cold region, lacking significant amounts of rainfall, high humidity and temperature. A 2.5 yr old male mixed breed dog was presented with a two months history of progressive hematuria and muscle weakness. Complete blood count and serum biochemistry were performed with results indicating impaired renal function. Urinalysis, showed hematuria as well as parasitic eggs, suggestive of D. renale infection. Urinary system ultrasonography revealed a hypoecogenic tubular structure in the right kidney. The animal was treated with fenbendazole (45 mg/kg, PO, QD - five days) and ivermectin (0.02 mg/kg, SC, single dose). One week later, repeated laboratory examination confirmed presence of at least one alive worm in the affected kidney. A unilateral nephrectomy was performed; one female (60 × 5 cm) and one male (30 × 3.8 cm) live worm were taken out of the extremely thin walled right kidney. One month later, due to failure of the remained kidney and poor condition, the patient deceased. We conclude that dioctophymosis can be found in cold and or relatively dry area. Moreover, the results showed that the worm was not affected with common anthelmintic drugs.

[Biodegradable catheters for fistula prevention in hypospadias. Experimental preliminary study].

PubMed

Ramos, J L; Aldazabal, P; Zuza, E; Sarasúa, J R; Arrieta, A; Villanueva, A; Eizaguirre, I

2013-04-01

Continuous technical innovations are not enough to resolve the high incidence of fistula after hypospadias repair. A urethral catheter-tutor made of reabsorbable polymeric biomaterial (RPB) which could be left in situ long enough could reduce the complications. To investigate in an animal model differents RPB to be used in urology. CRL Wistar rats, males, divided into 5 equal groups according to the used polymers: polylactide; lactic-coprolactone copolymer; lactic-glycolic copolymer; simulated; control silicones. Three individuals were sacrificed per group at 4th, 10th and 16th week. In all animals (exceptuating the simulated group), biomaterial was fixed to the bladder wall bylaparotomy. Animals remained in individual housing and kept under daily control of hematuria during the first 15 days and weekly weight and urine control for pH and lactate. After being slaughtered, remaining polymer was collected for chemical analysis and bladder tissue for hystologic study. There was no mortality, hematuria nor other clinical signs. The bladder wall showed a mild foreign body reaction. The values of lactate and pH in urine did not reach toxic levels. Lactic-glycolic was totally reabsorbed by the 10th week and had the lowest degree of calcification. Polylactide and lactic-coprolactone remained intact. The model of urinary bladder has proven useful for studying the degradation of bioresorbable polymers. The analyzed polymers have spent long time to be reabsorbed, so we will have to study new others.

Ultrasound-Guided Percutaneous Nephrostomy Performed on Neonates and Infants Using a "14-4" (Trocar and Cannula) Technique.

PubMed

Bas, Ahmet; Gülşen, Fatih; Emre, Senol; Samanci, Cesur; Uzunlu, Osman; Cantasdemir, Murat; Emir, Haluk; Numan, Furuzan

2015-12-01

Percutaneous nephrostomy (PCN) catheters are placed under combined ultrasound and fluoroscopic guidance in the interventional radiology suite and present unique challenges in neonates and infants. The purpose of this study was to demonstrate feasibility of PCN using a "14-4" (trocar and cannula) technique on neonates and infants. Between September 2009 and June 2014, data for 27 kidneys from consecutive 22 neonates or infants who underwent PCN catheter placement using the "14-4" technique were retrospectively analyzed. The median age at the time of placement of the PCN catheters was 11 days (range 5-300 days). There were 18 males and 4 females. All procedures were performed in the interventional radiology suite but without using fluoroscopy. Unilateral PCN was performed on 17 out of 22 patients, while bilateral drainage was performed on five patients. The technical success rate was 100%. The median duration of PCN catheter was 75 days (range 10-138 days). Minor macroscopic hematuria not requiring blood transfusion was present in two of the patients in which the hematuria lasted in 2 days. Placement of PCN catheters using a "14-4" technique with ultrasound as the sole imaging modality is a technically feasible and desirable option for neonates or infants. The technique obviates the need for ionizing radiation and potentially could be performed in the ultrasound room or even at the bedside.

Carpal tunnel syndrome – Part I (anatomy, physiology, etiology and diagnosis)☆☆☆

PubMed Central

Chammas, Michel; Boretto, Jorge; Burmann, Lauren Marquardt; Ramos, Renato Matta; dos Santos Neto, Francisco Carlos; Silva, Jefferson Braga

2014-01-01

Carpal tunnel syndrome (CTS) is defined by compression of the median nerve in the wrist. It is the commonest of the compressive syndromes and its most frequent cause is idiopathic. Even though spontaneous regression is possible, the general rule is that the symptoms will worsen. The diagnosis is primarily clinical, from the symptoms and provocative tests. Electroneuromyographic examination may be recommended before the operation or in cases of occupational illnesses. PMID:26229841

Left atrium and pulmonary artery compression due to aortic aneurysm causing heart failure symptoms.

PubMed

Jorge, Antonio José Lagoeiro; Martins, Wolney de Andrade; Moutinho, Victor M; Rezende, Juliano M; Alves, Patricia Y; Villacorta, Humberto; Silveira, Pedro F; Couto, Antonio A

2018-06-01

Patients with thoracic aortic aneurysm (TAA) are mostly asymptomatic and TAA is rarely related to heart failure (HF). We report the case of an 80-year-old female patient, with type A TAA without dissection, with right pulmonary artery and left atrium compression, who presented with HF, preserved ejection fraction and acute pulmonary edema. Copyright © 2018 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

Olfactory Neuroblastoma: A Rare Cause of External Ophthalmoplegia, Proptosis and Compressive Optic Neuropathy.

PubMed

Kartı, Ömer; Zengin, Mehmet Özgür; Çelik, Ozan; Tokat, Taşkın; Küsbeci, Tuncay

2018-04-01

Olfactory neuroblastoma (ONB), which is a neuroectodermal tumor of the nasal cavity, is a rare and locally aggressive malignancy that may invade the orbit via local destruction. In this study, we report a patient with proptosis, external ophthalmoplegia, and compressive optic neuropathy caused by ONB. A detailed clinical examination including ocular imaging and histopathological studies were performed. The 62-year-old female patient presented to our clinic with complaints of proptosis and visual deterioration in the left eye. Her complaints started 2 months prior to admission. Visual acuity in the left eye was counting fingers from 2 meters. There was relative afferent pupillary defect. She had 6 mm of proptosis and limitation of motility. Fundus examination was normal in the right eye, but there was a hyperemic disc, and increased vascular tortuosity and dilation of the retinal veins in the left eye. Computerized tomography and magnetic resonance imaging of the brain and orbits demonstrated a large heterogeneous mass in the left superior nasal cavity with extensions into the ethmoidal sinuses as well as into the left orbit, compressing the medial rectus muscle and optic nerve. Endoscopic biopsy of the lesion was consistent with an ONB (Hyams' grade III). Orbital invasion may occur in patients with ONB. Therefore, it is important to be aware of this malignancy because some patients present with ophthalmic signs such as external ophthalmoplegia, proptosis, or compressive optic neuropathy.

Evaluation of the effectiveness of olive cake residue as an expansive soil stabilizer

NASA Astrophysics Data System (ADS)

Nalbantoglu, Zalihe; Tawfiq, Salma

2006-08-01

The quantity of the by-product olive cake residue generated in most parts of the Mediterranean countries continues to increase and expected to double in amount within 10 15 years. This increase intensifies the problems associated with the disposal of this by-product. Olive cake residue has a potential for use as a soil stabilizer and large volumes can be beneficially used. This study is directed toward determining if olive cake residue can be utilized to increase the strength and stability of expansive soils which constitute a costly natural hazard to lightweight structures on shallow foundations. A series of laboratory tests using engineering properties, such as Atterberg limits, moisture-density relationship (compaction), swell, unconfined compressive strength were undertaken to evaluate the effectiveness and performance of the olive cake residue as a soil stabilizer. Test results indicate that an addition of only 3% burned olive waste into the soil causes a reduction in plasticity, volume change and an increase in the unconfined compressive strength. However, it was observed that the presence of burned olive waste in the soil greater than 3% caused an increase in the compressibility and a decrease in the unconfined compressive strength. Test results indicate that the use of olive waste in soil stabilization gives greater benefits to the environment than simply disposing of the by-product, olive cake residue.

Analysis of signal-dependent sensor noise on JPEG 2000-compressed Sentinel-2 multi-spectral images

NASA Astrophysics Data System (ADS)

Uss, M.; Vozel, B.; Lukin, V.; Chehdi, K.

2017-10-01

The processing chain of Sentinel-2 MultiSpectral Instrument (MSI) data involves filtering and compression stages that modify MSI sensor noise. As a result, noise in Sentinel-2 Level-1C data distributed to users becomes processed. We demonstrate that processed noise variance model is bivariate: noise variance depends on image intensity (caused by signal-dependency of photon counting detectors) and signal-to-noise ratio (SNR; caused by filtering/compression). To provide information on processed noise parameters, which is missing in Sentinel-2 metadata, we propose to use blind noise parameter estimation approach. Existing methods are restricted to univariate noise model. Therefore, we propose extension of existing vcNI+fBm blind noise parameter estimation method to multivariate noise model, mvcNI+fBm, and apply it to each band of Sentinel-2A data. Obtained results clearly demonstrate that noise variance is affected by filtering/compression for SNR less than about 15. Processed noise variance is reduced by a factor of 2 - 5 in homogeneous areas as compared to noise variance for high SNR values. Estimate of noise variance model parameters are provided for each Sentinel-2A band. Sentinel-2A MSI Level-1C noise models obtained in this paper could be useful for end users and researchers working in a variety of remote sensing applications.

Biomechanics of Sports-Induced Axial-Compression Injuries of the Neck

PubMed Central

Ivancic, Paul C.

2012-01-01

Context Head-first sports-induced impacts cause cervical fractures and dislocations and spinal cord lesions. In previous biomechanical studies, researchers have vertically dropped human cadavers, head-neck specimens, or surrogate models in inverted postures. Objective To develop a cadaveric neck model to simulate horizontally aligned, head-first impacts with a straightened neck and to use the model to investigate biomechanical responses and failure mechanisms. Design Descriptive laboratory study. Setting Biomechanics research laboratory. Patients or Other Participants Five human cadaveric cervical spine specimens. Intervention(s) The model consisted of the neck specimen mounted horizontally to a torso-equivalent mass on a sled and carrying a surrogate head. Head-first impacts were simulated at 4.1 m/s into a padded, deformable barrier. Main Outcome Measure(s) Time-history responses were determined for head and neck loads, accelerations, and motions. Average occurrence times of the compression force peaks at the impact barrier, occipital condyles, and neck were compared. Results The first local compression force peaks at the impact barrier (3070.0 ± 168.0 N at 18.8 milliseconds), occipital condyles (2868.1 ± 732.4 N at 19.6 milliseconds), and neck (2884.6 ± 910.7 N at 25.0 milliseconds) occurred earlier than all global compression peaks, which reached 7531.6 N in the neck at 46.6 milliseconds (P < .001). Average peak head motions relative to the torso were 6.0 cm in compression, 2.4 cm in posterior shear, and 6.4° in flexion. Neck compression fractures included occipital condyle, atlas, odontoid, and subaxial comminuted burst and facet fractures. Conclusions Neck injuries due to excessive axial compression occurred within 20 milliseconds of impact and were caused by abrupt deceleration of the head and continued forward torso momentum before simultaneous rebound of the head and torso. Improved understanding of neck injury mechanisms during sports-induced impacts will increase clinical awareness and immediate care and ultimately lead to improved protective equipment, reducing the frequency and severity of neck injuries and their associated societal costs. PMID:23068585

The Role of Microfossils in the Compression of Marine Sediments: Implications for Submarine Slope Failure

NASA Astrophysics Data System (ADS)

Reece, J. S.; Shackleton, T.

2016-12-01

The influence of microfossils on engineering properties has long been recognized. However, most experimental studies have been conducted on diatomites, which are almost exclusively composed of diatom fossils. Here, instead, we analyze the impact of varying amounts of microfossils in natural marine sediments on the macro-scale mechanical behavior. We use foraminifera as an example for microfossils, which, in contrast to diatoms, have been understudied. We uniformly mix foraminifera with natural mudstone from Site C0011 in the Nankai Trough, offshore Japan, obtained during Integrated Ocean Drilling Program (IODP) Expedition 322, at three different microfossil concentrations: 0 wt%, 5 wt%, and 10 wt%. The foraminifera, extracted by washing and sieving, originated from IODP Site U1338 in the Equatorial Pacific. We use resedimentation to prepare the homogeneous microfossil-rich mudstone samples and uniaxially compress them to 100 kPa. Additionally, we use scanning electron microscopy to investigate microstructural changes during compression as a function of microfossil content. Microfossil-rich sediments are known to initially not consolidate to as low porosities as other marine clays owing to microfossil shells acting as structural components. But they show a delayed compressibility when the yield stress is overcome and microfossil shells collapse resulting in an increase in porosity and compressibility. Here, we investigate the 1) threshold microfossil content at which the microfabric significantly changes during compression and 2) stress at which foraminifera chambers start to break. We anticipate to observe an increase in compressibility and microstructural changes in the vicinity of the yield stress with increasing microfossil content attributed to the crushing of foraminifera and particle rearrangement. But the total axial stress of 100 kPa at the end of the resedimentation experiments may not be large enough to have a significant effect on the macroscopic mudstone properties. This study has large implications for submarine slope failure due to the possible sudden expulsion of water causing a pore pressure increase, which may destabilize continental slopes, and cause a hazard for coastal communities and offshore infrastructure.