Sample records for renal scanning agent

  1. The renal scan in pregnant renal transplant patients

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


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

  2. Application of mobile scanning agent in the network security

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    闵君; 冯珊; 唐超; 梅纲


    To enhance the security of network systems, puts forward a kind of software agent is put forward, which has the induction ability of network frameworks and the ability of behavior independence. It is mobile scanning agent. More attentions is paid to expound how to design and realize mobile scanning agent. Besides, it is also explained the programs of mobile scanning agent system. In the end, it expects mobile scanning agent.

  3. Prospective evaluation of renal allograft dysfunction with 99mtechnetium-diethylenetriaminepentaacetic acid renal scans

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    McConnell, J.D.; Sagalowsky, A.I.; Lewis, S.E.; Gailiunas, P.; Helderman, J.H.; Dawidson, I.; Peters, P.C.


    A prospective, single-blinded study was done to determine the ability of serial 99mtechnetium-diethylenetriaminepentaacetic acid scans to diagnose renal allograft rejection. Among 28 transplant recipients 111 renal scans were obtained 1 day postoperatively and every 3 to 4 days thereafter for 3 weeks in all patients retaining an allograft. Computer-generated time-activity blood flow curves were analyzed semiquantitatively for the 1) interval between curve peaks of the allograft and iliac artery, 2) renal transit time and 3) renal washout of radionuclide. Excretory function was assessed by degree and interval to appearance of radionuclide in the calices and bladder. Deterioration of renal blood flow and excretion compared to the initial scan was considered rejection. Of 52 scans performed during clinical rejection 47 (90.4 per cent) were interpreted as showing rejection (sensitivity). Of 53 scans interpreted as showing rejection 47 (88.7 per cent) were positive for clinical rejection. The remaining 6 patients (initial false positive results) suffered clinical rejection within 24 to 72 hours. We conclude that 99mtechnetium-diethylenetriaminepentaacetic acid renal scans are useful in the differential diagnosis of renal allograft dysfunction.

  4. Scintigraphic features of duplex kidneys on DMSA renal cortical scans. (United States)

    Kwatra, Neha; Shalaby-Rana, Eglal; Majd, Massoud


    The spectrum of manifestations of duplex kidneys on (99m)Tc-dimercaptosuccinic acid (DMSA) renal cortical scans and correlating findings on other imaging modalities are presented. Relevant embryology of the duplex systems and technical aspects of DMSA scintigraphy are reviewed.

  5. Differentiation between renal allograft rejection and acute tubular necrosis by renal scan

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    Delmonico, F.L.; McKusick, K.A.; Cosimi, A.B.; Russell, P.S.


    The usefulness of the renal scan in diagnosing technical complications in the transplant patient is well established. However, the ability of the renal scan to differentiate between acute rejection and acute tubular necrosis has remained uncertain. We have evaluated the effectiveness of the /sup 99m/Tc DTPA computer-derived time-activity curve of renal cortical perfusion, as well as data obtained from scintillation camera images, in making such diagnoses. Fifteen patients with a clinical diagnosis of either acute rejection or acute tubular necrosis, or both, were studied retrospectively. Technetium scan diagnoses did not agree with the clinical assessment in nine of the patients. Thus selection of a course of treatment should not be based on data obtained from the scan alone.

  6. sup 99m Tc renal tubular function agents: Current status

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    Eshima, D.; Fritzberg, A.R.; Taylor, A. Jr. (Emory Univ. School of Medicine, Atlanta, GA (USA))


    Orthoiodohippuric (OIH) acid labeled with 131I is a widely used renal radiopharmaceutical agent and has been the standard radiopharmaceutical agent for the measurement of effective renal plasma flow (EPRF). Limitations to the routine clinical use of 131I OIH are related to the suboptimal imaging properties of the 131I radionuclide and its relatively high radiation dose. 123I has been substituted for 131I; however, its high cost and short shelf-life have limited its widespread use. Recent work has centered on the development of a new 99mTc renal tubular function agent, which would use the optimal radionuclidic properties and availability of 99mTc and combine the clinical information provided by OIH. The search for a suitable 99mTc renal tubular function agent has focused on the diamide dithiolate (N2S2), the paraaminohippuric iminodiacetic acid (PAHIDA), and the triamide mercaptide (N3S) donor ligand systems. To date, the most promising 99mTc tubular function agent is the N3S complex: 99mTc mercaptoacetyltriglycine (99mTc MAG3). Studies in animal models in diuresis, dehydration, acid or base imbalance, ischemia, and renal artery stenosis demonstrate that 99mTc MAG3 behaves similarly to 131I OIH. A simple kit formulation is available that yields the 99mTc MAG3 complex in high radiochemical purity. Studies in normal subjects and patients indicate that 99mTc MAG3 is an excellent 99mTc renal tubular agent, but its plasma clearance is only 50% to 60% that of OIH. In an effort to develop an improved 99mTc renal tubular function agent, changes have been made in the core N3S donor ligand system, but to date no agent has been synthesized that is clinically superior to 99mTc MAG3. 61 references.

  7. A simple and accurate grading system for orthoiodohippurate renal scans in the assessment of post-transplant renal function

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    Zaki, S.K.; Bretan, P.N.; Go, R.T.; Rehm, P.K.; Streem, S.B.; Novick, A.C. (Cleveland Clinic Foundation, OH (USA))


    Orthoiodohippurate renal scanning has proved to be a reliable, noninvasive method for the evaluation and followup of renal allograft function. However, a standardized system for grading renal function with this test is not available. We propose a simple grading system to distinguish the different functional phases of hippurate scanning in renal transplant recipients. This grading system was studied in 138 patients who were evaluated 1 week after renal transplantation. There was a significant correlation between the isotope renographic functional grade and clinical correlates of allograft function such as the serum creatinine level (p = 0.0001), blood urea nitrogen level (p = 0.0001), urine output (p = 0.005) and need for hemodialysis (p = 0.007). We recommend this grading system as a simple and accurate method to interpret orthoiodohippurate renal scans in the evaluation and followup of renal allograft recipients.

  8. Renal varices. Diagnosis with CT scan and treatment with embolization; Varices renales. Deagnostic tomodensitometrique et traitement par embolisation

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    Lenoir, S.; Strauss, Ch.; Fontanelle, L.; Bouzar, N.; Veillon, B.; Vallancien, G.; Palou, R. [Institut Mutualiste Montsouris, 75 - Paris (France)


    Two cases of recurrent macroscopic Hematuria in which the diagnosis of left renal vein varices was suggested on CT are described. Bloody efflux was seen from the left ureteric orifice. On CT scans, tubulated contrast-enhanced densities in left perirenal fat were seen. Selective renal angiography was normal. Selective left renal phlebography demonstrated intra and perirenal varices. In the two cases, embolization with metallic coil was successfully performed during left renal phlebography, to stop renal varices flux. Diagnostic and therapeutic modalities of renal varices are discussed with predominant place for CT and phlebography. (authors). 13 refs.

  9. Ultrasound scan in the diagnosis of neonatal renal candidiasis; Ecografia en el diagnostico de la candidiasis renal neonatal

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    Muro, D.; Sanguesa, C.; Torres, D.; Berbel, O.; Andres, V. [Hospital Infantil La Fe. Valencia (Spain)


    To describe the most pertinent echographic findings regarding systemic and renal candidiasis in high-risk neonates. Echographic findings and clinical histories of 40 neonates in the neonatal intensive care unit were retrospectively analyzed. Thirty-eight presented systemic candidiasis with renal participation, while two showed only renal candidiasis. Ultrasound scans were performed using 7.5 MHz probes. Alterations in renal echo structure, presence of echogenic material without acoustic shadowing in the excretory system (mycetoma), presence of lithiasis, pyonephrosis and associated renal malformations were all evaluated. Ten patients presented renal alterations in ultrasound scan. Six children had originally shown increased eye-catching in the renal parenchyma which was resolved after medical treatment. Four children presented renal mycetoma, and in two there were renal malformations. Both of these exhibited a profile for pyonephrosis. One patient with renal mycetoma without urological abnormalities developed a lithiasis. Surgical intervention was unnecessary in all cases. The most common echographic findings in immature high-risk low-weight patients with systemic and renal candidiasis were alterations in the eye-catching of renal parenchyma and the presence of mycetoma. (Author) 22 refs.

  10. Comparison of DMSA Scan 99 m and EC Scan 99 m in Diagnosis of Cortical Defect and Differential Renal Function


    Mohammadi-Fallah, M.; Alizadeh, M.; Lavin, T. Ahmadi


    Introduction: Diagnosis of renal cortical lesions by radioisotopes in nuclear medicine is one of the most common techniques and procedures can be performed by different radiotracer. However, all these materials are accurate in determining kidney function, but there are differences between them in the field. The purpose of this study was to evaluate the effectiveness of EC scans compared with DMSA scan in the detection of cortical lesions and DRF. Methods: 65 cases, which have been referred fo...

  11. Observation on local and/or unilateral pathologic changes in renal cortex by CT scan

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    Ishikawa, Isao; Shinoda, Akira (Kanazawa Medical Univ. (Japan)); Onouchi, Zengoro; Saito, Yasuhito; Matsuura, Hajime


    Renal cortex visualization after bolus injection of contrast medium using computed tomography (CT), was obtained in 132 consecutive patients with renal disease. Local pathological changes in the functioning cortex of the kidney were easily recognized in 37 cases and unilateral cortical thinning was found in 17 cases. Unilateral poor enhancement of the cortex with bilateral equal cortex thickness was noted in 4 cases. Several representative cases are reported with CT scans. The cortex at the posterior aspect of the renal graft compressed on psoas muscle was thinner than that at the anterior aspect in renal transplant cases. The macroscopic observation on the renal cortex presented here is far superior to the nephrogram or pyelogram seen through conventional radiographic examination. In vivo cortex visualization will correlate renal biopsy findings with the state of the whole kidney.

  12. Neuro-endovascular Embolic Agent for Treatment of a Renal Arteriovenous Fistula

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    Gurpreet Singh


    Full Text Available Renal arteriovenous fistula is a known complication following a renal biopsy, and may require catheter based embolization. Distal location of these fistulas in the renal parenchyma in many a case may necessitate non-traditional embolic materials. Liquid embolic agents that allow a controlled delivery may be suitable in this situation, as demonstrated in this case report.

  13. Treatment of renal anemia: Erythropoiesis stimulating agents and beyond

    Directory of Open Access Journals (Sweden)

    Patrick Biggar


    Full Text Available Anemia, complicating the course of chronic kidney disease, is a significant parameter, whether interpreted as subjective impairment or an objective prognostic marker. Renal anemia is predominantly due to relative erythropoietin (EPO deficiency. EPO inhibits apoptosis of erythrocyte precursors. Studies using EPO substitution have shown that increasing hemoglobin (Hb levels up to 10-11 g/dL is associated with clinical improvement. However, it has not been unequivocally proven that further intensification of erythropoiesis stimulating agent (ESA therapy actually leads to a comprehensive benefit for the patient, especially as ESAs are potentially associated with increased cerebro-cardiovascular events. Recently, new developments offer interesting options not only via stimulating erythropoeisis but also by employing additional mechanisms. The inhibition of activin, a member of the transforming growth factor superfamily, has the potential to correct anemia by stimulating liberation of mature erythrocyte forms and also to mitigate disturbed mineral and bone metabolism as well. Hypoxia-inducible factor prolyl hydroxylase inhibitors also show pleiotropic effects, which are at the focus of present research and have the potential of reducing mortality. However, conventional ESAs offer an extensive body of safety evidence, against which the newer substances should be measured. Carbamylated EPO is devoid of Hb augmenting effects whilst exerting promising tissue protective properties. Additionally, the role of hepcidin antagonists is discussed. An innovative new hemodialysis blood tube system, reducing blood contact with air, conveys a totally different and innocuous option to improve renal anemia by reducing mechanical hemolysis.

  14. Resolution of cortical lesions on serial renal scans in children with acute pyelonephritis

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    Agras, Koray; Tuncel, Altug; Atan, Ali [Numune Teaching and Research Hospital, Department of Urology, Ankara (Turkey); Ortapamuk, Huelya; Naldoeken, Seniha [Numune Teaching and Research Hospital, Department of Nuclear Medicine, Ankara (Turkey)


    The ideal time for distinguishing a renal scar from acute inflammatory lesions by renal DMSA scintigraphy remains controversial. To determine the time needed for resolution of lesions after acute pyelonephritis. A total of 105 children with acute pyelonephritis underwent renal sonography, voiding cystourethrography and baseline DMSA scintigraphy. Two subsequent scans were performed during the 6th and 12th months in patients with abnormal findings on the previous scan. The baseline DMSA scintigraphy revealed cortical lesions in 37 patients. At 6 months, 13 patients (38.2%) were found to have cortical lesions. At 12 months, 6 patients (17.6%) were found to have persistent renal cortical lesions. The resolution rates for lesions detected on the first scan were 61.8% and 82.4% on the 6- and 12-month scans, respectively. Vesicoureteric reflux, and bilaterality or multifocality were not relevant for resolution of lesions. Female gender seemed to be associated with a higher persistence rate. The renal cortical defects present at 6 months have a high rate of resolution later during follow-up. DMSA scintigraphy performed 12 months after the infection provides more reliable data regarding persistence of renal cortical lesions. (orig.)

  15. A case study presentation: The MAG3 captopril renal scan, which side are you on ?

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    Richards, A. [The Alfred Hospital, Prahran, VIC (Australia). Departmen of Nuclear Medicine


    Full text: A 68-year-old woman with widespread vascular disease presented to the Nuclear Medicine Department with severe hypertension, (a blood pressure of 200/160 supine), a known small right kidney, and a large abdominal aortic aneurysm. A baseline renal scan was performed with IV administration of 300 MBq of {sup 99m}Tc-labelled MAG3. A normal left kidney was demonstrated, with a Grade 0 renogram pattern. The right kidney was non visualised and non functioning. The patient was then administered orally with 25 mg of A.C.E. inhibitor captopril and her blood pressure fell by greater than 100 mm Hg. A second MAG3 Renal Scan was performed. The finding conflicted with results of a Renal Artery Angiogram and Renal Artery Doppler Ultrasound, both demonstrating a normal left renal artery. A repeat MAG3 Renal scan with captopril challenge was performed. Differential diagnosis included: 1.Left sided microvascular disease; 2. A functioning though very ischaemic right kidney that was producing renin, suggested by contrast opacification of the right renal cortex on CT; or 3. A false negative renal artery angiogram, with non-visualisation of an arterial stenosis caused by thrombus or compression of the left renal artery by the abdominal aortic aneurysm. Subsequent Renal Vein Renin Sampling measured left renal vein renin activity at 4.50,{mu}g/L/h, (compared with 4.80{mu}g/L/h in the IVC). Right renal vein renin activity was 13.20{mu}g/L/h. This lateralization of renin secretion to the right side with suppression of left sided secretion suggested that the renovascular hypertension was caused by the right kidney. This was a very unusual result, as the MAG3 captopril renal scan had incorrectly and strongly suggested a left sided origin to the renovascular hypertension. In addition, the right kidney not seen to accumulate MAG3 was in fact functioning sufficiently to produce renin. It is hypothesized that the left kidney had adjusted to allow normal function only at very high

  16. The value of post renal scans in the presence of a small kidney

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    Rahman, T.; Bannister, K.M. [Royal Adelaide Hospital, Adelaide, SA (Australia). Department of Nuclear Medicine


    Full text: A baseline and post captopril renal scan is generally accepted as indicating low probability of renal artery stenosis if both baseline and captopril scans are normal and high probability if the baseline study is normal but the post captopril scan changes significantly. However doubt remains about the significance of an abnormal captopril scan if the baseline scan is also abnormal. We retrospectively identified the last 20 patients with a small kidney (equal or less than 40% function) on a baseline renal scan ({sup 99m}Tc DTPA or Mag 3) who also underwent a post captopril study. All patients (males = 13 females = 7 mean age 69 yrs) were considered clinically `high risk` for renovascular disease. A significant change in the differential function post captopril was defined as a fall of greater than or equal to 20% of baseline function. Only 3 patients demonstrated a significant fall post captopril. Ten patients underwent intra arterial digital subtraction angiography. Two of the 3 patients with a fall in differential function post captopril had high grade (>90%) renal artery stenosis on angiography (the third patient did not undergo angiography). Of the remaining 8 patients with angiograms, one showed normal renal arteries, one a 60%. stenosis and the remaining 7 showed high grade stenosis to the small kidney. Although angiograms were not available on 10 patients it is reasonably likely that some of these cases also represent significant renovascular disease. We conclude that a small kidney on a baseline scan is a strong indicator of significant renal artery stenosis but a repeat study post captopril will add little to diagnostic accuracy

  17. Clinical Significances of {sup 99m}Tc-DMSA Renal Scan in Patients with Acute Pyelonephritis

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    Mok, Cha Soo; Shin, Dong Jin; Choi, Ho Cheon; Kim, Gyeong Wook; Yi, Gang Wook; Choi, Dae Seop [Sang Ae General Hospital, Seoul (Korea, Republic of)


    Patients with acute pyleonephritis may present with a spectrum of clinical symptoms and signs. There are few noninvasive diagnostic studies, however to confirm or exclude this diagnosis. To evaluate the clinical utility of {sup 99m}Tc-DMSA renal scan in diagnosis of acute pyelonephritis, we performed {sup 99m}Tc-DMSA renal scan in 37 patients suspected with urinary tract infection. Simultaneously kidney ultrasonography was done in 21 patients diagnosed with acute pyelonephritis, clinically. And we performed the followup scan after treatment in two to six weeks. The results were as follows. 1) {sup 99m}Tc-DMSA renal scan disclosed single of multiple cortical defects and decreased radiouptake ratio of affected kidney in 23 patients among 25 patients diagnosed with acute pyleonephritis. 2) In the 21 patients with acute pyelonephritis, kidney ultrasonography showed abnormal findings in the 7 patients. And {sup 99m}Tc-DMSA renal scan disclosed abnormal cortical defects in this 7 patients also. 3) Between the patients with acute pyelonephritis and those with lower urinary tract infection, asymptomatic bacteriuria or pyuria, right-to-left radiouptake ratios (R/L ratio ) were significantly different(p<0.001). 4) In two to six weeks after antibiotic therapy, we performed followup {sup 99m}Tc-DMSA renal scan for 5 patients among 25 acute pyelonephritis patients. And we have found the improvement of cortical defects and the right-to-left radiouptake ratio. In conclusion, we thought that {sup 99m}Tc-DMSA renal scan should be useful in diagnosis of acute pyelonephritis and follow up examination.

  18. Limitations of indium-111 leukocyte scanning in febrile renal transplant patients

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    Sebrechts, C.; Biberstein, M.; Klein, J.L.; Witztum, K.F.


    Indium-111-labeled leukocyte scanning was evaluated as a technique for investigating possible abscess as the cause of fever in 10 renal allograft recipients under therapy for rejection, acute tubular necrosis, or urinary infection. The usefulness of the method in this setting was found to be limited by marked nonspecificity of renal, pulmonary, and other focal leukocyte accumulation. Although wound infections were correctly identified, false-positive scans resulted in multiple nonproductive consultations and radiologic procedures (some invasive) and contributed to the decision to perform one negative exploratory laparotomy. Such generalized nonspecificity in this patient population is in distinct contrast to the experience with this diagnostic test in nontransplant patients, and has not previously been reported. Possible explanations and implications of these findings are discussed. Consequently, great caution is recommended in the use of indium-111 leukocyte scans to diagnose infection in febrile renal transplant patients who present in a similar clinical setting.

  19. [Study of renal veins by multidetector-row computed tomography scans]. (United States)

    Bouali, O; Mouttalib, S; Labarre, D; Munzer, C; Lopez, R; Lauwers, F; Moscovici, J


    To determine the prevalence of renal vein variants. To investigate the distribution of renal veins. We retrospectively reviewed spiral computed tomography (CT) scans of the abdomen performed during a two-month period. The same protocol was used for all CT scans: same multidetector-row CT scanner (Siemens(®)), 1 to 2-mm section thickness, injection of intravenous iomeprol. The study group included 121 patients, aged 21.7 to 93.4 years (mean age 60.9 ± 15.4 years). The sex ratio was 2/1, with 80 men and 41 women. Seventy-three percent of the study group (88 patients) had no variants of the renal veins. Indeed almost 40% (48 patients) had one artery and one vein on each side, with typical course, and 33% (40 patients) had course and/or number variants of the renal arteries. Variants of the right renal vein consisted in multiple veins in 20.6% (25 cases). We detected no case of multiple left renal veins, but we described variations of its course in 9.1% (11 cases): 5 cases of retroaortic left renal vein (4.1%) and 6 cases of circumaortic left renal vein (5%). Three of these 11 patients had an associated double right renal vein. The probability to have a right renal vein variant was significantly higher than a left one (OR = 2.6, P = 0.01). And we found a significantly higher risk of having a venous variant in women (OR = 2.4, P = 0.04). We detected no case of inferior vena cava variant. In our study, prevalence of a circum- or retroaortic left renal vein appeared higher than previously reported in the literature (9.1%). Knowledge of anatomical variants of renal vasculature is crucial and this study puts the emphasis on variations of course and number of renal vessels. Those variations are not so uncommon and should be known by radiologists and also by surgeons. Their knowledge has major clinical implications in practice and it contributes to the safety of renal and retroperitoneal surgery. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  20. Optimized Temporal Window for Detection and Characterization of Renal Cell Carcinomas with Dynamic CT Scanning

    Institute of Scientific and Technical Information of China (English)

    Jinhong Wang; Peijun Wang; Xiaohu Zhao; Xinqin Mao; Xiaolong Gao; Jun Liu


    OBJECTIVE To investigate the optimized time period for detection and characterization of renal cell carcinomas (RCC) when the specific CT features appear during spiral dynamic CT scanning, and to optimize an effective scanning protocol of spiral CT for evaluating RCC.METHODS Twenty-four patients with RCC verified by pathology had undergone a dynamic CT (D-CT) scan. A plain scan was employed to select the target slice. Single-level dynamic scanning started at 14-17 s after the intravenous contrast media had been administered, with a scan interval of 4.9 s acquiring a total number of 17~24 frames. A regular CT scan of the whole kidney followed by a delayed single slice acquisition through the target slice in the excretory phase was performed. Images were assessed in two ways: (1) A group of experienced radiologists reviewed the CT images to find when the specific signs appeared and when the CT features of RCC were optimally displayed; (2) Data measurement of the time-density curves (T-DC) of RCC. The exact time was obtained when the densities of the tumor, renal parenchyma, medulla and aorta reached their peak enhancement, thus also the time when the density difference between tumor and parenchyma was at maximum (Max T-M). Based on the slope of the contrast media uptake curve, T-DC types were ranked from the smallest to the biggest of slope as type A, B and C.RESULTS 1. The review of the CT images by the radiologists showed that the CT features of RCC were optimally demonstrated at 70.2 s. The earliest time at which RCC CT features were examined was at 23.9 s. 2. Image data analysis: the time that the density (or CT value) of the tumor mass reached peak enhancement was at 54 s and peak value was at 80.4 Hu for RCC. The time of the maximal difference of densities between tumor and renal parenchyma was at 102 s.CONCLUSION The following proposal is the scanning protocol for detecting RCC recommended by our research: After a plain scan to determine the target level, a

  1. Computing quantitative indicators of structural renal damage in pediatric DMSA scans. (United States)

    Sampedro, F; Domenech, A; Escalera, S; Carrio, I

    The proposal and implementation of a computational framework for the quantification of structural renal damage from (99m)Tc-dimercaptosuccinic acid (DMSA) scans. The aim of this work is to propose, implement, and validate a computational framework for the quantification of structural renal damage from DMSA scans and in an observer-independent manner. From a set of 16 pediatric DMSA-positive scans and 16 matched controls and using both expert-guided and automatic approaches, a set of image-derived quantitative indicators was computed based on the relative size, intensity and histogram distribution of the lesion. A correlation analysis was conducted in order to investigate the association of these indicators with other clinical data of interest in this scenario, including C-reactive protein (CRP), white cell count, vesicoureteral reflux, fever, relative perfusion, and the presence of renal sequelae in a 6-month follow-up DMSA scan. A fully automatic lesion detection and segmentation system was able to successfully classify DMSA-positive from negative scans (AUC=0.92, sensitivity=81% and specificity=94%). The image-computed relative size of the lesion correlated with the presence of fever and CRP levels (p<0.05), and a measurement derived from the distribution histogram of the lesion obtained significant performance results in the detection of permanent renal damage (AUC=0.86, sensitivity=100% and specificity=75%). The proposal and implementation of a computational framework for the quantification of structural renal damage from DMSA scans showed a promising potential to complement visual diagnosis and non-imaging indicators. Copyright © 2016 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  2. Renal length discrepancy by ultrasound is a reliable predictor of an abnormal DMSA scan in children. (United States)

    Khazaei, Mahmood R; Mackie, Fiona; Rosenberg, Andrew R; Kainer, Gad


    A renal length discrepancy (RLD) of more than 10 mm by ultrasound (US) is accepted as a potential indicator of an underlying renal pathology; however, there are few supporting data for this in children. Our objective was to determine a cutoff at which RLD on US is a reliable predictor of dimercaptosuccinate acid (DMSA) scan abnormality. We present data from 90 patients who had both renal US and a DMSA scan, as well as DMSA scan results compared with bipolar RLD by US. Positive (PPV) and negative (NPV) predictive values were calculated for renal RLD from 6 to >10 mm. The left kidney was longer in 56%, whereas the right kidney was longer in 37%; their lengths were equal in 8%. For children at all ages, a left kidney longer than the right by >or=10 mm or a right kidney longer than the left by >or=7 mm gave a PPV for DMSA abnormality of 79% and 100%, respectively. In children older than 4 years, if the right kidney was longer by >or=7 mm or if the left kidney was longer by >or=10 mm, the PPVs for DMSA abnormality were 100% and 63%, respectively. In children younger than 4 years, when the right kidney was longer by >or=6 mm or the left was kidney longer by >or=10 mm, the PPV were 86% and 100%, respectively. Thus, children with a right kidney longer than the left by even DMSA scan.

  3. Assessment of Renal Perfusion in a Canine Model Using FS069, A New Transpulmonary Echocontrast Agent. (United States)

    Mobarek, Sameh K.; Kates, Marc A.; Murgo, Joseph P.; Moreno, Carlos A.; Revall, Susan; Cheirif, Jorge


    We have previously demonstrated the safety and efficacy of FS069, a new transpulmonary echocontrast agent, for myocardial opacification. To our knowledge, no information exists regarding the use of this agent for transcutaneous assessment of renal perfusion. We studied 14 mongrel dogs using intravenously administered FS069. Renal ultrasound imaging was performed with a Hewlett-Packard Sonos 1500 using a 3.5-MHz transducer. Renal blood flow (ReBF) was altered using renal artery occlusion in four dogs and dipyridamole (0.56 mg/kg IV) in ten dogs. Renal perfusion was quantitatively assessed before and after each intervention using background subtracted peak intensity. ReBF was assessed with radiolabeled microspheres in ten dogs. Renal opacification was observed in all 14 dogs at baseline. The intravenous contrast dose required to produce optimal renal opacification ranged from 0.3-0.7 cc. After renal artery occlusion, peak intensity was reduced from 5.4 +/- 5.8 to 0.93 +/- 1.1 units (r = 0.99, P change from baseline). The inverse relation between ReBF and peak intensity observed suggests vasoconstriction of the afferent arterioles in response to dipyridamole and a reduced clearance of the contrast. These findings are in agreement with previous data demonstrating decreased renal thallium clearance postdipyridamole administration. Our data document the feasibility to assess renal perfusion under various flow states after intravenous injection of FS069.

  4. Value of Indium-111m labeled platelet scans for predicting early renal allograft loss

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    Shaffer, P.; Hinkle, G.; Olsen, J.; Sommer, B.; Henry, M.; Ferguson, R.


    In order to determine if In-111m labeled platelet scanning could be of use in predicting renal allograft prognosis, 41 patients (pts) thought to be at risk for graft loss were studied. In vitro labeling of platelets was performed followed by reinjection into the pt and scanning at 24 hours. The graft activity on platelet scan was compared to hepatic activity and classified as being either less than or equal to hepatic activity (NEG) or much greater than hepatic activity (POS). Results are compared to graft prognosis and are presented in this paper. The observed increase in early loss rate in the pts with POS scan over those with NEG scan was highly significant. (p .001). All pts with a POS scan were on cyclosporin A (CYA); no pt on conventional therapy (excluding CYA) had a POS scan. The authors conclude that the presence of a POS scan is a grave prognostic sign and that there appears to be a relationship between CYA, POS scan, and early graft loss.

  5. Ultrastructural analyses of the novel chimeric hemostatic agent generated via nanotechnology, ABS nanohemostat, at the renal tissue level. (United States)

    Huri, Emre; Dogantekin, Engin; Hayran, Murvet; Malkan, Umit Yavuz; Ergun, Mine; Firat, Aysegul; Beyazit, Yavuz; Ustun, Huseyin; Kekilli, Murat; Dadali, Mumtaz; Astarci, Muzeyyen; Haznedaroglu, Ibrahim C


    Ankaferd Blood Stopper (ABS), a hemostatic agent of plant origin, has been registered for the prevention of clinical hemorrhages. Currently there is no data regarding the ultrastructural analysis of ABS at the tissue level. The aim of this study is to assess renal tissue effects via scanning electron microscopy (SEM) analyses for the ABS and ABS nanohemostat (formed by the combination of self-assembling peptide amphiphile molecules and ABS). SEM experiments were performed with FEI Nova NanoSEM 230, using the ETD detector at low vacuum mode with 30 keV beam energy. SEM analyses revealed that significant erythroid aggregation are present inside the capillary bed of the renal tissue. However, neither the signs of necrosis nor any other sign of tissue damage are evident in the surrounding renal tissue supplied by the microcapillary vasculature. Our study is important for several reasons. Firstly, in our study we used ABS nanohemostat which was recently developed. This study adds valuable information to the literature regarding ABS nanohemostat. Secondly, this study is the first ultrastructural analysis of ABS that was performed at the tissue level. Thirdly, we disclosed that ABS nanohemostat could induce vital erythroid aggregation at the renal tissue level as detected by SEM. Lastly, we detected that ABS nanohemostat causes no harm to the tissues including necrosis and any other detrimental effects.

  6. Evaluation of a liquid embolization agent (Onyx) for transcatheter embolization for renal vascular lesions

    Energy Technology Data Exchange (ETDEWEB)

    Rennert, Janine; Herold, T.; Schreyer, A.G.; Jung, E.M.; Mueller-Wille, R.; Zorger, N. [Inst. fuer Roentgendiagnostik, Klinikum der Univ. Regensburg (Germany); Banas, B.; Feuerbach, S. [Medizinische Klinik, Nephrologie, Univ. Regensburg (Germany); Lenhart, M. [Klinik fuer Diagnostische und Interventionelle Radiologie, Sozialstiftung Bamberg (Germany)


    Purpose: to evaluate the therapeutic outcome after endovascular treatment of renal vascular lesions using the liquid embolization agent, Onyx. Materials and methods: between 2004 and 2008 nine patients with renal vascular lesions were treated with transcatheter arterial embolization using Onyx. The renal vascular lesions consisted of 4 AV-fistulas, a pseudoaneurysm, bleeding from a single subsegmental artery, diffuse parenchymal bleeding after trauma, septic embolizations and multiple aneurysms in endocarditis. All patients underwent selective angiography of the renal artery. A dimethyl sulfoxide (DMSO)-compatible microcatheter was used and Onyx was injected. The technical and clinical success rate, examination time and procedure-related complications were documented. Results: the overall technical and clinical success rate was 100%. One patient had to be treated twice due to recurrent bleeding after an accidental puncture with a drainage catheter. No loss of viable renal tissue occurred in 4 cases. In 4 patients mild to moderate parenchyma loss was noted. In one patient having diffuse renal bleeding, occlusion of the main renal artery was performed. No procedure-related complications were noted. The mean examination time was 16.17 min when treating with Onyx alone and 60 min when using a combination of Onyx and coils. Within an average follow-up period of 21 months, no recurrent renal bleeding or recurrent AV-fistulas occurred. Conclusion: Onyx is an effective embolization agent for the treatment of renal vascular lesions. It allows controlled and quick application with low complication rates and a short examination time as a standalone agent or in combination with coils. (orig.)

  7. Remarkable shrinkage of sarcomatoid renal cell carcinoma with single-agent gemcitabine. (United States)

    Fujiwara, Yoshiro; Kiura, Katsuyuki; Tabata, Masahiro; Takigawa, Nagio; Hotta, Katsuyuki; Umemura, Shigeki; Omori, Masako; Gemba, Kenichi; Ueoka, Hiroshi; Tanimoto, Mitsune


    A 60-year-old Japanese man presented to our hospital with a painful left hip. Computed tomography showed a tumor in the left kidney and metastases in the left gluteus maximus muscle and lung. The pathological diagnosis of a biopsy specimen obtained from a metastatic lesion in the left gluteus maximus muscle was sarcomatoid renal cell carcinoma. On admission, his general condition was extremely poor. He was confined to bed because of severe left hip pain and confusion, possibly caused by hypercalcemia. This seriously ill patient suffering from advanced sarcomatoid renal cell carcinoma was treated with single-agent gemcitabine, resulting in symptom relief and a dramatic improvement in his status; all of the tumors had regressed significantly by the 11th dose of gemcitabine. These findings indicate that single-agent gemcitabine is one of the few chemotherapeutic agents effective for palliation in patients with sarcomatoid renal cell carcinoma, even those with poor performance status.

  8. Application of low-vacuum scanning electron microscopy for renal biopsy specimens. (United States)

    Miyazaki, Hiroki; Uozaki, Hiroshi; Tojo, Akihiro; Hirashima, Sayuri; Inaga, Sumire; Sakuma, Kei; Morishita, Yasuyuki; Fukayama, Masashi


    Low-vacuum scanning electron microscopy (LV-SEM) has been developed which enables the observation of soft, moist, and electrically insulating materials without any pretreatment unlike conventional scanning electron microscopy, in which samples must be solid, dry and usually electrically conductive. The purpose of this study was to assess the usefulness of LV-SEM for renal biopsy specimens. We analyzed 20 renal biopsy samples obtained for diagnostic purposes. The sections were stained with periodic acid methenamine silver to enhance the contrast, and subsequently examined by LV-SEM. LV-SEM showed a precise and fine structure of the glomerulus in both formalin fixed paraffin and glutaraldehyde-osmium tetroxide-fixed epoxy resin sections up to 10,000-fold magnification. The spike formation on the basement membrane was clearly observed in the membranous nephropathy samples. Similarly to transmission electron microscopy, electron dense deposits were observed in the epoxy resin sections of the IgA nephropathy and membranous nephropathy samples. LV-SEM could accurately show various glomerular lesions at high magnification after a simple and rapid processing of the samples. We consider that this is a novel and useful diagnostic tool for renal pathologies.

  9. Diagnostic criteria of {sup 99m}Tc-diethylenetriaminepentaacetic acid captopril renal scan for the diagnosis of renovascular hypertension by unilateral renal artery stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Seung Jin; Hong, Il Ki; Chang, Jae Won; Park, Su Kil; Moon, Dae Hyuk [Asan Medical Center, Seoul (Korea, Republic of)


    We compared captopril renal scintigraphic criteria for the diagnosis of renovascular hypertension by unilateral renal artery stenosis. The study group consisted of 24 patients (m/f = 16/8, age: 39{+-}18 years) with unilateral renal artery stenosis who underwent renal artery revascularization and captopril renal scintigraphy with {sup 99m}Tc-diethylenetriaminepentaacetic acid between May 1995 and April 2004. The blood pressure response was classified as cure/improvement or failure. We evaluated captopril-induced changes in relative function (BCfun) and renogram grade (0 to 5: 0 = normal, and 5 = renal failure pattern without measurable uptake) (CBren) and the difference of renograms between the normal and stenotic kidney on captopril scan (CNren). Eight of 24 patients were cured and 11 improved and 5 patients were classified as failed revascularization. Significant predictors of a cure or improvement of blood pressure were younger age, stenosis by fibromuscular dysplasia or arteritis, BCfun, CBren and CNren. Areas under the receiver operating characteristic curve of age, BCfun, CBren and CNren were not significantly different. Positive and negative predictive values of predictors were 100% and 42% (age {<=} 38); 92% and 50% (BCfun{>=} 1 %); 92% and 75% (CBren{>=} 1), and 90% and 60% (CNren{>=} 1), respectively. Captopril induced changes in renal function and renogram can reliably predict hypertension response to revascularization. Renogram pattern on captopril scan can diagnose renovascular hypertension without baseline data in patients with unilateral renal artery stenosis.

  10. Minocycline hydrochloride as a soft sclerotizing agent for symptomatic simple renal and hepatic cysts. (United States)

    Danza, F M; Falcione, M; Bordonaro, V; Infante, A; Paladini, A; Bonomo, L


    To present the results of our ten-year case series in simple hepatic and renal cysts sclerosis using minocycline hydrochloride as a sclerotizing agent, evaluating the effectiveness, the safety and the feasibility of this agent for percutaneous sclerotherapy for symptomatic cysts. We retrospectively evaluated our archives of patients treated (54 patients with 60 renal cysts, 21 patients with 24 hepatic cysts) for symptomatic abdominal cysts. These patients were treated with ultrasound guided drainage and subsequent minocycline hydrochloride instillation. In large or recurrent cysts, we repeated the treatment for the second time. The patients were evaluated at 6 and 12 months; some patients underwent later, additional examinations and we also reviewed these exams for any eventual long-term relapse. The percentage of sclerosis success was found to be 100% for hepatic cysts and 86% for renal cysts. We also found that minimal complications were encountered. Minocycline hydrochloride has proven to be an effective sclerotizing agent. In our cases, symptoms disappeared in 100% of patients with hepatic cysts and in 93% of patients with renal cysts. It is also a safe sclerotizing agent, as demonstrated by the few complications encountered. Percutaneous sclerosis with Minocycline hydrochloride is a very effective and promising nonsurgical treatment for patients with symptomatic simple cysts, and it can be performed without major complications.

  11. Can focused US with a diagnostic US contrast agent favorably affect renal function? (United States)

    Sica, Domenic A


    Focused ultrasonography (US) with simultaneous administration of a US microbubble contrast agent was used to transiently increase the glomerular filtration rate while altering the sieving properties of glomeruli in normal rabbits. In its current form, this process has very limited application potential to states of abnormal renal function.

  12. Renal Tumor Cryoablation Planning. The Efficiency of Simulation on Reconstructed 3D CT Scan

    Directory of Open Access Journals (Sweden)

    Ciprian Valerian LUCAN


    Full Text Available Introduction & Objective: Nephron-sparing surgical techniques risks are related to tumor relationships with adjacent anatomic structures. Complexity of the renal anatomy drives the interest to develop tools for 3D reconstruction and surgery simulation. The aim of the article was to assess the simulation on reconstructed 3D CT scan used for planning the cryoablation. Material & Method: A prospective randomized study was performed between Jan. 2007 and July 2009 on 27 patients who underwent retroperitoneoscopic T1a renal tumors cryoablation (RC. All patients were assessed preoperatively by CT scan, also used for 3D volume rendering. In the Gr.A, the patients underwent surgery planning by simulation on 3D CT scan. In the Gr.B., patients underwent standard RC. The two groups were compared in terms of surgical time, bleeding, postoperative drainage, analgesics requirement, hospital stay, time to socio-professional reintegration. Results: Fourteen patients underwent preoperative cryoablation planning (Gr.A and 13 patients underwent standard CR (Gr.B. All parameters analyzed were shorter in the Gr.A. On multivariate logistic regression, only shortens of the surgical time (138.79±5.51 min. in Gr.A. vs. 140.92±5.54 min in Gr.B. and bleeding (164.29±60.22 mL in Gr.A. vs. 215.38±100.80 mL in Gr.B. achieved statistical significance (p<0.05. The number of cryoneedles assessed by simulation had a 92.52% accuracy when compared with those effectively used. Conclusions: Simulation of the cryoablation using reconstructed 3D CT scan improves the surgical results. The application used for simulation was able to accurately assess the number of cryoneedles required for tumor ablation, their direction and approach.

  13. Nanoparticle Enhanced MRI Scanning to Detect Cellular Inflammation in Experimental Chronic Renal Allograft Rejection

    Directory of Open Access Journals (Sweden)

    S. R. Alam


    Full Text Available Objectives. We investigated whether ultrasmall paramagnetic particles of iron oxide- (USPIO- enhanced magnetic resonance imaging (MRI can detect experimental chronic allograft damage in a murine renal allograft model. Materials and Methods. Two cohorts of mice underwent renal transplantation with either a syngeneic isograft or allograft kidney. MRI scanning was performed prior to and 48 hours after USPIO infusion using T2∗-weighted protocols. R2∗ values were calculated to indicate the degree of USPIO uptake. Native kidneys and skeletal muscle were imaged as reference tissues and renal explants analysed by histology and electron microscopy. Results. R2∗ values in the allograft group were higher compared to the isograft group when indexed to native kidney (median 1.24 (interquartile range: 1.12 to 1.36 versus 0.96 (0.92 to 1.04, P<0.01. R2∗ values were also higher in the allograft transplant when indexed to skeletal muscle (6.24 (5.63 to 13.51 compared to native kidney (2.91 (1.11 to 6.46 P<0.05. Increased R2∗ signal in kidney allograft was associated with macrophage and iron staining on histology. USPIO were identified within tissue resident macrophages on electron microscopy. Conclusion. USPIO-enhanced MRI identifies macrophage.

  14. Renal perfusion scintiscan (United States)

    Renal perfusion scintigraphy; Radionuclide renal perfusion scan; Perfusion scintiscan - renal; Scintiscan - renal perfusion ... supply the kidneys. This is a condition called renal artery stenosis. Significant renal artery stenosis may be ...

  15. A study of bone uptake according to renal function in the whole body bone scan

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Yong In; Jang, Dong Gun [Dept. of Nuclear Medicine, Dongnam Institute of Radiological and Medical Sciences Cancer Center, Busan (Korea, Republic of); Park, Cheol Woo [Dept. of Radiological Technology Dong-Eui Institute of Technology, Busan (Korea, Republic of)


    Whole body bone scan has been used to confirm bone metastasis and follow-up study with radio isotope. However, if the factors related to 99mTc uptake and waiting time for study are inappropriate, it would be image of low quality. The purpose of present study was to investigate correlation between the evaluation index of renal function and uptake of radiopharmaceuticals. The population for this retrospective study consisted of 387 patients who underwent whole body bone scan between June 2012 and December 2012. As a result of quantitative and qualitative analysis, we were able to confirm that GFR of less than normal range and creatinine levels in blood of more than average are more likely to be under the mean uptake rate. As a result of analysis on the indicator affecting soft-tissue and bone uptake, the correlation of all elements was somewhat low. Also there are no statistically significances due to the other parameters we did not deal with. Therefore, further research on additional factors is needed for exact study and improvement of the image quality.

  16. Radioisotope scanning of brain, liver, lung and bone with a note on tumour localizing agents (United States)

    Lavender, J. P.


    Radioisotopic scanning of brain, liver, lungs and the skeleton is briefly reviewed with a survey of recent developments of clinical significance. In brain scanning neoplasm detection rates of greater than 90% are claimed. The true figure is probably 70-80%. Autopsy data shows a number of false negatives, particularly with vascular lesions. Attempts to make scanning more specific in differentiating neoplasm from vascular lesions by rapid sequence blood flow studies are reviewed. In liver scanning by means of colloids again high success rate is claimed but small metastases are frequently missed and the false negative scan rate is probably quite high. Lung scanning still has its main place in investigating pulmonary embolic disease. Ventilation studies using Xenon 133 are useful, particularly combined with perfusion studies. The various radiopharmaceuticals for use in bone scanning are reviewed. The appearance of technetium labelled phosphate compounds will probably allow much wider use of total skeletal scanning. Research into tumour localizing agents continues, the most recent and interesting being Gallium citrate and labelled bleomycin. Neither agent is predictable however although Gallium may have a place in Hodgkins disease and bronchogenic neoplasm and both may have a place in the detection of cerebral tumours. ImagesFig. 1Fig. 2Fig. 3p452-bFig. 3bFig. 4Fig. 5Fig. 5bFig. 6Fig. 7Fig. 8Fig. 9Fig. 10Fig. 11Fig. 12Fig. 12c & 12dFig. 13Fig. 13 b,c,dFig. 14Fig. 14bFig. 15Fig. 15bFig. 16Fig. 17Fig. 18 PMID:4602127

  17. Effect on renal function of an iso-osmolar contrast agent in patients with monoclonal gammopathies

    Energy Technology Data Exchange (ETDEWEB)

    Preda, Lorenzo [Division of Radiology, European Institute of Oncology, IRCCS, Milan (Italy); Agazzi, Alberto; Martinelli, Giovanni [Division of Haematology, European Institute of Oncology, IRCCS, Milan (Italy); Raimondi, Sara [Division of Epidemiology and Biostatistics, European Institute of Oncology, IRCCS, Milan (Italy); University of Milan, Department of Occupational Medicin ' ' Clinica del Lavoro Luigi Devoto' ' Section of Medical Statistics and Biometry ' ' GA Maccacaro' ' , Milan (Italy); Lanfranchi, Carla Federica [University of Milan, IRCCS, School of Medicine, Milan (Italy); Passerini, Rita [Unit of Laboratory Medicine, European Institute of Oncology, IRCCS, Milan (Italy); Calvetta, Albania [Nephrology and Dialysis Unit, Istituto Clinico Humanitas, IRCCS, Rozzano, Milan (Italy); Bellomi, Massimo [Division of Radiology, European Institute of Oncology, IRCCS, Milan (Italy); University of Milan, IRCCS, School of Medicine, Milan (Italy)


    To assess the safety of the non-ionic iso-osmolar contrast agent iodixanol on renal function in patients with monoclonal gammopathies undergoing CT. We explored the effect of iodixanol on renal function in 30 patients with monoclonal gammopathies and 20 oncological patients with a normal electrophoretic profile (control group). The parameters used to estimate renal function were: serum creatinine, eGFR (determined 24 h before and 48 h after the administration of iodixanol), and urinary excretion of Neutrophil Gelatinase-Associated Lipocalin (NGAL) determined 2 h and 24 h after. Serum creatinine was also determined 1 month after the administration of iodixanol. No significant increase in serum creatinine values were observed in the monoclonal gammopathies group and in 19/20 patients in the control group. Only 1 patient in the control group developed a transient contrast agent-induced nephropathy. We found no statistically significant difference between the two groups regarding the percentage variation from baseline values of serum creatinine, creatinine clearance, NGAL 2 h after, and eGFR. Whereas NGAL at 24 h showed a statistically significant increase in patients with Monoclonal gammopathies. The use of iodixanol appears to be safe in patients with monoclonal gammopathies and an eGFR {>=} 60 ml/min/1.73 mq. (orig.)

  18. Tc-99m DTPA scans in renal allograft rejection and cyclosporine nephrotoxicity

    Energy Technology Data Exchange (ETDEWEB)

    Gedroyc, W.; Taube, D.; Fogleman, I.; Neild, G.; Cameron, S.; Maisey, M.


    Renal allograft dysfunction arising from rejection or cyclosporine (CsA) nephrotoxicity can currently only be distinguished reliably by allograft biopsy. We have assessed Technetium (Tc)-99m diethylamine pentacetic acid (DTPA) scanning in 30 CsA-treated patients with allograft dysfunction. Scintigrams were performed during 20 biopsy-proved episodes of rejection and during 14 episodes of CsA nephrotoxicity. These results were compared with the scintigrams of 15 allografts showing stable function. Quantitative indices expressing allograft perfusion (flow index) and function (uptake index) derived from the DTPA scintigrams showed no significant differences between the groups of patients with rejection, CsA nephrotoxicity, or stable or improving function. Similarly, the flow and uptake indices of individual allografts obtained during periods of stable or improving function and then during episodes of dysfunction due to rejection or CsA nephrotoxicity did not significantly change. We conclude that Tc-99m DTPA scintigrams are of limited value in the management of allograft dysfunction in patients immunosuppressed with CsA.

  19. [Renal calculus microflora in urolithiasis and search for agents of control of biofilms formed by uropathogenic bacteria]. (United States)

    Tolordava, E R; Tiganova, I G; Alekseeva, N V; Stepanova, T V; Terekhov, A A; Egamberdiev, D K; Mulabaev, N S; Shevliagina, N V; Didenko, L V; Romanova, Iu M


    Study bacterial biofilms in native material (renal calculus) by electron microscopy method and developmeit of biofilm model by isolates in vitro on sterile calculi of various chemical composition. Bacterial spectra of microflora of renal calculus lavages were studied, isolated pure cultures were identified up to species. Comparisons of urine microflora obtained before operation in patients with urolithiasis with microflora of removed renal calculi were carried out. Urease activity and genes coding pathogenicity factors were detected, and the ability to form biofilms by isolates was studied. Model of formation of biofilms in vitro on sterile renal calculi was developed and candidate agents reducing the biofilm forming ability were tested. Uropathogenic microorganisms infecting renal calculi and forming biofilms on them not only support chronic infection by increased resistance to therapy but also facilitate novel lithogenesis.

  20. Gadolinium released from MR contrast agents is deposited in brain tumors: in situ demonstration using scanning electron microscopy with energy dispersive X-ray spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Xia, Daniel; Davis, Richard L.; Crawford, Judith A.; Abraham, Jerrold L. (Dept. of Pathology, SUNY Upstate Medical Univ., Syracuse, NY (United States)), e-mail:


    Background: Gadolinium (Gd)-containing MRI contrast agents (GdCA) are widely used in studies of brain tumors, and a number of reports suggest that under certain conditions, such as renal failure, Gd may be released from GdCA into patient's tissues. Whether this may happen in abnormal tissues in the absence of renal failure has not been studied. Purpose: To test the hypothesis that the local retention of GdCA resulting from brain tumor-associated alterations in the blood-brain barrier (BBB) may result in the deposition of Gd released from the GdCA, depending on stability. Material and Methods: In this retrospective study, 30 selected brain tumor biopsies from 28 patients (taken before and after an institutional switch from a less stable to an intermediate stable GdCA) were searched for Gd-containing deposits using scanning electron microscopy/energy dispersive X-ray spectroscopy (SEM/EDS). Relevant histories and laboratory results were obtained through institutional electronic records. Associations between the presence of deposits and other variables were tested for statistical significance using the two-tailed Fisher's exact test. Results: Insoluble deposits containing Gd associated with phosphorus and calcium were found in seven biopsies from five patients. These deposits were found in patients with estimated GFRs above 53 ml/min, and were detected more often in those receiving GdCA before the switch from a less stable to an intermediate stable GdCA (P = 0.04), and may be more frequent in patients receiving more than one contrast-enhanced MR scan (P = 0.15). Conclusion: Gd-containing deposits are present in brain tumors following contrast-enhanced MR scans in patients without severe renal disease. Further studies are needed to assess the clinical importance of the deposits we observed and to determine whether they are also found in other conditions that alter the integrity of the BBB

  1. An investigation of potential desensitizing agents in the dentine disc model: a scanning electron microscopy study. (United States)

    Ling, T Y; Gillam, D G; Barber, P M; Mordan, N J; Critchell, J


    Cervical dentine sensitivity (CDS) may be defined as pain arising from exposed dentine. The prefix cervical indicates the location of the sensitivity and/or its subsequent treatment. Currently the most accepted mechanism of intradental nerve activation associated with dentine sensitivity appears to be hydrodynamic in nature. The concept of tubule occlusion as a method of dentine desensitization is a logical conclusion of the hydrodynamic theory. The authors employed the dentine disc model, qualitative scanning electron microscopy (SEM) and X-ray microanalysis to investigate whether selected desensitizing agents occlude dentinal tubule orifices. Strict control procedures have been used together with various methods of application to apply these agents to human dentine discs. SEM was used to examine the degree of deposit left by the various agents on disc surfaces and X-ray microanalysis was employed to characterize the elemental composition of the deposit. Analysis of selected agents, both prior to and after application on dentine discs was performed for comparative purposes. The degree of retention of the surface deposit upon rotation with saliva supernatant for 6 h was also studied. The results of this study indicated that ferric oxalate, the active ingredient of Sensodyne Sealant, which produced initial crystal-like structures, occluding almost all the tubule orifices was superior to potassium oxalate (Butler Protect). Of the over-the-counter (OTC) desensitizing products tested, both silica- and calcium-based abrasive components were observed both on the surface and within the tubules, indicating a certain degree of therapeutic potential for these two components. These findings suggest that certain desensitizing agents have tubule occluding properties as observed in this in vitro system which, in turn, may indicate a therapeutic potential in vivo.

  2. Novel route synthesis of porous and solid gold nanoparticles for investigating their comparative performance as contrast agent in computed tomography scan and effect on liver and kidney function

    Directory of Open Access Journals (Sweden)

    Aziz F


    Full Text Available Farooq Aziz,1,2 Ayesha Ihsan,1 Aalia Nazir,2 Ishaq Ahmad,3 Sadia Zafar Bajwa,1 Asma Rehman,1 Abdoulaye Diallo,4 Waheed S Khan1 1Nanobiotechnology Group, National Institute for Biotechnology and Genetic Engineering (NIBGE, Faisalabad, 2Department of Physics, Islamia University of Bahawalpur, Bahawalpur, 3National Center for Physics, Quaid-I-Azam University, Islamabad, Pakistan; 4Laboratory of Photonics and Nano-Fabrication, Faculty of Science and Technology, Cheikh Anta Diop University of Dakar (UCAD, Dakar-Fann Dakar, Senegal Abstract: Gold nanoparticles (GNPs with dimension in the range of 1–100 nm have a prominent role in a number of biomedical applications like imaging, drug delivery, and cancer therapy owing to their unique optical features and biocompatibility. In this work, we report a novel technique for the synthesis of two types of GNPs namely porous gold nanoparticles (PGNPs and solid gold nanoparticles (SGNPs. PGNPs of size 35 nm were fabricated by reduction of gold (III solution with lecithin followed by addition of L-ascorbic acid and tri-sodium citrate, whereas SGNPs with a dimension of 28 nm were prepared by reflux method using lecithin as a single reducing agent. Comparative studies using PGNPs (λmax 560 nm and SGNPs (λmax 548 nm were conducted for evaluating their use as a contrast agent. These studies reveled that in direct computed tomography scan, PGNPs exhibited brighter contrast (45 HU than SGNPs (26 HU. To investigate the effect of PGNPs and SGNPs on the liver and kidney profile, male rabbits were intravenously injected with an equal dose of 1 mg/kg weight of PGNPs and SGNPs. The effect on biochemical parameters was evaluated 72 hours after intravenous (IV injection including liver function profile, renal (kidney function biomarker, random blood glucose value, and cholesterol level. During one comparison of contrast in CT scan, PGNPs showed significantly enhanced contrast in whole-rabbit and organ CT scan as

  3. Role of cytokine therapy for renal cell carcinoma in the era of targeted agents (United States)

    Koneru, R.; Hotte, S.J.


    Starting in the late 1980s, cytokines were considered the mainstay of treatment for locally advanced or metastatic renal cell carcinoma (rcc) because of a lack of improved survival with either chemotherapy or hormonal therapy alone. The cytokine agents interferon alfa (ifnα) and interleukin-2 (il-2) have been the most evaluated, but a low overall response rate and a marginal survival advantage, coupled with significant toxicity, make these therapies less than ideal. Although complete tumour responses have occasionally been seen with high-dose il-2, this therapy is associated with significant morbidity and mortality, and its approval has been based on limited nonrandomized evidence. Newer anti-angiogenesis agents have been evaluated as single agents and in combination with infα, and these are now considered the standard of care for most patients with rcc. However, cytokines may still occasionally be recommended when angiogenesis inhibitors are not available or are contraindicated. In the present paper, we discuss the evidence for the use of cytokine therapy in the setting of pre– and post–targeted therapy for rcc. PMID:19478896

  4. Renal cell carcinoma: review of novel single-agent therapeutics and combination regimens. (United States)

    Amato, R J


    A search of the Medline database and ASCO 2003 conference proceedings was conducted to identify clinical trials currently underway using single-agent therapy for renal cell carcinoma (RCC). Combination trials were identified using the ASCO 2003 conference proceedings. Fourteen single-agent therapies employing different mechanisms of action were identified in the published literature: imatinib mesylate (Gleevec); bevacizumab (Avastin); thalidomide (Thalomid); gefitinib (ZD1839) (Iressa); cetuximab (IMC-C225) (Erbitux); bortezomib (PS-341) (Velcade); HSPPC-96 (Oncophage); BAY 59-8862; ABT-510; G250; CCI-779; SU5416; PTK/ZK; and ABX-EGF. Six distinct fields of clinical research have emerged: monoclonal antibodies, small molecules, vaccines, second-generation taxanes, nonapeptides and immunomodulators. Five combination regimens, primarily biological response modifiers (interleukin-2 or interferon-alpha), chemotherapy- or thalidomide-based, were identified. All therapies demonstrated acceptable toxicity profiles. Clinical benefit was assessed based on each study's reported criteria: antitumor response (regression or stability) ranged from 5% to 71%. In the past several years, significant advances in the underlying biological mechanisms of RCC, particularly the role of tumor angiogenesis, have permitted the design of molecularly targeted therapeutics. Based on preliminary and limited studies, combination therapies offer the greatest clinical benefit in the management of this malignancy, although additional basic research is still warranted.

  5. Scanning electron microscopic and X-ray micro analysis on tooth enamel exposed to alkaline agents. (United States)

    Taubee, Fabian; Steiniger, Frank; Nietzsche, Sandor; Norén, Jörgen G


    The background of this study comprises two clinical cases, where patients exposed to aerosols of an alkaline and surface active cleaning agent developed loss of enamel substance on their teeth, further resulting in loss of teeth and partially destroyed soft tissues. The alkaline cleaning agent consisted of potassium hydroxide and various surfactants. The purpose of this study was to investigate possible changes in morphology and composition in human teeth enamel exposed to alkaline solutions, by means of X-ray micro analysis (XRMA), FTIR-spectroscopic analyses and scanning electron microscopy (SEM). Extracted premolars, exposed to potassium hydroxide solutions and alkaline cleaning solution,were analyzed by means of XRMA and SEM. Enamel powder, exposed to cleaning solution, was analyzed by means of FTIR. The SEM analysis revealed an increased porosity of the enamel surface and partially loss of enamel substance after exposure to alkaline solutions. The XRMA analyses revealed a decrease in carbon concentration while phosphorous and calcium showed no marked changes. The FTIR analyses showed no significant changes in peak heights or peak positions for phosphate, carbonate or hydroxide. It was concluded that human teeth enamel exposed to alkaline solutions showed loss of organic substance, marked pores in enamel surface and loss of substance in the enamel surface.

  6. Novel route synthesis of porous and solid gold nanoparticles for investigating their comparative performance as contrast agent in computed tomography scan and effect on liver and kidney function (United States)

    Aziz, Farooq; Ihsan, Ayesha; Nazir, Aalia; Ahmad, Ishaq; Bajwa, Sadia Zafar; Rehman, Asma; Diallo, Abdoulaye; Khan, Waheed S


    Gold nanoparticles (GNPs) with dimension in the range of 1–100 nm have a prominent role in a number of biomedical applications like imaging, drug delivery, and cancer therapy owing to their unique optical features and biocompatibility. In this work, we report a novel technique for the synthesis of two types of GNPs namely porous gold nanoparticles (PGNPs) and solid gold nanoparticles (SGNPs). PGNPs of size 35 nm were fabricated by reduction of gold (III) solution with lecithin followed by addition of L-ascorbic acid and tri-sodium citrate, whereas SGNPs with a dimension of 28 nm were prepared by reflux method using lecithin as a single reducing agent. Comparative studies using PGNPs (λmax 560 nm) and SGNPs (λmax 548 nm) were conducted for evaluating their use as a contrast agent. These studies reveled that in direct computed tomography scan, PGNPs exhibited brighter contrast (45 HU) than SGNPs (26 HU). To investigate the effect of PGNPs and SGNPs on the liver and kidney profile, male rabbits were intravenously injected with an equal dose of 1 mg/kg weight of PGNPs and SGNPs. The effect on biochemical parameters was evaluated 72 hours after intravenous (IV) injection including liver function profile, renal (kidney) function biomarker, random blood glucose value, and cholesterol level. During one comparison of contrast in CT scan, PGNPs showed significantly enhanced contrast in whole-rabbit and organ CT scan as compared to SGNPs 6 hours after injection. Our findings suggested that the novel PGNPs enhance CT scan image with higher efficacy as compared to SGNPs. The results showed that IV administration of synthesized PGNPs increases the levels of aspartate aminotransferase (AST), alkaline phosphate (ALP), serum creatinine, and blood glucose, whereas that of SGNPs increases the levels of AST, ALP, and blood glucose. PMID:28280325

  7. Novel route synthesis of porous and solid gold nanoparticles for investigating their comparative performance as contrast agent in computed tomography scan and effect on liver and kidney function. (United States)

    Aziz, Farooq; Ihsan, Ayesha; Nazir, Aalia; Ahmad, Ishaq; Bajwa, Sadia Zafar; Rehman, Asma; Diallo, Abdoulaye; Khan, Waheed S


    Gold nanoparticles (GNPs) with dimension in the range of 1-100 nm have a prominent role in a number of biomedical applications like imaging, drug delivery, and cancer therapy owing to their unique optical features and biocompatibility. In this work, we report a novel technique for the synthesis of two types of GNPs namely porous gold nanoparticles (PGNPs) and solid gold nanoparticles (SGNPs). PGNPs of size 35 nm were fabricated by reduction of gold (III) solution with lecithin followed by addition of L-ascorbic acid and tri-sodium citrate, whereas SGNPs with a dimension of 28 nm were prepared by reflux method using lecithin as a single reducing agent. Comparative studies using PGNPs (λmax 560 nm) and SGNPs (λmax 548 nm) were conducted for evaluating their use as a contrast agent. These studies reveled that in direct computed tomography scan, PGNPs exhibited brighter contrast (45 HU) than SGNPs (26 HU). To investigate the effect of PGNPs and SGNPs on the liver and kidney profile, male rabbits were intravenously injected with an equal dose of 1 mg/kg weight of PGNPs and SGNPs. The effect on biochemical parameters was evaluated 72 hours after intravenous (IV) injection including liver function profile, renal (kidney) function biomarker, random blood glucose value, and cholesterol level. During one comparison of contrast in CT scan, PGNPs showed significantly enhanced contrast in whole-rabbit and organ CT scan as compared to SGNPs 6 hours after injection. Our findings suggested that the novel PGNPs enhance CT scan image with higher efficacy as compared to SGNPs. The results showed that IV administration of synthesized PGNPs increases the levels of aspartate aminotransferase (AST), alkaline phosphate (ALP), serum creatinine, and blood glucose, whereas that of SGNPs increases the levels of AST, ALP, and blood glucose.

  8. Renal Sympathetic Denervation by CT-scan-Guided Periarterial Ethanol Injection in Sheep

    Energy Technology Data Exchange (ETDEWEB)

    Firouznia, Kavous, E-mail:; Hosseininasab, Sayed jaber, E-mail: [Tehran University of Medical Sciences (TMUS), Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital Complex (Iran, Islamic Republic of); Amanpour, Saeid, E-mail: [Tehran University of Medical Science, Cancer Models Research Center, Cancer Institute of Iran (Iran, Islamic Republic of); Haj-Mirzaian, Arya, E-mail: [Tehran University of Medical Science, Department of Radiology and Imaging, MIC, Imam Khomeini Hospital (Iran, Islamic Republic of); Miri, Roza, E-mail: [Tehran University of Medical Science, Department of Pathology, Imam Khomeini Hospital Complex (Iran, Islamic Republic of); Muhammadnejad, Ahad, E-mail: [Tehran University of Medical Science, Cancer Research Center, Cancer Institute of Iran (Iran, Islamic Republic of); Muhammadnejad, Samad, E-mail: [Tehran University of Medical Sciences, Research Center for Molecular and Cellular Imaging (Iran, Islamic Republic of); Jalali, Amir H., E-mail: [Tehran University of Medical Sciences (TMUS), Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital Complex (Iran, Islamic Republic of); Ahmadi, Farrokhlagha, E-mail: [Tehran University of Medical Sciences, Nephrology Research Center, Imam Khomeini Hospital Complex (Iran, Islamic Republic of); Rokni-Yazdi, Hadi, E-mail: [Tehran University of Medical Sciences (TMUS), Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital Complex (Iran, Islamic Republic of)


    BackgroundRenal nerves are a recent target in the treatment of hypertension. Renal sympathetic denervation (RSD) is currently performed using catheter-based radiofrequency ablation (RFA) and because this method has limitations, percutaneous magnetic resonance (MR)-guided periarterial ethanol injection is a suggested alternative. However, few studies have been conducted on the effectiveness of percutaneous ethanol injection for RSD.AimTo evaluate the feasibility, efficacy, and complications of computed tomography (CT)-guided periarterial ethanol injection.MethodsEthanol (10 ml, 99.6 %) was injected around the right renal artery in six sheep under CT guidance with the left kidney serving as a control. Before and after the intervention, the sheep underwent MR imaging studies and the serum creatinine level was measured. One month after the intervention, the sheep were euthanized and norepinephrine (NE) concentration in the renal parenchyma was measured to evaluate the efficacy of the procedure. The treated tissues were also examined histopathologically to evaluate vascular, parenchymal, and neural injury.ResultsThe right kidney parenchymal NE concentration decreased significantly compared with the left kidney after intervention (average reduction: 40 %, P = 0.0016). Histologic examination revealed apparent denervation with no other vascular or parenchymal injuries observed in the histological and imaging studies.ConclusionEffective and feasible RSD was achieved using CT-guided periarterial ethanol injection. This technique may be a potential alternative to catheter-based RFA in the treatment of hypertension.

  9. Diagnostic performance of an expert system for interpretation of 99mTc MAG3 scans in suspected renal obstruction. (United States)

    Taylor, Andrew; Garcia, Ernest V; Binongo, Jose Nilo G; Manatunga, Amita; Halkar, Raghuveer; Folks, Russell D; Dubovsky, Eva


    The purpose of the study was to compare diuresis renography scan interpretation generated by a renal expert system with the consensus interpretation of 3 expert readers. The expert system was evaluated in 95 randomly selected furosemide-augmented patient studies (185 kidneys) obtained for suspected obstruction; there were 55 males and 40 females with a mean age +/- SD of 58.6 +/- 16.5 y. Each subject had a baseline (99m)Tc-mercaptoacetyltriglycine ((99m)Tc-MAG3) scan followed by furosemide administration and a separate 20-min acquisition. Quantitative parameters were automatically extracted from baseline and furosemide acquisitions and forwarded to the expert system for analysis. Three experts, unaware of clinical information, independently graded each kidney as obstructed/probably obstructed, equivocal, and probably nonobstructed/nonobstructed; experts resolved differences by a consensus reading. These 3 expert categories were compared with the obstructed, equivocal, and nonobstructed interpretations provided by the expert system. Agreement was assessed using weighted kappa, and the predictive accuracy of the expert system compared with expert readers was assessed by the area under receiver-operating-characteristic (ROC curve) curves. The expert system agreed with the consensus reading in 84% (101/120) of nonobstructed kidneys, in 92% (33/36) of obstructed kidneys, and in 45% (13/29) of equivocal kidneys. The weighted kappa between the expert system and the consensus reading was 0.72 and was comparable with the weighted kappa between experts. There was no significant difference in the areas under the ROC curves when the expert system was compared with each expert using the other 2 experts as the gold standard. The renal expert system showed good agreement with the expert interpretation and could be a useful educational and decision support tool to assist physicians in the diagnosis of renal obstruction. To better mirror the clinical setting, algorithms to

  10. Hypercalcaemia of malignancy: evidence for a nonparathyroid humoral agent with an effect on renal tubular handling of calcium. (United States)

    Ralston, S H; Fogelman, I; Gardner, M D; Dryburgh, F J; Cowan, R A; Boyle, I T


    The renal handling of calcium was examined in 31 patients with hypercalcaemia of malignancy. Results were compared with those from patients with primary hyperparathyroidism, and normal controls rendered hypercalcaemic by calcium infusion. On relating the urinary calcium excretion indices to serum calcium values, inappropriately low rates of urinary calcium excretion were generally found in patients with malignancy associated hypercalcaemia. Further, the pattern of urinary calcium excretion in these subjects was similar to that found in patients with primary hyperparathyroidism. These observations suggest that, in many solid tumours, the development of hypercalcaemia may be attributable to a humoral mediator with a parathyroid hormone-like effect on renal tubular calcium reabsorption. The relatively frequent occurrence of hypercalcaemia in malignant disease thus may be partially explained by the presence of this humoral agent, which may impair the renal excretion of an increase in filtered calcium load, whether due to bone metastases, or humorally mediated osteolysis.

  11. Interface Between MTA and Dental Bonding Agents: Scanning Electron Microscope Evaluation. (United States)

    Cervino, Gabriele; Fiorillo, Luca; Spagnuolo, Gianrico; Bramanti, Ennio; Laino, Luigi; Lauritano, Floriana; Cicciù, Marco


    Nowadays, the material that offers the best sealing characteristic in the field of endodontic treatment is the mineral trioxide aggregate (MTA), nevertheless, this material necessities an adhesive bonding agent to perfectly join to the dental surface. The aim of this study was to analyze using a scanning electron microscope (SEM) the possible microgap between the adhesive, MTA, and the dental surface. Fourteen extracted molars were divided into two groups - group A was prepared with MTA-component adhesive and group B was prepared with MTA and composite dual etching. The observations were carried out with a SEM Phenom G2 Pro mode S.E.I. JMP® software was used for statistical analysis, and a t-test was used for evaluating the difference between the two groups. The gap of the areas at higher magnification (1000×) with a size greater than 5 microns in width and 20 microns in length were considered significant, and only group A recorded significant data. The SEM analysis performed in the group A with interposition of adhesive and flow between the dental pulp chamber and MTA demonstrates the presence of a marginal gap of considerable amplitude in the all of the samples investigated.

  12. Intelligent Agent Appropriation in the Tracking Phase of an Environmental Scanning Process: A Case Study of a French Trade Union (United States)

    Lafaye, Christophe


    Introduction: The rapid growth of the Internet has modified the boundaries of information acquisition (tracking) in environmental scanning. Despite the numerous advantages of this new medium, information overload is an enormous problem for Internet scanners. In order to help them, intelligent agents (i.e., autonomous, automated software agents…

  13. Improved detection and biopsy of solid liver lesions using pulse-inversion ultrasound scanning and contrast agent infusion

    DEFF Research Database (Denmark)

    Skjoldbye, B.; Pedersen, Morten Høgholm; Struckmann, J.


    The purpose of this study was to assess the ability of pulse-inversion ultrasound (US) scanning (PIUS), combined with an IV contrast agent, to detect malignant liver lesions and its impact on patient management (resectability). Additionally, to determine the feasibility of US-guided biopsy of new...

  14. Hypertension in paediatrics: Can pre- and post-captopril technetium-99m dimercaptosuccinic acid renal scans exclude renovascular disease

    Energy Technology Data Exchange (ETDEWEB)

    Minty, I. (Hospital for Sick Children, London (United Kingdom). Dept. of Radiology); Lythgoe, M.F. (Hospital for Sick Children, London (United Kingdom). Dept. of Radiology); Gordon, I. (Hospital for Sick Children, London (United Kingdom). Dept. of Radiology)


    In children over 1 year of age, renal disease is the commonest cause of hypertension. Arteriography is considered the reference method to establish the diagnosis of enovascular disease; however, it is an invasive technique with a high radiation burden for children. This was a retrospective study of pre- and post-capto-technetium-99m dimercaptosuccinic acid (DMSA) imaging compared with arteriography in 18 children between the ages of 3 and 17 years. Alone, the [sup 99m]Tc-DMSA scan is a sensitive indicator of renal parenchymal disease, although non-specific in suggesting the pathology. The combination of pre- and post-captopril studies may increase the sensitivity and specificity in the diagnosis of renovascular disease in the presence of hypertension. This work suggests that a screening investigation with a low radiation burden can be carried out at most institutions; if the investigation is positive, there will be a high index of suspicion that renovascular disease is the cause of the hypertension. (orig.)

  15. Preparation and evaluation of {sup 68}Ga-ECC as a PET renal imaging agent

    Energy Technology Data Exchange (ETDEWEB)

    Mizaei, Alireza; Jaililan, Amir Reza; Mazidi, Mohammad; Aghanejad, Ayuob; Yousefnia, Hassan; Shabani, Gholamli; Ardaneh, Khosro [Radiation Application Research School, Nuclear Science and Technology Research Institute, Tehran (Iran, Islamic Republic of); Geramifar, Patham; Beiki, Davood [Research Center for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran (Iran, Islamic Republic of)


    Development of a gallium-68-labeled renal tracer can be a good substitute for Tc-99m, a known SPECT tracer. In this study, effort was made to develop {sup 68}Ga-ethylenecysteamine cysteine ({sup 68}Ga-ECC). Ga-ECC was prepared using generator-based {sup 68}GaCl3 and ethylenecysteamine cysteine (ECC) at optimized conditions. Stability of the complex was checked in human serum followed by partition coefficient determination of the tracer. The biodistribution of the tracer in rats was studied using tissue counting and PET/CT imaging up to 120 min. Ga-ECC was prepared at optimized conditions in 15 min at 90 °C (radiochemical purity ≈97 ± 0.88 % ITLC, >99 % HPLC, specific activity: 210 ± 5 GBq/mM). {sup 68}Ga-ECC was a water-soluble complex based on partition coefficient data (log P; −1.378) and was stable in the presence of human serum for 2 h at 37 °C. The biodistribution of the tracer demonstrated high kidney excretion of the tracer in 10–20 min. The SUV{sub max} ratios of the liver to left kidney were 0.38 and 0.39 for 30 and 90 min, respectively, indicating high kidney uptake. Initial biodistribution results showed significant kidney and urinary excretion of the tracer comparable to that of the homologous {sup 99m}Tc compound. The complex could be a possible PET kidney imaging agent with a fast imaging time.

  16. Comparison of magnetic resonance urography to dimercaptosuccinic acid scan for the identification of renal parenchyma defects in children with vesicoureteral reflux. (United States)

    Cerwinka, W H; Grattan-Smith, J D; Jones, R A; Haber, M; Little, S B; Blews, D E; Williams, J P; Kirsch, A J


    The objective of this study was to compare the accuracy of dimercaptosuccinic acid (DMSA) renal scan to magnetic resonance urography (MRU) in the identification of renal parenchyma defects (RPD). Twenty-five children with history of acute pyelonephritis and vesicoureteral reflux underwent DMSA scan and MRU to determine the presence of RPD. DMSA scans and MRUs were each evaluated by two radiologists and agreement achieved by consensus. Discordant DMSA-MRU findings were re-evaluated in a side-by-side comparison and an ultimate consensus reached. The ultimate consensus diagnosis was 18 kidneys with RPDs in 15 patients, of which five were classified as mild RPDs, six as moderate RPDs, and seven as severe RPDs. Although DMSA scan and MRU were similar in their ability to diagnose RPDs, MRU was considered to represent the true diagnosis in 11 of the 12 discordant cases in consensus review by four pediatric radiologists. MRU showed a much higher inter-observer agreement with a weighted kappa of 0.96 for both kidneys compared to 0.71 for the right kidney and 0.86 for the left kidney by DMSA scan. Our results suggest that MRU is superior to DMSA scan in the identification of renal parenchyma defects. Copyright © 2013 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  17. The skin-to-calyx distance measured by renal ct scan and ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Shan, Chen Jen; Mazzucchi, Eduardo; Payão, Fabio; Gomes, Andrea Cavalanti; Baroni, Ronaldo Hueb; Torricelli, Fabio Cesar; Vicentini, Fabio Carvalho; Srougi, Miguel [Hospital das Clínicas, University of Sao Paulo Medical School, Sao Paulo, SP (Brazil)


    Purpose: We developed a stereotactic device to guide the puncture for percutaneous nephrolithotripsy, which uses the distance from the target calyx to its perpendicular point on skin (SCD) to calculate the needle´s entry angle. This study seeks to validate the use of measurements obtained by ultrasound (US) and computerized tomography (CT) for needle´s entry angle calculation and to study factors that may interfere in this procedure. Materials and Methods: Height, weight, abdominal circumference, CT of the urinary tract in dorsal decubitus (DD) and ventral decubitus (VD), and US of the kidneys in VD were obtained from thirty-five renal calculi patients. SCD obtained were compared and correlated with body-mass index (BMI). Results: BMI was 28.66 ± 4.6 Kg/m2. SCD on CT in DD was 8.40 ± 2.06cm, in VD was 8.32 ± 1.95cm, in US was 6.74 ± 1.68cm. SCD measured by US and CT were statistically different (p < 0.001), whereas between CT in DD and VD were not. SCD of the lower calyx presented moderate correlation with BMI. Conclusion: SCD obtained by CT in ventral and dorsal decubitus may be used for calculation of the needle´s entry angle. SCD obtained by US cannot be used. A rule for the correlation between BMI and the SCD could not be determined. (author)

  18. Improved detection and biopsy of solid liver lesions using pulse-inversion ultrasound scanning and contrast agent infusion

    DEFF Research Database (Denmark)

    Skjoldbye, B.; Pedersen, Morten Høgholm; Struckmann, J.;


    The purpose of this study was to assess the ability of pulse-inversion ultrasound (US) scanning (PIUS), combined with an IV contrast agent, to detect malignant liver lesions and its impact on patient management (resectability). Additionally, to determine the feasibility of US-guided biopsy of new...... with additional findings by PIUS underwent US-guided biopsy. PIUS provided additional information in 18 patients (60%); of these, 13 (43%) had additional metastases. Of 19 patients found resectable by conventional US, 9 (47%) were considered inoperable using PIUS supported by biopsies. Biopsies of additional...... findings were performed in 17 of 18 patients. All biopsies of additional findings confirmed malignancy. PIUS with an IV contrast agent increased the ability to detect liver metastases compared to conventional US scanning. The technique had a high impact on patient management. The results showed that PIUS...

  19. Spontaneous renal artery dissection complicating with renal infarction. (United States)

    Tsai, Tsung-Han; Su, Jung-Tsung; Hu, Sung-Yuan; Chao, Chih-Chung; Tsan, Yu-Tse; Lin, Tzu-Chieh


    Spontaneous renal artery dissection (SRAD) is a rare entity. We reported a 30-year-old healthy man presenting with sudden onset of left flank pain. Abdominal plain film and sonography were unremarkable. The contrast-enhanced abdominal computed tomographic (CT) scan demonstrated a dissecting intimal flap of the left distal renal artery (RA) complicating infarction. Selective angiography of the renal artery disclosed a long dissection of left distal RA with a patent true lumen and occlusion of left accessory RA. Conservative treatment with control of blood pressure and antiplatelet agent was prescribed. The patient was discharged with an uneventful condition on day 5.

  20. Administered activity optimization in renal static scanning using 99m-Tc DMSA

    Energy Technology Data Exchange (ETDEWEB)

    Perez, Marlen; Casas, Gladys [Universidad Central Marta Abreu de las Villas, Villa Clara (Cuba); Dopico, Rolando; Estevez, Eric; Cabrera, Orlando [Hospital Universitario Celestino Hernandez Robau, Villa Clara (Cuba)


    The aim of this study was to determine the optimum administered activity to patients, of the DMSA-Tc-99m looking for good image quality in gamma camera and a best radiological protection for the patient. Three protocols and two activity values in each protocol were tested (71.2 MBq and 132.8 MBq) in six patients each. An observer blinded to the administered activity, graded the rear view of both kidneys in the 36 patients. The relation of the Rois in kidney/bladder and kidney/liver, and the labeling yield were the most important parameters in the construction of a discriminatory function of image quality (r=0.56, r=0.33 and r=0.461 respectively). The correlation between the observer's opinion and the prediction of the function was r=0.429. The function classified 91.7% of the cases correctly. The best results for the patient's radiological protection were obtained by using 71.2 MBq and 700 k Counts as stopped criterion. When the labeling yield was lower than 98% it was better to applied 132.8 MBq and to stop the scanning after 3 minutes to guarantee a best image quality. (author)

  1. Crossed Fused Renal Ectopia: Presentations on 99mTc-MAG3 Scan, 99mTc-DMSA SPECT, and Multidetector CT. (United States)

    Moon, Eun Ha; Kim, Min-Woo; Kim, Young Jun; Sun, In O


    Crossed renal ectopia is an uncommon developmental anomaly in which both kidneys are located on the same side of the body. The present case describes a 20-year-old man who underwent the military entrance physical examination. The ultrasound showed the right kidney in normal site with slightly increased size, but the left kidney was not identified. Tc-MAG3 scan showed a single kidney with 2 ureters, and the orifices of the ureters were connected at both sides of bladder. Tc-DMSA SPECT and contrast-enhanced multidetector CT were performed and revealed crossed fused renal ectopia.

  2. Comparative effects of chelating agents on distribution, excretion, and renal toxicity of gold sodium thiomalate in rats. (United States)

    Takahashi, Y; Funakoshi, T; Shimada, H; Kojima, S


    The effects of various chelating agents, such as (2S)-1-(3-mercaptopropionyl)-L-proline (captopril), N-(2-mercaptopropionyl)-glycine (tiopronin), L-cysteine (L-Cys), D-cysteine (D-Cys), N-acetyl-L-cysteine (L-NAC), N-benzyl-D-glucamine dithiocarbamate (BGD), and ethylenediaminetetraacetate (EDTA), on the distribution, excretion, and renal toxicity of gold sodium thiomalate (AuTM) in rats were investigated. Rats were intraperitoneally injected with the chelating agents (1.2 mmol/kg each) immediately after intravenous injection of AuTM (0.026 mmol/kg). Treatment with captopril or tiopronin significantly prevented increases in the urinary excretion of protein, aspartate aminotransferase (AST), and glucose and the blood urea nitrogen (BUN) level after AuTM injection. L-NAC and D-Cys significantly prevented increases in the urinary excretion of protein, AST, and glucose after AuTM injection, but did not reduce to control levels. Treatment with BGD, EDTA, or L-Cys did not prevent AuTM-induced increases in the urinary excretion of protein, AST, and glucose and BUN level. Tiopronin significantly increased the urinary excretion of gold. Captopril slightly promoted both the urinary and fecal excretion of gold, resulting in the significant increase in the total excretion of the metal. Tiopronin and captopril significantly decreased the gold concentration in the kidney and liver. L-Cys, D-Cys, L-NAC, BGD, and EDTA had no significant effect on the excretion or distribution of gold at 7 days after AuTM injection. These results indicate that tiopronin and captopril can ameliorate the renal toxicity induced by AuTM. In addition, the comparative effects of 2,3-dimercaptopropane sulfonate (DMPS), N-(2-mercapto-2-methylpropanoyl)-L-cysteine (bucillamine), captopril, and tiopronin at various dose levels (1.2, 0.4 or 0.2 mmol/kg) on the distribution and renal toxicity of gold were studied. DMPS was effective in removing gold from the kidney and in protecting against the renal toxicity

  3. Effect of administration route on the renal safety of contrast agents: a meta-analysis of randomized controlled trials. (United States)

    Dong, Mei; Jiao, Zhanquan; Liu, Tong; Guo, Fangming; Li, Guangping


    The objective of this study was to examine the association between administration route and relative renal safety of contrast agents. We searched all published articles indexed in Embase, Medline and the Cochrane Central Register of Controlled Trials, from January 1980 to November 2010, to identify relevant studies. Of the 1,047 initially identified studies, 11 randomized controlled trials (RCTs) including 2,210 patients with intra-arterial route and 7 RCTs including 919 patients with intravenous route were finally analyzed. With regard to intra-arterial route, our meta-analysis showed that iodixanol significantly decreased the risk of contrast-induced acute kidney injury (CI-AKI) when compared with a pool of low-osmolar contrast media (LOCM; risk ratio [RR] = 0.68; 95% confidence interval [95% CI], 0.50-0.92; Z=2.47; p=0.01), with no significant heterogeneity between individual studies (p=0.14, I2=32.4%). However, iodixanol was not associated with a reduction in CI-AKI compared with the LOCM pooled together (RR=0.75; 95% CI, 0.44-1.26; Z=1.10; p=0.27) with intravenous application, again with no significant heterogeneity between individual studies (p=0.40, I2=3.6%). Our meta-analysis suggests that administration route may affect the renal safety of contrast agents. Specifically, iodixanol may be a better choice for patients in the interventional cardiology setting.

  4. Analysis of the effects of different iodine concentrations on the characterization of small renal lesions detected by multidetector computed tomography scan: A pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hak Jong; Kim, Sang Youn; Cho, Jeong Yeon; Hwang, Sung Il; Moon, Min Hoan; Kim, Seung Hyup [Dept. of Radiology, Seoul National University College of Medicine, Seoul (Korea, Republic of)


    Our objective was to compare the effects of different iodine concentrations on characterizing small renal lesions. Thirty-eight patients were enrolled in this study. All patients underwent an initial CT scan using 370 mgI/mL iodinated contrast media. Patients were then randomized into two groups for a follow-up CT. Group A (n = 19) received 250 mgI/mL iodinated contrast media, and group B (n = 19) received 300 mgI/mL contrast media. The mean Hounsfield units (HU values) of small renal lesions with a maximum size of less than 2 cm were calculated. Signal to noise ratios (SNR values) were likewise evaluated. Three uroradiologists assessed the lesion's conspicuity and the diagnostic influence of the artifact's proximity to the adjacent renal parenchyma. In group A, there were significant differences between the HU values of renal lesions and those of the adjacent renal parenchyma between the initial and follow-up CT. Conversely, in group B, there was no significant difference. Moreover, SNR values showed no statistically significant difference between both groups. Regarding lesion conspicuity, only one reader identified a significant difference (p = 0.032) in group A; whereas in group B, there was no statistical difference. The artifact's proximity to the adjacent renal parenchyma did not appear to have any diagnostic influence on differentiating the two (p < 0.05). In evaluating small renal lesions, 300 mgI/mL instead of 370 mgI/mL contrast media can be used; however, it is important to note that the use of 250 mgI/mL contrast media may reveal different results from that of 370 mgI/mL contrast media.

  5. Amla as an antihyperglycemic and hepato-renal protective agent in fluoride induced toxicity

    Directory of Open Access Journals (Sweden)

    Rupal A Vasant


    Full Text Available Purpose of the study was to examine the antihyperglycemic and hepato-renal protective effects of Emblica officinalis (Eo fruit as a food supplement in fluoride induced toxicity. Eo fruit powder was incorporated into the diet (2.5, 5 and 10 gm % of fluoride exposed animals for a duration of 30 days. Fluoride exposure caused significant elevation in plasma glucose, serum glutamate oxaloacetate transaminase (SGOT, serum glutamate pyruvate transaminase (SGPT, acid phosphatase (ACP, alkaline phosphatase (ALP activities, hepatic glucose-6-phosphatase (G-6-Pase and decreased hepatic glycogen content, hexokinase activity and antioxidant profiles (hepatic and renal. An inclusion of Eo fruit powder significantly reduced plasma glucose levels, SGOT, SGPT, ACP and ALP activities, hepatic G-6-Pase activity and increased hepatic glycogen content and hexokinase activity. Hepatic and renal antioxidant status of fluoride exposed animals improved upon feeding Eo fruit powder. We, therefore, conclude that E. officinalis fruit could be useful in regulating hyperglycemia and enhances antioxidant status of fluoride exposed animals.

  6. A study on evaluation of the dependences of the function and the shape in a 99 m Tc-DMSA renal scan on the difference in acquisition count (United States)

    Dong, Kyung-Rae; Shim, Dong-Oh; Kim, Ho-Sung; Park, Yong-Soon; Chung, Woon-Kwan; Cho, Jae-Hwan


    In a nuclear medicine examination, methods to acquire a static image include the preset count method and the preset time method. The preset count method is used mainly in a static renal scan that utilizes 99 m Tc-DMSA (dimoercaptosuccinic acid) whereas the preset time method is used occasionally. When the preset count method is used, the same number of acquisition counts is acquired for each time, but the scan time varies. When the preset time method is used, the scan time is constant, but the number of counts acquired is not the same. Therefore, this study examined the dependence of the difference in information on the function and the shape of both sides of the kidneys on the counts acquired during a renal scan that utilizes 99 m Tc-DMSA. The study involved patients who had 40-60% relative function of one kidney among patients who underwent a 99 m Tc-DMSA renal scan in the Nuclear Medicine Department during the period from January 11 to March 31, 2012. A gamma camera was used to obtain the acquisition count continuously using 100,000 counts and 300,000 counts, and an acquisition time of 7 minutes (exceeding 300,000 counts). The function and the shape of the kidney were evaluated by measuring the relative function of both sides of the kidneys, the geometric mean, and the size of kidney before comparative analysis. According to the study results, neither the relative function nor the geometric mean of both sides of the kidneys varied significantly with the acquisition count. On the other hand, the size of the kidney tended to be larger with increasing acquisition count.

  7. Real-time point-of-care measurement of impaired renal function in a rat acute injury model employing exogenous fluorescent tracer agents (United States)

    Dorshow, Richard B.; Fitch, Richard M.; Galen, Karen P.; Wojdyla, Jolette K.; Poreddy, Amruta R.; Freskos, John N.; Rajagopalan, Raghavan; Shieh, Jeng-Jong; Demirjian, Sevag G.


    Renal function assessment is needed for the detection of acute kidney injury and chronic kidney disease. Glomerular filtration rate (GFR) is now widely accepted as the best indicator of renal function, and current clinical guidelines advocate its use in the staging of kidney disease. The optimum measure of GFR is by the use of exogenous tracer agents. However current clinically employed agents lack sensitivity or are cumbersome to use. An exogenous GFR fluorescent tracer agent, whose elimination rate could be monitored noninvasively through skin would provide a substantial improvement over currently available methods. We developed a series of novel aminopyrazine analogs for use as exogenous fluorescent GFR tracer agents that emit light in the visible region for monitoring GFR noninvasively over skin. In rats, these compounds are eliminated by the kidney with urine recovery greater than 90% of injected dose, are not broken down or metabolized in vivo, are not secreted by the renal tubules, and have clearance values similar to a GFR reference compound, iothalamate. In addition, biological half-life of these compounds measured in rats by noninvasive optical methods correlated with plasma derived methods. In this study, we show that this noninvasive methodology with our novel fluorescent tracer agents can detect impaired renal function. A 5/6th nephrectomy rat model is employed.

  8. Editor’s Pick: Targeted Agents in Patients with Metastatic Renal Cell Carcinoma on Dialysis: Myths and Reality

    Directory of Open Access Journals (Sweden)

    Annalisa Guida


    Full Text Available Agents targeting the vascular endothelial growth factor (VEGF/VEGF receptor (VEGFR pathway, as well as mammalian target of rapamycin (mTOR inhibitors have revolutionised the therapeutic landscape of metastatic renal cell carcinoma (mRCC in the past decade, greatly improving the survival rates of these patients. However, translating results of registrative Phase III trials into everyday clinical practice is often troublesome, since real-world patients are completely different from those enrolled in randomised controlled Phase III trials. Prospective data on active oncological treatments in mRCC patients on dialysis are dramatically lacking. This literature review summarises and critically comments on available data relative to mRCC patients on dialysis receiving either VEGF/VEGFR-targeting agents, or mTOR inhibitors. Although prospective studies would definitely be warranted in these specific patient populations, all the available data suggest that mRCC patients on dialysis have the same outcome, both in terms of efficacy and safety, as mRCC patients with normal or marginally impaired kidney function, when treated with VEGF/VEGFR-targeting agents and/or mTOR inhibitors.

  9. Is Imaging Time Between two Tc 99m DMSA Scans Sufficient for Reporting as Renal Parenchymal Scarring? Healed Parenchymal Renal Defect After 6 Years

    Directory of Open Access Journals (Sweden)

    Erdem Sürücü


    Full Text Available We aimed to report a healed renal parenchymal defect after 6 years in a 9-year-old girl who was being followed for recurrent urinary tract infection (UTI. The first UTI was at the age of two. She was being followed with ultrasonography, urine analysis and urine culture since the first UTI. Technetium-99m dimercaptosuccinic acid (DMSA scintigraphy was repeated four times up to the present day. She had a renal parenchymal defect reported as parenchymal scarring, which healed 6 years after the first DMSA scintigraphy.

  10. Effect of various chemical agents used in gingival retraction systems on smear layer: Scanning electron microscope study

    Directory of Open Access Journals (Sweden)

    Krishna Shivraj Lahoti


    Full Text Available Background: Chemical agents used for gingival retraction affects the smear layer. Aim: To determine the effect of three different chemical agents used for gingival retraction systems on smear layer. Materials and Methods: Four human premolars were prepared using air-rotor with air-water spray to receive full crown restoration. Three of them were treated with 21.3% aluminum chloride for 10 min, 0.05% oxymetazoline hydrochloride for 10 min, and expasyl for 2 min, respectively. One sample was left untreated. Then, the tooth specimens were rinsed with tap water to remove any residue of test materials. All the samples (treated and untreated were processed by scanning electron microscope (SEM. Processed samples were examined under SEM at ×2400 to evaluate the effect of chemical agents on smear layer. Results: SEM examination revealed that 0.05% oxymetazoline hydrochloride for 10 min produced no alteration to smear layer followed by minimum alteration by expasyl for 2 min and complete removal of smear layer with etching of dentin with 21.3% aluminum chloride for 10 min. Conclusion: 0.05% oxymetazoline hydrochloride and expasyl are kind to smear layer.

  11. Clinical experience with the adrenal scanning agents iodine 131-19-iodocholesterol and selenium 75-6-selenomethylcholesterol

    Energy Technology Data Exchange (ETDEWEB)

    Reschini, E. (Ospedale Maggiore, Milan (Italy). Dept. of Nuclear Medicine); Catania, A. (Milan Univ. (Italy). 1. Medical Clinic)


    Adrenocortical scintigraphy with iodine 131-19-iodocholesterol or selenium 75-6-selenomethylcholesterol was performed in 94 patients with proven or suspected adrenal disease. This revealed that 36 patients suffered from primary aldosteronism, 33 from Cushing's syndrome, 8 from low renin hypertension, 6 from non-functioning adrenal tumor, 4 from simple obesity, 3 from adrenal metastases, 1 from congenital adrenal hyperplasia, 1 from virilizing adrenal adenoma, 1 from extraadrenal pheochromocytoma, 1 from ganglioneuroma. Surgical confirmation of the diagnosis was obtained in most cases. With a few exceptions, the scintigraphy results were consistent with the final diagnosis. The two tracers were equally effective adrenal scanning agents. Tracer concentration was measured in a number of surgical specimens, mostly from patients given selenocholesterol. This measurement in surgical samples has not been reported in previous studies with this agent. The results provided a direct validation of uptake measurements in vivo. The data, collected over a 17-year period, demonstrate that despite the advent of new imaging techniques, adrenal scintigraphy that gives both functional and morphologic information still has an important role in the diagnosis of adrenal disease. (orig.).

  12. Chemical composition and biological evaluation of Physalis peruviana root as hepato-renal protective agent. (United States)

    El-Gengaihi, Souad E; Hassan, Emad E; Hamed, Manal A; Zahran, Hanan G; Mohammed, Mona A


    This study was designed to investigate the potential of Physalis peruviana root as a functional food with hepato-renal protective effects against fibrosis. The chemical composition of the plant root suggested the presence of alkaloids, withanolides and flavonoids. Five compounds were isolated and their structures elucidated by different spectral analysis techniques. One compound was isolated from the roots: cuscohygrine. The biological evaluation was conducted on different animal groups; control rats, control treated with ethanolic root extract, CCl(4) group, CCl(4) treated with root extract, and CCl(4) treated with silymarin as a standard herbal drug. The evaluation used the oxidative stress markers malondialdehyde (MDA), superoxide dismutase (SOD), and nitric oxide (NO). The liver function indices; aspartate and alanine aminotransferases (AST & ALT), alkaline phosphatase (ALP), gamma glutamyl transferase (GGT), bilirubin, and total hepatic protein were also estimated. Kidney disorder biomarkers; creatinine, urea, and serum protein were also evaluated. The results suggested safe administration, and improvement of all the investigated parameters. The liver and kidney histopathological analysis confirmed the results. In conclusion, P. peruviana succeeded in protecting the liver and kidney against fibrosis. Further studies are needed to discern their pharmacological applications and clinical uses.

  13. Development of a Physiologically Based Computational Kidney Model to Describe the Renal Excretion of Hydrophilic Agents in Rats (United States)

    Niederalt, Christoph; Wendl, Thomas; Kuepfer, Lars; Claassen, Karina; Loosen, Roland; Willmann, Stefan; Lippert, Joerg; Schultze-Mosgau, Marcus; Winkler, Julia; Burghaus, Rolf; Bräutigam, Matthias; Pietsch, Hubertus; Lengsfeld, Philipp


    A physiologically based kidney model was developed to analyze the renal excretion and kidney exposure of hydrophilic agents, in particular contrast media, in rats. In order to study the influence of osmolality and viscosity changes, the model mechanistically represents urine concentration by water reabsorption in different segments of kidney tubules and viscosity dependent tubular fluid flow. The model was established using experimental data on the physiological steady state without administration of any contrast media or drugs. These data included the sodium and urea concentration gradient along the cortico-medullary axis, water reabsorption, urine flow, and sodium as well as urea urine concentrations for a normal hydration state. The model was evaluated by predicting the effects of mannitol and contrast media administration and comparing to experimental data on cortico-medullary concentration gradients, urine flow, urine viscosity, hydrostatic tubular pressures and single nephron glomerular filtration rate. Finally the model was used to analyze and compare typical examples of ionic and non-ionic monomeric as well as non-ionic dimeric contrast media with respect to their osmolality and viscosity. With the computational kidney model, urine flow depended mainly on osmolality, while osmolality and viscosity were important determinants for tubular hydrostatic pressure and kidney exposure. The low diuretic effect of dimeric contrast media in combination with their high intrinsic viscosity resulted in a high viscosity within the tubular fluid. In comparison to monomeric contrast media, this led to a higher increase in tubular pressure, to a reduction in glomerular filtration rate and tubular flow and to an increase in kidney exposure. The presented kidney model can be implemented into whole body physiologically based pharmacokinetic models and extended in order to simulate the renal excretion of lipophilic drugs which may also undergo active secretion and reabsorption

  14. Trauma renal Renal trauma

    Directory of Open Access Journals (Sweden)

    Gerson Alves Pereira Júnior


    Full Text Available Apresentamos uma revisão sobre trauma renal, com ênfase na avaliação radiológica, particularmente com o uso da tomografia computadorizada, que tem se tornado o exame de eleição, ao invés da urografia excretora e arteriografia. O sucesso no tratamento conservador dos pacientes com trauma renal depende de um acurado estadiamento da extensão da lesão, classificado de acordo com a Organ Injury Scaling do Colégio Americano de Cirurgiões. O tratamento conservador não-operatório é seguro e consiste de observação contínua, repouso no leito, hidratação endovenosa adequada e antibioti- coterapia profilática, evitando-se uma exploração cirúrgica desnecessária e possível perda renal. As indicações para exploração cirúrgica imediata são abdome agudo, rápida queda do hematócrito ou lesões associadas determinadas na avaliação radiológica. Quando indicada, a exploração renal após controle vascular prévio é segura, permitindo cuidadosa inspeção do rim e sua reconstrução com sucesso, reduzindo a probabilidade de nefrectomia.We present a revision of the renal trauma with emphasis in the radiographic evaluation, particularly CT scan that it has largely replaced the excretory urogram and arteriogram in the diagnostic worh-up and management of the patient with renal trauma. The successful management of renal injuries depends upon the accurate assessment of their extent in agreement with Organ Injury Scaling classification. The conservative therapy managed by careful continuous observation, bed rest, appropriate fluid ressuscitation and prophylactic antibiotic coverage after radiographic staging for severely injured kidneys can yield favorable results and save patients from unnecessary exploration and possible renal loss. The indications for immediate exploratory laparotomy were acute abdomen, rapidly dropping hematocrit or associated injuries as determinated from radiologic evaluation. When indicated, renal exploration

  15. A Software Engine to Justify the Conclusions of an Expert System for Detecting Renal Obstruction on 99mTc-MAG3 Scans (United States)

    Garcia, Ernest V.; Taylor, Andrew; Manatunga, Daya; Folks, Russell


    The purposes of this study were to describe and evaluate a software engine to justify the conclusions reached by a renal expert system (RENEX) for assessing patients with suspected renal obstruction and to obtain from this evaluation new knowledge that can be incorporated into RENEX to attempt to improve diagnostic performance. Methods RENEX consists of 60 heuristic rules extracted from the rules used by a domain expert to generate the knowledge base and a forward-chaining inference engine to determine obstruction. The justification engine keeps track of the sequence of the rules that are instantiated to reach a conclusion. The interpreter can then request justification by clicking on the specific conclusion. The justification process then reports the English translation of all concatenated rules instantiated to reach that conclusion. The justification engine was evaluated with a prospective group of 60 patients (117 kidneys). After reviewing the standard renal mercaptoacetyltriglycine (MAG3) scans obtained before and after the administration of furosemide, a masked expert determined whether each kidney was obstructed, whether the results were equivocal, or whether the kidney was not obstructed and identified and ranked the main variables associated with each interpretation. Two parameters were then tabulated: the frequency with which the main variables associated with obstruction by the expert were also justified by RENEX and the frequency with which the justification rules provided by RENEX were deemed to be correct by the expert. Only when RENEX and the domain expert agreed on the diagnosis (87 kidneys) were the results used to test the justification. Results RENEX agreed with 91% (184/203) of the rules supplied by the expert for justifying the diagnosis. RENEX provided 103 additional rules justifying the diagnosis; the expert agreed that 102 (99%) were correct, although the rules were considered to be of secondary importance. Conclusion We have described and

  16. 血供丰富的乏脂肪肾脏错构瘤与肾透明细胞癌的CT鉴别诊断%Differentiation of CT scan diagnosis between minimal fat renal angiomyolipoma with sufficient blood supply and clear cell renal carcinoma

    Institute of Scientific and Technical Information of China (English)

    Yan Guo; Qian Peng; Zhuo Wang; Mingjuan Liu; Xufeng Yang; Teng Long


    Objective: The aim of our study was to investigate the feature of minimal fat renal angiomyolipoma with sufficient blood supply using CT scans and improve the diagnosis accuracy required to differentiate it from clear cell renal carcinoma.Methods: Retrospective analysis of 24 cases of post-surgery confirmed angiomyolipoma with sufficient blood supply (total of 25 tumors) in our hospital that were used for a pathological comparison study. Results: Among the 24 patients diagnosed with angiomyolipoma, nobody had bloody urine. Of the 96 patients diagnosed with clear cell renal cancer, 14 had bloody urine (14.6%). In our studied group, the size of angiomyolipomas with sufficient blood supply was between 1.5 cm×2.0 cm to 8.0cm × 10.0 cm. During CT scan analysis, twenty tumors had similar density, and five of them had higher density. Only one tumor had a few dots of calcification (4%). Adipose tissue was not visible in 9 tumors, while 16 tumors had visible dots of adipose tissue, as visualized by CT scan. Intensive scanning indicated that all of the tumors showed a strong enhancement in the renal corticomedullary phase. Twenty tumors had significant heterogeneous enhancement in the early phase, while another set of five cases had homogenous prolonged enhancement. Nineteen patients had surgery to remove the angiomyolipomas, while six patients had single side kidney removal due to misdiagnosis for renal cancer in cases where the tumor severely compromised the renal parenchyma and sinus. All 25 cases were classified as renal angiomyolipoma by pathological analysis. Within the 96 cases of clear cell renal cancer, 64 tumors had relatively low density, 29 tumors had equal density, and 3 cases had relatively higher density. Fourteen of the tumors had calcification (14.6% ), and none of them had visualized adipose tissue.Enhanced CT scans indicated that 69 cases of renal cancer showed significant enhancement in the renal corticomedullary phase, which had the abnormal pattern of

  17. Sex-related Differences in Emergency Department Renal Colic Management: Females Have Fewer Computed Tomography Scans but Similar Outcomes. (United States)

    Innes, Grant D; Scheuermeyer, Frank X; Law, Michael R; McRae, Andrew D; Weber, Bryce A; Boyda, Heidi N; Lonergan, Kevin; Andruchow, James E


    Sex-related differences occur in many areas of medicine. Emergency department (ED) studies have suggested differences in access to care, diagnostic imaging use, pain management, and intervention. We investigated sex-based differences in the care and outcomes for ED patients with acute renal colic. This was a multicenter population-based retrospective observational cohort study using administrative data and supplemented by structured chart review. All patients seen in Calgary Health Region EDs between January 1 and December 31, 2014, with an ED diagnosis of renal colic based on the following ICD-10 codes were eligible for inclusion: calculus of kidney (N200), calculus of ureter (N201), calculus of kidney with calculus of ureter (N202), hydronephrosis with renal and ureteral calculous obstruction (N132), unspecified renal colic (N23), and unspecified urinary calculus (N209). ED visit data and test results were accessed in the regional ED clinical database. Stone characteristics were captured from diagnostic imaging reports. Regional hospital databases were used to identify subsequent ED encounters, hospital admissions, and surgical procedures within 60 days. Outcomes were stratified by sex. The primary outcome, intended as a marker of overall effectiveness of ED care, was the unscheduled 7-day ED revisit rate among patients who were discharged home after their index ED visit. Secondary outcomes included ED pain management as reflected by administration of narcotics or intravenous nonsteroidals, the performance of advanced imaging-either ultrasound (US) or computed tomography (CT), and the proportion of patients who required hospitalization or surgical intervention within 60 days. From January 1 to December 31, 2014, a total of 3,104 eligible patients were studied: 1,111 women (35.8%) and 1,993 men (64.2%). Baseline characteristics, access times, analgesic use, and admission rates were similar in both groups. Men were more likely to have CT (68.9% vs. 58

  18. Iodine-123 as a diagnostic imaging agent in differentiated thyroid carcinoma: a comparison with iodine-131 post-treatment scanning and serum thyroglobulin measurement

    Energy Technology Data Exchange (ETDEWEB)

    Urhan, Muammer; Dadparvar, Simin; Mavi, Ayse; Houseni, Mohamed; Chamroonrat, Wichana; Alavi, Abass [Department of Medicine University of Pennsylvania Medical Center, Division of Nuclear Medicine, Department of Radiology, Philadelphia, PA (United States); Mandel, Susan J. [Department of Medicine University of Pennsylvania Medical Center, Division of Endocrinology, Diabetes and Metabolism, Philadelphia, PA (United States)


    Using{sup 123}I for diagnostic purposes avoids the risk of stunning for subsequent radioiodine treatment and affords an excellent image quality. In this study we assessed the role of{sup 123}I in comparison with{sup 131}I post-treatment imaging in patients with thyroid cancer. We compared a total of 292{sup 123}I scans with their corresponding post-treatment{sup 131}I images. Patients received a therapeutic dose of{sup 131}I following diagnostic scanning with 50-111 MBq of{sup 123}I. All patients were in a hypothyroid state (>30 {mu}IU/l) before radioiodine administration for either diagnostic or therapeutic purposes. In 228 out of 263 patients with a positive diagnostic scan,{sup 123}I whole-body scan findings were concordant with those of corresponding post-treatment{sup 131}I images (concordance rate 87%). However, there were 44 additional foci of abnormal uptake on post-treatment{sup 131}I scans in 22 discordant cases with no impact on therapeutic management of the patients. In 13 patients, there was at least one new site on post-treatment images that had been missed on pretreatment{sup 123}I images. Twenty-nine patients with a negative diagnostic scan were treated with{sup 131}I owing to a high serum thyroglobulin level (range 11.3-480 ng/ml). Radioiodine uptake sites were seen in eight post-treatment scans. In 21 pairs of whole-body scans, both the pre- and the post-treatment scan were negative (concordance rate 72.4%). {sup 123}I scanning is comparable to high-dose{sup 131}I post-treatment imaging in thyroid carcinoma patients, and {sup 123}I offers excellent image quality as a diagnostic agent. It avoids disadvantages such as stunning before treatment and delivery of a high radiation dose to patients. (orig.)

  19. Evaluation of optimized magnetic resonance perfusion imaging scanning time window after contrast agent injection for differentiating benign and malignant breast lesions. (United States)

    Dong, Jie; Wang, Dawei; Ma, Zhenshen; Deng, Guodong; Wang, Lanhua; Zhang, Jiandong


    The aim of the study was evaluate the 3.0 T magnetic resonance (MR) perfusion imaging scanning time window following contrast injection for differentiating benign and malignant breast lesions and to determine the optimum scanning time window for increased scanner usage efficiency and reduced diagnostic adverse risk factors. A total of 52 women with breast abnormalities were selected for conventional MR imaging and T1 dynamic-enhanced imaging. Quantitative parameters [volume transfer constant (Ktrans), rate constant (Kep) and extravascular extracellular volume fraction (Ve)] were calculated at phases 10, 20, 30, 40 and 50, which represented time windows at 5, 10, 15, 20 and 25 min, respectively, following injection of contrast agent. The association of the parameters at different phases with benign and malignant tumor diagnosis was analyzed. MR perfusion imaging was verified as an effective modality in the diagnosis of breast malignancies and the best scanning time window was identified: i) Values of Ktrans and Kep at all phases were statistically significant in differentiating benign and malignant tumors (P0.05); ii) values of Ve in benign tumors increased with phase number, but achieved no obvious changes at different phases in malignant tumors; iii) the optimum scanning time window of breast perfusion imaging with 3.0 T MR was between phases 10 and 30 (i.e., between 5 and 15 min after contrast agent injection). The variation trend of Ve values at different phases may serve as a diagnostic reference for differentiating benign and malignant breast abnormalities. The most efficient scanning time window was indicated to be 5 min after contrast injection, based on the observation that the Ve value only had statistical significance in diagnosis at stage 10. However, the optimal scanning time window is from 5 to 15 min following the injection of contrast agent, since that the variation trend of Ve is able to serve as a diagnostic reference.

  20. The evaluation of dentinal tubule occlusion by desensitizing agents: a real-time measurement of dentinal fluid flow rate and scanning electron microscopy. (United States)

    Kim, S Y; Kim, E J; Kim, D S; Lee, I B


    The aims of this study were to examine changes in dentinal fluid flow (DFF) during the application of a desensitizing agent and to compare the permeability reduction levels among different types of desensitizing agents. A cervical cavity was prepared for the exposure of cervical dentin on an extracted human premolar connected to a subnanoliter fluid flow measuring device under 20 cm of water pressure. The cavity was acid-etched with 32% phosphoric acid to make dentin highly permeable. The different types of desensitizing agents that were applied on the cavity were Seal&Protect as the light-curing adhesive type, SuperSeal and BisBlock as oxalate types, Gluma Desensitizer as the protein-precipitation type, and Bi-Fluoride 12 as the fluoride type. DFF was measured from the time before the application of the desensitizing agent throughout the application procedure to five minutes after the application. The characteristics of dentinal tubule occlusion of each desensitizing agent were examined by scanning electron microscopy. The DFF rate after each desensitizing agent application was significantly reduced when compared to the initial DFF rate before application for all of the desensitizing agents (pFluoride 12 (pFluoride 12 (ptypes showed greater reduction in the DFF rate than did the protein-precipitation and fluoride types.

  1. Scanning electron microscopy, X-ray diffraction and thermal analysis study of the TiH{sub 2} foaming agent

    Energy Technology Data Exchange (ETDEWEB)

    Mandrino, Djordje, E-mail: [Institute of Metals and Technology, Lepi pot 11, 1000 Ljubljana (Slovenia); Paulin, Irena [Institute of Metals and Technology, Lepi pot 11, 1000 Ljubljana (Slovenia); Skapin, Sreco D. [Jozef Stefan Institute, Jamova 39, 1000 Ljubljana (Slovenia)


    The decomposition of commercially available TiH{sub 2} was investigated while performing different thermal treatments. TiH{sub 2} powder, which is widely used as a foaming agent, was heat treated at 450 Degree-Sign C for various times, from 15 min to 120 min. Scanning electron microscopy (SEM) images of the surfaces at different magnifications were obtained and interpreted. A Bragg-Brentano X-ray diffractometer was used to measure the X-ray diffraction (XRD) spectra on all five samples. A close examination of the diffraction spectra showed that for an as-received sample and samples undergoing the longest thermal treatment (1 and 2 h) these spectra can be explained as deriving from cubic TiH{sub 1.924}, while for the other two samples they can be explained as deriving from tetragonal TiH{sub 1.924}. A constant-unit-cell-volume phase transition between the cubic and tetragonal phases in TiH{sub 2-y}-type compounds had been described in the literature. The unit-cell parameters obtained from measured spectra confirm that within the measurement uncertainty the unit-cell volume is indeed constant in all five samples. Thermo-gravimetry (TG) and differential thermal analysis (DTA) measurements were performed on all the samples, showing that the intensity of the dehydrogenation depends on the previous treatment of the TiH{sub 2}. After the thermal analysis XRD of the samples was performed again and the material was found to exhibit a Ti-like unit cell, but slightly enlarged due to the unreleased hydrogen. - Highlights: Black-Right-Pointing-Pointer TiH{sub 2} samples were cubic or tetragonal TiH{sub 1.924} Black-Right-Pointing-Pointer Onset of the hydrogen release temperature increases with the pre-treatment time. Black-Right-Pointing-Pointer Thermal dehydrogenation for the as-prepared TiH{sub 2} is a three-step process. Black-Right-Pointing-Pointer After thermal analysis 2 residual hydrogen TiH{sub x} phases, close to {alpha}Ti, appeared.

  2. Multifunctional Mesoporous Silica Nanospheres with Cleavable Gd(III) Chelates as MRI Contrast Agents: Synthesis, Characterization, Target-Specificity, and Renal Clearance (United States)

    Vivero-Escoto, Juan L.; Taylor-Pashow, Kathryn M. L.; Huxford, Rachel C.; Rocca, Joseph Della; Okoruwa, Christie; An, Hongyu; Lin, Weili


    Mesoporous silica nanospheres (MSNs) are a promising material for magnetic resonance imaging (MRI) contrast agents. In this paper multifunctional MSNs with cleavable Gd(III) chelates are synthesized and characterized, and their applicability as MRI contrast agents is demonstrated both in vitro and in vivo. The MSNs contain Gd(III) chelates that are covalently linked via a redox-responsive disulfide moiety. The MSNs are further functionalized with polyethylene glycol (PEG) and an anisamide ligand to improve their biocompatibility and target specificity. The effectiveness of MSNs as an MRI imaging contrast agent and their targeting ability are successfully demonstrated in vitro using human colon adenocarcinoma and pancreatic cancer cells. Finally, the capability of this platform as an in vivo MRI contrast agent is tested using a 3T scanner. The Gd(III) chelate was quickly cleaved by the blood pool thiols and eliminated through the renal excretion pathway. Further tuning of the Gd(III) chelate release kinetics is needed before the MSN system can be used as target-specific MRI contrast agents in vivo. PMID:22069305

  3. The protective effect of thymoquinone, an anti-oxidant and anti--inflammatory agent, against renal injury: A review

    Directory of Open Access Journals (Sweden)

    Ragheb Ahmed


    Full Text Available Thymoquinone (TQ, 2-Isopropyl-5-methyl-1, 4-benzoquinone, is one of the most active ingredients of Nigella Sativa seeds. TQ has a variety of beneficial properties including anti-oxidative and anti-inflammatory activities. Studies have provided original observations on the role of oxidative stress and inflammation in the development of renal diseases such as glomerulo-nephritis and drug-induced nephrotoxicity. The renoprotective effects of TQ have been demons-trated in animal models. Also, TQ has been used successfully in treating allergic diseases in humans. The aim of this review is to highlight the importance of reactive oxygen species in renal pathophysiology and the intriguing possibility for a role of TQ in the prevention of and/or protection from renal injury in humans.

  4. Impact of Levovist ultrasonographic contrast agent on the diagnosis and management of hypertensive patients with suspected renal artery stenosis: a Canadian multicentre pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Lacourciere, Y.; Levesque, J. [Centre Hospitalier de l' Universite du Quebec (Canada); Centre Hospitalier de l' Universite Laval, Sainte-Foy, Quebec (Canada); Onrot, J.M. [St. Paul' s Hospital, Vancouver, British Columbia (Canada)] [and others


    To compare the diagnoses obtained with unenhanced ultrasonography (US), contrast-enhanced US and captopril-enhanced renal scintigraphy and to determine whether use of a contrast agent improves ability to assess the renal arteries with duplex Doppler US. The study was an open-label controlled trial involving 78 patients with hypertension suspected to have a renovascular cause. The patients underwent captopril-enhanced scintigraphy or routine unenhanced US (the usual diagnostic methods at the centres where the study was conducted) and contrast-enhanced US (with Levovist, Berlex Canada, Lachine, Que.). The patients were followed for 3 months after the diagnostic tests were performed. Enhanced US yielded a diagnosis for a significantly greater proportion of patients than did unenhanced US (77 [99%] v. 64 [82%] of 78 patients; p = 0.002) or captopril-enhanced scintigraphy (71 [99%] v. 58 [81%] of 72 patients; p = 0.002). Diagnosis was possible with both enhanced and unenhanced duplex Doppler US in only 64 (82%) of the 78 patients, and the diagnosis was the same with both methods for 63 (98%) of these 64 patients. In contrast, diagnosis was possible for only 58 (81%) of the 72 patients who underwent both enhanced US and captopril-enhanced scintigraphy; the same diagnosis was reported in 53 (91%) of these 58 cases. During followup, 11 patients (21 kidneys) underwent angiography. Significant stenosis was detected in 6 (55%) of the patients (8 [38%] of the kidneys). Both the enhanced and unenhanced US results agreed more often with angiography than did captopril-enhanced scintigraphy (9 [82%] v. 8 [73%] of the 11 patients). The proportion of patients in whom the left and right renal artery could be assessed by duplex Doppler US increased significantly (by 58% and 43%, respectively) with use of the contrast agent. Enhanced US had a higher rate of successful diagnosis than unenhanced US and captopril-enhanced renal scintigraphy. Enhanced US might therefore be suitable as a

  5. A genome-wide admixture scan identifies MYH9 as a candidate locus associated with non-diabetic end stage renal disease in African Americans (United States)

    Linda Kao, WH; Klag, Michael J; Meoni, Lucy A; Reich, David; Berthier-Schaad, Yvette; Li, Man; Coresh, Josef; Patterson, Nick; Tandon, Arti; Powe, Neil R; Fink, Nancy E; Sadler, John H; Weir, Matthew R; Abboud, Hanna E; Adler, Sharon; Divers, Jasmin; Iyengar, Sudha K; Freedman, Barry I; Kimmel, Paul L; Knowler, William C; Kohn, Orly F; Kramp, Kristopher; Leehey, David J; Nicholas, Susanne; Pahl, Madeleine; Schelling, Jeffrey R; Sedor, John R; Thornley-Brown, Denyse; Winkler, Cheryl A; Smith, Michael W.; Parekh, Rulan S.


    End stage renal disease (ESRD) has a four times higher incidence in African Americans compared to European Americans. This led to the hypothesis that susceptibility alleles for ESRD have a higher frequency in West African than European gene pool. We performed a genome-wide admixture scan in 1,372 ESRD cases and 806 controls and demonstrated a highly significant association between excess African ancestry and non-diabetic ESRD (LOD 5.70) but not diabetic ESRD (LOD 0.47) on chromosome 22q12. Each copy of the European ancestral allele conferred a relative risk of 0.50 (95% credible interval 0.39 – 0.63) compared to African ancestry. Multiple common SNPs (allele frequency ranging from 0.2 to 0.6) in the gene that encodes non-muscle myosin heavy chain type II isoform A (MYH9) were associated with 2-4 times greater risk of non-diabetic ESRD and accounted for a large proportion of the excess risk of ESRD observed in African compared to European Americans. PMID:18794854

  6. Diagnostic value of tri-phase dynamic enhancement scan with CT for acute renal infarction%CT三期动态增强扫描对急性肾梗死的诊断价值

    Institute of Scientific and Technical Information of China (English)

    禹智波; 张云泉; 宋凌恒; 乔清; 李福锁; 黄敏; 胡文友; 李锦青


    Objective To investigate the imaging characteristics and diagnostic value of tri-phase dynamic enhancement scan with CT for acute renal infarction. Methods The image features of CT plain scan and tri-phase dynamic enhancement scan of 10 patients (19 sides) with acute renal infarction were retrospectively analyzed, and the CTA expression of 6 patients were observed. Results Fourteen acute renal infarction lesions of 10 cases were diagnosed. The CT scan showed there were 4 cases with enlargement of kidney, and the other 6 cases were of no abnormality. The tri-phase enhancement CT scan showed there were 6 cases of unilateral renal infarction and 4 cases of bilateral renal infarction, which totally involving 14 sides. The acute renal infarction lesions lacked of high density region in the corticomedullary in cortical phase, and there were wedge-shaped hypodense area, even low density of full kidney in parenchymal phase and pyelographic phase. The a-cute renal infarction lesions were revealed better in parenchymal phase and pyelographic phase than in cortical phase. Six cases of CTA re-vealed the responsible vessels of renal infarction lesions and the other vascular diseases. Conclusion CT tri-phase dynamic enhancement scan has important value in the diagnosis of acute renal infarction, and CTA can identify the responsible vessels of renal infarction lesions.%目的:探讨急性肾梗死CT三期动态增强扫描影像学特点及临床意义。方法回顾性分析10例临床影像确诊急性肾梗死患者19侧肾脏CT平扫、三期动态增强表现及6例CTA( CT血管造影术)表现。结果10例患者14侧肾脏发生急性肾梗死。 CT平扫:4例肾脏影增大,6例双侧肾脏CT平扫未见异常。 CT三期动态增强扫描:单侧肾梗死6例、双侧肾梗死4例,共累及14侧肾脏;肾梗死灶在皮质期呈为高密度皮质环中断,在实质期及肾盂期呈楔形无强化低密度影,或全肾无强化低密度影,以实质期和肾盂

  7. Frequent development of inflammatory lesions and lymphoid foci in the kidneys of Japanese wild crows (Corvus macrorhynchos and Corvus corone) as a result of the entry of causal agents via the renal portal blood. (United States)

    Hirata, Akihiro; Yonemaru, Kayoko; Kubo, Masahito; Murakami, Mami; Sakai, Hiroki; Yanai, Tokuma; Masegi, Toshiaki


    Although the increase in the number of wild crows is causing social problems in urban areas, crows play an increasingly important role in monitoring serious infectious diseases, such as highly pathogenic avian influenza and West Nile fever. To gain a better understanding of normal conditions and common disorders in crows, we conducted a retrospective study of wild crows captured in central Japan in the 1990s and examined the necropsy findings from 166 jungle crows (Corvus macrorhynchos) and 74 carrion crows (Corvus corone). We found frequent development of lymphoid foci and inflammatory lesions in the kidneys of both species of crows. These findings were unrelated to place or date of capture, indicating the universality of renal lesion developments in the Corvus species. In the kidneys, suppurative granulomas were concentrated in the renal cortex and the vein wall, indicating the haematoegenous spread of causal agents. However, the glomeruli remained intact, unlike the spreading of causal agents via arterial blood, which strongly suggested the renal portal blood as a possible entry route of causal agents. The renal lymphoid foci showed the same distribution as the granulomas, supporting the possibility of external agents entering through renal portal blood. We also identified types of parasites in Japanese wild crows by means of histopathological analysis. We hope that our data will contribute to the appropriate evaluation and a better understanding of pathological conditions in Japanese wild crows.

  8. Morphological Effect of the New Antifungal Agent ME1111 on Hyphal Growth of Trichophyton mentagrophytes, Determined by Scanning and Transmission Electron Microscopy. (United States)

    Nishiyama, Yayoi; Takahata, Sho; Abe, Shigeru


    The effects of ME1111, a novel antifungal agent, on the hyphal morphology and ultrastructure of Trichophyton mentagrophytes were investigated by using scanning and transmission electron microscopy. Structural changes, such as pit formation and/or depression of the cell surface, and degeneration of intracellular organelles and plasmolysis were observed after treatment with ME1111. Our results suggest that the inhibition of energy production by ME1111 affects the integrity and function of cellular membranes, leading to fungal cell death. Copyright © 2016 American Society for Microbiology.

  9. Economic impact of an ultrasonographic contrast agent on the diagnosis and initial management of patients with suspected renal artery stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Levesque, J.; Lacourciere, Y. [Centre Hospitalier de l' Universite du Quebec (Canada); Centre Hospitalier de l' Universite Laval, Sainte-Foy, Quebec (Canada); Onrot, J.M. [St. Paul' s Hospital, Vancouver, British Columbia (Canada)] [and others


    To determine resource use in the diagnosis and management of Canadian hypertensive patients with suspected renal artery stenosis and to estimate the impact of diagnosis with contrast-enhanced duplex Doppler ultrasonography (US) on resource use. Seventy-eight patients with suspected renal artery stenosis underwent usual diagnostic tests (captopril-enhanced renal scintigraphy or duplex Doppler US) and contrast-enhanced US. A management pathway ('planned') describing the medical resources required for further patient care was outlined on the basis of results from each test (separately), and a modified management pathway ('recommended'), which considered data from both diagnostic methods, was also outlined. Medical resources and productivity losses were assessed prospectively for a 3-month period after patients underwent both tests ('actual' management pathway). With usual diagnostic methods, 14 (18%) of the tests were inconclusive, whereas only 1 (1%) of the enhanced US examinations was inconclusive; the cost-efficacy ratio was $422 and $343 per successful diagnosis, respectively. Further management costs for patients with an inconclusive diagnosis were estimated at $6370 after the usual diagnostic tests, but only $1278 with enhanced US. Although the costs of the planned and recommended management pathways were similar ($227 and $294 per patient respectively), the proportion of patients requiring further resources was lower with enhanced US (56% v. 46%). Three-month actual management costs ranged from $121 to $1605 per patient (mean $360). Diagnostic tests and surgical procedures were the major cost drivers in all pathways, and costs wore highest for patients in whom stenosis was diagnosed. For patients with suspected renal artery stenosis, contrast-enhanced US had a higher diagnostic success rate than usual diagnostic methods and afforded savings through lower administrative costs and lower medical resource consumption for patients whose

  10. Scanning Electron Microscopy Investigations of Third-Instar Larva of Cordylobia rodhaini (Diptera: Calliphoridae), an Agent of Furuncular Myiasis. (United States)

    Pezzi, M; Cultrera, R; Chicca, M; Leis, M


    A scanning electron microscopy study of the third larval instar of Cordylobia rodhaini Gedoelst (Diptera: Calliphoridae), causing obligatory furuncular myiasis, is presented here for the first time. The larvae were collected from a patient exposed to them in the tropical rainforest of Kibale National Park (Uganda). Distinctive features are described in sequence from the anterior region to the posterior region, highlighting the morphological features of antennae, maxillary palps, structures related to mouth opening, sensory structures, thoracic and abdominal spines, and anterior and posterior spiracles. The results are compared with those of other Calyptrata flies, mainly from the family Calliphoridae and, when possible, with Cordylobia anthropophaga Blanchard (Diptera: Calliphoridae), the only other species of genus Cordylobia investigated by scanning electron microscopy.

  11. 64-MDCT imaging of the coronary arteries and systemic arterial vascular tree in a single examination: optimisation of the scan protocol and contrast-agent administration. (United States)

    Napoli, A; Anzidei, M; Francone, M; Cavallo Marincola, B; Carbone, I; Geiger, D; Zaccagna, F; Di Paolo, P L; Zini, C; Catalano, C; Passariello, R


    The aim of this study was to validate a 64-row multidetector computed tomography (64-MDCT) acquisition protocol with biphasic administration of contrast medium for comprehensive assessment of the coronary and systemic arterial tree in a single examination. The scanning protocol comprised two acquisitions: an electrocardiograph (ECG)-gated scan at the level of the heart, followed by a total-body, low-dose scan of the systemic arterial circulation. Twenty patients were evaluated using two different strategies for contrast administration. In ten patients, the delay between the two acquisitions was set at 40 s, whereas in the remaining patients, it varied between 45 s and 65 s. For both strategies, the degree of systemic arterial opacification and the attenuation gradient between arterial and venous structures were quantitatively assessed at six extracoronary locations. Two observers evaluated in consensus the presence or absence of atherosclerosis and the degree of stenosis of arterial segments. Three hundred coronary segments were analysed. Arterial-wall changes were depicted in 155 (51%) segments, and in 35 (23%), the degree of stenosis was > 50%. Of the 640 extracoronary arterial segments, 250 (39%) presented atherosclerotic wall alterations, in 50 (20%), the degree of stenosis was > 50% and five were affected by aneurysmal dilatation. The magnitude of arterial opacification values and attenuation gradients between arterial and venous structures were significantly higher in patients scanned with the 40-s fixed-delay strategy. Whole-body CT angiography with biphasic administration of contrast agent and fixed scan delay has been shown to be a feasible and reproducible technique. Comprehensive data on the global atherosclerotic burden potentially offer important therapeutic options for subclinical, high-risk segments.

  12. Agentes calciomiméticos en el tratamiento del hiperparatiroidismo secundario a la insuficiencia renal crónica Calcimimetic agents in the treatment of hyperparathyroidism secondary to chronic renal failure

    Directory of Open Access Journals (Sweden)

    A. L. Negri


    Full Text Available La reciente identificación y clonación del receptor sensor de calcio (RSCa ha permitido tener una mejor comprensión de la regulación normal del metabolismo del calcio y entender un número de trastornos relativamente poco frecuentes del metabolismo mineral. En la glándula paratiroides el RSCa es el mecanismo responsable de modular la liberación de la hormona paratiroidea en función del nivel de calcio extracelular. Este descubrimiento también ha permitido desarrollar drogas que imitan o potencian las acciones del calcio extracelular sobre el RSCa (llamadas calciomiméticos que disminuyen la secreción de paratohormona sin incrementar el calcio sérico. Los calciomiméticos de última generación son pequeñas moléculas orgánicas que actúan como moduladores alostéricos del RSCa y se encuentran en su fase inicial de desarrollo clínico. A pesar de que la experiencia obtenida con estas drogas hasta ahora es limitada, ellas han mostrado ser efectivas para reducir los niveles de paratohormona en pacientes con hiperparatiroidismo secundario a fallo renal terminal sin inducir efectos secundarios de importancia. Es por ello que los compuestos calciomiméticos tienen un considerable potencial como nuevas drogas para el tratamiento del hiperparatiroidismo secundario y de la enfermedad ósea secundaria a la insuficiencia renal.The recent discovery and cloning of the extra cellular calcium sensing receptor (CaSR has allowed a better understanding of the regulation of normal calcium metabolism and of rare disturbances in mineral metabolism. In the parathyroid glands the CaSR is responsable for modulating parathyroid hormone release as a function of the extra cellular calcium level. This discovery has allowed the development of drugs that mimics or potentiates the actions of extra cellular calcium on the CaSR, called calcimimetics that decrease parathyroid hormone secretion without increasing serum calcium. The new calcimimetics are small organic

  13. Combination use of medicines from two classes of renin–angiotensin system blocking agents: risk of hyperkalemia, hypotension, and impaired renal function (United States)

    Esteras, Raquel; Perez-Gomez, Maria Vanessa; Rodriguez-Osorio, Laura; Ortiz, Alberto


    European and United States regulatory agencies recently issued warnings against the use of dual renin–angiotensin system (RAS) blockade therapy through the combined use of angiotensin-converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers (ARBs) or aliskiren in any patient, based on absence of benefit for most patients and increased risk of hyperkalemia, hypotension, and renal failure. Special emphasis was made not to use these combinations in patients with diabetic nephropathy. The door was left open to therapy individualization, especially for patients with heart failure, when the combined use of an ARB and ACEI is considered absolutely essential, although renal function, electrolytes and blood pressure should be closely monitored. Mineralocorticoid receptor antagonists were not affected by this warning despite increased risk of hyperkalemia. We now critically review the risks associated with dual RAS blockade and answer the following questions: What safety issues are associated with dual RAS blockade? Can the safety record of dual RAS blockade be improved? Is it worth trying to improve the safety record of dual RAS blockade based on the potential benefits of the combination? Is dual RAS blockade dead? What is the role of mineralocorticoid antagonists in combination with other RAS blocking agents: RAAS blockade? PMID:26301070

  14. Combination use of medicines from two classes of renin-angiotensin system blocking agents: risk of hyperkalemia, hypotension, and impaired renal function. (United States)

    Esteras, Raquel; Perez-Gomez, Maria Vanessa; Rodriguez-Osorio, Laura; Ortiz, Alberto; Fernandez-Fernandez, Beatriz


    European and United States regulatory agencies recently issued warnings against the use of dual renin-angiotensin system (RAS) blockade therapy through the combined use of angiotensin-converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers (ARBs) or aliskiren in any patient, based on absence of benefit for most patients and increased risk of hyperkalemia, hypotension, and renal failure. Special emphasis was made not to use these combinations in patients with diabetic nephropathy. The door was left open to therapy individualization, especially for patients with heart failure, when the combined use of an ARB and ACEI is considered absolutely essential, although renal function, electrolytes and blood pressure should be closely monitored. Mineralocorticoid receptor antagonists were not affected by this warning despite increased risk of hyperkalemia. We now critically review the risks associated with dual RAS blockade and answer the following questions: What safety issues are associated with dual RAS blockade? Can the safety record of dual RAS blockade be improved? Is it worth trying to improve the safety record of dual RAS blockade based on the potential benefits of the combination? Is dual RAS blockade dead? What is the role of mineralocorticoid antagonists in combination with other RAS blocking agents: RAAS blockade?

  15. High prevalence of nephrogenic systemic fibrosis in chronic renal failure patients exposed to gadodiamide, a gadolinium-containing magnetic resonance contrast agent

    DEFF Research Database (Denmark)

    Rydahl, Casper; Thomsen, Henrik S; Marckmann, Peter


    OBJECTIVE: Nephrogenic systemic fibrosis (NSF) is a serious disease affecting renal failure patients. It may be caused by some gadolinium (Gd)-containing contrast agents, including gadodiamide. The study aimed at estimating the prevalence of NSF after gadodiamide exposure for patients with chronic...... kidney disease (CKD). MATERIALS AND METHODS: Retrospective cohort study of 190 consecutive nephrological patients in different categories of kidney function referred for gadodiamide-enhanced magnetic resonance imaging in the period January 1, 2004 to March 21, 2006. RESULTS: Eighteen patients (18/190; 10......%, 95% CI: 6%-15%) were diagnosed with NSF within a mean follow-up period of 29 months (range 16-43 months). All 18 cases had stage 5 CKD (ie, estimated glomerular filtration rate less than 15 mL/min/1.73 m2 or in dialysis therapy) at the time of their gadodiamide exposure. The prevalence of NSF among...

  16. Diagnostic significance of gas distension technique of the stomach with gas-forming agent on CT scan of stomach cancer

    Energy Technology Data Exchange (ETDEWEB)

    Rho, Tae Jin; Song, Chang June; Choi, Joong Chan; Park, Cheong Hee; Cho, June Sik; Rhee, Byung Chull [Chungnam National University College of Medicine, Dajeon (Korea, Republic of)


    CT is a valuable method for preoperative staging of patients with stomach cancers. However, in patients with poor distension of the stomach and scanty fat between the stomach and adjacent organs, CT findings may indicate a false impression of gastric wall thickening and cannot provide the precise extent of stomach cancer. We studied the usefulness of gastric distension by gas-forming agent in 28 cases of pathologically confirmed gastric cancers on CT. Comparative analysis between CT findings and surgical pathologic findings was done in 22 cases who underwent surgery. The results were as follows; 1. Conventional CT failed to define the wall thickening or masses of the stomach, in 14 cases of 23 advanced gastric cancers, while CT with gas distension technique allowed good visualization in all advanced gastric cancers. 2. In 2 cases of 5 early gastric cancers, CT with gas distension technique could detect focal thickening of the gastric wall, even less than 1cm thickness. 3. Among 13 cases with indistinguishable border between stomach and liver on conventional CT, 7 cases were diagnosed as negative invasion on CT with gas distension technique and 5 cases of these were confirmed by surgery. 4. Among 11 cases with indistinguishable border between stomach and pancreas on conventional CT, 3 cases were diagnosed as negative invasion on CT with gas distension technique, all of which were confirmed by surgery. 5. There was no significant difference between conventional CT and CT with gas distension technique of the stomach to diagnose invasion into transverse colon, transverse colon, transverse mesocolon, lymph node metastasis, and various distant metastasis.

  17. Angio-embolization of a renal pseudoaneurysm complicating a percutaneous renal biopsy: a case report. (United States)

    Rafik, Hicham; Azizi, Mounia; El Kabbaj, Driss; Benyahia, Mohammed


    We report the treatment of a bleeding renal pseudoaneurysm by angio-embolization. A 21 years old woman developed macroscopic haematuria following renal biopsy. Renal angio-scan showed a 1.4 cm renal pseudoaneurysm in the left kidney. The presence of pseudoaneurysm was confirmed by selective renal angiography. Successful embolization was performed using gelatine sponge particles.

  18. Recent advances in the management of renal cell carcinoma-a ...

    African Journals Online (AJOL)


    May 16, 2017 ... Renal cell carcinoma (RCC) is a rare cancer in developing countries like Nigeria. However, with an ..... metabolic panel, urinalysis, abdominopelvic CT scan or abdominopelvic .... FDA) has approved seven targeted therapeutic agents for treatment of .... High serum lactate dehydrogenase (LDH) level (>1.5.

  19. Evaluation of glycerol as an osmotic agent for continuous ambulatory peritoneal dialysis in end-stage renal failure. (United States)

    Heaton, A; Ward, M K; Johnston, D G; Alberti, K G; Kerr, D N


    Six patients established on continuous ambulatory peritoneal dialysis entered a trial of treatment with dialysis fluid containing glycerol instead of glucose as the osmotic agent in an attempt to decrease the energy load. They were observed for a further 6 months after reconversion to glucose-based dialysis. During the 6 month control period fluid balance was achieved mainly with a solution containing 76 mmol of glucose/1. Fluid balance was maintained during the 6 month period of treatment with glycerol only by the increased use of solutions containing a high concentration of glycerol (152 mmol/l and 272 mmol/l). Thus the energy value of the absorbed osmotic agent did not differ at a mean of 1607 kJ (384 kcal)/day using glycerol and 1669 kJ (399 kcal)/day using glucose as the osmotic agent. In five subjects, fasting and peak blood glycerol levels did not change over the 6 months, but one subject, who accumulated glycerol, developed symptoms of hyperosmolality after 2 months and glycerol therapy was discontinued. In a further subject glycerol-based dialysis was terminated at 3 months when increasing angina was reported. Mean fasting plasma triglyceride concentrations were 50% higher during the 6 months on glycerol (3.12 +/- 1.12 mmol/l) than on glucose (2.19 +/- 0.97 mmol/l) (P less than 0.05). There was a small rise in very low density lipoprotein-cholesterol concentrations with glycerol dialysis but total cholesterol levels were unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)

  20. Detection of pyelonephritis and renal scars by 99 Tcm-DMSA renal scan: an experimental study in piglets%99Tcm-DMSA肾显像诊断肾盂肾炎和 肾脏瘢痕的动物模型实验研究

    Institute of Scientific and Technical Information of China (English)


    目的 制作猪肾盂肾炎和肾脏瘢痕动物模型,评价99Tcm-二巯基丁二酸(DMSA)肾脏平面显像和SPECT断层显像诊断肾盂肾炎和肾脏瘢痕的灵敏度和特异性,并探讨SPECT的诊断价值。方法 中国实验动物小型猪13只,先制成膀胱输尿管返流动物模型,然后引入大肠埃稀杆菌导致上尿路感染,感染前后用ADAC Vertex型双探头SPECT仪,配低能高分辨率准直器进行肾脏前后位平面和断层显像,将显像结果同组织病理学检查进行对比研究。结果 平面显像诊断肾盂肾炎和肾脏瘢痕的灵敏度为71.2%,特异性为100%,准确性为87.5%;平面加断层显像诊断肾盂肾炎和肾脏瘢痕的灵敏度为78.3%,特异性为100%,准确性为90.5%。以病理检查为标准,平面显像和平面加断层显像对病灶的检出率差异无显著性。结论 99Tcm-DMSA肾脏显像是诊断肾盂肾炎和肾脏瘢痕的灵敏可靠方法。平面加断层显像可能有助于提高检测的灵敏度,并对病变范围作更准确的估价。%Objective To provide an accurate and scientific method of radionuclide imaging for the clinical application and to study the value of SPECT imaging in detection and localization of the lesions in diagnosing pyelonephritis and renal scars in children, we evaluated the sensitivitiy and specificity of planar and planar+SPECT imaging with 99 Tcm-DMSA renal scan in diagnosing the pyelonephritis and renal scars in an experimental piglet model of pyelonephritis and renal scars established in this hospital. Methods We surgically created vesicoureteral reflux (VUR) in 13 female Chinese piglets, then we introduced Escherichia coli broth culture into the bladder of those presenting VUR two weeks later. 99 Tcm-DMSA renal scan (planar and SPECT) was performed before and after introducing infection by VETEX dual-headed SPECT, then the animal and compared the images with histopathological findings were sacrificed. At last, there were

  1. Correlation of the CT values of abdominal aorta,renal artery and renal cortex with its thickness on 64-MDCT contrast en-hanced images

    Institute of Scientific and Technical Information of China (English)

    Alomary Mahfooz-Naef; Vikash; Wang Qiu-xia; Zhang Jin-hua; Hu Dao-yu


    Objective:To investigate the correlation of abdominal aorta CT value,renal artery CT value and renal cor-tex thickness with renal cortex CT value on contrast enhanced 64-slice CT images.Methods:96 patients (50 men and 46 women;16~74 years)with normal kidney function,which was confirmed by kidney function test were enrolled in this stud-y,including bilateral kidneys of 92 cases and unilateral kidney of 4 cases (total of 188 kidneys;92 left,96 right).After intra-venous (IV)injection of contrast agent the kidneys of the selected patients were scanned by MDCT.The scans were per-formed in arterial,venous and 3min delayed phases.All statistical analyses were performed by using IBM SPSS 20.0.Graphs were generated using Graph Pad Prism 5 software.Quantitative data were presented as mean ± standard deviation,while qualitative data were presented as frequency (%).P<0.05 was considered to be statistically significant.Results:The mean renal cortex thickness was (5.19±0.81)mm in all kidneys.In the arterial phase,a statistically significant positive correla-tion between renal cortex CT values and abdominal aortic CT values was showed (r= 0.584;P<0.001).A statistically sig-nificant positive correlation between renal cortex CT values and renal cortex thickness was demonstrated (r= 0.533,P<0.0001).Likewise,there was a positive correlation between renal cortex CT value and renal artery CT values (r= 0.43,P<0.001).Conclusion:It is a promising approach to assess the individual kidney function by measuring abdominal aorta CT value,renal artery CT value,renal cortex CT value and renal cortex thickness using contrast MDCT.

  2. What role do combinations of interferon and targeted agents play in the first-line therapy of metastatic renal cell carcinoma? (United States)

    Bukowski, Ronald M


    Interferons (IFNs) are a class of cytokines with pleotropic actions that regulate a variety of cellular activities. Clinical trials with recombinant IFNs (IFN-alpha2a and IFN-alpha2b) have demonstrated clinical activity in patients with advanced renal cell carcinoma (RCC). Their efficacy is characterized by a low overall tumor regression rate of < 15%, progression-free survival of 4-5 months, and overall median survival of 10-18 months. This cytokine became the standard of care for patients with metastatic RCC and was then used as the comparator arm in a series of phase II and III clinical trials that have defined a new treatment paradigm for patients with advanced RCC. This paradigm uses the tyrosine kinase inhibitors (TKIs) sorafenib and sunitinib, the mammalian target of rapamycin (mTOR) inhibitor temsirolimus, and the vascular endothelial growth factor monoclonal antibody bevacizumab. These 3 categories of agents were then investigated in combination with IFN-alpha in a series of preclinical and clinical studies. The collective data from these reports suggest the combination of IFN-alpha and bevacizumab is active and has a role in RCC therapy, whereas combinations with the TKIs or mTOR inhibitors have limited efficacy and/or excessive toxicity. The clinical and preclinical studies leading to these conclusions are reviewed herein.

  3. The use of Haemostatic Agents does not impact the rate of hemorrhagic complications in patients undergoing partial nephrectomy for renal masses. (United States)

    Abu-Ghanem, Yasmin; Dotan, Zohar; Kaver, Issac; Zilberman, Dorit E; Ramon, Jacob


    Hemostatic agents(HAs) have gained increasing popularity as interventions to improve perioperative haemostasis and diminish the need for allogeneic red cell transfusion(PBT) despite a paucity of data supporting the practice. The aim of the current study is to examine the efficacy of HAs in reducing the rate of hemorrhagic complications during partial nephrectomy(PN). Data on 657 patients, who underwent elective PN between 2004-2013, were analyzed. The impact of HAs and SURGICEL was evaluated by comparing four sequential groups of patients: Group1 = Sutures alone, Group2 = sutures and HA, Group3 = sutures and SURGICEL, Group4 = both HA and SURGICEL. Complications included post-operative urinary leak(UL), PBT rate, delayed bleeding and post-operative renal failure. Results showed that the use of HAs did not engender a statistically significant difference in overall complications rate. Specifically, the addition of HAs did not reduce the rate of PBT, delayed bleeding or UL. Further analysis revealed that patients who received SURGICEL had significantly higher PBT rate and higher prevalence of UL cases. Addition of HAs to SURGICEL had no effect on the rate of these complications. In the current study, the use of HAs during open and laparoscopic PN did not reduce the rate of negative outcomes. Adequate suture renorrhaphy may be sufficient to prevent hemorrhagic complications.

  4. Mechanistic investigation of the interaction between bisquaternary antimicrobial agents and phospholipids by liquid secondary ion mass spectrometry and differential scanning calorimetry. (United States)

    Pashynskaya, V A; Kosevich, M V; Gömöry, A; Vashchenko, O V; Lisetski, L N


    Mechanisms of interaction between the antimicrobial drugs decamethoxinum and aethonium, which are based on bisquaternary ammonium compounds, and a phospholipid component of biological membranes, dipalmitoylphosphatidylcholine, were studied by means of liquid secondary ion mass spectrometry (LSIMS) and differential scanning calorimetry (DSC). Supramolecular complexes of the drugs with this phospholipid were recorded under secondary ion mass spectrometric conditions. The dependence of the structures of these complexes on structural parameters of the dications of the bisquaternary ammonium compounds was demonstrated. Tandem mass spectrometric investigations of the metastable decay of doubly charged ions of decamethoxinum and aethonium complexes with dipalmitoylphosphatidylcholine allowed estimation of structural parameters of these complexes in the gas phase. Interactions of decamethoxinum and aethonium with model membrane assemblies built from hydrated dipalmitoylphosphatidylcholine were studied using DSC. It was shown that while both drugs can interact with model membranes, the mechanisms of such interactions for decamethoxinum and aethonium differ. The correlation between the nature of these interactions and structural and electronic parameters of the dications of the two bisquaternary agents is discussed. Interpretation of combined mass spectrometric and calorimetric experimental data led to proposals that the molecular mechanisms of antimicrobial action of bisquaternary ammonium compounds are related to their effect on the membrane phospholipid components of microbial cells.

  5. Renal tubule cell repair following acute renal injury. (United States)

    Humes, H D; Lake, E W; Liu, S


    Experimental data suggests the recovery of renal function after ischemic or nephrotoxic acute renal failure is due to a replicative repair process dependent upon predominantly paracrine release of growth factors. These growth factors promote renal proximal tubule cell proliferation and a differentiation phase dependent on the interaction between tubule cells and basement membrane. These insights identify the molecular basis of renal repair and ischemic and nephrotoxic acute renal failure, and may lead to potential therapeutic modalities that accelerate renal repair and lessen the morbidity and mortality associated with these renal disease processes. In this regard, there is a prominent vasoconstrictor response of the renal vasculature during the postischemic period of developing acute renal failure. The intravenous administration of pharmacologic doses of atrial natriuretic factor (ANF) in the postischemic period have proven efficacious by altering renal vascular resistance, so that renal blood flow and glomerular filtration rate improve. ANF also appears to protect renal tubular epithelial integrity and holds significant promise as a therapeutic agent in acute renal failure. Of equal or greater promise are the therapeutic interventions targeting the proliferative reparative zone during the postischemic period. The exogenous administration of epidermal growth factor or insulin-like growth factor-1 in the postischemic period have effectively decreased the degree of renal insufficiency as measured by the peak serum creatinine and has hastened renal recovery as measured by the duration of time required to return the baseline serum creatinine values. A similarly efficacious role for hepatocyte growth factor has also been recently demonstrated.

  6. [Uricosuric agent]. (United States)

    Ohno, Iwao


    Urate lowering treatment is indicated in patients with recurrent acute attacks, tophi, gouty arthropathy, radiographic changes of gout, multiple joint involvement, or associated uric acid nephrolithiasis. Uricosuric agents like benzbromarone and probenecid are very useful to treat hyperuricemia as well as allopurinol (xanthine oxidase inhibitor). Uricosuric agents act the urate lowering effect through blocking the URAT1, an urate transporter, in brush border of renal proximal tubular cells. In order to avoid the nephrotoxicity and urolithiasis due to increasing of urinary urate excretion by using uricosuric agents, the proper urinary tract management (enough urine volume and correction of aciduria) should be performed.

  7. Primary renal hydatidosis

    Directory of Open Access Journals (Sweden)

    Johnsy Merla Joel


    Full Text Available Echinococcosis or hydatidosis caused by the tapeworm, Echinococcus granulosus, has the highest prevalence in endemic regions and sheep farming areas. The most common organ involved is the liver (50–75% followed by the lungs (15–20% and other organs (10–20%. Primary involvement of the kidney without the involvement of the liver and lungs, i.e., isolated renal hydatid disease is extremely rare even in endemic areas. The incidence of renal echinococcosis is 2–4%. Renal hydatid cysts usually remain asymptomatic for many years and are multiloculated. A 63-year-old male presented with left loin pain. Computed tomography scan abdomen revealed a presumptive diagnosis of renal hydatid disease. The nephrectomy specimen received in histopathology confirmed the diagnosis. We describe a rare case of primary renal hydatidosis.

  8. The Korean Clinical Research Center for End-Stage Renal Disease Study Validates the Association of Hemoglobin and Erythropoiesis-Stimulating Agent Dose with Mortality in Hemodialysis Patients.

    Directory of Open Access Journals (Sweden)

    Owen Kwon

    Full Text Available Anemia is an important risk factor for mortality in hemodialysis (HD patients. However, higher hemoglobin (Hb is not necessarily better, as seen in several studies. This study aimed to validate the clinical use of an Hb target of 10-11 g/dL in Korean HD patients.A total of 1,276 HD patients from the Clinical Research Center (CRC for End-Stage Renal Disease (ESRD were investigated in a prospective observational study. Cox proportional hazard analysis was conducted for each category of time-dependent Hb level and erythropoiesis-stimulating agent (ESA dose, with subgroup analysis stratified by age and diabetes status.Using a reference Hb level of 10-11 g/dL, the hazard ratios (HRs of death were 5.12 (95% confidence interval [CI], 2.62-10.02, P <0.05 for Hb level <9.0 g/dL, and 2.03 (CI, 1.16-3.69, P <0.05 for Hb level 9.0-10.0 g/dL, after adjustment for multiple clinical variables. However, an Hb level ≥11 g/dL was not associated with decreased mortality risk. In an adjusted model categorized by Hb and ESA dose, the risk of death at an Hb level <10 g/dL and a higher dose of ESA (≥126 U/kg/week had an HR of 2.25 (CI, 1.03-4.92, P <0.05, as compared to Hb level 10-11 g/dL and a lower dose of ESA. In subgroup analysis, those older than 65 years or who were diabetic had greater risk for mortality only in Hb category <9.0 g/dL. However, there was no significant interaction between age or diabetes status and Hb.Using CRC-ESRD data, we validated the association between Hb and ESA dose and mortality in Korean HD patients. The clinical practice target of an Hb of 10-11 g/dL before the new KDIGO guideline era seems reasonable considering its survival benefit in HD patients.

  9. Lactulose and renal failure. (United States)

    Vogt, B; Frey, F J


    The introduction of lactulose as a new therapeutic agent for treatment of hepatic encephalopathy was a major breakthrough in this field. It was hypothesized that lactulose might prevent postoperative renal impairment after biliary surgery in patients with obstructive jaundice. The presumable mechanism purported was the diminished endotoxinemia by lactulose. Unfortunately, such a reno-protective effect has not been shown conclusively until now in clinical studies. In chronic renal failure lactulose is known to promote fecal excretion of water, sodium, potassium, amonium, urea, creatinine and protons. Thus, lactulose could be useful for the treatment of chronic renal failure. However, compliance to the therapy represents a major problem.

  10. Renal arteriography (United States)

    ... Read More Acute arterial occlusion - kidney Acute kidney failure Aneurysm Atheroembolic renal disease Blood clots Renal cell carcinoma Renal venogram X-ray Review Date 1/5/2016 Updated by: Jason Levy, ...

  11. 螺旋CT多期扫描测定肾移植供体肾功能的价值%Glomerular filtration rate in living renal donor measured by helical CT multi-phase scanning

    Institute of Scientific and Technical Information of China (English)

    窦鑫; 周科峰; 李丹燕; 胡安宁; 杨尚文; 郭宏骞; 刘铁石; 朱斌


    目的:评价多层螺旋CT多期扫描测定肾移植供体肾功能的方法及应用.方法:58例活体肾移植供体行腹部多层螺旋CT多期(动脉期、实质期、排泄期)扫描,在动脉期与实质期之间插入5个低剂量全肾扫描序列,数据传入AW4.2工作站进行测量,根据全肾Patlak方程,计算单侧肾小球滤过率(glomerular filtration rate,GFR),同时与单光子发射计算机体层成像(single photon emission computed tomography,SPECT)所测定的单侧GFR相对照,进行直线回归与相关分析.结果:两种方法测定的GFR相关性良好,总肾的GFR相关系数r=0.904,直线回归方程为GFR(CT)=20.841+0.753×GFR(ECT),n=58,单侧GFR相关系数r=0.946,直线回归方程为GFR(CT)=7.086+0.864×GFR(ECT),n=116,配对t检验显示,两者测定的单侧及双侧GFR之间均无显著性差异(P>0.05).结论:螺旋CT多期扫描测定的移植肾供体的GFR结果准确,可以和同位素测定结果相互替代.%Objective:To evaluate the technique and application for measuring glomerular filtration rate in living renal donor by 16-slice spiral CT multi-phase scanning. Methods:58 living renal donors were underwent abdominal multi-phase enhancement CT scan, between the arterial and parenchymal phase. 5 continuous low dose kidney series were inserted. Using the known patlak equation, the GFR in a single kidney was calculated in CT scan and the exact information of GFR was gained by performing renal SPECT with Tc99m-TDPA. GFR of the two groups were analyzed by linear regression analysis. Results: Linear regression analysis show that the two groups GFR had very well associativity. The correlation coefficient of whole kidney and divided one is 0. 904 and 0. 946. With a line of regression GFR(CT) = 20. 841 + 0. 753 × GFR (ECT).n=58(the whole kidney); GFR(CT)=7. 086 + 0. 864 XGFR(ECT) .n= 116 (the divided kidney), they had no statistical significance in pair t test( P >0. 05). Conclusion:The GRF measured by multi-phase CT

  12. Transcatheter embolisation of renal angiomyolipoma.

    LENUS (Irish Health Repository)

    Leong, S


    Angiomyolipomas (AML) are rare benign renal tumours which are associated with aneurysms that can cause haemorrhage. Embolisation of AML greater than 4 cm with a variety of embolic agents is now the first-line treatment in these cases.

  13. Renal Toxicities of Targeted Therapies. (United States)

    Abbas, Anum; Mirza, Mohsin M; Ganti, Apar Kishor; Tendulkar, Ketki


    With the incorporation of targeted therapies in routine cancer therapy, it is imperative that the array of toxicities associated with these agents be well-recognized and managed, especially since these toxicities are distinct from those seen with conventional cytotoxic agents. This review will focus on these renal toxicities from commonly used targeted agents. This review discusses the mechanisms of these side effects and management strategies. Anti-vascular endothelial growth factor (VEGF) agents including the monoclonal antibody bevacizumab, aflibercept (VEGF trap), and anti-VEGF receptor (VEGFR) tyrosine kinase inhibitors (TKIs) all cause hypertension, whereas some of them result in proteinuria. Monoclonal antibodies against the human epidermal growth factor receptor (HER) family of receptors, such as cetuximab and panitumumab, cause electrolyte imbalances including hypomagnesemia and hypokalemia due to the direct nephrotoxic effect of the drug on renal tubules. Cetuximab may also result in renal tubular acidosis. The TKIs, imatinib and dasatinib, can result in acute or chronic renal failure. Rituximab, an anti-CD20 monoclonal antibody, can cause acute renal failure following initiation of therapy because of the onset of acute tumor lysis syndrome. Everolimus, a mammalian target of rapamycin (mTOR) inhibitor, can result in proteinuria. Discerning the renal adverse effects resulting from these agents is essential for safe treatment strategies, particularly in those with pre-existing renal disease.

  14. [sup 99m]TC-MAG[sub 3] renal function scintigraphy and captopril in the diagnosis of renovascular hypertension. [sup 99m]Tc-MAG[sub 3]-Nierenfunktionsszintigraphie ohne und mit Captopril zur Diagnostik der renovaskulaeren Hypertonie

    Energy Technology Data Exchange (ETDEWEB)

    Piepenburg, R. (Mainz Univ. (Germany). Klinik mit Poliklinik fuer Nuklearmedizin); Bockisch, A. (Mainz Univ. (Germany). Klinik mit Poliklinik fuer Nuklearmedizin); Andreas, J. (Mainz Univ. (Germany). Klinik mit Poliklinik fuer Nuklearmedizin); Dueber, C. (Mainz Univ. (Germany). Klinik fuer Roentgendiagnostik); Kann, P. (Mainz Univ. (Germany). 3. Medizinische Klinik und Poliklinik, Innere Medizin und Endokrinologie); Maier, G. (Mainz Univ. (Germany). Klinik mit Poliklinik fuer Nuklearmedizin); Hahn, K. (Mainz Univ. (Germany). Klinik mit Poliklinik fuer Nuklearmedizin)


    In this study, the diagnostic value of renal function scintigraphy performed both without and with ACE inhibition has been evaluated using the new radiopharmaceutical [sup 99m]Tc-MAG[sub 3]. In cases of decompensated renal artery stenoses, the typical scan finding with this tubular excreted agent was shown to be a distinct parenchymal nuclide retention in combination with a delayed appearance of the radiotracer in the pelvic system. Using this criterion in 43 patients with suspected renovascular hypertension, sensitivity and specificity were 89 and 88%, respectively. Bilateral positive findings were non-specific; excluding them from the study, specificity increased to 100%. In renal insufficiency, captopril scans seem to be of reduced diagnostic value. Summarising our experiences, renal function scintigraphy using [sup 99m]Tc-MAG[sub 3] without and with captopril was proved to be a reliable non-invasive method to detect or exclude haemodynamically relevant renal artery stenosis. (orig.)

  15. Initiation and recovery processes of endotoxin induced disseminated intravascular coagulation (DIC: scanning and transmission electron microscopic observations of rat renal tissues.

    Directory of Open Access Journals (Sweden)



    Full Text Available To clarify the initiation, development and recovery processes of disseminated intravascular coagulation (DIC, rat glomerular capillaries and fibrin thrombi were examined under transmission and scanning electron microscopes. DIC was induced in rats by a single intraperitoneal injection of endotoxin (Et., 7.5 mg/kg lipopolysaccharide:B, E. coli 026:B6. At 2 h after Et. injection, the endothelial surface of the glomerular capillary became irregular with projections like a sea anemone. At 4 h after Et. injection, agglomerated fibrin thrombi composed of fibrin fiber bundles with fine cross-striated fibriform structures were observed in the capillary lumen. The fibrin thrombi gradually changed into fine reticular systems suggesting a degradation process by 6 h after Et. injection, and formed a coarse granular agglomerate by 8 h after Et. injection. These fibrin thrombi disappeared within 12 h of Et. injection, but the endothelial surface remained edematous. At 24 h after Et. injection, the microstructure of the glomerular capillaries returned normal. Based on these observations, we concluded that DIC was primarily initiated by injury to the capillary endothelium, and that changes on the endothelial surface contributed to the development of DIC.

  16. Essential Heavy Metals in Renal Tumor Tissue and Its Possible Relation to Carcinogenesis: Applying the Scanning Electron Microscopy Coupled with X-Ray Microanalysis Technique

    Directory of Open Access Journals (Sweden)

    Tânia Nogueira


    Full Text Available Background: Metals such as copper and zinc are crucial in several vital functions in the human body; the absence of these metals can cause serious illness. When in excess, however, they can have toxic effects which may be associated with carcinogenesis, as is described in the literature. Thus, it is important to realize that without these essential metals in their due proportion, the human body could not maintain its proper metabolic function. Methods: The main goal of this paper was to compare qualitatively and semi-quantitatively the amount of both copper and zinc present in the tumor tissue (tissue from patients who had undergone partial or radical nephrectomy and in the control tissue (which was adjacent to the tumor tissue. This study was carried out using Scanning Electron Microscopy coupled with X-Ray Microanalysis (SEM-XRM. Results: There is a different concentration of copper and zinc in the samples of tumor tissue and controls that were studied. Conclusion: This work complements previously published results about the presence of metals in the human body and their probable influence on carcinogenesis.

  17. Perioperative acute renal failure.

    LENUS (Irish Health Repository)

    Mahon, Padraig


    PURPOSE OF REVIEW: Recent biochemical evidence increasingly implicates inflammatory mechanisms as precipitants of acute renal failure. In this review, we detail some of these pathways together with potential new therapeutic targets. RECENT FINDINGS: Neutrophil gelatinase-associated lipocalin appears to be a sensitive, specific and reliable biomarker of renal injury, which may be predictive of renal outcome in the perioperative setting. For estimation of glomerular filtration rate, cystatin C is superior to creatinine. No drug is definitively effective at preventing postoperative renal failure. Clinical trials of fenoldopam and atrial natriuretic peptide are, at best, equivocal. As with pharmacological preconditioning of the heart, volatile anaesthetic agents appear to offer a protective effect to the subsequently ischaemic kidney. SUMMARY: Although a greatly improved understanding of the pathophysiology of acute renal failure has offered even more therapeutic targets, the maintenance of intravascular euvolaemia and perfusion pressure is most effective at preventing new postoperative acute renal failure. In the future, strategies targeting renal regeneration after injury will use bone marrow-derived stem cells and growth factors such as insulin-like growth factor-1.

  18. The Influence of Perfusion Values of Renal Cortex on Altering Image Frequency and Slice Thickness at CT Scan%扫描频率和层厚选择对肾皮质CT灌注参数值的影响

    Institute of Scientific and Technical Information of China (English)

    王琦; 时高峰; 王士杰; 田志辉


    目的 研究选择不同扫描频率和层厚对肾皮质CT灌注参数值的影响.方法 15例志愿者行肾脏CT灌注扫描,扫描时间为32 s.扫描层厚为5 mm,重建层厚2.5 mm.采用cine扫描模式完成扫描.然后依据间隔1 s、2 s、3 s分别选取一系列图像进行灌注分析,观察不同时间间隔灌注参数血流量(BF)、血容量(BV)、平均通过时间(MTT)、毛细血管表面通透性(PS)4项灌注参数值的差异.2种层厚的对照研究采用单变量计量资料中的配对t检验;不同频率选择采用配伍设计的方差分析.结果 通过cine模式、层厚5 mm连续扫描获得肾皮质的BF、BV、MTT、PS参数值分别为(407.10±86.69) ml·min-1·100 ml-1、(21.59±3.93) ml/100 g、(3.37±0.65) s、(56.42±16.30) ml·min-1·100 ml-1.与层厚为2.5 mm肾皮质的灌注参数值比较,不同层厚BF、BV、MTT和PS组间均无统计学意义(P>0.05).另与间隔1 s、间隔2 s、间隔3 s的肾皮质灌注参数值比较,前3种扫描时间间隔对BF、BV及PS灌注参数影响不大(P>0.05).间隔3 s的图像较少,得到的各项灌注参数值均明显不同于其他的序列,且相关性较差.结论 对肾皮质CT灌注成像,间隔1 s或2 s是值得提倡的扫描模式.5 mm和2.5 mm层厚的选择对CT灌注参数值没有影响.%Objective To study the influcnce of perfusion values of renal cortex on image frequency and slice thickness at CT scan . Methods 15 volunteers underwent renal CT cine perfusion during 32 second with 5 mm slice thickness and reconstructed 2. 5 mm slice thickness. The series of images in the interval at 1,2 and 3 second were chosen to analyse the blood flow(BF) , blood volume( BV) , mean transit time ( MTT) , permeability surface ( PS) of the renal cortex. The comparison between 2. 5 mm and 5 mm slice thickness was analayzed with paired t-test for depcndent samples. The comparison of the different image frequency was analayzed with two-way analysis of variance( ANOVA) and linear

  19. Computed tomography scan measurement of abdominal wall thickness for application of near-infrared spectroscopy probes to monitor regional oxygen saturation index of gastrointestinal and renal circulations in children. (United States)

    Balaguru, Duraisamy; Bhalala, Utpal; Haghighi, Mohammad; Norton, Karen


    To measure abdominal wall thickness to determine the depth at which the renal vascular bed and mesenteric vascular bed are located, and to determine the appropriate site for placement of near-infrared spectroscopy probes for accurate monitoring regional oxygen saturation index in children. Abdominal computerized tomography scans in children were used to measure the abdominal wall thickness and to ascertain the location of kidneys. Tertiary care children's hospital. Children 0-18 yrs of age; n = 38. None. The main mass of the kidneys is located between vertebral levels T12 and L2 on both sides. The left kidney is located about a half-vertebral length higher than the right kidney. Posterior abdominal wall thickness ranged from 6.6 to 115.8 mm (median, 22.1 mm). Posterolateral abdominal wall thickness ranged from 6.7 to 114.5 mm (median, 19.6 mm). Anterior abdominal wall thickness in the supraumbilical level ranged from 3.5 to 62.9 mm (median, 16.0 mm). All abdominal wall thicknesses correlated better with weight of the subjects than their age. Abdominal wall thickness potentially exceeds the sampling depth of currently used near-infrared spectroscopy probes above a certain body size. Application of current near-infrared spectroscopy probes and design of future probes should consider patient size variations in the pediatric population.

  20. Nuclear Scans (United States)

    Nuclear scans use radioactive substances to see structures and functions inside your body. They use a special ... images. Most scans take 20 to 45 minutes. Nuclear scans can help doctors diagnose many conditions, including ...

  1. Renal Osteodystrophy

    Directory of Open Access Journals (Sweden)

    Aynur Metin Terzibaşoğlu


    Full Text Available Chronic renal insufficiency is a functional definition which is characterized by irreversible and progressive decreasing in renal functions. This impairment is in collaboration with glomeruler filtration rate and serum creatinine levels. Besides this, different grades of bone metabolism disorders develop in chronic renal insufficiency. Pathologic changes in bone tissue due to loss of renal paranchyme is interrelated with calcium, phosphorus vitamine-D and parathyroid hormone. Clinically we can see high turnover bone disease, low turnover bone disease, osteomalacia, osteosclerosis and osteoporosis in renal osteodystropy. In this article we aimed to review pathology of bone metabolism disorders due to chronic renal insufficiency, clinic aspects and treatment approaches briefly.

  2. Renal vascular effects of calcium channel blockers in hypertension. (United States)

    Benstein, J A; Dworkin, L D


    Recent evidence suggests that calcium channel blockers have specific effects on renal hemodynamics in patients with hypertension and may also slow the progression of chronic renal failure. When these agents are studied in vitro, their predominant effect is to reverse afferent arteriolar vasoconstriction induced by catecholamines or angiotensin II. Because efferent resistance may remain high, glomerular filtration rate rises while renal blood flow remains low. The effects in vivo are less consistent. In human hypertension, calcium channel blockers lower renal resistance and may raise both renal blood flow and glomerular filtration rate. In experimental models of chronic renal disease, calcium channel blockers slow the progression of renal damage; however, variable effects on renal hemodynamics have been found. Other factors implicated in the progression of renal damage, including compensatory renal hypertrophy, platelet aggregation, and calcium deposition, may also be favorably influenced by these agents. Recent studies suggest that calcium channel blockers may have similar protective effects in patients with hypertension and chronic renal disease.

  3. 双能量CT在肾癌诊断及分型中的应用%Application of dual-source dual-energy CT scanning in diagnosis and typing of renal cell carcinoma

    Institute of Scientific and Technical Information of China (English)

    金原; 武志峰; 吴山; 刘世杰; 王沙沙


    Objective To investigate the value of dual-energy virtual unenhanced and dual-energy iodine value distribution diagram type of kidney cancer.Methods A retrospective analysis of 35 cases of renal cell carcinoma dual-energy CT scan data,compared to kidney pathology data,analyze the image quality and radiation dose dual-energy virtual unenhanced and dual energy distribution of iodine in clear cell carcinoma and non-clear cell carcinoma the differences that exist.Results Unenhanced and virtual unenhanced image quality was quite,CT value (routine unenhanced renal parenchyma 31.90±4.10 HU,abdominal aortic 45.60±6.30 HU,psoas 50.00±6.6 HU3,kidney 1.410±17.06 HU; virtual unenhanced renal parenchyma abdominal aortic 33.20±5.50 HU,48.30±8.00 HU,52.40±10.63 HU psoas kidney 0.87±17.48 HU),signal to noise ratio (routine unenhanced renal abdominal aorta 3.22±1.49,5.13±2.57,4.56±2.12 psoas kidney 3.24±2.27 virtual unenhanced renal abdominal aorta 2.73±1.08,3.79±1.64,3.23±1.35 psoas kidney 2.18± 1.57) had not significantly different (P > 0.05).Clear cell carcinoma of the skin medullart junction of iodinedistribution of images Iodine (2.75±1.05) mg/ml was higher than non-clear cell carcinoma (1.25±0.72) mg/ml,the difference was statistically significant (t =7.048,P < 0.05).Conclusions CT examination in patients with renal cell carcinoma virtual unenhanced image quality is similar with routine unenhanced image quality,it reduces radiation dose.The distribution of iodine can provide more diagnostic information that can help us be more intuitive and accurate judgments of the blood supply and kidney cancer subtypes.%目的 探讨双能量CT虚拟平扫及双能量碘分布图在肾癌诊断及分型中的应用价值.方法 收集35例肾癌患者双能量增强CT扫描数据及病理结果,分析双能量CT虚拟平扫的图像质量及辐射剂量、双能量碘分布图在透明细胞癌及非透明细胞癌中存在的差异.结果 虚拟平扫与常规平扫

  4. Acute renal dysfunction in liver diseases

    Institute of Scientific and Technical Information of China (English)


    Renal dysfunction is common in liver diseases, either as part of multiorgan involvement in acute illness or secondary to advanced liver disease. The presence of renal impairment in both groups is a poor prognostic indicator. Renal failure is often multifactorial and can present as pre-renal or intrinsic renal dysfunction. Obstructive or post renal dysfunction only rarely complicates liver disease. Hepatorenal syndrome (MRS) is a unique form of renal failure associated with advanced liver disease or cirrhosis, and is characterized by functional renal impairment without significant changes in renal histology. Irrespective of the type of renal failure, renal hypoperfusion is the central pathogenetic mechanism, due either to reduced perfusion pressure or increased renal vascular resistance. Volume expansion, avoidance of precipitating factors and treatment of underlying liver disease constitute the mainstay of therapy to prevent and reverse renal impairment. Splanchnic vasoconstrictor agents, such as terlipressin, along with volume expansion, and early placement of transjugular intrahepatic portosystemic shunt (TIPS) may be effective in improving renal function in HRS. Continuous renal replacement therapy (CRRT) and molecular absorbent recirculating system (MARS) in selected patients may be life saving while awaiting liver transplantation.

  5. Renal uptake of /sup 67/Ga-citrate in renal amyloidosis due to Familiar Mediterranean Fever

    Energy Technology Data Exchange (ETDEWEB)

    Banzo-Marraco, J.; Abos-Olivares, M.D.; Iribar-Ibabe, M.C.; Prats-Rivera, E.; Banzo-Marraco, J.I.; Teijeiro-Vidal, J.; Nerin-Mora, E.; Nerin de la Puerta, I.


    Renal uptake of /sup 67/Ga-citrate is described in a patient with biopsy-proven amyloidosis of the kidneys, due to Familiar Mediterranean Fever. After administration 150 MBq (4mCi) /sup 67/Ga-citrate, scans were done at 48, 72, and 120 h. Intense uptake was noted in both kidneys. A renal biopsy done 5 days after the /sup 67/Ga-citrate scan revealed a pattern typical of amyloidosis. Gallium scanning can be useful in patients with fever of unknown origin. Renal amyloidosis can be considered when renal uptake of /sup 67/Ga-citrate associated with nephrotic syndrome is observed.

  6. Greater efficacy of atorvastatin versus a non-statin lipid-lowering agent against renal injury: potential role as a histone deacetylase inhibitor (United States)

    Singh, Ravi Shankar; Chaudhary, Dharmendra Kumar; Mohan, Aradhana; Kumar, Praveen; Chaturvedi, Chandra Prakash; Ecelbarger, Carolyn M.; Godbole, Madan M.; Tiwari, Swasti


    Statins, 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase inhibitors have been shown to improve diabetic nephropathy. However, whether they provide protection via Histone deacetylases (HDAC) inhibition is not clear. We conducted a comparative evaluation of Atorvastatin (AT) versus the non-statin cholesterol-lowering drug, Ezetimibe (EZT) on severity of diabetic nephropathy. Streptozotocin-treated male Wistar rats were fed a cholesterol-supplemented diet and gavaged daily with vehicle, AT or EZT. Control rats received normal diet and gavaged vehicle (n = 8–9/group). Diabetes increased blood glucose, urine albumin-to-creatinine ratio (ACR), kidney pathology and HDAC activity, and reduced renal E-cadherin levels. Both AT and EZT reduced circulating cholesterol, attenuated renal pathology, and did not lower blood glucose. However, AT was significantly more effective than EZT at reducing kidney pathology and HDAC activity. Chromatin immunoprecipitation revealed a significantly higher association of acetylated H3 and H4 with the E-cadherin promoter in kidneys from AT-, relative to EZT- or vehicle-treated rats. Moreover, we demonstrated a direct effect of AT, but not EZT, on HDAC-inhibition and, H3 and H4- acetylation in primary glomerular mesangial cells. Overall, both AT and EZT attenuated diabetic nephropathy; however, AT exhibited greater efficacy despite a similar reduction in circulating cholesterol. HDAC-inhibition may underlie greater efficacy of statins in attenuating kidney injury. PMID:27901066

  7. Utility evaluation on application of geometric mean depending on depth of kidney in split renal function test using 99mTc-MAG{sub 3}

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Byeul; Ahn, Sung Min [Dept. of Radiological Science, Gachon University, Incheon (Korea, Republic of); Lee, Wang Hui [Dept. of Nuclear Medicine, Gil-Hospital, Incheon (Korea, Republic of)


    99mTc-MAG{sub 3} Renal scan is a method that acquires dynamic renal scan image by using 99mTc-MAG{sub 3} and dynamically visualizes process of radioactive agent being absorbed to kidney and excreted continuously. Once the test starts, ratio in both kidneys in 1-2.5 minutes was measured to obtain split renal function and split renal function can be expressed in ratio based on overall renal function. This study is based on compares split renal function obtained from data acquired from posterior detector, which is a conventional renal function test method, with split renal function acquired from the geometric mean of values obtained from anterior and posterior detectors, and studies utility of attenuation compensation depending on difference in geometric mean kidney depth. From July, 2015 to February 2016, 33 patients who undertook 99mTc-MAG{sub 3} Renal scan(13 male, 20 female, average age of 44.66 with range of 5-70, average height of 160.40 cm, average weight of 55.40 kg) were selected as subjects. Depth of kidney was shown to be 65.82 mm at average for left and 71.62 mm at average for right. In supine position, 30 out of 33 patients showed higher ratio of deep-situated kidney and lower ratio of shallow-situated kidney. Such result is deemed to be due to correction by attenuation between deep-situated kidney and detector and in case where there is difference between the depth of both kidneys such as, lesions in or around kidney, spine malformation, and ectopic kidney, ratio of deep-situated kidney must be compensated for more accurate calculation of split renal function, when compared to the conventional test method (posterior detector counting)

  8. Renal infarction caused by spontaneous renal artery dissection: treatment with catheter-directed thrombolysis and stenting. (United States)

    Jeon, Yong Sun; Cho, Soon Gu; Hong, Ki Cheon


    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.

  9. Bone scanning in otolaryngology. (United States)

    Noyek, A M


    Modern radionuclide bone scanning has introduced a new concept in physiologic and anatomic diagnostic imaging to general medicine. As otolaryngologists must diagnose and treat disease in relation to the bony and/or cartilaginous supporting structures of the neurocranium and upper airway, this modality should be included in the otolaryngologist's diagnostic armamentarium. It is the purpose of this manuscript to study the specific applications of bone scanning to our specialty at this time, based on clinical experience over the past three years. This thesis describes the development of bone scanning in general (history of nuclear medicine and nuclear physics; history of bone scanning in particular). General concepts in nuclear medicine are then presented; these include a discussion of nuclear semantics, principles of radioactive emmissions, the properties 99mTc as a radionuclide, and the tracer principle. On the basis of these general concepts, specific concepts in bone scanning are then brought forth. The physiology of bone and the action of the bone scan agents is presented. Further discussion considers the availability and production of the bone scan agent, patient factors, the gamma camera, the triphasic bone scan and the ultimate diagnostic principle of the bone scan. Clinical applications of bone scanning in otolaryngology are then presented in three sections. Proven areas of application include the evaluation of malignant tumors of the head and neck, the diagnosis of temporomandibular joint disorders, the diagnosis of facial fractures, the evaluation of osteomyelitis, nuclear medicine imaging of the larynx, and the assessment of systemic disease. Areas of adjunctive or supplementary value are also noted, such as diagnostic imaging of meningioma. Finally, areas of marginal value in the application of bone scanning are described.

  10. Renal scintigraphy in infants with antenatally diagnosed renal pelvis dilatation

    Directory of Open Access Journals (Sweden)

    Ajdinović Boris


    Full Text Available Background/Aim. Ureteropelvic junction obstruction and vesicoureteral reflux are the most frequent entities identified on the basis of antenatal hydronephrosis. The aim of this study was to determine the incidence and pattern of abnormal renal scintigraphy findings in postnatal investigation of children with antenatal hydronephrosis. Methods. Twenty four infants (19 boys and five girls presented with antenatal hydronephrosis and mild to moderate hydronephrosis on ultrasound in newborn period were referred for renal scintigraphy. Ten patients with vesicoureteral reflux documented on micturating cystoureterography underwent 99mTc-DMSA renal scintigraphy and 14 patients were subjected to 99mTc-DTPA scintigraphy. Results. Anteroposterior pelvic diameter on ultrasound ranged from 11 to 24 mm. Renal DMSA scans identified congenital scars in two boys with bilateral reflux of grade V and unilateral reflux of grade III. Relative kidney uptake (RKU less than 40% was found in three, and poor kidney function (RKU less than 10% in two patients. Significant obstruction was shown on DTPA diuretic renal scintigraphy in 6/14 patients. Some slowing in dranaige (T1/2 greater than 10 minutes with no reduction in differential renal function was identified in three patients. Differential renal function less than 10% was obtained in one case. Conclusion. A high percent of abnormal renal scintigraphy findings was obtained. Renal scintigraphy was useful in determination of underlying cause of antenatally detected hydronephrosis.

  11. Path scanning for the detection of anomalous subgraphs and use of DNS requests and host agents for anomaly/change detection and network situational awareness

    Energy Technology Data Exchange (ETDEWEB)

    Neil, Joshua Charles; Fisk, Michael Edward; Brugh, Alexander William; Hash, Jr., Curtis Lee; Storlie, Curtis Byron; Uphoff, Benjamin; Kent, Alexander


    A system, apparatus, computer-readable medium, and computer-implemented method are provided for detecting anomalous behavior in a network. Historical parameters of the network are determined in order to determine normal activity levels. A plurality of paths in the network are enumerated as part of a graph representing the network, where each computing system in the network may be a node in the graph and the sequence of connections between two computing systems may be a directed edge in the graph. A statistical model is applied to the plurality of paths in the graph on a sliding window basis to detect anomalous behavior. Data collected by a Unified Host Collection Agent ("UHCA") may also be used to detect anomalous behavior.

  12. [Unusual elements in renal calculi]. (United States)

    Rodríguez-Miñón Cifuentes, J L; Salvador, E; Traba Villameytide, M L


    A group of 54 renal calculi were spontaneously passed renal stone after a nephritic colic. Two groups of calculi were found: papillary and non-papillary calculi. All calculi were analyzed by infrared spectroscopy and electronic microscopy scan (EMS) and EDAX. When the stones were analyzed with EDAX, elements such as C, N, O, Na, S, Mg, Al, Si, Cl, K, Ca, Mn, Fe, Ni, Zn were detected. The possible origin of these elements is discussed in this work.

  13. Successful renal transplantation during pregnancy. (United States)

    Hold, Phoebe M; Wong, Christopher F; Dhanda, Raman K; Walkinshaw, Steve A; Bakran, Ali


    Little is known about the implications of performing a renal transplant on a patient who is already pregnant. This case study reports a successful outcome of pregnancy, diagnosed coincidentally following renal transplantation at 13 weeks gestation. The recipient was a 23-year-old woman with chronic kidney disease who received a live-related renal transplant from her father. Pregnancy was discovered at routine ultrasound scanning of the renal allograft at 5 days posttransplant and estimated at 13 weeks gestation. She received ciclosporin monotherapy as immunosuppression throughout the pregnancy, and was given valacyclovir as prophylaxis against cytomegalovirus (CMV) infection. Renal function remained stable throughout the pregnancy, which progressed normally, resulting in the vaginal delivery of a healthy, liveborn male infant at 37 weeks gestation. This case study demonstrates that transplantation during pregnancy can have a successful outcome.

  14. Probing of the combined effect of bisquaternary ammonium antimicrobial agents and acetylsalicylic acid on model phospholipid membranes: differential scanning calorimetry and mass spectrometry studies. (United States)

    Kasian, N A; Pashynska, V A; Vashchenko, O V; Krasnikova, A O; Gömöry, A; Kosevich, M V; Lisetski, L N


    A model molecular biosystem of hydrated dipalmitoylphosphatidylcholine (DPPC) bilayers that mimics cell biomembranes is used to probe combined membranotropic effects of drugs by instrumental techniques of molecular biophysics. Differential scanning calorimetry reveals that doping of the DPPC model membrane with individual bisquaternary ammonium compounds (BQAC) decamethoxinum, ethonium, thionium and acetylsalicylic acid (ASA) leads to lowering of the membrane melting temperature (Tm) pointing to membrane fluidization. Combined application of the basic BQAC and acidic ASA causes an opposite effect on Tm (increase), corresponding to the membrane densification. Thus, modulation of the membranotropic effects upon combined use of the drugs studied can be revealed at the level of model membranes. Formation of noncovalent supramolecular complexes of the individual BQACs and ASA with DPPC molecules, which may be involved in the mechanism of the drug-membrane interaction at the molecular level, is demonstrated by electrospray ionization (ESI) mass spectrometry. In the ternary (DPPC + ASA + BQAC) model systems, the stable complexes of the BQAC dication with the ASA anion, which may be responsible for modulation of the membranotropic effects of the drugs, were recorded by ESI mass spectrometry. The proposed approach can be further developed for preliminary evaluation of the combined effects of the drugs at the level of model lipid membranes prior to tests on living organisms.

  15. 造影剂流速对前列腺癌 MR 动态增强扫描效果的影响%Effect of Contrast Agent Flow Rate on MR Dynamic Enhanced Scan of Prostate Cancer

    Institute of Scientific and Technical Information of China (English)

    倪文君; 李庆伟; 李群根; 孙立娜; 周航; 王锋


    Objective to study effect of contrast agent flow rate on MR dynamic enhanced scan of prostate cancer to determine the optimal flow rate. Methods carry on multiple dynamic enhanced scanning for liver acquisition with volume acceleration(i.e.“LAVA”) sequence of 50 patients with 3.0TGE magnetic resonance scanner. Among which, contrast agent injection velocity of 25 patients was 2.5mL/s, that of another 25 patients was 5.0ml/s. Calculate and analyze effect of different contrast agent flow rate for MR dynamic enhancement index of prostate cancer. Results Tmax, Slmax% and Rmax difference between two groups prostate cancer patients with different flow rates showed statistical significance(P< 0.05). Dynamic enhanced perfusion of Tmax of prostate cancer patients with contrast agent flow rate of 5.0mL/s was shorter than patients with contrast agent flow rate of 2. 5mL/s, and Slmax% and Rmax was higher. Conclusion sensitivity of dynamic enhanced perfusion index of prostate cancer patients with contrast agent flow rate of 5.0mL/s is higher than patients with contrast agent flow rate of 2. 5mL/s, the former can enhance checkup effect of prostate cancer patients, and can effectively improve diagnosis accuracy of prostate cancer patients.%目的:探讨造影剂流速对前列腺癌 MR 动态增强扫描效果的影响,以确定最佳流速。方法应用3.0TGE 磁共振扫描仪对50例患者进行肝脏的快速容积采集(即“LAVA”)序列多次动态增强扫描,其中25例患者的造影剂注射流速为2.5mL/s,另外25例患者的注射流速是5.0mL/s,计算并分析造影剂流速的不同对前列腺癌的 MR 动态增强指标的影响。结果造影剂流速不同的两组前列腺癌患者的 Tmax、Slmax%与 Rmax 的差异,具有统计学意义(P<0.05)。造影剂流速为5.0mL/s 的前列腺癌患者与流速2.5mL/s 患者相比动态增强灌注的 Tmax 缩短,Slmax%和 Rmax 升高。结论造影剂5.0mL/s 流速的前列腺癌患者


    Directory of Open Access Journals (Sweden)

    A. V. Govorov


    Full Text Available Renal cryoablation is an alternative minimally-invasive method of treatment for localized renal cell carcinoma. The main advantages of this methodology include visualization of the tumor and the forming of "ice ball" in real time, fewer complications compared with other methods of treatment of renal cell carcinoma, as well as the possibility of conducting cryotherapy in patients with concomitant pathology. Compared with other ablative technologies cryoablation has a low rate of repeat sessions and good intermediate oncological results. The studies of long-term oncological and functional results of renal cryoablation are presently under way.

  17. Renal angiomyolipoma

    DEFF Research Database (Denmark)

    Holm-Nielsen, P; Sørensen, Flemming Brandt


    lesion. Three cases of renal angiomyolipoma, 2 of which underwent perfusion-fixation, were studied by electron microscopy to clarify the cellular composition of this lesion. In the smooth muscle cells abundant accumulation of glycogen was found, whereas the lipocytes disclosed normal ultrastructural......-specific vesicular structures. These findings suggest a secondary vascular damage, i.e. the thickened vessels may not be a primary, integral part of renal angiomyolipoma. Evidence of a common precursor cell of renal angiomyolipoma was not disclosed. It is concluded that renal angiomyolipoma is a hamartoma composed...

  18. Anatomia do sistema porta renal e suas implicações no emprego de agentes anestésicos na contenção de avestruzes (Struthio camelus Anatomy of the renal portal system and its implications for the use of anesthetic agents in the restraint of ostriches (Struthio camelus

    Directory of Open Access Journals (Sweden)

    Haley Silva de Carvalho


    Full Text Available Objetivou-se com este estudo caracterizar a anatomia do sistema porta renal e verificar sua influência sobre o protocolo anestésico xilazina, tiletamina e zolazepam na contenção de avestruzes, por comparação da administração dos fármacos nos músculos da perna ou da asa. Em cinco animais foi injetado látex nas veias femorais no sentido de drenagem e, posteriormente, as aves foram fixadas em formol a 10%, por 72 horas. Em uma ave, procedeu-se à localização, colheita e fixação das valvas portais renais em formol a 10%. O sistema porta renal apresentou-se constituído por duas veias portais renais craniais, duas veias portais renais caudais e seis valvas portais renais. Na contenção química, seis avestruzes foram pré-tratados com xilazina (1mg kg-1 e, decorridos 10 minutos, receberam tiletamina/zolazepam (6mg kg-1. Os animais foram manipulados em duas ocasiões diferentes, sendo que na primeira anestesia o protocolo foi administrado nos músculos da base das asas (GI e, após 15 dias, os mesmos animais receberam o protocolo nos músculos das pernas (GII. Os períodos de latência, hábil e de recuperação não foram diferentes entre os grupos (P>0,05. A freqüência cardíaca permaneceu abaixo dos valores basais durante a anestesia (PThis study was aimed at characterizing the anatomy of the renal portal system, and determining its influence on the anesthetic protocol xylazine, tiletamine and zolazepam, in the restraint of ostriches, compared with the administration of drugs into the leg or wing muscles. Latex was injected into the femoral veins of five animals, for drainage purposes, and the birds were then fixed in 10% formaldehyde, for 72 hours. In one bird, the renal portal valves were located, collected and fixed in 10% formaldehyde. The renal portal system consisted of two cranial renal portal veins, two caudal renal portal veins, and six renal portal valves. In the chemical restraint, six ostriches were anesthetized with

  19. Chemical Renal Denervation in the Rat

    Energy Technology Data Exchange (ETDEWEB)

    Consigny, Paul M., E-mail:; Davalian, Dariush, E-mail: [Abbott Vascular, Innovation Incubator (United States); Donn, Rosy, E-mail:; Hu, Jie, E-mail: [Abbott Vascular, Bioanalytical and Material Characterization (United States); Rieser, Matthew, E-mail:; Stolarik, DeAnne, E-mail: [Abbvie, Analytical Pharmacology (United States)


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

  20. Renal cancer

    NARCIS (Netherlands)

    Corgna, Enrichetta; Betti, Maura; Gatta, Gemma; Roila, Fausto; De Mulder, Pieter H. M.


    In Europe, renal cancer (that is neoplasia of the kidney, renal pelvis or ureter (ICD-9 189 and ICD-10 C64-C66)) ranks as the seventh most common malignancy in men amongst whom there are 29,600 new cases each year (3.5% of all cancers). Tobacco, obesity and a diet poor in vegetables are all acknowle

  1. Renal fallure

    Institute of Scientific and Technical Information of China (English)


    920705 Endothelin and acute renal failure:study on their relationship and possiblemechanisms. LIN Shanyan(林善锬), et al.Renal Res Lab, Huashan Hosp, Shanghai MedUniv, Shanghai, 200040. Natl Med J China 1992;72(4): 201-205. In order to investigate the role of endothelin

  2. Renal cancer.

    NARCIS (Netherlands)

    Corgna, E.; Betti, M.; Gatta, G.; Roila, F.; Mulder, P.H.M. de


    In Europe, renal cancer (that is neoplasia of the kidney, renal pelvis or ureter (ICD-9 189 and ICD-10 C64-C66)) ranks as the seventh most common malignancy in men amongst whom there are 29,600 new cases each year (3.5% of all cancers). Tobacco, obesity and a diet poor in vegetables are all

  3. Renal cancer

    NARCIS (Netherlands)

    Corgna, Enrichetta; Betti, Maura; Gatta, Gemma; Roila, Fausto; De Mulder, Pieter H. M.


    In Europe, renal cancer (that is neoplasia of the kidney, renal pelvis or ureter (ICD-9 189 and ICD-10 C64-C66)) ranks as the seventh most common malignancy in men amongst whom there are 29,600 new cases each year (3.5% of all cancers). Tobacco, obesity and a diet poor in vegetables are all

  4. Power doppler ultrasound findings of renal infarct after experimental renal artery occlusion: comparison with spiral CT

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Seung Eun; Shinn, Kyung Sub; Kim, Hak Hee; Mun, Seok Hwan; Lee, Young Joon; Lee, Bae Young; Choi, Byung Gil; Lee, Jae Mun; Lee, Hee Jeong [The Catholic University of Korea College of Medicine, Seoul (Korea, Republic of)


    To evaluate the efficacy of power Doppler ultrasonography (PDUS) in depicting renal infarction in rabbits during experimental renal segmental arterial occlusion, and to compare the results with those of CT scanning. In 28 rabbits weighing 2.5 4kg, the segmental renal artery was occluded through the left main renal artery by embolization with Ivalon (Nycomed, Paris, France). Power Doppler ultrasonography and spiral CT scanning were performed before and at 2, 5, 8, 15, and 24 hours, and 3 and 7 days after occlusion of the segmental renal artery. The location of infarcted areas and collaterals, as seen on PDUS and CT scans, was evaluated by two radiologists. In all cases, as seen on power Doppler ultrasonography, infarcted areas-when compared with normal parenchyma, clearly demonstrated wedge-shaped perfusion defects in the kidney. The location of the lesion closely corresponded to the location seen during CT scanning. After renal arterial occlusion, transiently congested capsular arteries, which were named 'capsular sign', were seen in 63% of rabbits in the two and five-hour groups. No significant cortical rim sign was demonstrated on power Doppler ultrasonography, though it was noted on spiral CT at 15 and 24 hours, and 3 and 7 days after renal arterial occlusion. Power Doppler ultrasonography was useful for the diagnosis of renal infarction. Congested capsular artery seen in the early stage of renal infarction might be a characteristic finding of this condition, as seen on power Doppler ultrasonography.

  5. 连续性血液净化救治对比剂急性肾损伤的临床研究%The Clinical Research of Contrast Agent-induced Acute Renal Injury with Treatment of Continuous Blood Purification

    Institute of Scientific and Technical Information of China (English)

    孟建中; 荣鹏; 周春华; 王素霞; 刘文渊; 景颖; 贾凤玉; 葛彦明; 岳冀


    To study the clinical features of Contrast agent - induced acute renal injury(CI - AKI) with treatment of continuous blood purification (CBP). 32 cases of CI - AKI patients we treated from May 2003 to May 2010 were selected. We analyzed the patho-genesis, detected the continuous changes of the levels of serum creatinine ( Scr) , uric acid (UA) , high - sensitivity C - reactive pro-tein (hs - CRP) and other biochemical indicators before and after imaging and before and after CBP treatment, observed the mortality of CI - AKI patients in 28 days. The law of the incidence; 17 cases with coronary heart disease with diabetes suffered from CI - AKI af-ter receiving treatment in the cardiac catheterization. Among them, 13 cases (40.62% ) while taking biguanide hypoglycemic agents. Clinical features; At 24h after angiography, uric acid and hs - CRP levels were significantly increased, and peaked at 48h. The Scr level increased at 48h after angiography, and reached a peak at 72h after surgery. The correlation analysis showed that serum uric acid levels and changes in hs - CRP levels showed a positive correlation (r = 0.66,P<0.05). Outcome: 29 cases (90.62% ) patients out of oliguria after 48h in CBP treatment, people/kidney were to survive. 2 cases (6.25% ) due to renal failure, survival was dependent on maintenance dialysis. 1 patient died (3.12% ) of malignant arrhythmia after PCI, 12 d. Biguanide hypoglycemic is an independent risk factor in diabetic patients suffering from CI - AKI after PCI. The changes of Serum uric acid and hs - CRP levels are sensitive indicator reflect cell damage in CI - AKI. CBP can improve renal perfusion, accelerate the excretion of uric acid and contrast agent, re-duce the effect of oxidative stress in the renal tubular epithelial cells, protect renal function.%研究连续性血液净化(CBP)救治对比剂急性肾损伤(CI-AKI)的临床特点.选取2003年5月至2010年5月间救治的32例CI-AKI患者,分析发病规律,检测造影前、

  6. Blunt Renal Trauma in a Pre-Existing Renal Lesion

    Directory of Open Access Journals (Sweden)

    G.V. Soundra Pandyan


    Full Text Available A 70-year-old male presented with direct trauma to his loin with gross hematuria, as an isolated case of blunt renal trauma (BRT due to a traffic accident. A pre-existing renal lesion (PERL was strongly suspected by his past history of gross macroscopic hematuria and monotrauma to the kidney without other associated injuries. Spiral CT scan with contrast and a retrograde pyelogram (RGP confirmed an occult complex renal cyst. The gold standard of CT diagnosis in this situation is stressed. Computed tomography is particularly useful in evaluating traumatic injuries to kidneys with pre-existing abnormalities. The decision on the initial course of conservative management, ureteral retrograde stenting to drain extravasation, and its final outcome are discussed. Radical nephroureterectomy was carried out by a transperitoneal approach with an early vascular control of the renal pedicle. A brief review of recent literature has been undertaken.

  7. VEGF pathway inhibition by anticancer agent sunitinib and susceptibility to atherosclerosis plaque disruption. (United States)

    Ropert, Stanislas; Vignaux, Olivier; Mir, Olivier; Goldwasser, François


    Patients treated with anti-VEGF agents are at increased risk for arterial thrombo-embolic events (ATEs). However, the pathophysiology of such acute vascular complications remains unclear. We report on a case of bowel infarction in a renal cancer patient treated with the anti-VEGF agent sunitinib. An abdominal CT-scan evidenced the rupture of an atherosclerotic plaque located at the emergence of the superior mesenteric artery. In view of this report, we suggest that evaluation of the risk of ATE in patients receiving anti-VEGF agents should include not only age and past history of ATE as suggested by previous studies, but also assessment of atherosclerotic lesions on CT-scan.

  8. Peginterferon Beta-1a Shows Antitumor Activity as a Single Agent and Enhances Efficacy of Standard of Care Cancer Therapeutics in Human Melanoma, Breast, Renal, and Colon Xenograft Models. (United States)

    Boccia, Antonio; Virata, Cyrus; Lindner, Daniel; English, Nicki; Pathan, Nuzhat; Brickelmaier, Margot; Hu, Xiao; Gardner, Jennifer L; Peng, Liaomin; Wang, Xinzhong; Zhang, Xiamei; Yang, Lu; Perron, Keli; Yco, Grace; Kelly, Rebecca; Gamez, James; Scripps, Thomas; Bennett, Donald; Joseph, Ingrid B; Baker, Darren P


    Because of its tumor-suppressive effect, interferon-based therapy has been used for the treatment of melanoma. However, limited data are available regarding the antitumor effects of pegylated interferons, either alone or in combination with approved anticancer drugs. We report that treatment of human WM-266-4 melanoma cells with peginterferon beta-1a induced apoptotic markers. Additionally, peginterferon beta-1a significantly inhibited the growth of human SK-MEL-1, A-375, and WM-266-4 melanoma xenografts established in immunocompromised mice. Peginterferon beta-1a regressed large, established WM-266-4 xenografts in nude mice. Treatment of SK-MEL-1 tumor-bearing mice with a combination of peginterferon beta-1a and the MEK inhibitor PD325901 ((R)-N-(2,3-dihydroxypropoxy)-3,4-difluoro-2-(2-fluoro-4-iodophenylamino)benzamide) significantly improved tumor growth inhibition compared with either agent alone. Examination of the antitumor activity of peginterferon beta-1a in combination with approved anticancer drugs in breast and renal carcinomas revealed improved antitumor activity in these preclinical xenograft models, as did the combination of peginterferon beta-1a and bevacizumab in a colon carcinoma xenograft model.

  9. Renal teratogens. (United States)

    Morgan, Thomas M; Jones, Deborah P; Cooper, William O


    In utero exposure to certain drugs early in pregnancy may adversely affect nephrogenesis. Exposure to drugs later in pregnancy may affect the renin-angiotensin system, which could have an impact on fetal or neonatal renal function. Reduction in nephron number and renal function could have adverse consequences for the child several years later. Data are limited on the information needed to guide decisions for patients and providers regarding the use of certain drugs in pregnancy. The study of drug nephroteratogenicity has not been systematized, a large, standardized, global approach is needed to evaluate the renal risks of in utero drug exposures.

  10. Cryoablation for Small Renal Masses

    Directory of Open Access Journals (Sweden)

    J. L. Dominguez-Escrig


    Full Text Available Advances in imaging techniques (CT and MRI and widespread use of imaging especially ultrasound scanning have resulted in a dramatic increase in the detection of small renal masses. While open partial nephrectomy is still the reference standard for the management of these small renal masses, its associated morbidity has encouraged clinicians to exploit the advancements in minimally invasive ablative techniques. The last decade has seen the rapid development of laparoscopic partial nephrectomy and novel ablative techniques such as, radiofrequency ablation (RFA, high-intensity focused ultrasound (HIFU, and cryoablation (CA. In particular, CA for small renal masses has gained popularity as it combines nephron-sparing surgery with a minimally invasive approach. Studies with up to 5-year followup have shown an overall and cancer-specific 5-year survival of 82% and 100%, respectively. This manuscript will focus on the principles and clinical applications of cryoablation of small renal masses, with detailed review of relevant literature.

  11. [Renal angiomyolipoma complicated by retroperitoneal hematoma]. (United States)

    Rabii, R; Fekak, H; Moufid, K; Joual, A; Benjelloun, S; Khaleq, K; Idali, B; Harti, A; Barrou, L


    Renal angiomyolipoma (AML) is a benign tumor, they are generally asymptomatic or can manifested by abdominal pain, palpable mass or hematuria. We report an uncommoun case of 65 years old women who consulted for retroperitoneal hemorrhage by spontaneous rupture of renal AML with palpable mass. The ultrasound and CT abdominopelvic scan were performed in the preoperative diagnosis and showed a typical right renal AML with retroperitoneal hematoma. The right nephrectomy by transperitoneal approach was performed with a good follow-up. The histological examination confirmed the diagnosis for renal AML. About this case, the authors discuses the diagnosis and the management for AML with retroperitoneal hemorrhage.

  12. Sarcoidose renal

    Directory of Open Access Journals (Sweden)



    Full Text Available Em uma mulher de 62 anos, branca, em avaliação pré-operatória de facectomia, foram detectadas alterações urinárias, tendo sido firmados os diagnósticos de calculose renal esquerda e exclusão renal homolateral. No pré-operatório da nefrectomia foram evidenciados processo pulmonar intersticial bilateral e adenopatia torácica, cuja investigação foi adiada para após a cirurgia. No rim retirado foram detectados granulomas epitelióides não necrotizantes, o mesmo ocorrendo posteriormente em biópsia transbrônquica. A paciente foi tratada com metilprednisolona, com discreta melhora pulmonar, o que não ocorreu com a função renal. O diagnóstico final foi de sarcoidose com envolvimento pulmonar, ganglionar torácico e renal.

  13. Renal failure

    Institute of Scientific and Technical Information of China (English)


    930150 Epidermal growth factor and its recep-tor in the renal tissue of patients with acute re-nal failure and normal persons.LIU Zhihong(刘志红),et al.Jinling Hosp,Nanjing,210002.Natl Med J China 1992;72(10):593-595.Epidermal growth factor(EGF)and its receptor(EGF-R)were identified by immunohis-tochemical method(4 layer PAP)in the renaltissue specimens obtained from 11 normal kid-neys and 17 cases of acute renal failure(ARF).The quantitative EGF and EGF-R in the tissuewere expressed as positive tubules per mm~2.The amount of EGF and EGF-R in renal tissue

  14. Renal failure

    Institute of Scientific and Technical Information of China (English)


    2005234 Association between serum fetuin-A and clinical outcome in end-stage renal disease patients. WANG Kai(王开), Dept Renal Dis, Renji Hosp Shanghai, 2nd Med Univ, Shanghai 200001. Chin J Nephrol, 2005;21(2):72-75. Objective: To investigate the change of serum fetuin-A level before and after dialysis, and the association of serum fetuin-A level with clinical parameters

  15. Renal failure

    Institute of Scientific and Technical Information of China (English)


    950351 Serum erythropoietin levels in chronic renalinsufficiency.ZHAI Depei(翟德佩),et al.DeptNephrol.General Hosp,Tianjin Med Univ,Tianjin,300000.Tianjin Med J 1995;23(1):19-21.Patients with chronic renal insufficiency(CRI) areoften associated with anemia.The deficiency of EPOproduction in the kidney is thought to be a key factorin the pathogenesis of renal anemia.Serum erythropoi-

  16. Renal failure

    Institute of Scientific and Technical Information of China (English)


    2008463 Protective effect of recombination rat augmenter of liver regeneration on kidney in acute renal failure rats. TANG Xiaopeng(唐晓鹏), et al. Dept Nephrol, 2nd Affili Hosp Chongqing Med Univ, Chongqing 400010.Chin J Nephrol 2008;24(6):417-421. Objective To investigate the protective effects of recombination rat augmenter of liver regeneration (rrALR) on tubular cell injury and renal dysfunction

  17. Renal Hemangiopericytoma

    Directory of Open Access Journals (Sweden)

    İbrahim Halil Bozkurt


    Full Text Available Hemangiopericytoma is an uncommon perivascular tumor originating from pericytes in the pelvis, head and tneck, and the meninges; extremely rarely in the urinary system. We report a case of incidentally detected renal mass in which radiologic evaluation was suggestive of renal cell carcinoma. First, we performed partial nephrectomy, and then, radical nephrectomy because of positive surgical margins and the pathological examination of the surgical specimen that revealed a hemangiopericytoma. No additional treatment was administered.

  18. 2种硬化剂在单纯性肝肾囊肿硬化治疗中的对比研究%Comparative study on two sclerosant agents sclerotherapy for simple hepatic and renal cysts

    Institute of Scientific and Technical Information of China (English)



    Objective :To comparatively study the therapeutic effects on two sclerosant agents for sclerotherapy sinple hepatic and renal cysts under the guideline of ultrasound .Methods: Thirty-two cases with 36 cysts (18 hepatic cysts , 18 renal cysts in 14 cases) ,after the liquid material of the cystw as aspirated tonet by ultrasound-guided ,new sclerosant agent polidocanol(approved by State H20080445 ) was injected into and then remained in the hepatic and renal cysts .Adverse reactions and patient to lerance was ob served clinically , the efficien trate was counted an d trackied in 6 month s , and this statistics were compared with the corresponding notes of anhydrous ethanol sclerotherapy .Results : T hirty-two patients with 36 cysts were first punctured successfully ,according to 1/10-1/4 ratio of fluid capacity of cyst,polidocanol was injected into and kept in the cysts .The patients felt well, there was no irritating symptom s of pain and drunkenness .In a week after treatment,9 patients with flanks mild pain , interm ittent fevered 2 days , the symptom s went away w ithout special treatment ,no severe adverse reactions were ob served , 33 cysts disappeared and 3 cysts reduced above 2 /3 after 6 months , the overall response was 100% .The long- termcurative effect was still track ing .Twenty cases (12 hepatic cysts ,8 renalcysts )with ethanol sclerothecapy , after the liquid materialwas aspirated to net. according to 1/4-1/3 ratio of fluid capacity of cyst, anhydrous ethanolw as injected into the cysts .When injecting , short- term irritantpain occurred , 18 cases had flushing , rapid heartoeat, dry mouth , nausea , vomiting and so on symptom s of drunkenness , 15 cysts disappeared and 5 cases reduced above 2/3 6 months later.Conclusion : The effect of new sclerosan tagent polidocanol is consistent with anhydrous ethanol in sclero therapy simple hepatic and renal cysts .But polidocanol can be kept in the cyst, operation is sinple , the patients felt well in treatm

  19. MRI Scans (United States)

    Magnetic resonance imaging (MRI) uses a large magnet and radio waves to look at organs and structures inside your body. Health care professionals use MRI scans to diagnose a variety of conditions, from ...

  20. Drugs in pregnancy. Renal disease. (United States)

    Marsh, J E; Maclean, D; Pattison, J M


    The management of pregnant women with renal impairment presents a major challenge to obstetricians, nephrologists, and ultimately paediatricians. As renal failure progresses there is an increase in both maternal and fetal complications. Often these women have intercurrent medical conditions and, prior to conception, are receiving a broad range of prescribed medications. A successful obstetric outcome relies upon careful pre-pregnancy counselling and planning, obsessive monitoring during pregnancy, and close liaison between different specialist teams. Experience is mounting in the management of pregnant transplant recipients, but the introduction of newer immunosuppressive agents which have great promise in prolonging graft survival present new problems for those recipients of a kidney transplant who are planning to conceive. We review drug prescription for pregnant patients with renal impairment, end-stage renal failure, or a kidney transplant.

  1. Comparison of renal ultrasonography and dimercaptosuccinic acid renal scintigraphy in febrile urinary tract infection. (United States)

    Ayazi, Parviz; Mahyar, Abolfazl; Noroozian, Elham; Esmailzadehha, Neda; Barikani, Ameneh


    Accurate and early diagnosis and appropriate treatment of patient with urinary tract infection (UTI) are essential for the prevention or restriction of permanent damage to the kidneys in children. The aim of this study was to compare renal ultrasonography (US) and dimercaptosuccinic acid (DMSA) renal scan in the diagnosis of patients with febrile urinary tract infection. This study involved the medical records of children with febrile urinary tract infection who were admitted to the children's hospital in Qazvin, Iran. Pyelonephritis was diagnosed on the basis of clinical symptoms, laboratory tests and abnormal DMSA renal scans. The criteria for abnormality of renal US were an increase or a decrease in diffuse or focal parenchymal echogenicity, loss of corticomedullary differentiation, kidney position irregularities, parenchymal reduction and increased kidney size. Of the 100 study patients, 23% had an abnormal US and 46% had an abnormal DMSA renal scan. Of the latter patients, 15 had concurrent abnormal US (P value ≤ 0.03, concordance rate: 18%). Renal US had a sensitivity of 32%, specificity of 85%, positive predictive value of 65% and negative predictive value of 60%. Of the 77 patients with normal US, 31 (40.2%) had an abnormal DMSA renal scan. Despite the benefits and accessibility of renal US, its value in the diagnosis of pyelonephritis is limited.

  2. [Spontaneous renal artery dissection with renal infarction: a case report]. (United States)

    Oki, Takashi; Adachi, Hiroyuki; Tahara, Hideo; Kino, Sigeo


    A 58-year-old woman visited our hospital with nausea and right flank pain. At first abdominal ultrasonography was performed, suggesting a right renal infarction. Computed tomography (CT) study of the abdomen with intravenous contrast was performed to determine the cause of the symptoms. The scan revealed poor enhancement in the lower half of the right kidney. She was diagnosed with a right renal infarction. She was initially treated with anticoagulant therapy, but 5 days later, she complained of nausea. This time, CT demonstrated exacerbation of a right renal infarction with renal artery dissection. Based on this finding, we performed a right nephrectomy. The result of pathology was segmental arterial mediolysis. She was discharged 12 days after the surgery and is doing well at 6 months after discharge. Spontaneous renal artery dissection is a rare disease. It constitutes approximately 0.05% of arteriographic dissections. In addition, spontaneous renal artery dissection shows nonspecific symptoms. Together, these two factors may cause a delay in diagnosis.

  3. Radiocontrast-induced renal failure

    Energy Technology Data Exchange (ETDEWEB)

    Misson, R.T.; Cutler, R.E.


    Review of the literature concerning contrast-induced renal dysfunction shows that the currently used agents are remarkably safe with careful patient selection. Clinically apparent kidney failure after their use is essentially nonexistent in those without preexistent renal insufficiency. The incidence rises rapidly in those with azotemia from any cause, however, and diabetic persons with nephropathy are perhaps at special risk. Vigorous volume expansion is possibly effective as a preventive measure and may attenuate adverse effects in those in whom postcontrast dysfunction occurs. New agents are becoming available. It is not yet known if these will prove safer or cost-effective. They have some experimentally demonstrated and theoretical advantages over the presently used agents. 58 references, 1 figure, 2 tables.

  4. Scan Statistics

    CERN Document Server

    Glaz, Joseph


    Suitable for graduate students and researchers in applied probability and statistics, as well as for scientists in biology, computer science, pharmaceutical science and medicine, this title brings together a collection of chapters illustrating the depth and diversity of theory, methods and applications in the area of scan statistics.


    Kistner, I; Ott, C; Jumar, A; Friedrich, S; Grosso, R; Siegl, C; Schmieder, R E; Janka, R


    Renal perfusion is a key parameter of kidney function and the decrement of renal perfusion is a marker of target organ damage caused by hypertension. Detecting these changes in renal perfusion could help to manage antihypertensive therapy and evaluate patients[Combining Acute Accent] prognosis. Measurement of renal perfusion by MRI arterial spin labelling (ASL) is a non-invasive and non-time-consuming method without the need to inject any contrast agent. This study examined reproducibility of renal perfusion measured by 1.5 Tesla MRI. Renal perfusion was measured by ASL technique using an 1.5 Tesla MRI scanner. Subjects were scanned 3 times at two different days in an interval of two weeks to assess the test-retest reproducibility. Renal perfusion was automatically calculated for the cortex and medulla of the kidney by dedicated software. 14 patients were included with mean age 48.9 ± 12.7 and mean office blood pressure 132 ± 16/82 ± 10mmHg and estimated glomerular filtration rate> 60 ml/min/1.73m. The change of the mean total, cortical and medullary renal perfusion from the first examination to the second examination was 0.37 ± 13/0.62 ± 18/0.00 ± 12 ml/min/100 g kidney weight (p = 0.915/p = 0.898/p = 0.998), respectively. There was also no significant difference between the three renal perfusion measurements at one time point. For clinical trials these data indicate that to detect a 5% (10%) difference of cortical renal perfusion due to an intervention (vs placebo) only 38 (14) patients are required in face of the observed standard deviation for the change in renal perfusion. The inter and intra-session reproducibility of cortical renal perfusion assessed by MRI ASL 1.5 Tesla is excellent and small study cohorts can be used for examination of renal perfusion.

  6. Diagnostic Value of Multi-slice Spiral CT Multi-phase Scanning in Early Sage Renal Pelvis Cancer%多层螺旋CT多期扫描对早期肾盂癌的诊断价值

    Institute of Scientific and Technical Information of China (English)

    葛芳清; 韩希年


    目的 探讨多层螺旋CT多期扫描对早期肾盂癌的诊断价值.方法 回顾性分析5 8例肾盂癌的CT表现并进行CT分期,与组织病理学结果对照.结果 CT图像分期A期(早期)1 8例、B期3 2例、C期8例;病理分期早期(A期)24例、B期26例、C期8例.24例A期肾盂癌中,CT分期正确的1 7例,7例A期误判为B期,1例B期误判为A期.CT评判早期肾盂癌的敏感性70.8%(17/24),特异性97%(32/33),阳性预测值94.4% (17/18)%.结论 多层螺旋CT多期扫描对早期肾盂癌的判断有很高的特异性,对临床手术方案的选择起到很好的指导作用.%Objective To investigate the diagnostic value of enhanced multi-phase spiral CT in the early renal pelvis cancer.Methods CT manifestations of 58 cases with renal pelvis cancer were retrospectively analyzed and CT staged,and compared to its pathological results.Results CT image stage showed A stage (early stage) in 18 cases,B stage in 32 cases,C stage in 8 cases; pathological stage showed A stage (early stage) in 24 cases,B stage in 26 cases,C stage in 8 cases.Of all 24 cases with A stage renal pelvis cancer,17 cases were diagnosed correctly,and 7 cases with A stage cancer were misdiagnosed as B stage,and 1 case with B stage cancer misdiagnosed as A stage.The sensitivity,specificity,positive predictive value of CT stage in evaluation of early renal pelvis cancer were 70.8%(17/24),97% (32/33),and 94.4% (17/18) %.Conclusion Enhanced multi-phase spiral CT has high specificity in diagnosis of early stage renal pelvis cancer.It plays an important role in clinical operation scheme selection.

  7. Gadobutrol in Renally Impaired Patients (United States)

    Michaely, Henrik J.; Aschauer, Manuela; Deutschmann, Hannes; Bongartz, Georg; Gutberlet, Matthias; Woitek, Ramona; Ertl-Wagner, Birgit; Kucharczyk, Walter; Hammerstingl, Renate; De Cobelli, Francesco; Rosenberg, Martin; Balzer, Thomas; Endrikat, Jan


    Objective The aim of this study was to assess the potential risk of gadobutrol-enhanced magnetic resonance imaging (MRI) in patients with moderate to severe renal impairment for the development of nephrogenic systemic fibrosis (NSF). Materials and Methods We performed a prospective, international, multicenter, open-label study in 55 centers. Patients with moderate to severe renal impairment scheduled for any gadobutrol-enhanced MRI were included. All patients received a single intravenous bolus injection of gadobutrol at a dose of 0.1 mmol/kg body weight. The primary target variable was the number of patients who develop NSF within a 2-year follow-up period. Results A total of 908 patients were enrolled, including 586 with moderate and 284 with severe renal impairment who are at highest risk for developing NSF. The mean time since renal disease diagnosis was 1.83 and 5.49 years in the moderate and severe renal impairment cohort, respectively. Overall, 184 patients (20.3%) underwent further contrast-enhanced MRI with other gadolinium-based contrast agents within the 2-year follow-up. No patient developed symptoms conclusive of NSF. Conclusions No safety concerns with gadobutrol in patients with moderate to severe renal impairment were identified. There were no NSF cases. PMID:27529464

  8. Mechanism of action of tin-containing fluoride solutions as anti-erosive agents in dentine - an in vitro tin-uptake, tissue loss, and scanning electron microscopy study. (United States)

    Ganss, Carolina; Hardt, Martin; Lussi, Adrian; Cocks, Ann-Kristin; Klimek, Joachim; Schlueter, Nadine


    Solutions containing tin and fluoride exhibit remarkable anti-erosive properties with tin ions as a major agent. To elucidate its mechanism of action in dentine, the tin uptake on and in the tissue was investigated and related to histological findings and substance loss. Samples were treated twice daily, each treatment lasting for 2 min, with fluoride solutions [pH 4.5; 1,500 parts per million (p.p.m.) F] containing 2,100, 1,400, or 400 p.p.m. Sn as SnCl(2). In experiments 1 and 2, samples were eroded with citric acid (pH 2.3) six times each day, each treatment lasting for 5 min; in experiment 2, the demineralized organic matrix was continuously digested by collagenase; in experiment 3, no erosive challenges were performed. Sample surfaces and cross-sections were investigated using energy dispersive X-ray spectroscopy, scanning electron microscopy, and profilometry. Surface retention of tin was found in almost all treatment groups and was highest in experiment 2. On cross-sections, tin was retained within the organic matrix; in mineralized areas, tin was found mainly within a depth of 10 mum. Test solutions inhibited substance loss significantly; in experiment 2, the effect was dose-dependent. Erosion inhibition seemed to depend mainly on the incorporation of tin in the mineralized dentine when the organic portion was preserved, but on surface precipitation when the organic portion was continuously digested. (c) 2010 The Authors. Journal compilation (c) 2010 Eur J Oral Sci.

  9. Renal Cysts (United States)

    ... as “simple” cysts, meaning they have a thin wall and contain water-like fluid. Renal cysts are fairly common in ... simple kidney cysts, meaning they have a thin wall and only water-like fluid inside. They are fairly common in ...

  10. Renal failure

    Institute of Scientific and Technical Information of China (English)


    970363 Effect on serum PTH and 1, 25(OH)2 D3levels of rapid correction of metabolic acidosis in CRFpatients with secondary hyperparathyroidism. YUANQunsheng(袁群生), et al. Renal Div, PUMC Hosp,Beijing, 100730. Chin J Nephrol 1996; 12(6): 328-331.

  11. Drug-induced renal injury

    African Journals Online (AJOL)

    Drugs can cause acute renal failure by causing pre-renal, intrinsic or post-renal toxicity. Pre-renal ... incidence of drug dose adjustment in renal impairment in the SAMJ. ... Fever, haemolytic anaemia, thrombocytopenia, renal impairment and.

  12. Evaluation of left renal vein entrapment using multidetector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Poyraz, Ahmet K.; Onur, Mehmet R. [Dept. of Radiology, Firat Univ. School of Medicine, Elazig (Turkey)], e-mail:; Firdolas, Fatih [Dept. of Urology, Firat Univ. School of Medicine, Elazig (Turkey); Kocakoc, Ercan [Dept. of Radiology, Bezmialem Vakif Univ., School of Medicine, Istanbul (Turkey)


    Background: Nutcracker syndrome, also called left renal vein entrapment syndrome, is a cause of non-glomerular hematuria with difficulties in diagnosis. Multidetector computed tomography (MDCT) is a powerful tool to prevent unnecessary diagnostic procedures. Purpose: To retrospectively determine the prevalence of nutcracker phenomenon and nutcracker syndrome seen in MDCT in consecutive patients. Material and Methods: The institutional review board approved the study and waived the requirement for informed consent. Abdominal contrast-enhanced MDCT scans were reviewed from 1000 consecutive patients. MDCT scan assessment included renal vein diameter measurements and evaluation for the presence of anterior or posterior left renal vein entrapment. Electronic medical records and urine analysis reports of patients with left renal vein entrapment were reviewed. Student's t test was used to assess differences in renal vein diameter in patients with left renal vein entrapment. Results: Left renal vein entrapment was observed in 10.9% (109), retroaortic left renal vein in 6.5% (65), entrapment of left renal vein between superior mesenteric artery and aorta in 4.1% (41), and circumaortic left renal vein in 0.3% (3) of patients. Mean diameters of right (8.8 {+-} 1.9 mm) and unentrapped left (8.9 {+-} 1.8 mm) renal veins were not significantly different (P = 0.1). The mean diameter of anterior entrapped left renal veins (10.3 {+-} 2 mm) was significantly greater (P = 0.04) than contralateral renal veins (8.6 {+-} 2.1 mm) in their widest portion. In 8.8% of patients with the left renal vein entrapment, urine analysis showed isomorphic hematuria or proteinuria with no other known cause. Varicocele and pelvic congestion were seen in 5.5% of patients with the left renal vein entrapment. Conclusion: Left renal vein entrapment is not a rare entity and renal nutcracker phenomenon might be underdiagnosed.

  13. Head CT scan (United States)

    Brain CT; Cranial CT; CT scan - skull; CT scan - head; CT scan - orbits; CT scan - sinuses; Computed tomography - cranial; CAT scan - brain ... hold your breath for short periods. A complete scan usually take only 30 seconds to a few ...

  14. Renal failure (chronic)


    Clase, Catherine


    Chronic renal failure is characterised by a gradual and sustained decline in renal clearance or glomerular filtration rate (GFR). Continued progression of renal failure will lead to renal function too low to sustain healthy life. In developed countries, such people will be offered renal replacement therapy in the form of dialysis or renal transplantation. Requirement for dialysis or transplantation is termed end-stage renal disease (ESRD).Diabetes, glomerulonephritis, hypertension, pyelone...

  15. Emphysematous prostatitis in renal transplant

    Directory of Open Access Journals (Sweden)

    Krishnaswamy Sampathkumar


    Full Text Available Urinary tract infections are common following renal transplant. The spectrum varies from asymptomatic bacteriuria to septicemia. Gas-producing infections of the urinary tract are rare but tend to have a grave prognosis when they do occur. We report a 57-year-old gentleman who underwent a renal transplant 20 months earlier. He presented to us with fever and dysuria. Clinical examination revealed a febrile and ill-looking patient with severe graft tenderness. An emergency pelvic CT scan revealed presence of emphysematous prostatitis, cystitis and pyelitis. Urine and blood cultures grew E. coli . Endoscopic abscess drainage was done and antibiotics given but he succumbed to his illness due to multiorgan failure within 48h. This is the first reported case of emphysematous prostatitis in a renal allograft recipient.

  16. Split renal function measured by triphasic helical CT

    Energy Technology Data Exchange (ETDEWEB)

    Hackstein, Nils [Radiologische Gemeinschaftspraxis am Evangelischen Krankenhaus, Paul-Zipp-Str. 171, 35398 Giessen (Germany)]. E-mail:; Buch, Thomas [Department of Diagnostic Radiology, Klinikstr. 36, Justus-Liebig University Giessen, 35385 Giessen (Germany)]. E-mail:; Rau, Wigbert S. [Department of Diagnostic Radiology, Klinikstr. 36, Justus-Liebig University Giessen, 35385 Giessen (Germany)]. E-mail:; Weimer, Rolf [Department of Internal Medicine, Klinikstr. 36, Justus-Liebig University Giessen, 35385 Giessen (Germany)]. E-mail:; Klett, Rigobert [Clinic of Nuclear Medicine, Friedrichstr. 25, Justus-Liebig University Giessen, 35385 Giessen (Germany)]. E-mail:


    Purpose: To present a method for calculating split renal function solely from routine triphasic helical computed tomography (CT). Subjects and methods: We retrospectively included 26 adult patients who received renal scintigraphy and triphasic CT within 4 weeks in the years 2003 and 2004. All scans were performed using a standard abdominal protocol. Split renal function was calculated as relative single-kidney glomerular filtration rate (GFR) using a simplified 'two-point Patlak plot' technique. As a reference method, split renal function was determined from renal scintigraphy using the standard technique. Results: Linear correlation between the two methods was r = 0.91, split renal function (CT) = 0.0266 + 0.9573 x split renal function (scintigraphy). Conclusion: Split renal function can be measured accurately by minimally extended triphasic CT.

  17. Renal infarct: a rare disease due to a rare etiology (United States)

    Akshintala, Divya; Bansal, Saurabh K.; Emani, Vamsi Krishna; Yadav, Manajyoti


    Renal infarction is caused by profound hypoperfusion secondary to embolic/thrombotic occlusion of the renal artery or vasospasm of the renal artery. We present a case of a 54-year-old patient who presented with nausea, vomiting, and vague abdominal pain. He had frequent episodes of migraine headaches and he treated himself with as needed rizatriptan. CT scan of the abdomen showed renal cortical infarction. After extensive investigations, etiology of his renal infarct was deemed to be due to rizatriptan. PMID:26091657

  18. Renal infarct: a rare disease due to a rare etiology

    Directory of Open Access Journals (Sweden)

    Divya Akshintala


    Full Text Available Renal infarction is caused by profound hypoperfusion secondary to embolic/thrombotic occlusion of the renal artery or vasospasm of the renal artery. We present a case of a 54-year-old patient who presented with nausea, vomiting, and vague abdominal pain. He had frequent episodes of migraine headaches and he treated himself with as needed rizatriptan. CT scan of the abdomen showed renal cortical infarction. After extensive investigations, etiology of his renal infarct was deemed to be due to rizatriptan.

  19. Case report of a symptomatic giant renal oncocytoma.

    LENUS (Irish Health Repository)

    Ahmad, Sarfraz


    Renal oncocytomas are benign tumours, often asymptomatic, and picked incidentally on radiological imaging. We present a case report of a symptomatic giant renal oncocytoma in a 61-year old man having lower back\\/right flank pain. A large right renal mass was identified on abdominal CT scan. Radiological features were not sufficient to differentiate this lesion from renal cancer. Right radical nephrectomy was performed. Typical features of oncocytoma, without evidence of malignancy, were seen on histological examination of the specimen. In this report, we discuss literature review of radiological, genetic, and pathological characteristics of renal oncocytoma.

  20. Contrast-enhanced peripheral MRA. Technique and contrast agents

    Energy Technology Data Exchange (ETDEWEB)

    Nielsen, Yousef W. [Dept. of Radiology, Copenhagen Univ. Hospital Bispebjerg, Bispebjerg (Denmark)], e-mail:; Thomsen, Henrik S. [Dept. of Diagnostic Radiology, Copenhagen Univ. Hospital Herlev, Herlev (Denmark)


    In the last decade contrast-enhanced magnetic resonance angiography (CE-MRA) has gained wide acceptance as a valuable tool in the diagnostic work-up of patients with peripheral arterial disease. This review presents current concepts in peripheral CE-MRA with emphasis on MRI technique and contrast agents. Peripheral CE-MRA is defined as an MR angiogram of the arteries from the aortic bifurcation to the feet. Advantages of CE-MRA include minimal invasiveness and lack of ionizing radiation. The basic technique employed for peripheral CE-MRA is the bolus-chase method. With this method a paramagnetic MRI contrast agent is injected intravenously and T1-weighted images are acquired in the subsequent arterial first-pass phase. In order to achieve high quality MR angiograms without interfering venous contamination or artifacts, a number of factors need to be taken into account. This includes magnetic field strength of the MRI system, receiver coil configuration, use of parallel imaging, contrast bolus timing technique, and k-space filling strategies. Furthermore, it is possible to optimize peripheral CE-MRA using venous compression techniques, hybrid scan protocols, time-resolved imaging, and steady-state MRA. Gadolinium(Gd)-based contrast agents are used for CE-MRA of the peripheral arteries. Extracellular Gd agents have a pharmacokinetic profile similar to iodinated contrast media. Accordingly, these agents are employed for first-pass MRA. Blood-pool Gd-based agents are characterized by prolonged intravascular stay, due to macromolecular structure or protein binding. These agents can be used for first-pass, as well as steady-state MRA. Some Gd-based contrast agents with low thermodynamic stability have been linked to development of nephrogenic systemic fibrosis in patients with severe renal insufficiency. Using optimized technique and a stable MRI contrast agent, peripheral CE-MRA is a safe procedure with diagnostic accuracy close to that of conventional catheter X

  1. Isolated pleural metastases from renal cell carcionoma

    DEFF Research Database (Denmark)

    Eckardt, Jens; Ladegaard, Lars; Licht, Peter Bjorn


    A 71-year-old female was referred with three right-sided intrathoracic tumours. In 2003, she underwent radical left nephrectomy for renal cell cancer (RCC) clinical stage 1. She was since followed at her local hospital with annual computed tomography (CT)-scans during the first five years and did....... Histology demonstrated metastases from RCC which apparently can reach the parietal pleura without lung metastases. Keywords: Pleural metastasis; Renal cell cancer....

  2. Sorafenib in renal cell carcinoma. (United States)

    Davoudi, Ehsan Taghizadeh; bin-Noordin, Mohamed Ibrahim; Javar, Hamid Akbari; Kadivar, Ali; Sabeti, Bahare


    Cancer is among most important causes of death in recent decades. Whoever the renal cell carcinoma incidence is low but it seems it is more complicated than the other cancers in terms of pathophysiology and treatments. The purpose of this work is to provide an overview and also deeper insight to renal cell carcinoma and the steps which have been taken to reach more specific treatment and target therapy, in this type of cancer by developing most effective agents such as Sorafenib. To achieve this goal hundreds of research paper and published work has been overviewed and due to limitation of space in a paper just focus in most important points on renal cell carcinoma, treatment of RCC and clinical development of Sorafenib. The information presented this paper shows the advanced of human knowledge to provide more efficient drug in treatment of some complicated cancer such as RCC in promising much better future to fight killing disease.

  3. Renal cell carcinoma in functional renal graft: Toward ablative treatments. (United States)

    Tillou, Xavier; Guleryuz, Kerem; Collon, Sylvie; Doerfler, Arnaud


    The occurrence of a kidney transplant tumor is a rare but serious issue with a double risk: the return to dialysis and the development of metastatic cancer. Publications on this topic are mainly case reports. The purpose of this review was to report an exhaustive literature review of functional graft renal cell carcinomas to highlight the impact of tumors on the renal graft outcomes. 201 de novo renal carcinomas in functional renal grafts from 69 publications were included. Incidence was estimated at 0.18%. Graft tumors were mostly asymptomatic (85.9%). Whatever the discovery circumstances of graft tumors, they were mostly documented by graft ultrasounds supplemented by CT-scanning or MR imaging. Nephron sparing surgery (95 patients) was the first treatment performed followed by radiofrequency ablation (38 patients) and cryotherapy (10 patients). The most common tumor graft histology was clear cell carcinoma (46.4%), followed by papillary carcinoma (43.7%). Specific mortality was 2.9% with 6 deaths. Renal graft cell carcinoma is a rare pathology with a low specific death. When possible, conservative treatment should be the first choice. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Renale Osteopathie


    Horn S


    Die renale Osteopathie umfaßt Erkrankungen des Knochens, die bei Patienten mit chronischen Nierenerkrankungen auftreten, wie den sekundären bzw. tertiären Hyperparathyreoidismus, die adynamische Knochenerkrankung und die Osteopathie nach Nierentransplantation. Durch die Identifikation des Kalzium-Sensing-Rezeptors bzw. des Vitamin D-Rezeptors hat sich unser Verständnis der Zusammenhänge in den letzten Jahren erheblich verbessert. Neue Medikamente versprechen effizientere Prophylaxe- und Thera...

  5. Renale Knochenerkrankungen

    Directory of Open Access Journals (Sweden)

    Mayer G


    Full Text Available Störungen des Mineral- und Knochenstoffwechsels sind bei fast allen Patienten mit chronischen Nierenerkrankungen anzutreffen. Pathogenetisch spielt eine Neigung zur Phosphatretention bei einer Reduktion der glomerulären Filtrationsrate die zentrale Rolle. Neben typischen, aber sehr variablen Veränderungen der Knochenstruktur (renale Osteopathie besteht auch eine sehr enge Assoziation zwischen diesen Störungen und dem massiv erhöhten kardiovaskulären Risiko der Patienten.

  6. Obesity and renal hemodynamics

    NARCIS (Netherlands)

    Bosma, R. J.; Krikken, J. A.; van der Heide, J. J. Homan; de Jong, P. E.; Navis, G. J.


    Obesity is a risk factor for renal damage in native kidney disease and in renal transplant recipients. Obesity is associated with several renal risk factors such as hypertension and diabetes that may convey renal risk, but obesity is also associated with an unfavorable renal hemodynamic profile

  7. Obesity and renal hemodynamics

    NARCIS (Netherlands)

    Bosma, R. J.; Krikken, J. A.; van der Heide, J. J. Homan; de Jong, P. E.; Navis, G. J.


    Obesity is a risk factor for renal damage in native kidney disease and in renal transplant recipients. Obesity is associated with several renal risk factors such as hypertension and diabetes that may convey renal risk, but obesity is also associated with an unfavorable renal hemodynamic profile inde

  8. Metastatic renal cell carcinoma management

    Directory of Open Access Journals (Sweden)

    Flavio L. Heldwein


    Full Text Available PURPOSE: To assess the current treatment of metastatic renal cell carcinoma, focusing on medical treatment options. MATERIAL AND METHODS: The most important recent publications have been selected after a literature search employing PubMed using the search terms: advanced and metastatic renal cell carcinoma, anti-angiogenesis drugs and systemic therapy; also significant meeting abstracts were consulted. RESULTS: Progress in understanding the molecular basis of renal cell carcinoma, especially related to genetics and angiogenesis, has been achieved mainly through of the study of von Hippel-Lindau disease. A great variety of active agents have been developed and tested in metastatic renal cell carcinoma (mRCC patients. New specific molecular therapies in metastatic disease are discussed. Sunitinib, Sorafenib and Bevacizumab increase the progression-free survival when compared to therapy with cytokines. Temsirolimus increases overall survival in high-risk patients. Growth factors and regulatory enzymes, such as carbonic anhydrase IX may be targets for future therapies. CONCLUSIONS: A broader knowledge of clear cell carcinoma molecular biology has permitted the beginning of a new era in mRCC therapy. Benefits of these novel agents in terms of progression-free and overall survival have been observed in patients with mRCC, and, in many cases, have become the standard of care. Sunitinib is now considered the new reference first-line treatment for mRCC. Despite all the progress in recent years, complete responses are still very rare. Currently, many important issues regarding the use of these agents in the management of metastatic renal cancer still need to be properly addressed.

  9. Post-renal acute renal failure due to a huge bladder stone. (United States)

    Celik, Orcun; Suelozgen, Tufan; Budak, Salih; Ilbey, Yusuf Ozlem


    A 63-year old male was referred to our emergency unit due to acute renal failure. The level of serum renal function tests levels, blood urea nitrogen (BUN)/creatinine, were 63 mmol/L/848 μmol/L. CT (Computarised Tomography) scan showed a huge bladder stone (5 cm x 6 cm x 5 cm) with increased bladder wall thickness. Post-renal acute renal failure due to bilateral ureterohydronephrosis was diagnosed. The huge bladder stone was considered to be the cause of ureterohydronephrosis and renal failure. The patient was catheterised and received haemodialysis immediately. He received haemodialysis four times during ten days of hospitalization and the level of serum renal function tests levels (BUN/ creatinine) decreased 18 mmol/L/123 μmol/L. After improvement of renal function, we performed cystoscopy that demonstrated normal prostatic urethra and bladder neck and bilaterally normal ureteral orifices. Bladder wall was roughly trabeculated and Bladder outlet was completely obstructed by a huge bladder stone. After cystoscopy open, cystolithotomy was performed to remove calcium phosphate and magnesium ammonium phosphate stone weighing 200 g removed. Four days after operation the patient was discharged uneventfully and urethral catheter was removed on the seventh day. Post-renal acute renal failure due to large bladder stones is rare in literature. According to the our knowledge; early diagnosis of the stone avoid growth to large size and prevent renal failure.

  10. Ossifying renal tumor of infancy. (United States)

    Schelling, Johannes; Schröder, Annette; Stein, Raimund; Rösch, Wolfgang H


    A renal ossifying tumor of infancy is a rare event with few cases having been published, and the etiology has not yet been established. We report on two new cases of this unusual neoplasm. A 2-year-old boy presented with intermittent painless gross hematuria. After several diagnostic procedures, an open pyelolithotomy was performed and the histological diagnosis of renal tumor of infancy was finally made. The history of the second case is very similar. An 8-week-old infant presented with gross hematuria. As in the first case, an open pyelolithotomy was performed and a tumor entirely covered with blood clots was found in the renal pelvis and completely removed. A histological diagnosis of renal ossifying tumor of infancy was made. Using the literature available, the histological criteria and biological behavior are discussed, together with the diagnostic and therapeutic algorithm for this tumor. In infants with gross hematuria and a calcified (non-)invasive mass in the pelvi-calceal system, renal ossifying tumor should be considered in the differential diagnosis. MRI or CT scan offers a good diagnostic guide.

  11. Renal parameter estimates in unrestrained dogs (United States)

    Rader, R. D.; Stevens, C. M.


    A mathematical formulation has been developed to describe the hemodynamic parameters of a conceptualized kidney model. The model was developed by considering regional pressure drops and regional storage capacities within the renal vasculature. Estimation of renal artery compliance, pre- and postglomerular resistance, and glomerular filtration pressure is feasible by considering mean levels and time derivatives of abdominal aortic pressure and renal artery flow. Changes in the smooth muscle tone of the renal vessels induced by exogenous angiotensin amide, acetylcholine, and by the anaesthetic agent halothane were estimated by use of the model. By employing totally implanted telemetry, the technique was applied on unrestrained dogs to measure renal resistive and compliant parameters while the dogs were being subjected to obedience training, to avoidance reaction, and to unrestrained caging.

  12. Renal Aspects of Peptic Ulcer Pharmacology

    Directory of Open Access Journals (Sweden)

    Daniel Muruve


    Full Text Available Medications to treat peptic ulcer disease are used widely and may have adverse effects on renal function. Similarly, renal dysfunction may alter the pharmacokinetics of this diverse group of medications resulting in dosage adjustments. The older agents, antacids and sucralfate, allow absorption of cations (calcium, magnesium and aluminum which may result in toxicity. Newer medications (H2 blockers and omeprazole appear to have fewer side effects and be better tolerated with appropriate dosage adjustments.

  13. Thyroid Scan and Uptake (United States)

    ... News Physician Resources Professions Site Index A-Z Thyroid Scan and Uptake Thyroid scan and uptake uses ... the Thyroid Scan and Uptake? What is a Thyroid Scan and Uptake? A thyroid scan is a ...

  14. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Thyroid Scan and Uptake Thyroid scan and uptake uses ... the Thyroid Scan and Uptake? What is a Thyroid Scan and Uptake? A thyroid scan is a ...

  15. Thyroid Scan and Uptake (United States)

    ... Physician Resources Professions Site Index A-Z Thyroid Scan and Uptake Thyroid scan and uptake uses small ... Thyroid Scan and Uptake? What is a Thyroid Scan and Uptake? A thyroid scan is a type ...


    Institute of Scientific and Technical Information of China (English)


    Objective To further evaluate the effect of hypertension on renal graft function, and the relationship between hypertension, hyperlipoidemia and ischemic heart disease. Methods 102 renal transplant recipients with a functioning renal graft for more than 1 year were enrolled in this study. Renal function was followed for the further 24 months. Results The overall prevalence of hypertension was 89.2%(91/102) and 36.2%(33/91) hypertensive patients had uncontrolled blood pressure. After 24 months those with high blood pressure had significantly higher Scr levels than normotensive patients (P<0.05). The number of different antihypertensive classes required was related to Scr (P<0.05). Plasma cholesterol levels in hypertension patients especially in blood pressure uncontrolled group were significantly elevated (P<0.01). Ischemic heart disease was more common in hypertensive patients (P<0.05). Cyclosporine A was associated with hypertension more frequently than azathioprine and FK506, whereas low-dose prednisolone did not appear to influence blood pressure. Conclusion The data further confirmed that hypertension was associated with hyperlipidemia and ischemic heart disease, and emerged as a predictor of renal graft dysfunction. Whether cyclosporine A should be converted to new immunosuppressive agents and which class of antihypertensive medication is more effective in this population remain open questions.

  17. Emergency Transcatheter Arterial Embolization for Acute Renal Hemorrhage. (United States)

    Wang, Hong Liang; Xu, Chun Yang; Wang, Hong Hui; Xu, Wei


    The aims of this study were to identify arteriographic manifestations of acute renal hemorrhage and to evaluate the efficacy of emergency embolization. Emergency renal artery angiography was performed on 83 patients with acute renal hemorrhage. As soon as bleeding arteries were identified, emergency embolization was performed using gelatin sponge, polyvinyl alcohol particles, and coils. The arteriographic presentation and the effect of the treatment for acute renal hemorrhage were analyzed retrospectively. Contrast extravasation was observed in 41 patients. Renal arteriovenous fistulas were found in 12 of the 41 patients. In all, 8 other patients had a renal pseudoaneurysm, 5 had pseudoaneurysm rupture complicated by a renal arteriovenous fistula, and 1 had pseudoaneurysm rupture complicated by a renal artery-calyceal fistula. Another 16 patients had tumor vasculature seen on arteriography. Before the procedure, 35 patients underwent renal artery computed tomography angiography (CTA). Following emergency embolization, complete hemostasis was achieved in 80 patients, although persistent hematuria was present in 3 renal trauma patients and 1 patient who had undergone percutaneous nephrolithotomy (justifying surgical removal of the ipsilateral kidney in this patient). Two-year follow-up revealed an overall effective rate of 95.18 % (79/83) for emergency embolization. There were no serious complications. Emergency embolization is a safe, effective, minimally invasive treatment for renal hemorrhage. Because of the diversified arteriographic presentation of acute renal hemorrhage, proper selection of the embolic agent is a key to successful hemostasis. Preoperative renal CTA plays an important role in diagnosing and localizing the bleeding artery.

  18. Bilateral Renal Mass-Renal Disorder: Tuberculosis

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    Ozlem Tiryaki


    Full Text Available A 30-year-old woman has presented complaining of weakness and fatigue to her primary care physician. The renal sonography is a routine step in the evaluation of new onset renal failure. When the renal masses have been discovered by sonography in this setting, the functional imaging may be critical. We reported a case about bilateral renal masses in a young female patient with tuberculosis and renal insufficiency. Magnetic resonance (MR has revealed the bilateral renal masses in patient, and this patient has been referred to our hospital for further management. The patient’s past medical and surgical history was unremarkable.

  19. Colovesical fistula demonstrated on renal cortical scintigraphy. (United States)

    Stathaki, Maria; Vamvakas, Lampros; Papadaki, Emmanouela; Papadimitraki, Elisavet; Tsaroucha, Angeliki; Karkavitsas, Nikolaos


    A 70-year-old man with a history of weight loss, changes in bowel habits, and hematochezia had rectal adenocarcinoma. He was palliated with diverting colostomy, followed by radiochemotherapy. Bilateral hydronephrosis was found incidentally on lower abdominal CT scan. He underwent 99mTc dimercaptosuccinic acid scan prior to percutaneous nephrostomy tube placement. Apart from the renal cortex, scintigraphy showed activity in the ascending colon continuous to the activity of the bladder. This indicated urine extravasation on account of a colovesical fistula, complicating postoperative radiation treatment. Here we highlight the contribution of renal cortical scintigraphy in the detection of colovesical fistulas.

  20. Distal renal tubular acidosis (United States)

    Renal tubular acidosis - distal; Renal tubular acidosis type I; Type I RTA; RTA - distal; Classical RTA ... excreting it into the urine. Distal renal tubular acidosis (Type I RTA) is caused by a defect ...

  1. Proximal renal tubular acidosis (United States)

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

  2. Multicentre, parallel-group, comparative trial evaluating the efficacy and safety of sugammadex in patients with end-stage renal failure or normal renal function.

    NARCIS (Netherlands)

    Staals, L.M.; Snoeck, M.M.J.; Driessen, J.J.; Flockton, E.A.; Heeringa, M.; Hunter, J.M.


    BACKGROUND: Sugammadex, a modified gamma-cyclodextrin, is the first selective relaxant binding agent that specifically encapsulates the steroidal neuromuscular blocking agent, rocuronium. The action of rocuronium is prolonged in patients with renal failure. As sugammadex is primarily cleared

  3. Renal tuberculosis

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    Džamić Zoran


    Full Text Available Tuberculosis is still a significant health problem in the world, mostly in developing countries. The special significance lies in immunocompromised patients, particularly those suffering from the HIV. Urogenital tuberculosis is one of the most common forms of extrapulmonary tuberculosis, while the most commonly involved organ is the kidney. Renal tuberculosis occurs by hematogenous dissemination of mycobacterium tuberculosis from a primary tuberculosis foci in the body. Tuberculosis is characterized by the formation of pathognomonic lesions in the tissues - granulomata. These granulomata may heal spontaneously or remain stable for years. In certain circumstances in the body associated with immunosuppression, the disease may be activated. Central caseous necrosis occurs within tuberculoma, leading to formation of cavities that destroy renal parenchyma. The process may gain access to the collecting system, forming the caverns. In this way, infection can be spread distally to renal pelvis, ureter and bladder. Scaring of tissue by tuberculosis process may lead to development of strictures of the urinary tract. The clinical manifestations are presented by nonspecific symptoms and signs, so tuberculosis can often be overlooked. Sterile pyuria is characteristic for urinary tuberculosis. Dysuric complaints, flank pain or hematuria may be presented in patients. Constitutional symptoms of fever, weight loss and night sweats are presented in some severe cases. Diagnosis is made by isolation of mycobacterium tuberculosis in urine samples, by cultures carried out on standard solid media optimized for mycobacterial growth. Different imaging studies are used in diagnostics - IVU, CT and NMR are the most important. Medical therapy is the main modality of tuberculosis treatment. The first line anti-tuberculosis drugs include isoniazid, rifampicin, pyrazinamide and ethambutol. Surgical treatment is required in some cases, to remove severely damaged kidney, if

  4. Renale Osteopathie

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    Horn S


    Full Text Available Die renale Osteopathie umfaßt Erkrankungen des Knochens, die bei Patienten mit chronischen Nierenerkrankungen auftreten, wie den sekundären bzw. tertiären Hyperparathyreoidismus, die adynamische Knochenerkrankung und die Osteopathie nach Nierentransplantation. Durch die Identifikation des Kalzium-Sensing-Rezeptors bzw. des Vitamin D-Rezeptors hat sich unser Verständnis der Zusammenhänge in den letzten Jahren erheblich verbessert. Neue Medikamente versprechen effizientere Prophylaxe- und Therapiemöglichkeiten. Wir beeinflussen dadurch nicht nur die Morbidität und Lebensqualität, sondern auch die Mortalität unserer Patienten.

  5. Renal disease in pregnancy. (United States)

    Thorsen, Martha S; Poole, Judith H


    Anatomic and physiologic adaptations within the renal system during pregnancy are significant. Alterations are seen in renal blood flow and glomerular filtration, resulting in changes in normal renal laboratory values. When these normal renal adaptations are coupled with pregnancy-induced complications or preexisting renal dysfunction, the woman may demonstrate a reduction of renal function leading to an increased risk of perinatal morbidity and mortality. This article will review normal pregnancy adaptations of the renal system and discuss common pregnancy-related renal complications.


    Directory of Open Access Journals (Sweden)

    N Ataei


    Full Text Available "nUrinary tract infection (UTI may lead to irreversible changes in renal parenchyma. Early diagnosis using scintigraphy with technetium-99m-labeled dimercaptosuccinic acid (DMSA scan and early treatment may decrease or prevent development of renal parenchymal lesions. The aim of this study was to assess the occurrence of renal parenchymal lesion in children admitted with a first-time symptomatic UTI and to evaluate the relation between renal parenchymal damage and severity of vesicoureteral reflux (VUR. A total of 102 children with first time acute pyelonephritis (APN were enrolled in the study. All children studied with DMSA scan and ultrasonography (US. Voiding cystourethrography (VCUG was performed in 98 children when urine culture became negative. Changes on the DMSA scan and US were found in 178 (88% and 5 (2.4% out of 203 renal units during the acute phase, respectively. All abnormal renal units on US showed severe parenchymal involvement on DMSA. We also found significant correlation between severity of VUR and abnormal US results on kidneys. Of 40 kidneys with reflux, 38 (95% were found to have abnormal renal scan. Among 155 kidneys with non-refluxing ureters 132 (85.2% revealed parenchymal changes on renal cortical scintigraphy. Kidneys with moderate to severe reflux were more likely to have severe renal involvement. We found a high incidence of renal parenchymal changes in children with APN. Additionally, renal involvement was significantly higher in children with moderate to severe reflux. When there are high-grade VUR and female gender, the risk of renal parenchymal involvement is higher.

  7. Renal calculus

    CERN Document Server

    Pyrah, Leslie N


    Stone in the urinary tract has fascinated the medical profession from the earliest times and has played an important part in the development of surgery. The earliest major planned operations were for the removal of vesical calculus; renal and ureteric calculi provided the first stimulus for the radiological investigation of the viscera, and the biochemical investigation of the causes of calculus formation has been the training ground for surgeons interested in metabolic disorders. It is therefore no surprise that stone has been the subject of a number of monographs by eminent urologists, but the rapid development of knowledge has made it possible for each one of these authors to produce something new. There is still a technical challenge to the surgeon in the removal of renal calculi, and on this topic we are always glad to have the advice of a master craftsman; but inevitably much of the interest centres on the elucidation of the causes of stone formation and its prevention. Professor Pyrah has had a long an...

  8. Posterior urethral valves: relationship between vesicoureteral reflux and renal function. (United States)

    Cozzi, Denis A; Morgante, Debora; Frediani, Simone; Iaconelli, Romina; Ceccanti, Silvia; Mele, Ermelinda; Cozzi, Francesco


    To investigate the relationship between renal function and vesicoureteral reflux before and after valve ablation in patients with posterior urethral valves. In these patients, back pressure may not be the only cause of renal damage. We conducted a retrospective review of 37 patients with valves consecutively treated between 1970 and 2002. Data were available for 31 patients, 19 of whom presented reflux at presentation. Grade of reflux was ascertained by voiding cystourethrography. Overall renal function was measured by serum creatinine, and split renal function was estimated by dimercaptosuccinic acid scan available for all patients but two. Before relief of obstruction, there was no correlation between split renal function and grade of reflux into 25 kidneys of the 17 patients (r = -.13; 95% CI, -.50 to .27; P = .51). High-grade reflux (grade IV-V) affected 6 of the 11 renal units, with split renal function >40% vs 11 of the 14 units with split renal function 40% vs 4 of the 14 units with split renal function <40% (P = .0005). The good renal function of more than half of the renal units with high-grade reflux at presentation, and the persistence of reflux mainly in nonfunctioning or poorly functioning kidneys after valve ablation, support the concept that in some patients with valves, reflux and renal damage are associated anomalies. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. MAG3 renal scintigraphy: improved ability to make anatomical diagnoses in neonates

    Energy Technology Data Exchange (ETDEWEB)

    Rossleigg, M.A.; Kainer, G.; Rosenberg, A.R. [Prince of Wales Hospital, Randwick, NSW (Australia); Farnaworth, R.H. [Prince Henry Hospital, Sydney, NSW (Australia). Dept. of Urology


    Technetium-99m mercaptoacetyltriglycine (MAG3) is the most recently introduced renal radiopharmaceutical in Australia and is established as the agent of choice for use in diuresis renography, particularly in neonates and infants. It provides superior anatomical information compared to previously used agents. Three cases are reported in which MAG3 diuresis renography was performed in neonates, who were found to have hydronephrosis detected antenatally. In two neonates, a previously unrecognized horseshoe kidney was demonstrated and in case 3 there were scan features characteristic of a ureterocele. It is highly unlikely that these abnormalities would have been delineated with {sup 99m}Tc dimethyltriamine pentaacetic acid (DTPA) study, as confirmed in case 1, because of the relatively poor uptake of DTPA when compared to MAG3. 6 refs., 3 figs.

  10. Helix Scan: A Scan Design for Diagnosis

    Institute of Scientific and Technical Information of China (English)

    WANG Fei; HU Yu; LI Xiaowei


    Scan design is a widely used design-for-testability technique to improve test quality and efficiency. For the scan-designed circuit, test and diagnosis of the scan chain and the circuit is an important process for silicon debug and yield learning. However, conventional scan designs and diagnosis methods abort the subsequent diagnosis process after diagnosing the scan chain if the scan chain is faulty. In this work, we propose a design-for-diagnosis scan strategy called helix scan and a diagnosis algorithm to address this issue. Unlike previous proposed methods, helix scan has the capability to carry on the diagnosis process without losing information when the scan chain is faulty. What is more, it simplifies scan chain diagnosis and achieves high diagnostic resolution as well as accuracy. Experimental results demonstrate the effectiveness of our design.

  11. Differential analysis of clinical features in atherosclerotic renal artery stenosis and benign nephrosclerosis

    Institute of Scientific and Technical Information of China (English)



    Objective To analyze and compare the clinical characteristics of atherosclerotic renal artery stenosis (ARAS) and benign nephrosclerosis (BN) in order to distinguish the ARAS from BN. Methods A retrospective study was performed on 82 hypertensive patients with renal injury. Patients were divided into BN and ARAS group according to renal artery doppler scanning. The

  12. US detection of renal and ureteral calculi in patients with suspected renal colic


    Vallone, Gianfranco; Napolitano, Giuseppina; Fonio, Paolo; Antinolfi, Gabriele; Romeo, Antonio; Macarini, Luca; Genovese, Eugenio Annibale; Brunese, Luca


    Purpose The purpose of this study was to determine whether the color Doppler twinkling sign could be considered as an additional diagnostic feature of small renal lithiasis (_5mm). Methods 181 patients underwent CT scans performed for other pathologies; the images were also analyzed by a radiologists to identify the incidental presence of renal lithiasis equal to or smaller than 5 mm. These patients underwent an abdominal ultrasound examination, including grayscale analysis of the kidneys and...

  13. Comparison between the use of 99% ethanol and 3% polidocanol in percutaneous echoguided sclerotherapy treatment of simple renal cysts

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    Lucio Dell′Atti


    Conclusions: Polidocanol is a safe and effective sclerosing agent for renal cysts, with superior clinical results than ethanol. Therefore, polidocanol can be an alternative to ethanol in sclerotherapy of renal cysts.

  14. Comparative effects of enalapril and nifedipine on renal hemodynamics in hypertensive renal allograft recipients. (United States)

    Abu-Romeh, S H; el-Khatib, D; Rashid, A; Patel, M; Osman, N; Fayyad, M; Scheikhoni, A; Higazi, A S


    The comparative effects of enalapril (E) and nifedipine (N) on renal hemodynamics were assessed in twenty-two moderately hypertensive, cadaveric renal transplant patients who were maintaining stable renal function. Fourteen patients were on cyclosporin (CSA) and eight were receiving azathioprine with prednisolone (AZA). In each patient effective renal plasma flow (ERPF) was determined four times, first baseline, second with E, third as another baseline after a washout period, and fourth with N; and renal vascular resistance (RVR) was derived in each. ERPF and RVR were significantly compromised in the CSA group (202 +/- 55 ml/min and 65 +/- 18 mmHg/ml/min) compared to the AZA group (302 +/- 99 and 43 +/- 15 respectively). During E therapy, RVR further increased in the CSA group to 82 +/- 37 while it decreased in the AZA group to 31 +/- 7 (both changes were significant when compared to their respective baseline values). N, on the other hand, only significantly lowered RVR in the AZA group. Furthermore, two patients, one from each group, developed acute reversible renal failure shortly after E therapy. However, both agents were effective in lowering blood pressure to a comparable degree in both groups. In conclusion, our data showed a somewhat less favourable renal hemodynamic response to short-term enalapril therapy in hypertensive renal transplant patients maintained on CSA. However, the significance of such hemodynamic changes for long-term renal function remains uncertain.

  15. Renal actinomycosis with concomitant renal vein thrombosis. (United States)

    Chang, Dong-Suk; Jang, Won Ik; Jung, Ji Yoon; Chung, Sarah; Choi, Dae Eun; Na, Ki-Ryang; Lee, Kang Wook; Shin, Yong-Tai


    Renal actinomycosis is a rare infection caused by fungi of the genus Actinomyces. A 74-year-old male was admitted to our hospital because of gross hematuria with urinary symptoms and intermittent chills. Computed tomography of the abdomen showed thrombosis in the left renal vein and diffuse, heterogeneous enlargement of the left kidney. After nephrectomy, sulfur granules with chronic suppurative inflammation were seen microscopically, and the histopathological diagnosis was renal actinomycosis. Our case is the first report of renal actinomycosis with renal vein thrombosis.


    Directory of Open Access Journals (Sweden)

    Soraia Geraldo Rozza Lopes


    Full Text Available El objetivo del estudio fue comprender el significado de espera del trasplante renal para las mujeres en hemodiálisis. Se trata de un estudio cualitativo-interpretativo, realizado con 12 mujeres en hemodiálisis en Florianópolis. Los datos fueron recolectados a través de entrevistas en profundidad en el domicilio. Fue utilizado el software Etnografh 6.0 para la pre-codificación y posterior al análisis interpretativo emergieron dos categorías: “las sombras del momento actual”, que mostró que las dificultades iniciales de la enfermedad están presentes, pero las mujeres pueden hacer frente mejor a la enfermedad y el tratamiento. La segunda categoría, “la luz del trasplante renal”, muestra la esperanza impulsada por la entrada en la lista de espera para un trasplante.

  17. Renal failure

    Institute of Scientific and Technical Information of China (English)


    930564 Dwell times affect the local host de-fence mechanism of peritoneal dialysis patients.WANG Tao(汪涛),et al.Renal Instit,SunYatsen Med Univ,Guangzhou,510080.Chin JNephrol 1993;9(2):75—77.The effect of different intraperitoneal awelltimes on the local host defence in 6 peritonealdialysis patients was studied.A significant de-crease in the number of peritoneal cells,IgG con-centration and the phagoeytosis and bactericidalactivity of macrophages was determined when thedwell time decreased from 12 to 4 hs or form 4 to0.5hs,but the peroxidase activity in macrophagesincreased significantly.All variables,except theperoxidase activity in macrophages,showed nosignificant difference between patients of high or

  18. Traumatismo renal


    Rocha, Sofia Rosa Moura Gomes da


    Introdução: A realização deste trabalho visa a elaboração de uma revisão sistematizada subordinada à temática da traumatologia renal. Objectivos: Os principais objectivos deste trabalho são: apurar a etiologia, definir a classificação, analisar o diagnóstico e expôr o tratamento e as complicações. Desenvolvimento: Os traumatismos são a principal causa de morte antes dos 40 anos. O rim é o órgão do aparelho génito-urinário mais frequentemente atingido. Os traumatismos renais são mais fre...

  19. Lumbar spine CT scan (United States)

    CAT scan - lumbar spine; Computed axial tomography scan - lumbar spine; Computed tomography scan - lumbar spine; CT - lower back ... your breath for short periods of time. The scan should take only 10 to 15 minutes.

  20. IgG4-related inflammatory pseudotumor of the renal pelvis involving renal parenchyma, mimicking malignancy. (United States)

    Park, Ho Gyun; Kim, Kyoung Min


    IgG4-related disease is a recently recognized systemic disease characterized by storiform fibrosis with infiltration of IgG4-positive plasma cells. In rare incidences, IgG4-related renal disease can present as a solitary mass lesion at renal pelvis and can pose a diagnostic challenge since these lesions mimic malignancy. Herein, we present a rare case of IgG4-related disease presenting as inflammatory pseudotumor lesion, involving the renal pelvis and also neighboring renal parenchyma. A 75-year-old man with no history of IgG4-related disease underwent computed tomography (CT) scan for evaluation of prostatic cancer. The CT scan incidentally revealed a mass lesion located at the right renal pelvis. Radiologic findings were highly suggestive of malignancy. Therefore, the patient underwent right nephroureterectomy. Microscopically, the mass lesion showed storiform fibrosis with diffuse and intense inflammatory cell infiltration. Infiltrating cells were mainly histiocytes and plasma cells. Tubulointerstitium adjacent to the lesion also showed fibrosis with abundant plasmacytic infiltration. Immunohistochemical staining revealed the presence of IgG4-positive plasma cells in both the mass lesion and tubulointerstitium (mean of 94/HPF per field). Considering these findings, we diagnosed the mass lesion as IgG4-related inflammatory pseudotumor of the renal pelvis. In patients with renal pelvic masses, IgG4-related inflammatory pesudotumor should be considered in the differential diagnosis to avoid unnecessary surgical intervention.

  1. 75 FR 49215 - Medicare Program; End-Stage Renal Disease Quality Incentive Program (United States)


    ... Renal Disease Quality Incentive Program AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS...) for Medicare outpatient end-stage renal disease (ESRD) dialysis providers and facilities with payment... Erythropoiesis stimulating agent ESRD End stage renal disease FDA Food and Drug Administration Kt/V A measure...

  2. CT增强扫描对比剂碘帕醇大量渗漏1例的改进措施及护理体会%Improvement measures and nursing experience for one case of large leakage of enhanced CT scan contrast agent Iopamidol

    Institute of Scientific and Technical Information of China (English)



    Enhanced CT scan contrast agent is administrated through high-pressure injection, with large pressure and high flow rate, it is prone to leak. Through effective nursing of one case of large leakage of enhanced CT scan contrast agent Iopamidol, the patient achieved good recovery. Through analyzing the patient, the causes were investigated, and the CT scan setting was improved and the intravenous catheter was applied. As a result, large leakage was prevented and the incidence of leakage was significantly reduced.%CT增强扫描对比剂为高压注射,压力大,流速快,容易发生渗漏.本文对1例对比剂碘帕醇大量渗漏的病例通过有效的护理,患者取得较好的恢复效果.通过该例患者的分析,查找原因,并进行CT扫描设置的改进和采用静脉留置针,防止了大剂量渗漏的发生,大大减少了渗漏的发生率.

  3. Acute leukaemia following renal transplantation. (United States)

    Subar, M; Gucalp, R; Benstein, J; Williams, G; Wiernik, P H


    Four renal transplant patients on immunosuppressive therapy who presented with acute myeloid leukaemia are described. In two cases, azathioprine may have played an important role as a cofactor in leukaemogenesis. In a third case, the alkylating agent cyclophosphamide may have contributed. All patients were treated for leukaemia with full doses of cytotoxic chemotherapy and, in each case, a functioning renal allograft was preserved throughout the treatment despite attenuation of immunosuppressive therapy. Three patients achieved complete remission. Of the three, one is surviving at 2 years and two expired during the pancytopenic phase of their treatment with no active leukaemia present, and with intact renal function. As increasing expertise in the field of organ transplantation allows patients to survive longer, such patients' exposure to immunosuppressive and potentially leukaemogenic drugs is prolonged. The risk of secondary neoplasia has been previously documented in this population. Two of the four cases reported here suffered from polycystic kidney disease as their underlying condition. While this report suggests that the leukaemias are related to renal transplantation, we cannot rule out an association with the underlying disease which led to the transplant. This report further suggests that the leukaemia that develops in such patients may respond to standard therapy, and that such treatment does not compromise the transplanted kidney.

  4. Fibrate therapy and renal function. (United States)

    Sica, Domenic A


    Fibrates are a class of lipid-lowering medications primarily used as second-line agents behind statins. The adverse-effect profile of fibrates has been marked by a puzzling yet reversible rise in serum creatinine values with their use. It is not known whether this finding represents a true change in renal function. One proposed explanation for this phenomenon is that fibrates increase the production of creatinine, in which case a rise in serum creatinine values would not represent a true deterioration in renal function. An alternative theory is that fibrates reduce the production of vasodilatory prostaglandins, which would lead to a true change in renal function in patients who experience a rise in serum creatinine values. Routine serum creatinine monitoring is advisable in fibrate-treated patients, particularly in those with preexisting renal disease. A 30% increase in serum creatinine values in the absence of other causes of serum creatinine change warrants discontinuation of fibrate therapy. Serum creatinine values can take several weeks to return to their baseline values following discontinuation of a fibrate.

  5. Right-Sided Intrarenal Splenosis Mimicking a Renal Carcinoma

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    Jay B. Page


    Full Text Available We describe a patient who underwent nephrectomy for an enhancing right renal mass that was subsequently pathologically confirmed as right renal splenosis. Since renal splenosis is quite rare and has previously been reported only in the left kidney, we did not consider splenosis in our differential diagnosis during the evaluation of the renal mass. Magnetic resonance imaging, as well as radionucleotide scan using 99mTc-labelled red blood cells, has been utilized for identifying ectopic splenic tissue. An elevated index of suspicion must be present in patients with a history of splenectomy or traumatic splenic rupture to avoid undue nephrectomy.

  6. Drug administration in patients with renal insufficiency. Minimising renal and extrarenal toxicity. (United States)

    Matzke, G R; Frye, R F


    Renal insufficiency has been associated with an increased risk of adverse effects with many classes of medications. The risk of some, but not all, adverse effects has been linked to the patient's degree of residual renal function. This may be the result of inappropriate individualisation of those agents that are primarily eliminated by the kidney, or an alteration in the pharmacodynamic response as a result of renal insufficiency. The pathophysiological mechanism responsible for alterations in drug disposition, especially metabolism and renal excretion, is the accumulation of uraemic toxins that may modulate cytochrome P450 enzyme activity and decrease glomerular filtration as well as tubular secretion. The general principles to enhance the safety of drug therapy in patients with renal insufficiency include knowledge of the potential toxicities and interactions of the therapeutic agent, consideration of possible alternatives therapies and individualisation of drug therapy based on patient level of renal function. Although optimisation of the desired therapeutic outcomes are of paramount importance, additional pharmacotherapeutic issues for patients with reduced renal function are the prevention or minimisation of future acute or chronic nephrotoxic insults, as well as the severity and occurrence of adverse effects on other organ systems. Risk factors for the development of nephrotoxicity for selected high-risk therapies (e.g. aminoglycosides, nonsteroidal anti-inflammatory drugs, ACE inhibitors and radiographic contrast media) are quite similar and include pre-existing renal insufficiency, concomitant administration of other nephrotoxins, volume depletion and concomitant hepatic disease or congestive heart failure. Investigations of prophylactic approaches to enhance the safety of these agents in patients with renal insufficiency have yielded inconsistent outcomes. Hydration with saline prior to drug exposure has given the most consistent benefit, while sodium

  7. Novel use of carbon dioxide arteriography in renal artery pseudoaneurysm in patients with poor renal function (United States)

    Said, Mohammed A; McGuire, Barry B; Liu, Joceline S; Resnick, Scott A; Nadler, Robert B


    Renal artery pseudoaneurysm (RAP) is a rare complication of partial nephrectomy, but is usually effectively managed with renal vessel embolisation. We report a particularly challenging case of a patient with chronic kidney disease (CKD) who developed a RAP following a laparoscopic heminephrectomy and was treated using superselective renal vessel coil embolisation with carbon dioxide (CO2) as the primary contrast agent for arteriographic localisation of the RAP and feeder artery. To the best our knowledge we report the first utilisation of CO2 arteriography in the definitive diagnosis and treatment of RAP following heminephrectomy in a patient with severe CKD. PMID:25498109

  8. Renal tumor and trauma: a pitfall for conversative management

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    Simone de Campos Vieira Abib


    Full Text Available PURPOSE: Conservative management has been largely used for renal trauma. Although this approach is safe and highly recommended, it can hide a pre-existing unknown condition, such as tumors or urinary malformations. A high index of suspicion is needed for early recognition of these conditions. We present four cases treated at the Pediatric Oncology Institute - Federal University of São Paulo, which have been initially treated conservatively for renal trauma. MATERIALS AND METHODS: We reviewed all 218 renal cases of renal tumors treated at our institution in a 22-year period, searching for associated trauma events. RESULTS: Four cases of renal tumors were initially treated conservatively for blunt renal trauma of low energy mechanism. Patients' ages ranged from 7 to 12 years old. Two patients had no previous symptoms, one patient had hematuria and another had an abdominal mass. Computerized Axial Tomography (CT of the abdomen revealed disparate magnitude of the renal bleeding to the low energy mechanism of trauma. All patients underwent surgical treatment. Kidney specimens showed Wilms tumor in three cases and renal carcinoma in one. CONCLUSIONS: The association between renal tumors and trauma should be suspected when renal trauma hemorrhage on abdominal CT scan does not match the low energy mechanism of blunt abdominal trauma. The key for a successful diagnosis of renal tumor or congenital malformations is the high index of suspicion for these conditions.

  9. Unusual Presentation of Renal Vein Thrombosis in a Preterm Infant. (United States)

    Yang, Chang-Yo; Fu, Ren-Huei; Lien, Reyin; Yang, Peng-Hong


    Neonatal renal vein thrombosis is the most common vascular condition in the newborn kidney, which could lead to serious complication in infants undergoing intensive care. In this study, we report the case of a preterm infant with left renal vein and inferior vena cava thrombosis, presented with gross hematuria, thrombocytopenia, transient hypertension, and adrenal hemorrhage. Supportive care was offered instead of heparin therapy or thrombolytic agents. In conclusion, our case teaches that, despite the lack of a clinically obvious shock event, renal vein thrombosis should be considered in a macrohematuric newborn without renal failure.

  10. Evaluation of Renal Histopathological Changes, as a Predictor of Recoverability of Renal Function Following Pyeloplasty for Ureteropelvic Junction Obstruction

    Directory of Open Access Journals (Sweden)



    Full Text Available Background Pyeloplasty is a widely accepted treatment for ureteropelvic junction obstruction (UPJO. However, the renal function recoverability after pyeloplasty is still a matter of debate. Different parameters have been used to predict renal functional recoverability after corrective surgery, with conflicting results. Objectives In this study, renal biopsy was carried on a series of cases of UPJO, during pyeloplasty, to study the extent of histological alterations in renal parenchyma, as a result of obstruction, and its predictive value in renal function recoverability after pyeloplasty. Patients and Methods We retrospectively analyzed the renal biopsy obtained during pyeloplasty in 53 adult patients. Histopathological changes were graded on a scale of 1 to 3, according to their severity, and compared with the differential renal function (DRF revealed on the preoperative and postoperative follow up diethylene triamine pentaacetic acid (DTPA renal scan. A Fischer’s t test was used to evaluate statistical differences between values. Results This study showed a linear relationship between the severity of histological changes and renal function recovery, after pyeloplasty. Out of 24 obstructed renal units (ORU, with minimal histopathological changes (grade I, 21 ORU (87.5%, with > 35% DRF preoperatively, showed significant improvement in renal function after 12 months of pyeloplasty (P 0.05. Renal function deterioration after pyeloplasty was not observed in any of the cases. Conclusions The severity of pathological changes in renal parenchyma, due to UPJO, is a good predictor of renal function recoverability, after pyeloplasty. The ORUs, with DRF > 35%, usually have normal (grade I renal biopsy and might be expected to present better functional recoverability after pyeloplasty.

  11. Anatomic variations of the renal vessels: focus on the precaval right renal artery. (United States)

    Bouali, Ourdia; Labarre, David; Molinier, François; Lopez, Raphaël; Benouaich, Vincent; Lauwers, Frédéric; Moscovici, Jacques


    The aim of this study was to determine the prevalence of precaval right renal artery and to investigate the distribution of renal arteries and veins. We discuss a theory of development of renal vascular variants. We retrospectively reviewed 120 arterial phase contrast material-enhanced spiral computerized tomography scans of the abdomen (1- to 2-mm section thickness) performed during a two-month period. Forty percent of the study group (48 patients) had one artery and one vein on each side, with typical course. There was a 9.17% prevalence of precaval right renal artery: 10 patients had a lower pole accessory artery in precaval position and one patient had the main and the accessory arteries that pass anterior to the inferior vena cava. In these cases, associated variations of renal vessels were higher than in the patients without precaval artery variant. There were multiple arteries in 28.3% of the right kidneys and in 26.7% of the left ones. Variants of the right renal vein consisted in multiple veins in 20% (24 cases). We detected no case of multiple left renal veins, but we described variations of its course (circum- or retroaortic vein) in 9.17% (11 cases). Twenty-six patients (21.7%) had associated variations of the renal pedicle. The current technical support allows for a minimally invasive study of vessels anatomy. In our study the prevalence of a precaval right renal artery appears to be higher than previously reported (9.17%). Knowledge on anatomical variations of right renal artery and associated renal vessels variations has major clinical implications.

  12. MRI with a lymph-node-specific contrast agent as an alternative to CT scan and lymph-node dissection in patients with prostate cancer: a prospective multicohort study.

    NARCIS (Netherlands)

    Heesakkers, R.A.M.; Hovels, A.M.; Jager, G.J.; Bosch, H.C. van den; Witjes, J.A.M.; Raat, H.P.; Severens, J.L.; Adang, E.M.M.; Hulsbergen- van de Kaa, C.A.; Futterer, J.J.; Barentsz, J.O.


    BACKGROUND: In patients with prostate cancer who are deemed to be at intermediate or high risk of having nodal metastases, invasive diagnostic pelvic lymph-node dissection (PLND) is the gold standard for the detection of nodal disease. However, a new lymph-node-specific MR-contrast agent ferumoxtran

  13. Cyclosporine-induced renal dysfunction in human renal allograft recipients. (United States)

    Kiberd, B A


    Cyclosporine-treated renal allograft recipients frequently suffer CsA-related nephrotoxicity and hypertension. This study demonstrates that glomerular filtration rate is reduced acutely by 13% (P less than 0.02) and renal vascular resistance increased by 30% (P less than 0.05), immediately after patients take their CsA dose. The reduction in GFR is directly related to their trough CsA level (r = 0.82; P less than 0.01). The lower the trough CsA level the greater the fall in GFR after the CsA dose. Plasma renin activity does not increase after the CsA dose (pre-CsA 0.6 +/- 0.2 ng/L/sec vs. post-CsA 0.4 +/- 0.1 ng/L/sec; P = NS), and therefore cannot be responsible for the reduction in renal function. Short-term nifedipine treatment is effective in preventing the acute reduction in GFR (P less than 0.05). This occurred despite no apparent effect of nifedipine in altering trough or post-dose CsA levels. Furthermore nifedipine was effective in lowering both the mean arterial blood pressure (109 mmHg to 94 mmHg; P less than 0.01) and the elevated renal vascular resistance (25% reduction; P less than 0.02) observed in these patients. These results suggest that nifedipine may be a suitable agent for limiting acute CsA nephrotoxicity and for treating CsA-associated hypertension in renal allograft recipients.

  14. Imaging Renal Urea Handling in Rats at Millimeter Resolution using Hyperpolarized Magnetic Resonance Relaxometry

    DEFF Research Database (Denmark)

    Reed, Galen D; von Morze, Cornelius; Verkman, Alan S


    originated from the renal extravascular space, thus allowing the vascular and renal filtrate contrast agent pools of the [(13)C,(15)N2]urea to be distinguished via multi-exponential analysis. The T2 response to induced diuresis and antidiuresis was performed with two imaging agents: hyperpolarized [(13)C,(15...

  15. Non-contrast magnetic resonance angiography in renal transplantation and renal donation

    DEFF Research Database (Denmark)

    Blankholm, Anne Dorte


    examination of living kidney donors. We compared CTA to an extensive MRI protocol without the use of contrast agents, including NCMRA, and to observations from living donor nephrectomy, which served as the reference standard. We concluded that an optimised MRI protocol without contrast agents could...... be substituted for CTA for preoperative vessel assessment in living kidney donors.......Renal transplantation is the treatment of choice in cases of severe renal disease. The majority of candidates for kidney transplantation have arteriosclerosis to some extent; thus, preoperative imaging of the vessels is needed. Different imaging modalities are available and are used...

  16. Renal hemodynamics in hypertensive renal allograft recipients: effects of calcium antagonists and ACE inhibitors. (United States)

    Grekas, D; Dioudis, C; Kalevrosoglou, I; Alivanis, P; Derveniotis, V; Tourkantonis, A


    Hypertension present in more than 50% of successfully renal transplanted patients and its prevalence has slightly increased since the introduction of cyclosporine A. Twenty patients, 9 women and 11 men aged from 30 to 58 years, with stable cadaveric renal allograft function and moderate to severe hypertension, were included in the study. Renal artery graft stenosis causing hypertension were excluded. All patients were given triple drug immunosuppressive treatment with methylprednisolone, azathioprine and cyclosporine A (CsA) and their hypertension was treated with a nifedipine dose of 20 mg twice daily. To evaluate the effect of ACE inhibitors on renal hemodynamics and hypertension, a 4 mg/daily dose of perindopril was added to the above regimen for two months. Effective renal plasma flow (ERPF) decreased from 208 +/- 54 to 168 +/- 61 ml/min and renal vascular resistance (RVR) increased from 75 +/- 12 to 88 +/- 17 mm Hg/ml/min (P nifedipine. It is suggested that the combination of both antihypertensive agents was more effective than monotherapy with nifedipine in controlling blood pressure, but less favorable on the renal hemodynamic response in hypertensive renal transplant patients who were maintained on CsA.

  17. Blunt abdominal injury induced by injury of renal pedicle renal infarction after analysis of characteristics of MSCT%腹部钝性伤致肾蒂损伤后肾梗死的MSCT特征分析

    Institute of Scientific and Technical Information of China (English)

    王富泉; 蔡艳伟


    pedicle hemoperitoneum MSCT performance: ( 1 ) , ( 2 ) thickening and diaphragm diaphragm the feet infiltrating signs , ( 3 ) the clearance sheet after bleeding , (4) 1-12 h after injury of renal contour , shape, size, density did not see abnormalities , renal adipose capsule around the clear, (5) after the injury after 24 h before the kidney, renal fascia slightly thickened, week renal adipose capsule a funicular , (6) after 3 days after injury kidney volume increased further , density decreased , renal adipose capsule flocculent shadow , zhou renal fascia thickening , diaphragmatic after clearance and diaphragm foot HP did not increase , both in the renal inside , no kidney laterally hemorrhage, (7) enhanced scanning contrast agents within the visible renal vascular and renal perfusion reduction and renal perfusion , could appear renal segmental and complete renal infarction , renal cortex showed linear strengthening "cortical ring sign"(8) merger and bowel mesenteric vascular injury contusion .Conclusion:Early bleeding after renal pedicle injury should be characteristic medial to the kid -ney, mainly in the diaphragm and diaphragm foot clearance , after merger of mesenteric vascular and bowel lesions , enhanced scan could be found as early as possible renal perfusion , provide imaging basis for clinical choice suitable treatment , surgeons in excessive force should be paid attention to when the intestinal surgery to repair , to avoid further injury of renal pedicle .

  18. [Pharmacology of inotropic agents]. (United States)

    Pastelín Hernández, Gustavo


    High-risk patients, during anesthesia and after surgery present changes in pharmacokinetics (biotransformation reactions, renal clearance, drug interactions, etc.) modifying the usefulness of most drugs, cardiac inotropics included. This group of substances is formed by adrenergic agents, phospodiesterase inhibitors and digitalis compounds. Adrenergic agents are the catecholamines, adrenaline (A), noradrenaline (NA) and dopamine (D), plus dopaminergic agonists as dobutamine and pirbuterol. Phosphodiesterase inhibitors, as amrinone and milrinone, produce their inotropic action by preserving cyclic adenosine monophosphate (AMPc) from its intracellular catabolism. Recent studies on the utility of digitalis compounds demonstrated the valuable applicability of digoxin in chronic and acute heart failure. Another group of substances whose mechanism of action differs from that of the inotropics, offers future utility in high risk patients, they include: inhibitors of nitric oxide sintases, natriuretic atrial peptide inhibitors, Q-10 coenzyme, endothelin antagonists, and anti-tumoral necrosis factor.

  19. [Bilateral renal infarction after discontinuation of anticoagulant therapy]. (United States)

    Lavoignet, Charles-Éric; Le Borgne, Pierrick; Ugé, Sarah; Veneziano, Rinaldo; Brunhuber, Claudia; Kam, Claire; Bilbault, Pascal


    Acute renal infarction is an uncommon and often under diagnosed condition mostly because of misleading symptoms. Accurate data regarding clinical presentation, laboratory tests, diagnostic and treatment are lacking. Detection is often delayed or missed because of non-specific clinical presentation. The mechanisms of acute renal infarction are various, mainly embolic or thrombotic. Abdominal CT scan remains the most valuable exam to confirm the diagnosis. Therapeutic guidelines for the treatment of renal embolism have not been well established. The standard treatment strategy includes anticoagulation with or without thrombolysis. Despite the uncertainty regarding management, the renal outcome remains favorable. Some patients do develop some degree of renal insufficiency during the acute episode. We report here the case of a 73-year-old woman with bilateral acute renal infarction after discontinuation of anticoagulant therapy.

  20. Lung gallium scan (United States)

    Gallium 67 lung scan; Lung scan; Gallium scan - lung; Scan - lung ... Gallium is injected into a vein. The scan will be taken 6 to 24 hours after the gallium is injected. (Test time depends on whether your condition is acute or chronic .) ...

  1. Invasive Aspergillosis in a Renal Transplant Recipient Successfully Treated with Interferon-Gamma

    Directory of Open Access Journals (Sweden)

    C. Estrada


    Full Text Available Invasive aspergillosis is a serious complication of solid organ transplantation. An early diagnosis is hampered by the lack of reliable serum markers and, even if appropriately diagnosed and treated with current antifungal agents, has a high mortality rate. We report a case of invasive pulmonary and cerebral aspergillosis in a renal transplant patient treated with IFN-γ in conjunction with combination anti-fungal therapy for six weeks in whom complete resolution of the fungal infection was achieved. Renal function remained intact throughout the treatment period. Surveillance CT scans of the chest and head showed resolution of prior disease but revealed a new left upper lobe mass four months after completion of treatment with IFN-γ. Biopsy of the lesion was positive for primary lung adenocarcinoma, for which she underwent left upper lobe resection. The pathology report confirmed clear surgical margins and lymph nodes and no evidence of fungal hyphae. IFN-γ should be considered early in the management of invasive aspergillosis in renal transplant patients. To date, allograft rejection has not been encountered.

  2. (67/68)Ga-labeling agent that liberates (67/68)Ga-NOTA-methionine by lysosomal proteolysis of parental low molecular weight polypeptides to reduce renal radioactivity levels. (United States)

    Uehara, Tomoya; Rokugawa, Takemi; Kinoshita, Mai; Nemoto, Souki; Fransisco Lazaro, Guerra Gomez; Hanaoka, Hirofumi; Arano, Yasushi


    The renal localization of gallium-67 or gallium-68 ((67/68)Ga)-labeled low molecular weight (LMW) probes such as peptides and antibody fragments constitutes a problem in targeted imaging. Wu et al. previously showed that (67)Ga-labeled S-2-(4-isothiocyanatobenzyl)-1,4,7-triazacyclononane-1,4,7-triacetic acid (SCN-Bz-NOTA)-conjugated methionine ((67)Ga-NOTA-Met) was rapidly excreted from the kidney in urine following lysosomal proteolysis of the parental (67)Ga-NOTA-Bz-SCN-disulfide-stabilized Fv fragment (Bioconjugate Chem., (1997) 8, 365-369). In the present study, a new (67/68)Ga-labeling reagent for LMW probes that liberates (67/68)Ga-NOTA-Met was designed, synthesized, and evaluated using longer-lived (67)Ga in order to reduce renal radioactivity levels. We employed a methionine-isoleucine (MI) dipeptide bond as the cleavable linkage. The amine residue of MI was coupled with SCN-Bz-NOTA for (67)Ga-labeling, while the carboxylic acid residue of MI was derivatized to maleimide for antibody conjugation in order to synthesize NOTA-MI-Mal. A Fab fragment of the anti-Her2 antibody was thiolated with iminothiolane, and NOTA-MI-Mal was conjugated with the antibody fragment by maleimide-thiol chemistry. The Fab fragment was also conjugated with SCN-Bz-NOTA (NOTA-Fab) for comparison. (67)Ga-NOTA-MI-Fab was obtained at radiochemical yields of over 95% and was stable in murine serum for 24 h. In the biodistribution study using normal mice, (67)Ga-NOTA-MI-Fab registered significantly lower renal radioactivity levels from 1 to 6 h postinjection than those of (67)Ga-NOTA-Fab. An analysis of urine samples obtained 6 h after the injection of (67)Ga-NOTA-MI-Fab showed that the majority of radioactivity was excreted as (67)Ga-NOTA-Met. In the biodistribution study using tumor-bearing mice, the tumor to kidney ratios of (67)Ga-NOTA-MI-Fab were 4 times higher (6 h postinjection) than those of (67)Ga-NOTA-Fab. Although further studies including the structure of radiometabolites and

  3. Changes in renal cortical and medullary perfusion in a patient with renal vein thrombosis

    Directory of Open Access Journals (Sweden)

    Al-Said Jafar


    Full Text Available Dynamic renal perfusion computerized tomographic (CT scan was performed to test the cortical and medullary perfusion in a patient with unilateral renal vein thrombosis secondary to idiopathic focal and segmental glomerulosclerosis (FSGS. Forty mL of Iohexol was injected intra-venously. Multiple fixed repeated axial renal CT scan cuts at specific intervals, over the mid pole, were recorded over 400 seconds. Radio density was measured over the aorta, cortex and medulla during that period. Graphs for the radio contrast density against time were plotted. Aortic, cortical and medullary perfusions were calculated by estimating the slopes of the curves. Based on the CT scan findings, perfusion of different parts of the kidney was measured. The reduction in kidney function with renal vein thrombosis seems to be secondary to hypoperfusion of renal cortex and medulla. Further studies are required to confirm this observation. The blood flow to the kidney im-proved within four days after therapy with anticoagulation and pulse steroids. The sequences of events that take place need further studies for validation.

  4. Renal Papillary Necrosis: Role of Radiology (United States)

    Pandya, Vaidehi K.


    Renal Papillary Necrosis (RPN) is idefined as Ischemic necrobiosis of the papilla in the medulla of the kidneys. Variety of etiological factors are recognized which cause papillary necrosis, such as analgesic nephropathy, diabetes mellitus, urinary obstruction and sickle cell haemoglobinopathy. The early diagnosis of RPN is important to improve prognosis and reduce morbidity. Radiological Imaging offers early diagnosis and can guide prompt treatment of papillary necrosis and can minimize a decline in renal function. Here we report three cases of RPN with typical imaging findings. One of them was diabetic and hypertensive female with recurrent Urinary tract Infections and other was a male with no known co-morbidity. Both of them were diagnosed to have renal papillary necrosis on CT scan and were managed operatively and conservatively, respectively. Third case was a healthy female being investigated to be renal donor for her son. Here RPN was an incidental finding and was treated conservatively. Thus CT scan could detect it pre-operatively and complications due to transplantation of a kidney with papillary necrosis were avoided. So, we want to emphasize the importance of Radiology, particularly CT scanning in detection of RPN and to guide early and prompt treatment. PMID:26894147

  5. Kidney (Renal) Failure (United States)

    ... How is kidney failure treated? What is kidney (renal) failure? The kidneys are designed to maintain proper fluid ... marrow and strengthen the bones. The term kidney (renal) failure describes a situation in which the kidneys have ...

  6. Renal arteries (image) (United States)

    A renal angiogram is a test used to examine the blood vessels of the kidneys. The test is performed ... main vessel of the pelvis, up to the renal artery that leads into the kidney. Contrast medium ...

  7. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... limitations of the Thyroid Scan and Uptake? What is a Thyroid Scan and Uptake? A thyroid scan ... tissues in your body. top of page How is the procedure performed? Nuclear medicine imaging is usually ...

  8. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... of the Thyroid Scan and Uptake? What is a Thyroid Scan and Uptake? A thyroid scan is ... code: Phone no: Thank you! Do you have a personal story about radiology? Share your patient story ...

  9. Heart PET scan (United States)

    ... nuclear medicine scan; Heart positron emission tomography; Myocardial PET scan ... A PET scan requires a small amount of radioactive material (tracer). This tracer is given through a vein (IV), ...

  10. Captopril {sup 99m}Tc-DTPA Renal Scintigraphy in Diagnosis of Renovascular Hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Yang, In Hyung; Lee, Dong Soo; Kim, Sung Chul [Seoul National University College of Medicine, Seoul (Korea, Republic of)


    To evaluate the sensitivity and specificity of captopril renal scan for renovascular hypertension, we employed the captopril renal scan in conjunction with renal angiography in 81 patients, 159 kidneys, who were referred to evaluate the cause of hypertension. We defined the renovascular hypertension by the criteria of demonstration of renal artery stenosis by angiography, and improvement or cure of hypertension by revascularization. Visual and quantitative evaluation of {sup 99m}Tc-DTPA renal scan was performed pre and post captopril administration. The prevalence rate of renovascular hypertension was 40% in comparing with renal angiography, and 70% in confirmed cases. The causes of renovascular hypertension in 81 patients were Takayasu's arteritis, fibromuscular dysplasia, atherosclerosis, essential hypertension, chronic pyelonephritis etc. The sensitivity and specificity of captopril renal scan in comparing with renal angiography were 80%, 86.5%, respectively and also 84.2%, 72.6% in confirmed cases of renovascular hypertension, respectively. The causes of false negative cases were nonfunctioning kidney due to complete obstruction or long duration of disease in basal scan, segmental branch artery stenosis, unknown causes, and suspicious true negative cases without confirmation. The false positive cases were abdominal aortic stenosis or aneurysm, dehydration, unknown causes, and suspicious true positive cases. We conclude that captopril renal scintigraphy is highly sensitive, reasonably specific diagnostic method and comparable to other techniques very favorably.

  11. Renal Primitive Neuroectodermal Tumor: A Case Report. (United States)

    Yang, Cheng; Xu, Hanjiang; Zhou, Jun; Hao, Zongyao; Wang, Jianzhong; Lin, Changmin; Zhang, Li; Zhu, Xia; Liang, Chaozhao


    Primitive neuroectodermal tumor (PNET) is a malignant small round cell tumor and typically arises from bone or soft tissue in adolescents and young adults. Renal PNET is extraordinarily rare and exhibits highly aggressive biological behavior with poor prognosis.We present here a new case of renal PNET in a 31-year-old female. The patients were referred to our hospital because of left flank pain with nausea and vomiting for 1 week. A computed tomography scan revealed a 14.7 × 12.7 cm well-defined, unevenly mass lesion with both solid and cystic components and the tumor was not enhanced uniformly.A preoperative diagnosis of cystic renal cell carcinoma and urinary tract infection was made. The patient undergone anti-inflammatory therapy followed by a left radical nephrectomy. Taken with morphological pattern and immunohistochemical markers, a diagnosis of renal PNET was made. Two cycles of combined chemotherapy were executed. At the 14-month follow-up, no evidence of metastasis or recurrence was indicated.This case reminds clinicians that for adolescents and young adults with a suspicious renal mass, a diagnosis of renal PNET should be always considered. An initial surgery followed by radiotherapy and chemotherapy is suggested for the therapeutic management.

  12. [Renal leiomyoma. Case report]. (United States)

    Joual, A; Guessous, H; Rabii, R; Benjelloun, M; Benlemlih, A; Skali, K; el Mrini, M; Benjelloun, S


    The authors report a case of renal leiomyoma observed in a 56-year-old man. This cyst presented in the from of loin pain. Computed tomography revealed a homogeneous renal tumor. Treatment consisted of radical nephrectomy. Histological examination of the specimen showed benign renal leiomyoma.

  13. Renal inflammatory myofibroblastic tumor

    DEFF Research Database (Denmark)

    Heerwagen, S T; Jensen, C; Bagi, P


    Renal inflammatory myofibroblastic tumor (IMT) is a rare soft-tissue tumor of controversial etiology with a potential for local recurrence after incomplete surgical resection. The radiological findings in renal IMT are not well described. We report two cases in adults with a renal mass treated...

  14. Scan BIST with biased scan test signals

    Institute of Scientific and Technical Information of China (English)

    XIANG Dong; CHEN MingJing; SUN JiaGuang


    The conventional test-per-scan built-in self-test (BIST) scheme needs a number of shift cycles followed by one capture cycle.Fault effects received by the scan flip-flops are shifted out while shifting in the next test vector like scan testing.Unlike deterministic testing,it is unnecessary to apply a complete test vector to the scan chains.A new scan-based BIST scheme is proposed by properly controlling the test signals of the scan chains,Different biased random values are assigned to the test signals of scan flip-flops in separate scan chains.Capture cycles can be inserted at any clock cycle if necessary.A new testability estimation procedure according to the proposed testing scheme is presented.A greedy procedure is proposed to select a weight for each scan chain.Experimental results show that the proposed method can improve test effectiveness of scan-based BIST greatly,and most circuits can obtain complete fault coverage or very close to complete fault coverage.

  15. 18F-fluorodeoxyglucose positron emission tomography-computed tomography finding of left gonadal vein thrombosis in a case of renal cell carcinoma. (United States)

    Narayan, Ravishwar; Ravishankar, Uma; Natarajan, Savita; Vohra, Sandeep


    Tumor thrombus from renal cell carcinoma is commonly reported in renal vein and inferior vena cava with a few reports of gonadal vein involvement. Here, we report a case of an elderly female who underwent fluorodeoxyglucose (FDG) positron emission tomography-computed tomography scan for initial staging of left renal cell carcinoma. Along with an FDG avid left renal mass lesion, scan also revealed FDG avid tumor thrombus in the entire length of the left gonadal vein.

  16. Anesthesia for parturient with renal transplantation

    Directory of Open Access Journals (Sweden)

    Beena K Parikh


    Full Text Available Management of successful pregnancy after renal transplantation is a unique challenge to nephrologist, obstetrician, and anesthesiologist, as these patients have altered physiology and are immune-compromised. We present the anesthetic management of three postrenal transplant patients scheduled for cesarean section. While conducting such cases, cardiovascular status, hematological status, and function of transplanted kidney should be assessed thoroughly. Side effects of immunosuppressant drugs and their interaction with anesthetic agents should be taken into consideration. Main goal of anesthetic management is to maintain optimum perfusion pressure of renal allograft to preserve its function.

  17. Plant-Derived Agents for Counteracting Cisplatin-Induced Nephrotoxicity (United States)

    Venkataraman, Balaji; Kurdi, Amani; Mahgoub, Eglal; Sadek, Bassem


    Cisplatin (CSP) is a chemotherapeutic agent commonly used to treat a variety of malignancies. The major setback with CSP treatment is that its clinical efficacy is compromised by its induction of organ toxicity, particular to the kidneys and ears. Despite the significant strides that have been made in understanding the mechanisms underlying CSP-induced renal toxicity, advances in developing renoprotective strategies are still lacking. In addition, the renoprotective approaches described in the literature reveal partial amelioration of CSP-induced renal toxicity, stressing the need to develop potent combinatorial/synergistic agents for the mitigation of renal toxicity. However, the ideal renoprotective adjuvant should not interfere with the anticancer efficacy of CSP. In this review, we have discussed the progress made in utilizing plant-derived agents (phytochemicals) to combat CSP-induced nephrotoxicity in preclinical studies. Furthermore, we have also presented strategies to utilize phytochemicals as prototypes for the development of novel renoprotective agents for counteracting chemotherapy-induced renal damage.

  18. Renal Cell Carcinoma Metastasized to Pagetic Bone. (United States)

    Ramirez, Ashley; Liu, Bo; Rop, Baiywo; Edison, Michelle; Valente, Michael; Burt, Jeremy


    Paget's disease of the bone, historically known as osteitis deformans, is an uncommon disease typically affecting individuals of European descent. Patients with Paget's disease of the bone are at increased risk for primary bone neoplasms, particularly osteosarcoma. Many cases of metastatic disease to pagetic bone have been reported. However, renal cell carcinoma metastasized to pagetic bone is extremely rare. A 94-year-old male presented to the emergency department complaining of abdominal pain. A computed tomography scan of the abdomen demonstrated a large mass in the right kidney compatible with renal cell carcinoma. The patient was also noted to have Paget's disease of the pelvic bones and sacrum. Within the pagetic bone of the sacrum, there was an enhancing mass compatible with renal cell carcinoma. A subsequent biopsy of the renal lesion confirmed renal cell carcinoma. Paget's disease of the bone places the patient at an increased risk for bone neoplasms. The most commonly reported sites for malignant transformation are the femur, pelvis, and humerus. In cases of malignant transformation, osteosarcoma is the most common diagnosis. Breast, lung, and prostate carcinomas are the most common to metastasize to pagetic bone. Renal cell carcinoma associated with Paget's disease of the bone is very rare, with only one prior reported case. Malignancy in Paget's disease of the bone is uncommon with metastatic disease to pagetic bone being extremely rare. We report a patient diagnosed with concomitant renal cell carcinoma and metastatic disease within Paget's disease of the sacrum. Further research is needed to assess the true incidence of renal cell carcinoma associated with pagetic bone.

  19. Postpartum renal vein thrombosis. (United States)

    Rubens, D; Sterns, R H; Segal, A J


    Renal vein thrombosis in adults is usually a complication of the nephrotic syndrome. Rarely, it has been reported in nonnephrotic women postpartum. The thrombosis may be a complication of the hypercoagulable state associated with both the nephrotic syndrome and pregnancy. Two postpartum patients with renal vein thrombosis and no prior history of renal disease are reported here. Neither patient had heavy proteinuria. In both cases, pyelonephritis was suspected clinically and the diagnosis of renal vein thrombosis was first suggested and confirmed by radiologic examination. Renal vein thrombosis should be considered in women presenting postpartum with flank pain.


    Directory of Open Access Journals (Sweden)

    Deb Kumar Boruah


    Full Text Available BACKGROUND Renal replacement lipomatosis is an uncommon benign entity where abundance of fibrofatty tissue proliferation occurs in renal sinus with further extension of proliferated fatty tissues into renal hilum, perinephric and periureteric spaces. It is usually associated with renal atrophy and marked renal parenchymal destruction. Aim of our study was cross-sectional imaging evaluation of Renal Replacement Lipomatosis (RRL. METHODS A hospital based cross-sectional retrospective study was conducted. The study group comprised of 16 patients presenting to the Departments of Radio-diagnosis, Surgery and Urology in a tertiary care hospital from May 2014 to April 2016. All patients were initially evaluated clinically and ultrasonographically followed by cross-sectional imaging modality like Computed Tomography (CT, Magnetic Resonance Imaging (MRI or both. RESULTS Out of 16 patients of renal replacement lipomatosis, 15 patients (93.8% had associated renal pelvic or ureteric calculus while 1 patient (6.2% had left para-aortic mass without associated calculus. Out of fifteen patients of calculus related RRL, 8 patients (53.3% had calculus size more than 40 mm, followed by 4 patients (26.7% who had size from 20 to 40 mm and 3 patients (20% had size less than 20 mm. The mean CT HU value of calculus was 1334±84.5 in our study. Three patients (18.8% had only renal hilar fatty excessive deposition, 1 patient (6.2% had renal hilar and perinephric space fat depositions, 3 patients (18.8% had renal hilar, perinephric and periureteric spaces depositions and 9 patients (56.2% had renal hilar and periureteric excessive fatty depositions. Delayed renal functioning was noted in 9 patients (56%, followed by non-functioning in 5 patients (31.2% and 2 patients (12.5% had normally functioning kidneys. CONCLUSION Cross-sectional imaging like CT and MRI scan helps in diagnosing RRL and proper delineation of extensions of excessive fatty tissue proliferation.

  1. Statins and progressive renal disease. (United States)

    Buemi, Michele; Senatore, Massimino; Corica, Francesco; Aloisi, Carmela; Romeo, Adolfo; Cavallaro, Emanuela; Floccari, Fulvio; Tramontana, Domenico; Frisina, Nicola


    Thanks to the administration of hypocholesterolemic drugs, important advances have been made in the treatment of patients with progressive renal disease. In vitro and in vivo findings demonstrate that statins, the inhibitors of HMG-CoA reductase, can provide protection against kidney diseases characterized by inflammation and/or enhanced proliferation of epithelial cells occurring in rapidly progressive glomerulonephritis, or by increased proliferation of mesangial cells occurring in IgA nephropathy. Many of the beneficial effects obtained occur independent of reduced cholesterol levels because statins can directly inhibit the proliferation of different cell types (e.g., mesangial, renal tubular, and vascular smooth muscle cells), and can also modulate the inflammatory response, thus inhibiting macrophage recruitment and activation, as well as fibrosis. The mechanisms underlying the action of statins are not yet well understood, although recent data in the literature indicate that they can directly affect the proliferation/apoptosis balance, the down-regulation of inflammatory chemokines, and the cytogenic messages mediated by the GTPases Ras superfamily. Therefore, as well as reducing serum lipids, statins and other lipid-lowering agents may directly influence intracellular signaling pathways involved in the prenylation of low molecular weight proteins that play a crucial role in cell signal transduction and cell activation. Statins appear to have important potential in the treatment of progressive renal disease, although further studies are required to confirm this in humans.

  2. Renal infarction resulting from traumatic renal artery dissection. (United States)

    Kang, Kyung Pyo; Lee, Sik; Kim, Won; Jin, Gong Yong; Na, Ki Ryang; Yun, Il Yong; Park, Sung Kwang


    Renal artery dissection may be caused by iatrogenic injury, trauma, underlying arterial diseases such as fibromuscular disease, atherosclerotic disease, or connective tissue disease. Radiological imaging may be helpful in detecting renal artery pathology, such as renal artery dissection. For patients with acute, isolated renal artery dissection, surgical treatment, endovascular management, or medical treatment have been considered effective measures to preserve renal function. We report a case of renal infarction that came about as a consequence of renal artery dissection.

  3. Renal Localization of {sup 67}Ga Citrate in Noninfectious Nephritis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kang Wook; Jeong, Min Soo; Rhee, Sunn Kgoo; Kim, Sam Yong; Shin, Young Tai; Ro, Heung Kyu [Chungnam University College of Medicine, Deajeon (Korea, Republic of)


    {sup 67}Ga citrate scan has been requested for detection or follow-up of inflammatory or neoplastic disease. Visualization of {sup 67}Ga citrate in the kidneys at 48 and 72 hr post injection is usually interpreted as evidence of renal pathology. But precise mechanisms of abnormal {sup 67}Ga uptake in kidneys were unknown. We undertook a study to determine the clinical value of {sup 67}Ga citrate imaging of the kidneys in 68 patients with primary or secondary nephropathy confirmed by renal biopsy and 66 control patients without renal disease. Renal uptake in 48 to 72 hr images was graded as follows: Grade 0=background activity;1=faint uptake greater than background; 2=definite uptake, but less than lumbar vertebrae;3 same uptake as lumbar vertebrae, but less than liver; 4=same or higher uptake than liver. The results were as follows. 1) 42 of 68(62%) patients with noninfectious nephritis showed grade 2 or higher {sup 67}Ga renal uptake but only 10 percent of control patients showed similar uptake. 2) In 14 patients with systemic lupus erythematosus, 8 of 9 (89%) patients with lupus nephritis exhibited marked renal uptake. 3) 36 of 41 patients (88%) with combined nephrotic syndrome showed Grade 2 or higher renal uptake. 4) Renal {sup 67}Ga uptake was correlated with clinical severity of nephrotic syndrome determined by serum albumin level, 24 hr urine protein excretion and serum lipid levels. 5) After complete remission of nephrotic syndrome, renal uptake in all 8 patients who were initially Grade 3 or 4, decreased to Grade 1 or 0. In conclusion, we think that the mechanism of renal {sup 67}Ga uptake in nephrotic syndrome might be related to the pathogenesis of nephrotic syndrome. In systemic lupus erythematosus, {sup 67}Ga citrate scan is useful in predicting renal involvement.

  4. Surface roughness average and scanning electron microscopic observations of resin luting agents Alteração de rugosidade superficial e observações em microscopia eletrônica de varredura de cimentos resinosos

    Directory of Open Access Journals (Sweden)

    Rafael Francisco Lia Mondelli


    Full Text Available The objective of this work was to evaluate the surface roughness changes of three current resin cements after tooth brushing simulation, as well as discuss its relation with scanning electron microscopic observations. The materials employed were Enforce Sure Cure (Dentsply, Rely X (3M-ESPE and Variolink II (Vivadent. They were subjected to brushing abrasion (100,000 strokes for each specimen and the surface roughness alterations (before and after strokes were detected. For each roughness test condition, specimens were coated with gold-palladium and observed on a DSM 900 Zeiss scanning electron microscope. Roughness changes values (Ra were statistically increased after brushing strokes. Based on the microscopic observations and roughness changes analysis, all cements studied became rougher after brushing strokes.O objetivo desse estudo foi avaliar a alteração de rugosidade superficial de três cimentos resinosos após submetê-los a ciclos de escovação simulada e analisar qualitativamente a sua superfície através de observações microscópicas. Os materiais empregados neste estudo foram Enforce Sure Cure (Dentsply, Rely X (3M-ESPE e Variolink II (Vivadent. Estes foram submetidos à ciclos de escovação simulada (100.000 ciclos para cada espécime e a alteração de sua rugosidade superficial (antes e após escovação foi avaliada. Para cada material e condição de rugosidade, espécimes foram selecionados, metalizados e observados em microscopia eletrônica de varredura (DSM 900 Zeiss. Baseado nas observações microscópicas e nos valores de alteração de rugosidade, todos os materiais apresentaram aumento de rugosidade aritmética (Ra após ciclos de escovação simulada.

  5. Reduced clearance of rocuronium and sugammadex in patients with severe to end-stage renal failure: a pharmacokinetic study.

    NARCIS (Netherlands)

    Staals, L.M.; Snoeck, M.M.J.; Driessen, J.J.; Hamersvelt, H.W. van; Flockton, E.A.; Heuvel, M.W. van den; Hunter, J.M.


    BACKGROUND: Sugammadex is a selective relaxant binding agent designed to encapsulate the neuromuscular blocking agent, rocuronium. The sugammadex-rocuronium complex is eliminated by the kidneys. This trial investigated the pharmacokinetics (PKs) of sugammadex and rocuronium in patients with renal

  6. Primary renal carcinoid tumor: A radiologic review

    Directory of Open Access Journals (Sweden)

    Leslie Lamb, MD, Msc, Bsc


    Full Text Available Carcinoid tumor is the classic famous anonym of neuroendocrine neoplasms. Primary renal carcinoid tumors are extremely rare, first described by Resnick and colleagues in 1966, with fewer than a total of 100 cases reported in the literature. Thus, given the paucity of cases, the clinical and histological behavior is not well understood, impairing the ability to predict prognosis. Computed tomography and (occasionally octreotide studies are used in the diagnosis and followup of these rare entites. A review of 85 cases in the literature shows that no distinctive imaging features differentiate them from other primary renal masses. The lesions tend to demonstrate a hypodense appearance and do not usually enhance in the arterial phases, but can occasionally calcify. Octreotide scans do not seem to help in the diagnosis; however, they are more commonly used in the postoperative followup. In addition, we report a new case of primary renal carcinoid in a horseshoe kidney.

  7. Conventional cerebrospinal fluid scanning

    Energy Technology Data Exchange (ETDEWEB)

    Schicha, H.


    Conventional cerebrospinal fluid scanning (CSF scanning) today is mainly carried out in addition to computerized tomography to obtain information about liquor flow kinetics. Especially in patients with communicating obstructive hydrocephalus, CSF scanning is clinically useful for the decision for shunt surgery. In patients with intracranial cysts, CSF scanning can provide information about liquor circulation. Further indications for CSF scanning include the assessment of shunt patency especially in children, as well as the detection and localization of cerebrospinal fluid leaks.

  8. Proposal for classification of the circumaortic renal collar's morphology. (United States)

    Natsis, Konstantinos; Tsitouridis, Ioannis; Totlis, Trifon; Levva, Sofia; Tsikaras, Prokopios; Skandalakis, Panagiotis


    In the present study, we propose a classification of the different forms of the circumaortic renal collar based on the findings of 319 patients and on a literature review. The patients underwent a CT angiography scan of the abdomen for various diagnostic reasons. The different forms in which the circumaortic renal collar may appear were categorized. The renal collar was observed in eight of the 319 (2.5%) patients. The classification we propose is the following: Type I, one left renal vein splitting into two branches, a preaortic and a retroaortic, draining into the inferior vena cava; Type II, two different left renal veins, the one preaortic and the other retroaortic, draining into the inferior vena cava; and Type III, either anastomoses between the preaortic and retroaortic vein, being multiple or not, or multiple preaortic or retroaortic renal veins without anastomoses. Although the circumaortic renal collar is usually asymptomatic, the knowledge of this variation is useful, mainly before abdominal aortic aneurysm surgery and renal transplantation. Failure to recognize the collar's retroaortic component may lead to hemorrhage and death during retroperitoneal surgery. We believe that our classification contributes to recognize the circumaortic renal collar's morphology both preoperatively and intraoperatively.

  9. Three new renal simulators for use in nuclear medicine (United States)

    Dullius, Marcos; Fonseca, Mateus; Botelho, Marcelo; Cunha, Clêdison; Souza, Divanízia


    Renal scintigraphy is useful to provide both functional and anatomic information of renal flow of cortical functions and evaluation of pathological collecting system. The objective of this study was develop and evaluate the performance of three renal phantoms: Two anthropomorphic static and another dynamic. The static images of the anthropomorphic phantoms were used for comparison with static renal scintigraphy with 99mTc-DMSA in different concentrations. These static phantoms were manufactured in two ways: one was made of acrylic using as mold a human kidney preserved in formaldehyde and the second was built with ABS (acrylonitrile butadiene styrene) in a 3D printer. The dynamic renal phantom was constructed of acrylic to simulate renal dynamics in scintigraphy with 99mTc-DTPA. These phantoms were scanned with static and dynamic protocols and compared with clinical data. Using these phantoms it is possible to acquire similar renal images as in the clinical scintigraphy. Therefore, these new renal phantoms can be very effective for use in the quality control of renal scintigraphy, and image processing systems.

  10. Three new renal simulators for use in nuclear medicine

    Directory of Open Access Journals (Sweden)

    Dullius Marcos


    Full Text Available Renal scintigraphy is useful to provide both functional and anatomic information of renal flow of cortical functions and evaluation of pathological collecting system. The objective of this study was develop and evaluate the performance of three renal phantoms: Two anthropomorphic static and another dynamic. The static images of the anthropomorphic phantoms were used for comparison with static renal scintigraphy with 99mTc-DMSA in different concentrations. These static phantoms were manufactured in two ways: one was made of acrylic using as mold a human kidney preserved in formaldehyde and the second was built with ABS (acrylonitrile butadiene styrene in a 3D printer. The dynamic renal phantom was constructed of acrylic to simulate renal dynamics in scintigraphy with 99mTc-DTPA. These phantoms were scanned with static and dynamic protocols and compared with clinical data. Using these phantoms it is possible to acquire similar renal images as in the clinical scintigraphy. Therefore, these new renal phantoms can be very effective for use in the quality control of renal scintigraphy, and image processing systems.

  11. Potential Use of Autologous Renal Cells from Diseased Kidneys for the Treatment of Renal Failure. (United States)

    George, Sunil K; Abolbashari, Mehran; Jackson, John D; Aboushwareb, Tamer; Atala, Anthony; Yoo, James J


    Chronic kidney disease (CKD) occurs when certain conditions cause the kidneys to gradually lose function. For patients with CKD, renal transplantation is the only treatment option that restores kidney function. In this study, we evaluated primary renal cells obtained from diseased kidneys to determine whether their normal phenotypic and functional characteristics are retained, and could be used for cell therapy. Primary renal cells isolated from both normal kidneys (NK) and diseased kidneys (CKD) showed similar phenotypic characteristics and growth kinetics. The expression levels of renal tubular cell markers, Aquaporin-1 and E-Cadherin, and podocyte-specific markers, WT-1 and Nephrin, were similar in both NK and CKD kidney derived cells. Using fluorescence- activated cell sorting (FACS), specific renal cell populations were identified and included proximal tubular cells (83.1% from NK and 80.3% from CKD kidneys); distal tubular cells (11.03% from NK and 10.9% from CKD kidneys); and podocytes (1.91% from NK and 1.78% from CKD kidneys). Ultra-structural analysis using scanning electron microscopy (SEM) revealed microvilli on the apical surface of cultured cells from NK and CKD samples. Moreover, transmission electron microscopy (TEM) analysis showed a similar organization of tight junctions, desmosomes, and other intracellular structures. The Na+ uptake characteristics of NK and CKD derived renal cells were also similar (24.4 mmol/L and 25 mmol/L, respectively) and no significant differences were observed in the protein uptake and transport characteristics of these two cell isolates. These results show that primary renal cells derived from diseased kidneys such as CKD have similar structural and functional characteristics to their counterparts from a normal healthy kidney (NK) when grown in vitro. This study suggests that cells derived from diseased kidney may be used as an autologous cell source for renal cell therapy, particularly in patients with CKD or end

  12. Refractory anemia leading to renal hemosiderosis and renal failure


    Sujatha Siddappa; K M Mythri; Kowsalya, R.; Ashish Parekh


    Renal hemosiderosis is a rare cause of renal failure and, as a result, may not be diagnosed unless a detailed history, careful interpretation of blood parameters and renal biopsy with special staining is done. Here, we present a rare case of renal hemosiderosis presenting with renal failure.

  13. Refractory anemia leading to renal hemosiderosis and renal failure

    Directory of Open Access Journals (Sweden)

    Sujatha Siddappa


    Full Text Available Renal hemosiderosis is a rare cause of renal failure and, as a result, may not be diagnosed unless a detailed history, careful interpretation of blood parameters and renal biopsy with special staining is done. Here, we present a rare case of renal hemosiderosis presenting with renal failure.

  14. Renal replacement therapy for acute renal failure. (United States)

    Macedo, E; Bouchard, J; Mehta, R L


    Renal replacement therapy became a common clinical tool to treat patients with severe acute kidney injury (AKI) since the 1960s. During this time dialytic options have expanded considerably; biocompatible membranes, bicarbonate dialysate and dialysis machines with volumetric ultrafiltration control have improved the treatment for acute kidney injury. Along with advances in methods of intermittent hemodialysis, continuous renal replacement therapies have gained widespread acceptance in the treatment of dialysis-requiring AKI. However, many of the fundamental aspects of the renal replacement treatment such as indication, timing of dialytic intervention, and choice of dialysis modality are still controversial and may influence AKI patient's outcomes. This review outlines current concepts in the use of dialysis techniques for AKI and suggests an approach for selecting the optimal method of renal replacement therapy.

  15. Ureteropelvic junction obstruction: the effect of pyeloplasty on renal function

    Energy Technology Data Exchange (ETDEWEB)

    Dowling, K.J.; Harmon, E.P.; Ortenberg, J.; Polanco, E.; Evans, B.B.


    We studied preoperatively and postoperatively 41 children who underwent pyeloplasty for correction of unilateral ureteropelvic junction obstruction. Conventional radiological studies and quantitative radioiodine hippurate renal scans were obtained to assess the effect of pyeloplasty on the appearance of the kidney and its function. Analysis of the data suggests that the degree of improvement in renal function is related primarily to the age at which the surgical correction is accomplished and whether infection has occurred preoperatively.

  16. Comparative in vitro evaluation of internal adaptation of resin-modified glass ionomer, flowable composite and bonding agent applied as a liner under composite restoration: A scanning electron microscope study. (United States)

    Soubhagya, M; Goud, K Mallikarjun; Deepak, B S; Thakur, Sophia; Nandini, T N; Arun, J


    The use of resin-modified glass Ionomer cement in sandwich technique is widely practiced with the advent of various newer generation of composites the bond between resin-modified glass Ionomer and these resins should be validated. This study is done to evaluate the interfacial microgaps between different types of liners and dentin, liners and composite (Filtek p60 [FLp60]) using scanning electron microscope (SEM). Standardized Class V preparations were performed in buccal/lingual surfaces of 30 caries, crack and defect-free extracted human third molars. The prepared teeth were divided into three groups. Group I: Single bond (SB), Group II: SB + synergy flow, Group III: SB + vitrebond. They were restored with composite resin FLp60, according to the manufacturer instructions. The SB + vitrebond, cross-sectioned through the canter of the restoration. The specimens were fixed, dehydrated, polished, and processed for SEM. The internal adaptation of the materials to the axial wall was analyzed under SEM with ×1000 magnification. The data obtained were analyzed with nonparametric tests (Kruskal-Wallis, P composite or resin-modified glass ionomer applied in conjunction with adhesive resulted in statistically wider microgaps than occurred when the dentin was only hybridized prior to the restoration. Hybridization of dentin only provides superior sealing of the dentin-restoration interface than does flowable resin or resin-modified glass ionomer.

  17. Value of renal cortical thickness as a predictor of renal function impairment in chronic renal disease patients

    Directory of Open Access Journals (Sweden)

    Samia Rafael Yamashita


    Full Text Available Objective: To determine the presence of linear relationship between renal cortical thickness, bipolar length, and parenchymal thickness in chronic kidney disease patients presenting with different estimated glomerular filtration rates (GFRs and to assess the reproducibility of these measurements using ultrasonography. Materials and Methods: Ultrasonography was performed in 54 chronic renal failure patients. The scans were performed by two independent and blinded radiologists. The estimated GFR was calculated using the Cockcroft-Gault equation. Interobserver agreement was calculated and a linear correlation coefficient (r was determined in order to establish the relationship between the different renal measurements and estimated GFR. Results: The correlation between GFR and measurements of renal cortical thickness, bipolar length, and parenchymal thickness was, respectively, moderate (r = 0.478; p < 0.001, poor (r = 0.380; p = 0.004, and poor (r = 0.277; p = 0.116. The interobserver agreement was considered excellent (0.754 for measurements of cortical thickness and bipolar length (0.833, and satisfactory for parenchymal thickness (0.523. Conclusion: The interobserver reproducibility for renal measurements obtained was good. A moderate correlation was observed between estimated GFR and cortical thickness, but bipolar length and parenchymal thickness were poorly correlated.

  18. Renal function after renal artery stenting

    Institute of Scientific and Technical Information of China (English)

    George S. Hanzel; Mark Downes; Peter A. McCullough


    @@ Atherosclerotic renal artery stenosis (ARAS), a common clinical finding, is increasing in prevalence as the population ages. ARAS is seen in ~ 7% of persons over 65 years of age1 and in ~ 20% of patients at the time of coronary angiography.2 It is an important cause of chronic kidney disease and may result in 11-14% of cases of end stage renal disease.3

  19. Unilateral Hydronephrosis and Renal Damage after Acute Leukemia

    Directory of Open Access Journals (Sweden)

    Egle Simanauskiene


    Full Text Available A 14-year-old boy presented with asymptomatic right hydronephrosis detected on routine yearly ultrasound examination. Previously, he had at least two normal renal ultrasonograms, 4 years after remission of acute myeloblastic leukemia, treated by AML-BFM-93 protocol. A function of the right kidney and no damage on the left was confirmed by a DMSA scan. Right retroperitoneoscopic nephrectomy revealed 3 renal arteries with the lower pole artery lying on the pelviureteric junction. Histologically chronic tubulointerstitial nephritis was detected. In the pathogenesis of this severe unilateral renal damage, we suspect the exacerbation of deleterious effects of cytostatic therapy on kidneys with intermittent hydronephrosis.

  20. Isolated renal metastasis from squamous cell lung cancer

    Directory of Open Access Journals (Sweden)

    Cai Jun


    Full Text Available Abstract Renal metastasis from non-small cell lung cancer is rather uncommon. The mechanism underlying the occurrence of metastasis in this site is still not well understood. We report a case of a 53-year-old Chinese woman who had moderately differentiated squamous cell carcinoma of the lung. After a ten months post-surgery interval of disease free survival, computed tomography (CT scan found that left renal parenchymal was occupied by a mass, confirmed by kidney biopsy to be a metastasis from squamous cell lung carcinoma. Based on this case, we are warned to be cautious in diagnosis and treatment when renal lesion are detected.

  1. Recovery of renal function after prolonged dialysis and transplantation. (United States)

    Nunan, T O; Stevens, E A; Croft, D N; Hilton, P J; Jones, N F; Wing, A J


    Out of 250 patients with renal failure, seven (2.8%) treated by regular haemodialysis alone (four) or given cadaveric allografts (three) later showed recovery of function of their own kidneys lasting from one to four years. In the patients receiving haemodialysis alone recovery was easily recognised from their serum creatinine concentrations, but in those with transplants recovery was discovered unexpectedly during radionuclide scanning. These findings suggest that recovery of renal function may be more common than generally recognised, which should be borne in mind when beginning renal replacement treatment and particularly when contemplating bilateral nephrectomy. Images p248-a PMID:6409268

  2. Line scanning, stage scanning confocal microscope (LSSSCM). (United States)

    Gareau, Daniel S; Krueger, James G; Hawkes, Jason E; Lish, Samantha R; Dietz, Michael P; Mülberger, Alba Guembe; Mu, Euphemia W; Stevenson, Mary L; Lewin, Jesse M; Meehan, Shane A; Carucci, John A


    For rapid pathological assessment of large surgical tissue excisions with cellular resolution, we present a line scanning, stage scanning confocal microscope (LSSSCM). LSSSCM uses no scanning mirrors. Laser light is focused with a single cylindrical lens to a line of diffraction-limited width directly into the (Z) sample focal plane, which is parallel to and near the flattened specimen surface. Semi-confocal optical sections are derived from the linear array distribution (Y) and a single mechanical drive that moves the sample parallel to the focal plane and perpendicular to the focused line (X). LSSSCM demonstrates cellular resolution in the conditions of high nuclear density within micronodular basal cell carcinoma.

  3. Imaging of renal osteodystrophy

    Energy Technology Data Exchange (ETDEWEB)

    Jevtic, V. E-mail:


    Chronic renal insufficiency, hemodialysis, peritoneal dialysis, renal transplantation and administration of different medications provoke complex biochemical disturbances of the calcium-phosphate metabolism with wide spectrum of bone and soft tissue abnormalities termed renal osteodystrophy. Clinically most important manifestation of renal bone disease includes secondary hyperparathyroidism, osteomalacia/rickets, osteoporosis, adynamic bone disease and soft tissue calcification. As a complication of long-term hemodialysis and renal transplantation amyloid deposition, destructive spondyloarthropathy, osteonecrosis, and musculoskeletal infections may occur. Due to more sophisticated diagnostic methods and more efficient treatment classical radiographic features of secondary hyperparathyroidism and osteomalacia/rickets are now less frequently seen. Radiological investigations play an important role in early diagnosis and follow-up of the renal bone disease. Although numerous new imaging modalities have been introduced in clinical practice (scintigraphy, CT, MRI, quantitative imaging), plain film radiography, especially fine quality hand radiograph, still represents most widely used examination.

  4. Measurement of renal cortical thickness using spiral CT in early diabetic nephropathy

    Energy Technology Data Exchange (ETDEWEB)

    Koo, Bong Sig; Chung, Won Jung; Park, Byeong Ho; Choi, Jong Cheol; Nam, Kyung Jin; Lee, Yung Il; Chung, Duk Hwan [Donga Univ. College of Medicine, Pusan (Korea, Republic of)


    To compare the ratio of renal cortical thickness to renal parenchymal thickness in early diabetic nephropathy and in normal control group. We performed spiral CT in 17 patients suffering from diabetic nephropathy without renal failure or renal atrophy. The normal control group consisted of 19 persons who were normal on renal function test and did not show any abnormality of the kidney. Renal cortical and parenchymal thicknesses were measured at renal hilum level perpendicular to the renal surface by electronic caliper on contrast-enhanced transverse scan demonstrating the cortical nephrogram phase. Using student's test, the difference in renal parenchymal and cortical thickness between the two groups was tested for statistical significance. There was no significant difference in renal parenchymal thickness between the two groups (p>0.05);the patient group had a thicker renal cortex than the normal control group however (p<0.05). The ratio of renal cortical thickness to parenchymal thickness in early diabetic nephropathy patients (Rt.:0.041{+-}0.051, Lt.:0.382{+-}0.053) was significantly higher than in the normal control group (Rt.:0.331{+-}0.067, Lt.:0.323{+-}0.064). The kidney of early diabetic nephropathy patients had a thicker renal cortex than normal kidney.

  5. Calcineurin inhibitors and male fertility after renal transplantation - a review. (United States)

    Georgiou, G K; Dounousi, E; Harissis, H V


    Renal transplantation and restoration of renal function are associated with significant favourable changes regarding the reproductive capacity of male patients with previous end-stage renal disease. However, there is evidence that some of the immunosuppressive agents may impair male fertility after all. Calcineurin inhibitors (CNIs), cyclosporine A and tacrolimus (FK506), which constitute the cornerstone of immunosuppression regimen following renal transplantation, have been implicated in causing an overall decline in the fertilisation capacity of male renal transplant recipients (RTRs). In this review, data from human clinical studies are collectively presented in an effort to estimate the potential adverse effects of CNIs on the masculine reproductive organs, the hormonal axis of males, the process of spermatogenesis and generally the male RTRs capacity to fertilise. © 2015 Blackwell Verlag GmbH.

  6. Renal cortical volume measured using automatic contouring software for computed tomography and its relationship with BMI, age and renal function

    Energy Technology Data Exchange (ETDEWEB)

    Muto, Natalia Sayuri, E-mail: [Department of Radiology, Hokkaido University Hospital, N15 W7, kita-ku, Sapporo City, 0608638 (Japan); Kamishima, Tamotsu, E-mail: [Department of Radiology, Hokkaido University Hospital, N15 W7, kita-ku, Sapporo City, 0608638 (Japan); Harris, Ardene A., E-mail: [Department of Radiology, Hokkaido University Hospital, N15 W7, kita-ku, Sapporo City, 0608638 (Japan); Kato, Fumi, E-mail: [Department of Radiology, Hokkaido University Hospital, N15 W7, kita-ku, Sapporo City, 0608638 (Japan); Onodera, Yuya, E-mail: [Department of Radiology, Hokkaido University Hospital, N15 W7, kita-ku, Sapporo City, 0608638 (Japan); Terae, Satoshi, E-mail: [Department of Radiology, Hokkaido University Hospital, N15 W7, kita-ku, Sapporo City, 0608638 (Japan); Shirato, Hiroki, E-mail: [Department of Radiology, Hokkaido University Hospital, N15 W7, kita-ku, Sapporo City, 0608638 (Japan)


    Purpose: To evaluate the relationship between renal cortical volume, measured by an automatic contouring software, with body mass index (BMI), age and renal function. Materials and methods: The study was performed in accordance to the institutional guidelines at our hospital. Sixty-four patients (34 men, 30 women), aged 19 to 79 years had their CT scans for diagnosis or follow-up of hepatocellular carcinoma retrospectively examined by a computer workstation using a software that automatically contours the renal cortex and the renal parenchyma. Body mass index and estimated glomerular filtration rate (eGFR) were calculated based on data collected. Statistical analysis was done using the Student t-test, multiple regression analysis, and intraclass correlation coefficient (ICC). Results: The ICC for total renal and renal cortical volumes were 0.98 and 0.99, respectively. Renal volume measurements yielded a mean cortical volume of 105.8 cm{sup 3} {+-} 28.4 SD, mean total volume of 153 cm{sup 3} {+-} 39 SD and mean medullary volume of 47.8 cm{sup 3} {+-} 19.5 SD. The correlation between body weight/height/BMI and both total renal and cortical volumes presented r = 0.6, 0.6 and 0.4, respectively, p < 0.05, while the correlation between renal cortex and age was r = -0.3, p < 0.05. eGFR showed correlation with renal cortical volume r = 0.6, p < 0.05. Conclusion: This study demonstrated that renal cortical volume had a moderate positive relationship with BMI, moderate negative relationship with age, and a strong positive relationship with the renal function, and provided a new method to routinely produce volumetric assessment of the kidney.

  7. Association between antiretroviral exposure and renal impairment among HIV-positive persons with normal baseline renal function : the D:A:D study

    NARCIS (Netherlands)

    Ryom, Lene; Mocroft, Amanda; Kirk, Ole; Worm, Signe W; Kamara, David A; Reiss, Peter; Ross, Michael; Fux, Christoph A; Morlat, Philippe; Moranne, Olivier; Smith, Colette; Lundgren, Jens D; Schölvinck, Elisabeth H.


    BACKGROUND: Several antiretroviral agents (ARVs) are associated with chronic renal impairment, but the extent of such adverse events among human immunodeficiency virus (HIV)-positive persons with initially normal renal function is unknown. METHODS: D:A:D study participants with an estimated glomerul

  8. Incidental renal neoplasms

    DEFF Research Database (Denmark)

    Rabjerg, Maj; Mikkelsen, Minne Nedergaard; Walter, Steen;


    On the basis of associations between tumor size, pathological stage, histological subtype and tumor grade in incidentally detected renal cell carcinoma vs symptomatic renal cell carcinoma, we discussed the need for a screening program of renal cell carcinoma in Denmark. We analyzed a consecutive...... series of 204 patients with renal tumors in 2011 and 2012. The tumors were classified according to detection mode: symptomatic and incidental and compared to pathological parameters. Eighty-nine patients (44%) were symptomatic, 113 (55%) were incidental. Information was not available in two patients...

  9. Insuficiencia renal aguda.


    Carlos Hernán Mejía


    Acute renal failure (ARF) is a clinic syndrome characterized by decline in renal function occurring over a short time period. Is a relatively common complication in hospitalized critically ill patients and is associated with high morbidity and mortality. ARF has often a multi-factorial etiology syndrome usually approached diagnostically as pre-renal, post-renal, or intrinsic ARF. Most intrinsic ARF is caused by ischemia or nephrotoxins and is classically associated with acute tubular necrosis...

  10. Vasoactive Agents


    Husedzinovic, Ino; Bradic, Nikola; Goranovic, Tanja


    This article is a short review of vasoactive drugs which are in use in todays clinical practice. In the past century, development of vasoactive drugs went through several phases. All of these drugs are today divided into several groups, depending on their place of action, pharmacological pathways and/or effects on target organ or organ system. Hence, many different agents are today in clinical practice, we have shown comparison between them. These agents provide new directions in the treatmen...

  11. Management of Asymptomatic Renal Stones in Astronauts (United States)

    Reyes, David; Locke, James


    Introduction: Management guidelines were created to screen and manage asymptomatic renal stones in U.S. astronauts. The risks for renal stone formation in astronauts due to bone loss and hypercalcuria are unknown. Astronauts have a stone risk which is about the same as commercial aviation pilots, which is about half that of the general population. However, proper management of this condition is still crucial to mitigate health and mission risks in the spaceflight environment. Methods: An extensive review of the literature and current aeromedical standards for the monitoring and management of renal stones was done. The NASA Flight Medicine Clinic's electronic medical record and Longitudinal Survey of Astronaut Health were also reviewed. Using this work, a screening and management algorithm was created that takes into consideration the unique operational environment of spaceflight. Results: Renal stone screening and management guidelines for astronauts were created based on accepted standards of care, with consideration to the environment of spaceflight. In the proposed algorithm, all astronauts will receive a yearly screening ultrasound for renal calcifications, or mineralized renal material (MRM). Any areas of MRM, 3 millimeters or larger, are considered a positive finding. Three millimeters approaches the detection limit of standard ultrasound, and several studies have shown that any stone that is 3 millimeters or less has an approximately 95 percent chance of spontaneous passage. For mission-assigned astronauts, any positive ultrasound study is followed by low-dose renal computed tomography (CT) scan, and flexible ureteroscopy if CT is positive. Other specific guidelines were also created. Discussion: The term "MRM" is used to account for small areas of calcification that may be outside the renal collecting system, and allows objectivity without otherwise constraining the diagnostic and treatment process for potentially very small calcifications of uncertain

  12. Management of Asymptomatic Renal Stones in Astronauts (United States)

    Reyes, David; Locke, James


    Introduction: Management guidelines were created to screen and manage asymptomatic renal stones in U.S. astronauts. The risks for renal stone formation in astronauts due to bone loss and hypercalcuria are unknown. Astronauts have a stone risk which is about the same as commercial aviation pilots, which is about half that of the general population. However, proper management of this condition is still crucial to mitigate health and mission risks in the spaceflight environment. Methods: An extensive review of the literature and current aeromedical standards for the monitoring and management of renal stones was done. The NASA Flight Medicine Clinic's electronic medical record and Longitudinal Survey of Astronaut Health were also reviewed. Using this work, a screening and management algorithm was created that takes into consideration the unique operational environment of spaceflight. Results: Renal stone screening and management guidelines for astronauts were created based on accepted standards of care, with consideration to the environment of spaceflight. In the proposed algorithm, all astronauts will receive a yearly screening ultrasound for renal calcifications, or mineralized renal material (MRM). Any areas of MRM, 3 millimeters or larger, are considered a positive finding. Three millimeters approaches the detection limit of standard ultrasound, and several studies have shown that any stone that is 3 millimeters or less has an approximately 95 percent chance of spontaneous passage. For mission-assigned astronauts, any positive ultrasound study is followed by low-dose renal computed tomography (CT) scan, and flexible ureteroscopy if CT is positive. Other specific guidelines were also created. Discussion: The term "MRM" is used to account for small areas of calcification that may be outside the renal collecting system, and allows objectivity without otherwise constraining the diagnostic and treatment process for potentially very small calcifications of uncertain

  13. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... interfere with the procedure. You will receive specific instructions based on the type of scan you are ... after your nuclear medicine scan. If any special instructions are necessary, you will be informed by a ...

  14. RBC nuclear scan (United States)

    ... page: // RBC nuclear scan To use the sharing features on this page, please enable JavaScript. An RBC nuclear scan uses small amounts of radioactive material to ...

  15. [Urinary tract infections and chronic renal failure]. (United States)

    Sobotová, D


    The paper briefly summarizes issues related to urinary tract infections in adults: predispositions and risk factors, classification, assessment of pathogenicity of bacterial agents, the role of bacteriuria and leucocyturia, interpretation of findings, treatment principles and an association with chronic renal failure. Urinary tract infections are the second most frequent infectious disease in the population. They most often affect women of childbearing potential and then seniors of both sexes who have multiple risk factors. Escherichia coli and Staphylococcus saprophyticus are the most pathogenic towards urinary tract; they are responsible for 85% and 10-15% of cases of acute uncomplicated urinary infections, respectively. Chronic pyelonephritis, a chronic interstitial nephritis, is the fourth most frequent cause of chronic renal failure. Chronic renal failure is a risk factor for the development of urinary infections due to metabolic disorders resulting in secondary immunodeficiencywith a disorder of all components of immunity. In patients with chronic renal failure, urinary tract infections occur most frequently after kidney transplantation when graft pyelonephritis is a life-threatening complication. Therefore, urinary tract infection prevention with co-trimoxazole once daily over at least 6 months is recommended in renal allograft recipients.

  16. Pediatric renal transplantation: Jordan′s experience

    Directory of Open Access Journals (Sweden)

    Issa Hazza


    Full Text Available To evaluate our experience with pediatric renal transplantation at King Hussein Medical Center, the medical records of 71 pediatric patients who underwent a renal transplantation procedure between the years 2004 and 2010 or started follow-up at our center within one week of transplantation done elsewhere were reviewed. Over the seven-year period, 71 children under the age of 14 years who received their first renal transplant were studied. About 56% (40 were males. The mean age was 9.44 ± 2.86 years. Dysplastic kidney was the most common cause of end-stage renal failure in our group, followed by glomerulonephritis. Mothers were the donors in 39.4% of the cases, followed by fathers. Twenty-three patients (32.4% were transplanted preemptively. The overall one-year graft survival was 96%, three-year survival was 95%, and the five-year survival was 88%. Prednisone, tacrolimus, and mycophenolate mofetil formed the main-stay of immunosuppressive agents. We have developed a successful live donor program for renal transplantation in children at King Hussein Medical Center in Amman. Although our experience is still short, the graft survival is similar to that achieved in the developed world, especially with preemptive transplant.

  17. PET/Computed Tomography in Renal, Bladder, and Testicular Cancer. (United States)

    Bouchelouche, Kirsten; Choyke, Peter L


    Imaging plays an important role in the clinical management of cancer patients. Hybrid imaging with PET/computed tomography (CT) is having a broad impact in oncology, and in recent years PET/CT is beginning to have an impact in urooncology. In both bladder and renal cancers, there is a need to study the efficacy of other tracers than F-18 fluorodeoxyglucose (FDG), particularly tracers with limited renal excretion. Thus, new tracers are being introduced. This review focuses on the clinical role of FDG and other PET agents in renal, bladder, and testicular cancers.

  18. PET/CT in renal, bladder and testicular cancer (United States)

    Bouchelouche, Kirsten; Physician, Chief; Choyke, Peter L.


    Imaging plays an important role in the clinical management of cancer patients. Hybrid imaging with PET/CT is having a broad impact in oncology, and in recent years PET/CT is beginning to have an impact in uro-oncology as well. In both bladder and renal cancer there is a need to study the efficacy of other tracers than F-18 fluorodeoxyglucose (FDG), particularly tracers with only limited renal excretion. Thus, new tracers are being introduced in these malignancies. This review focuses on the clinical role of FDG and other PET agents in renal, bladder and testicular cancer. PMID:26099672

  19. Isolated Renal Hydatidosis Presenting as Renal Mass: A Diagnostic Dilemma

    Directory of Open Access Journals (Sweden)

    Datteswar Hota


    Full Text Available Hydatid disease is a parasitic infestation by larval form of Echinococcus granulosus. Isolated renal involvement is extremely rare. There are no specific signs and symptoms of renal hydatidosis. However it may present as palpable mass, flank pain, hematuria, malaise, fever, and hydatiduria or as a complication of it such as infection, abscess, hemorrhage, necrosis and pelviureteric junction obstruction, renal failure etc. Except hydatiduria, none are pathognomonic for renal hydatidosis. There is no literature on renal hydatidosis presenting as renal mass we report 2 cases of isolated renal hydatidosis, which mimicked a renal mass on imaging study.

  20. Distal renal tubular acidosis in recurrent renal stone formers

    DEFF Research Database (Denmark)

    Osther, P J; Hansen, A B; Røhl, H F


    (1.1%) had complete distal renal tubular acidosis and 14 (15.5%) incomplete distal renal tubular acidosis. Our results confirm that distal renal tubular acidification defects are associated with a more severe form of stone disease and make distal renal tubular acidosis one of the most frequent...... metabolic disturbances in renal stone formers. Distal renal tubular acidosis (dRTA) was relatively more common in female stone formers and most often found in patients with bilateral stone disease (36%). Since prophylactic treatment in renal stone formers with renal acidification defects is available...

  1. Laparoscopic treatment for renal hydatid cyst. (United States)

    Rabii, Redouane; Mezzour, Mohamed Hicham; Essaki, Hicham; Fekak, Hamid; Joual, Abdenbi; Meziane, Fethi


    A multivesicular hydatid cyst was removed from the left kidney of a 26-year-old woman by retroperitoneal laparoscopy to avoid contamination of the abdominal cavity. A scolicidal agent (20% hypertonic saline) was injected around the kidney initially and then instilled into the cyst after the contents had been evacuated. There were no complications and no anaphylactic shock. This appears to be the first reported case of treatment of renal hydatid cyst by laparoscopy.

  2. Renal pelvis or ureter cancer (United States)

    Transitional cell cancer of the renal pelvis or ureter; Kidney cancer - renal pelvis; Ureter cancer ... Cancer can grow in the urine collection system, but it is uncommon. Renal pelvis and ureter cancers ...

  3. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... of the Thyroid Scan and Uptake? What is a Thyroid Scan and Uptake? A thyroid scan is ... encourage linking to this site. × Recommend RadiologyInfo to a friend Send to (friend's e-mail address): From ( ...

  4. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... of the Thyroid Scan and Uptake? What is a Thyroid Scan and Uptake? A thyroid scan is ... encourage linking to this site. × Recommend RadiologyInfo to a friend Send to (friend's e-mail address): From ( ...

  5. Iodinated contrast media and the role of renal replacement therapy. (United States)

    Weisbord, Steven D; Palevsky, Paul M


    Iodinated contrast media are among the most commonly used pharmacologic agents in medicine. Although generally highly safe, iodinated contrast media are associated with several adverse effects, most significantly the risk of acute kidney injury, particularly in patients with underlying renal dysfunction. By virtue of their pharmacokinetic characteristics, these contrast agents are efficiently cleared by hemodialysis and to a lesser extent, hemofiltration. This has led to research into the capacity for renal replacement therapies to prevent certain adverse effects of iodinated contrast. This review examines the molecular and pharmacokinetic characteristics of iodinated contrast media and critically analyzes data from past studies on the role of renal replacement therapy to prevent adverse effects of these diagnostic agents. Published by Elsevier Inc.

  6. Pulmonary ventilation/perfusion scan (United States)

    V/Q scan; Ventilation/perfusion scan; Lung ventilation/perfusion scan ... A pulmonary ventilation/perfusion scan is actually two tests. They may be done separately or together. During the perfusion scan, a health care provider injects ...

  7. [Inotropic agents]. (United States)

    Sasayama, Shigetake


    Depression of myocardial contractility plays an important role in the development of heart failure and many inotropic agents were developed to improve the contractile function of the failing heart. Agents that increase cyclic AMP, either by increasing its synthesis or reducing its degradation, exerted dramatic short-term hemodynamic benefits, but these acute effects were not extrapolated into long-term improvement of the clinical outcome of heart failure patients. Administration of these agents to an energy starved failing heart would be expected to increase myocardial energy use and could accelerate disease progression. The role of digitalis in the management of heart failure has been controversial, however, the recent large scale clinical trial has ironically proved that digoxin reduced the rate of hospitalization both overall and for worsening heart failure. More recently, attention was paid to other inotropic agents that have a complex and diversified mechanism. These agents have some phosphodiesterase-inhibitory action but also possess additional effects, including cytokine inhibitors, immunomodulators, or calcium sensitizers. In the Western Societies these agents were again shown to increase mortality of patients with severe heart failure in a dose dependent manner with the long-term administration. However, it may not be the case in the Japanese population in whom mortality is relatively low. Chronic treatment with inotropic agent may be justified in Japanese, as it allows optimal care in the context of relief of symptoms and an improved quality of life. Therefore, each racial group should obtain specific evidence aimed at developing its own guidelines for therapy rather than translating major guidelines developed for other populations.

  8. Acute renal failure with severe loin pain and patchy renal ischemia after anaerobic exercise in patients with or without renal hypouricemia. (United States)

    Ishikawa, Isao


    Acute renal failure induced by rhabdomyolysis after strenuous exercise is well known. We describe here a new type of acute renal failure with severe loin pain which develops after anaerobic exercise (ALPE), for example, 200-meter track racing. The patients complained of severe loin pain several hours after exercise and presented at the emergency room. Since our first description 118 cases have been reported. The serum creatinine concentration was 4.7 +/- 2.9 mg/dl (mean +/- SD) at the initial examination and 6.0 +/- 3.0 mg/dl at maximum. Forty-nine of 96 cases whose serum uric acid levels were described revealed renal hypouricemia (51.0%). A specific risk factor is suggested by the fact that acute renal failure recurred after exercise in 20 of 118 cases. The creatine phosphokinase and serum myoglobin concentrations were normal or only slightly elevated, suggesting damaged type 2 muscle fibers. Renal computed tomography scans, performed several hours to 1-2 days after contrast medium administration, revealed multiple wedge-shaped areas of contrast enhancement. Forty-six of 50 cases examined by delayed computed tomography scan revealed bilateral wedge-shaped contrast enhancement. Although less efficient, radioisotopic scans, such as a methylene diphosphonate bone scan, have also been employed to detect patchy accumulation of isotopes in the kidneys (12 of 19 cases). The pathogenesis of ALPE may be patchy vasoconstriction of the renal vessels, because of its wedge-shaped distribution and its reversibility. Such vascular spasm would account for the renal pain. The prognosis was good, although 20 of 109 cases required dialysis treatment. In conclusion, there are two types of exercise-induced acute renal failure: one is the well-known myoglobin-induced acute renal failure, and the other is ALPE that may be nonmyoglobin induced or induced by myolysis of type 2 muscle fibers due to anaerobic exercise. One hundred and eighteen cases of ALPE were collected from the

  9. Estimation of feline renal volume using computed tomography and ultrasound. (United States)

    Tyson, Reid; Logsdon, Stacy A; Werre, Stephen R; Daniel, Gregory B


    Renal volume estimation is an important parameter for clinical evaluation of kidneys and research applications. A time efficient, repeatable, and accurate method for volume estimation is required. The purpose of this study was to describe the accuracy of ultrasound and computed tomography (CT) for estimating feline renal volume. Standardized ultrasound and CT scans were acquired for kidneys of 12 cadaver cats, in situ. Ultrasound and CT multiplanar reconstructions were used to record renal length measurements that were then used to calculate volume using the prolate ellipsoid formula for volume estimation. In addition, CT studies were reconstructed at 1 mm, 5 mm, and 1 cm, and transferred to a workstation where the renal volume was calculated using the voxel count method (hand drawn regions of interest). The reference standard kidney volume was then determined ex vivo using water displacement with the Archimedes' principle. Ultrasound measurement of renal length accounted for approximately 87% of the variability in renal volume for the study population. The prolate ellipsoid formula exhibited proportional bias and underestimated renal volume by a median of 18.9%. Computed tomography volume estimates using the voxel count method with hand-traced regions of interest provided the most accurate results, with increasing accuracy for smaller voxel sizes in grossly normal kidneys (-10.1 to 0.6%). Findings from this study supported the use of CT and the voxel count method for estimating feline renal volume in future clinical and research studies.

  10. Sunscreening Agents (United States)

    Martis, Jacintha; Shobha, V; Sham Shinde, Rutuja; Bangera, Sudhakar; Krishnankutty, Binny; Bellary, Shantala; Varughese, Sunoj; Rao, Prabhakar; Naveen Kumar, B.R.


    The increasing incidence of skin cancers and photodamaging effects caused by ultraviolet radiation has increased the use of sunscreening agents, which have shown beneficial effects in reducing the symptoms and reoccurrence of these problems. Many sunscreen compounds are in use, but their safety and efficacy are still in question. Efficacy is measured through indices, such as sun protection factor, persistent pigment darkening protection factor, and COLIPA guidelines. The United States Food and Drug Administration and European Union have incorporated changes in their guidelines to help consumers select products based on their sun protection factor and protection against ultraviolet radiation, whereas the Indian regulatory agency has not yet issued any special guidance on sunscreening agents, as they are classified under cosmetics. In this article, the authors discuss the pharmacological actions of sunscreening agents as well as the available formulations, their benefits, possible health hazards, safety, challenges, and proper application technique. New technologies and scope for the development of sunscreening agents are also discussed as well as the role of the physician in patient education about the use of these agents. PMID:23320122

  11. [Hemorrhagic bilateral renal angiomyolipoma]. (United States)

    Benjelloun, Mohamed; Rabii, Redouane; Mezzour, Mohamed Hicham; Joual, Abdenbi; Bennani, Saâd; el Mrini, Mohamed


    Renal angiomyolipoma is a rare benign tumour, often associated with congenital diseases especially de Bourneville's tuberous sclerosis. Bilateral angiomyolipoma is exceptional. The authors report a case of bilateral renal angiomyolipoma in a 33-year-old patient presenting with haemorrhagic shock. In the light of this case and a review of the literature, the authors discuss the diagnostic and therapeutic aspects of this disease.


    Directory of Open Access Journals (Sweden)

    Musso CG


    Full Text Available Renal physiology plays a key role in the pharmacokinetics of many drugs. Knowledge of the particularities of each nephron function (filtration, secretion, reabsorption and excretion and each of renal tubular transport mechanisms (simple diffusion, facilitated diffusion, facilitated transport, active transport, endocytosis and pinocytosis is fundamental to achieve better management of drug prescriptions.

  13. Adverse Renal Effects of Novel Molecular Oncologic Targeted Therapies: A Narrative Review

    Directory of Open Access Journals (Sweden)

    Kenar D. Jhaveri


    Full Text Available Novel targeted anti-cancer therapies have resulted in improvement in patient survival compared to standard chemotherapy. Renal toxicities of targeted agents are increasingly being recognized. The incidence, severity, and pattern of renal toxicities may vary according to the respective target of the drug. Here we review the adverse renal effects associated with a selection of currently approved targeted cancer therapies, directed to EGFR, HER2, BRAF, MEK, ALK, PD1/PDL1, CTLA-4, and novel agents targeted to VEGF/R and TKIs. In summary, electrolyte disorders, renal impairment and hypertension are the most commonly reported events. Of the novel targeted agents, ipilumumab and cetuximab have the most nephrotoxic events reported. The early diagnosis and prompt recognition of these renal adverse events are essential for the general nephrologist taking care of these patients.

  14. Massive hematuria due to a congenital renal arteriovenous malformation mimicking a renal pelvis tumor: a case report

    Directory of Open Access Journals (Sweden)

    Sountoulides P


    Full Text Available Abstract Introduction Congenital renal arteriovenous malformations (AVMs are very rare benign lesions. They are more common in women and rarely manifest in elderly people. In some cases they present with massive hematuria. Contemporary treatment consists of transcatheter selective arterial embolization which leads to resolution of the hematuria whilst preserving renal parenchyma. Case presentation A 72-year-old man, who was heavy smoker, presented with massive hematuria and flank pain. CT scan revealed a filling defect caused by a soft tissue mass in the renal pelvis, which initially led to the suspicion of a transitional cell carcinoma (TCC of the upper tract, in view of the patient's age and smoking habits. However a subsequent retrograde study could not depict any filling defect in the renal pelvis. Selective right renal arteriography confirmed the presence of a renal AVM by demonstrating abnormal arterial communication with a vein with early visualization of the venous system. At the same time successful selective transcatheter embolization of the lesion was performed. Conclusion This case highlights the importance of careful diagnostic work-up in the evaluation of upper tract hematuria. In the case presented, a congenital renal AVM proved to be the cause of massive upper tract hematuria and flank pain in spite of the initial evidence indicating the likely diagnosis of a renal pelvis tumor.

  15. Amygdalin inhibits renal fibrosis in chronic kidney disease. (United States)

    Guo, Junqi; Wu, Weizheng; Sheng, Mingxiong; Yang, Shunliang; Tan, Jianming


    Renal interstitial fibrosis is a common outcome of chronic renal diseases. Amygdalin is one of a number of nitrilosides, the natural cyanide‑containing substances abundant in the seeds of plants of the prunasin family that are used to treat cancer and relieve pain. However, whether amygdalin inhibits the progression of renal fibrosis or not remains unknown. The present study aimed to assess the therapeutic potential of amygdalin by investigating its effect and potential mechanism on the activation of renal interstitial fibroblast cells and renal fibrosis in rat unilateral ureteral obstruction (UUO). Treatment of the cultured renal interstitial fibroblasts with amygdalin inhibited their proliferation and the production of transforming growth factor (TGF)‑β1. In the rat model of obstructive nephropathy, following ureteral obstruction, the administration of amygdalin immediately eliminated the extracellular matrix accumulation and alleviated the renal injury on the 21st day. Collectively, amygdalin attenuated kidney fibroblast (KFB) activation and rat renal interstitial fibrosis. These results indicate that amygdalin is a potent antifibrotic agent that may have therapeutic potential for patients with fibrotic kidney diseases.

  16. Stent sizing strategies in renal artery stenting: the comparison of conventional invasive renal angiography with renal computed tomographic angiography

    Directory of Open Access Journals (Sweden)

    Jacek Kadziela


    Full Text Available Introduction : Randomized trials comparing invasive treatment of renal artery stenosis with standard pharmacotherapy did not show substantial benefit from revascularization. One of the potential reasons for that may be suboptimal procedure technique. Aim : To compare renal stent sizing using two modalities: three-dimensional renal computed tomography angiography (CTA versus conventional angiography. Material and methods: Forty patients (41 renal arteries, aged 65.1 ±8.5 years, who underwent renal artery stenting with preprocedural CTA performed within 6 months, were retrospectively analyzed. In CTA analysis, reference diameter (CTA-D and lesion length (CTA_LL were measured and proposed stent diameter and length were recorded. Similarly, angiographic reference diameter (ANGIO_D and lesion length (ANGIO_LL as well as proposed stent dimensions were obtained by visual estimation. Results: The median CTA_D was 0.5 mm larger than the median ANGIO_D (p < 0.001. Also, the proposed stent diameter in CTA evaluation was 0.5 mm larger than that in angiography (p < 0.0001. The median CTA_LL was 1 mm longer than the ANGIO_LL (p = NS, with significant correlation of these variables (r = 0.66, p < 0.0001. The median proposed stent length with CTA was equal to that proposed with angiography. The median diameter of the implanted stent was 0.5 mm smaller than that proposed in CTA (p < 0.0005 and identical to that proposed in angiography. The median length of the actual stent was longer than that proposed in angiography (p = 0.0001. Conclusions : Renal CTA has potential advantages as a tool adjunctive to angiography in appropriate stent sizing. Careful evaluation of the available CTA scans may be beneficial and should be considered prior to the planned procedure.

  17. Renal morphology of Bradypus torquatus

    Directory of Open Access Journals (Sweden)

    Pedro Kastein Faria da Cunha Bianchi


    Full Text Available Among the Xenarthras, sloths present a hydric ingestion restricted to water from leaves, fruits, and vegetables. As a first approach to verify whether these animals have some morphophysiological difference which could justify or compensate this low hydric ingestion, the renal anatomy of these animals was investigated, particularly that of maned sloth (Bradypus torquatus. Kidneys from these animals were macroscopically analyzed, through light microscopy and scanning electron microscopy. The Bradypus torquatus kidneys are bean-shaped paired organs, located dorso-cranially to the pelvic girdle, between the peritoneum and the posterior abdominal wall. The use of histological techniques allowed us to identify, in the cortical region, the renal corpuscles and tubules, and, in the medullary region, a significant amount of interstitial tissue with a collecting duct. The results of this study showed that, although Bradypus torquatus doesn’t drink water directly, its kidneys doesn’t differ from that of most mammals, presenting the same anatomical structure, suggesting that these animals fully reach their hydric needs, basically by consuming leaves, fruits, and sprouts. Nevertheless, in order to confirm this hypothesis, studies on the effectiveness of water reabsorption, such as the renin-angiotensin-aldosterone system, must be carried out.

  18. Noncontrast-enhanced renal angiography using multiple inversion recovery and alternating TR balanced steady-state free precession. (United States)

    Dong, Hattie Z; Worters, Pauline W; Wu, Holden H; Ingle, R Reeve; Vasanawala, Shreyas S; Nishimura, Dwight G


    Noncontrast-enhanced renal angiography techniques based on balanced steady-state free precession avoid external contrast agents, take advantage of high inherent blood signal from the T 2 / T 1 contrast mechanism, and have short steady-state free precession acquisition times. However, background suppression is limited; inflow times are inflexible; labeling region is difficult to define when tagging arterial flow; and scan times are long. To overcome these limitations, we propose the use of multiple inversion recovery preparatory pulses combined with alternating pulse repetition time balanced steady-state free precession to produce renal angiograms. Multiple inversion recovery uses selective spatial saturation followed by four nonselective inversion recovery pulses to concurrently null a wide range of background T 1 species while allowing for adjustable inflow times; alternating pulse repetition time steady-state free precession maintains vessel contrast and provides added fat suppression. The high level of suppression enables imaging in three-dimensional as well as projective two-dimensional formats, the latter of which has a scan time as short as one heartbeat. In vivo studies at 1.5 T demonstrate the superior vessel contrast of this technique.

  19. Effect of large contrast agent dose and prolong scanning time on the image quality of CT portal venous phase images in patients with liver cirrhosis%延长扫描时间和大剂量对比剂对肝硬化患者门静脉期CT图像质量的影响

    Institute of Scientific and Technical Information of China (English)

    鲁慧; 杨剑


    目的:探讨大剂量对比剂及延长扫描时间对肝硬化患者门静脉期CT图像质量的影响。方法选取75例肝硬化患者,其中采用常规时间常规剂量扫描(60 s,1.5 ml/kg)患者为对照组(25例),延长扫描时间(70 s)患者为延长组(25例),在延长扫描时间的基础上增加对比剂剂量(2.5 ml/kg)患者为大剂量组(25例),不同延长扫描时间和不同扫描剂量肝静脉、肝实质、门静脉强化峰值、平均强化峰值时间与图像质量双盲目测评分值的差异。结果延长扫描时间后,延长组肝静脉、肝实质、门静脉强化峰值、静脉与肝实质差值、图像质量评分为(206.4±3.6)Hu、(110±13)Hu、(188±13)Hu、(74±11)Hu、(3.0±1.2)分,均明显高于对照组,肝实质、门静脉平均强化峰值时间明显低于对照组,2组比较差异具有统计学意义(P<0.05);在延长扫描时间的基础上增大对比剂剂量后,大剂量组上述指标分别为(218±11)Hu、(115±14)Hu、(214±16)Hu、(86±13)Hu、(3.6±0.7)分、(63.8±2.9)s、(44±5)s,均明显优于延长组,2组比较差异具有统计学意义(P<0.05)。结论延长扫描时间(70 s)和增加对比剂剂量(2.5 ml/kg)在一定程度上改善肝硬化患者门静脉期CT图像质量,有利于获取更清晰的CT图像。%Objective To discuss effect of large contrast agent dose and prolonged scanning time on the image quality of CT portal venous phase images in patients with liver cirrhosis. Methods Seventy-five cases of liver cirrho-sis were divided into three groups, which used the conventional time and dose scan (60 s, 1.5 ml/kg) were chosen as control group (25 cases), prolonged scanning time (70 s) and conventional dose scan were as prolonged group (25 cases), high dose (2.5 ml/kg) and prolonged scanning time were as high dose group (25 cases). The

  20. Mobile Agents (United States)

    Satoh, Ichiro

    Mobile agents are autonomous programs that can travel from computer to computer in a network, at times and to places of their own choosing. The state of the running program is saved, by being transmitted to the destination. The program is resumed at the destination continuing its processing with the saved state. They can provide a convenient, efficient, and robust framework for implementing distributed applications and smart environments for several reasons, including improvements to the latency and bandwidth of client-server applications and reducing vulnerability to network disconnection. In fact, mobile agents have several advantages in the development of various services in smart environments in addition to distributed applications.

  1. Renal replacement therapy after cardiac surgery; renal function recovers

    DEFF Research Database (Denmark)

    Steinthorsdottir, Kristin Julia; Kandler, Kristian; Agerlin Windeløv, Nis


    To assess renal outcome in patients discharged from hospital following cardiac surgery-associated acute kidney injury (CSA-AKI) with need for renal replacement therapy.......To assess renal outcome in patients discharged from hospital following cardiac surgery-associated acute kidney injury (CSA-AKI) with need for renal replacement therapy....

  2. Diuretic use in renal disease. (United States)

    Sica, Domenic A


    Diuretics are agents commonly used in diseases characterized by excess extracellular fluid, including chronic kidney disease, the nephrotic syndrome, cirrhosis and heart failure. Multiple diuretic classes, including thiazide-type diuretics, loop diuretics and K(+)-sparing diuretics, are used to treat patients with these diseases, either individually or as combination therapies. An understanding of what determines a patient's response to a diuretic is a prerequisite to the correct use of these drugs. The response of patients with these diseases to diuretics, which is related to the dose, is best described by a sigmoid curve whose contour can become distorted by any of the several sodium-retaining states that are directly or indirectly associated with renal disease. Diuretic actions are of considerable importance to patients who have renal disease, as their effective use assists in extracellular fluid volume control, reducing excretion of protein in urine and lessening the risk of developing hyperkalemia. Diuretic-related adverse events that involve the uric acid, Na(+) and K(+) axes are not uncommon; therefore the clinician must be vigilant in looking for biochemical disturbances. As a result of diuretic-related adverse events, clinicians must be resourceful in the dose amount and frequency of dosing.

  3. Antibiotic Agents (United States)

    ... agents. A recent survey reported that 76% of liquid soaps from 10 states in the US contained triclosan ... regulated depends upon its intended use and its effectiveness. The US Food and Drug Administration (FDA) regulates antibacterial soaps and antibacterial substances that will either be used ...

  4. Radionucleotide scanning in osteomyelitis

    Energy Technology Data Exchange (ETDEWEB)

    Sachs, W.; Kanat, I.O.


    Radionucleotide bone scanning can be an excellent adjunct to the standard radiograph and clinical findings in the diagnosis of osteomyelitis. Bone scans have the ability to detect osteomyelitis far in advance of the standard radiograph. The sequential use of technetium and gallium has been useful in differentiating cellulitis and osteomyelitis. Serial scanning with technetium and gallium may be used to monitor the response of osteomyelitis to antibiotic therapy.

  5. Laser Scanning in Forests


    Håkan Olsson; Juha Hyyppä; Markus Holopainen


    The introduction of Airborne Laser Scanning (ALS) to forests has been revolutionary during the last decade. This development was facilitated by combining earlier ranging lidar discoveries [1–5], with experience obtained from full-waveform ranging radar [6,7] to new airborne laser scanning systems which had components such as a GNSS receiver (Global Navigation Satellite System), IMU (Inertial Measurement Unit) and a scanning mechanism. Since the first commercial ALS in 1994, new ALS-based fore...

  6. Renal neuroendocrine tumors

    Directory of Open Access Journals (Sweden)

    Brian R Lane


    Full Text Available Objectives: Neuroendocrine tumors (NETs are uncommon tumors that exhibit a wide range of neuroendocrine differentiation and biological behavior. Primary NETs of the kidney, including carcinoid tumor, small cell carcinoma (SCC, and large cell neuroendocrine carcinoma (LCNEC are exceedingly rare. Materials and Methods: The clinicopathologic features of renal NETs diagnosed at a single institution were reviewed along with all reported cases in the worldwide literature. Results: Eighty renal NETs have been described, including nine from our institution. Differentiation between renal NETs and the more common renal neoplasms (renal cell carcinoma, transitional cell carcinoma can be difficult since clinical, radiographic, and histopathologic features overlap. Immunohistochemical staining for neuroendocrine markers, such as synaptophysin and chromogranin, can be particularly helpful in this regard. Renal carcinoids are typically slow-growing, may secrete hormones, and pursue a variable clinical course. In contrast, SCC and LCNEC often present with locally advanced or metastatic disease and carry a poor prognosis. Nephrectomy can be curative for clinically localized NETs, but multimodality treatment is indicated for advanced disease. Conclusions: A spectrum of NETs can rarely occur in the kidney. Renal carcinoids have a variable clinical course; SCC and LCNEC are associated with poor clinical outcomes. Diagnosis of NETs, especially LCNEC, requires awareness of their rare occurrence and prudent use of immunohistochemical neuroendocrine markers.

  7. Pregnancy and renal transplantation. (United States)

    Başaran, O; Emiroğlu, R; Seçme, S; Moray, G; Haberal, M


    Ovarian dysfunction, anovulatory vaginal bleeding, amenorrhea, high prolactin levels, and loss of libido are the causes of infertility in women with chronic renal failure. After renal transplantation, endocrine function generally improves after recovery of renal function. In this study we retrospectively evaluated the prepregnancy and postdelivery renal function, outcome of gestation, as well as maternal and fetal complications for eight pregnancies in eight renal transplant recipients between November 1975 and March 2003 of 1095 among 1425. Eight planned pregnancies occurred at a mean of 3.6 years posttransplant. Spontaneous abortion occured in the first trimester in one case. One intrauterine growth retardation was observed with a full-term pregnancy; one intrauterine growth retardation and preterm delivery; one preeclampsia with preterm delivery and urinary tract infection; and one preeclampsia with preterm delivery and oligohydramnios. The mean gestation period was 35.5 +/- 3.0 weeks (31.2 to 38.0). Pregnancy had no negative impact on renal function during a 2-year follow-up. No significant proteinuria or acute rejection episodes were observed. Among the seven deliveries, no congenital anomaly was documented and no postpartum problems for the child and the mother were observed. Our study suggests that successful pregnancy is possible in renal transplant recipients. In cases with good graft function and absence of severe proteinuria or hypertension, pregnancy does not affect graft function or patient survival; however, fetal problems are encountered such as intrauterine growth retardation, low birth weight, and preeclampsia.

  8. Renal autotransplantation: current perspectives. (United States)

    Stewart, B H; Banowsky, L H; Hewitt, C B; Straffon, R A


    Autotransplantation, with or without an extracorporeal renal operation, has been done 39 times in 37 patients. Indications for the procedure included severe ureteral injury in 4 patients, failed supravesical diversion in 2, renal carcinoma in a solitary kidney in 1, renovascular hypertension in 1 and donor arterial reconstruction before renal transplantation in 29. Success was obtained in all but 2 procedures, both of which involved previously operated kidneys with severe inflammation and adhesions involving the renal pelvis and pedicle. Based on our experience and a review of currently available literature we believe that renal autotransplantation and extracorporeal reconstruction can provide the best solution for patients with severe renovascular and ureteral disease not correctable by conventional operative techniques. The technique can be of particular value in removing centrally located tumors in solitary kidneys and in preparing donor kidneys with abnormal arteries for renal transplantation. The role of autotransplantation in the management of advanced renal trauma and calculus disease is less clear. A long-term comparison of patients treated by extracorporeal nephrolithotomy versus conventional lithotomy techniques will be necessary before a conclusion is reached in these disease categories.

  9. Development of a porcine renal extracellular matrix scaffold as a platform for kidney regeneration. (United States)

    Choi, Seock Hwan; Chun, So Young; Chae, Seon Yeong; Kim, Jin Rae; Oh, Se Heang; Chung, Sung Kwang; Lee, Jin Ho; Song, Phil Hyun; Choi, Gyu-Seog; Kim, Tae-Hwan; Kwon, Tae Gyun


    Acellular scaffolds, possessing an intact three-dimensional extracellular matrix (ECM) architecture and biochemical components, are promising for regeneration of complex organs, such as the kidney. We have successfully developed a porcine renal acellular scaffold and analyzed its physical/biochemical characteristics, biocompatibility, and kidney reconstructive potential. Segmented porcine kidney cortexes were treated with either 1% (v/v) Triton X-100 (Triton) or sodium dodecyl sulfate (SDS). Scanning electron microscopy showed both treatments preserved native tissue architecture, including porosity and composition. Swelling behavior was higher in the Triton-treated compared with the SDS-treated scaffold. Maximum compressive strength was lower in the Triton-treated compared with the SDS-treated scaffold. Attenuated total reflective-infrared spectroscopy showed the presence of amide II (-NH) in both scaffolds. Furthermore, richer ECM protein and growth factor contents were observed in the Triton-treated compared with SDS-treated scaffold. Primary human kidney cell adherence, viability, and proliferation were enhanced on the Triton-treated scaffold compared with SDS-treated scaffold. Following murine in vivo implantation, tumorigenecity was absent for both scaffolds after 8 weeks and in the Triton-treated scaffold only, glomeruli-like structure formation and neovascularity were observed. We identified 1% Triton X-100 as a more suitable decellularizing agent for porcine renal ECM scaffolds prior to kidney regeneration.

  10. The Diagnostic Value and Type of Multi-slice Spiral CT Reconstruction in Small Renal Carcinomas%多层螺旋CT三维重建对小肾癌的诊断及分型

    Institute of Scientific and Technical Information of China (English)

    宋强; 汪秀玲; 胡春峰


    Objective:According to the CT scan image and the performance of three-dimensional reconstruction,to study the diagnostic value and type of MSCT reconstruction in small renal carcinomas.Materials and Methods:A retrospective analysis was done for 43 cases of small renal carcinomas which received MSCT examination and confirmed by pathology in our hospital,analysis and type them with their performance in the CT examination.Results:There are 16 cases of small renal carcinoma of protruding type,their performance of CT examination are the tumors convex to the outline of the kidney or convex to the renal pelvis or calyx,when in enhancement CT scan,the contrast agent in the tumor are fast flowing in and fast flowing out which are the performance of malignant tumor;There are 6 cases of small renal carcinoma of inside renal parenchyma type,their performance of CT examination are the tumors limited in the renal parenchyma,when in enhancement CT scan,the performance of the tumor are f the typical performance of malignant tumor;There are 9 cases of small renal carcinoma of cystic type,their performance of CT examination are that when in enhancement CT scan,there are multiple enhanced uneven thickness stripes or small pitchy enhancement in the tumor;There are 5 cases of small renal carcinoma of multiple type,their performance of CT examination are that there are multiple small renal carcinomas in one kidney.Conclusion:Multi-slice spiral CT scan with 3D reconstruction image post-processing techniques can accurately and effectively diagnose various types of small renal carcinoma.%目的:根据CT扫描图像及三维重建表现,探讨多层螺旋CT扫描对小肾癌的诊断及鉴别诊断的价值,并对小肾癌进行分型。资料与方法:收集行多层螺旋CT扫描并经临床病理证实的43例小肾癌病例资料,就其CT表现进行分析并进行分型。结果:凸出型小肾癌23例,CT表现为肿瘤凸向肾轮廓之外或凸向肾盂、肾盏,增强

  11. Midterm renal functions following acute renal infarction

    Directory of Open Access Journals (Sweden)

    Sakir Ongun


    Full Text Available The aim of this study was to explore clinical features of renal infarction (RI that may have a role in diagnosis and treatment in our patient cohort and provide data on midterm renal functions. Medical records of patients with diagnosis of acute RI, established by contrast enhanced computed tomography (CT and at least 1 year follow-up data, who were hospitalized in our clinic between 1998 and 2012 were retrospectively reviewed; including descriptive data, clinical signs and symptoms, etiologic factors, laboratory findings, and prescribed treatments. Patients with solitary infarct were treated with acetylsalicylic acid (ASA only, whereas patients with atrial fibrillation (AF or multiple or global infarct were treated with anticoagulants. Estimated Glomerular Filtration Rate (eGFR referring to renal functions was determined by the Modification of Diet in Renal Disease (MDRD formula. Twenty-seven renal units of 23 patients with acute RI were identified. The mean age was 59.7 ± 15.7 years. Fourteen patients (60.8% with RI had atrial fibrillation (AF as an etiologic factor of which four had concomitant mesenteric ischemia at diagnosis. At presentation, 20 patients (86.9% had elevated serum lactate dehydrogenase (LDH, 18 patients (78.2% had leukocytosis, and 16 patients (69.5% had microscopic hematuria. Two patients with concomitant mesenteric ischemia and AF passed away during follow up. Mean eGFR was 70.8 ± 23.2 mL/min/1.73 m2 at admission and increased to 82.3 ± 23.4 mL/min/1.73 m2 at 1 year follow up. RI should be considered in patients with persistent flank or abdominal pain, particularly if they are at high risk of thromboembolism. Antiplatelet and/or anticoagulant drugs are both effective treatment options according to the amplitude of the infarct for preserving kidney functions.

  12. Midterm renal functions following acute renal infarction. (United States)

    Ongun, Sakir; Bozkurt, Ozan; Demir, Omer; Cimen, Sertac; Aslan, Guven


    The aim of this study was to explore clinical features of renal infarction (RI) that may have a role in diagnosis and treatment in our patient cohort and provide data on midterm renal functions. Medical records of patients with diagnosis of acute RI, established by contrast enhanced computed tomography (CT) and at least 1 year follow-up data, who were hospitalized in our clinic between 1998 and 2012 were retrospectively reviewed; including descriptive data, clinical signs and symptoms, etiologic factors, laboratory findings, and prescribed treatments. Patients with solitary infarct were treated with acetylsalicylic acid (ASA) only, whereas patients with atrial fibrillation (AF) or multiple or global infarct were treated with anticoagulants. Estimated Glomerular Filtration Rate (eGFR) referring to renal functions was determined by the Modification of Diet in Renal Disease (MDRD) formula. Twenty-seven renal units of 23 patients with acute RI were identified. The mean age was 59.7 ± 15.7 years. Fourteen patients (60.8%) with RI had atrial fibrillation (AF) as an etiologic factor of which four had concomitant mesenteric ischemia at diagnosis. At presentation, 20 patients (86.9%) had elevated serum lactate dehydrogenase (LDH), 18 patients (78.2%) had leukocytosis, and 16 patients (69.5%) had microscopic hematuria. Two patients with concomitant mesenteric ischemia and AF passed away during follow up. Mean eGFR was 70.8 ± 23.2 mL/min/1.73 m(2) at admission and increased to 82.3 ± 23.4 mL/min/1.73 m(2) at 1 year follow up. RI should be considered in patients with persistent flank or abdominal pain, particularly if they are at high risk of thromboembolism. Antiplatelet and/or anticoagulant drugs are both effective treatment options according to the amplitude of the infarct for preserving kidney functions.

  13. Tc-99m Dimercaptosuccinic Acid (DMSA) Renal Scintigraphy in Patients with Acute Pyelonephritis (United States)

    Lee, Kang Wook; Bin, Ki Tae; Jeong, Min Soo; Shong, Min Ho; Shin, Young Tai; Ro, Heung Kyu


    Objectives Recently, several authors reported that Tc-99m DMSA renal scan frequently showed cortical defects of the involved kidneys even in the patients with acute pyelonephritis who did not show abnormal findings in the ultrasonography and intravenous pyelography IVP). Methods In order to evaluate the utilities of Tc-99m DMSA renal scan and the clinical meanig of cortical defects in the Tc-99m DMSA renal scan of the patients with acute pyelonephritis, ninety two patients with acute pyelonephritis, from March 1991 to February 1994 in Chungnam National University Hospital(CNUH), were included in this study. Patients were subdivided as Group A:Patients showing normal Tc-99m DMSA renal scan(n=42) and Group B:Patients with definit cortical defects on the Tc-99m DMSA renal scan(n=50). We compared clinical characteristics such as age and sex, recurrency, duration of fever, bacterial culture study, incidence of renal insufficiency and the results of renal ultrasonography and intravenous pyelography between the two groups. Results Fifty four percents of 92 patients with acute pyelonephritis showed a significantly longer febrile period after admission, higher positive rates on the urine and blood culture studies and higher incidence of renal insufficiency than those of the Group A patients. Sixty nine percents of Group B patients showed normal results in ultrasonography or IVP study. Conclusions Tc-99m DMSA renal scan was a more sensitive imaging test than ultrasonography in kidneys and IVP to detect pyelonephritis lesions and may be useful to predict the patient group with a severe disease course. These patients may need more careful management and further studies to evaluate the possibility of complications. PMID:7626556

  14. The new technique of using the epigastric arteries in renal transplantation with multiple renal arteries

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Amirzargar


    Full Text Available The most common anatomic variant seen in the donor kidneys for renal transplantation is multiple renal arteries (MRA, which can cause an increased risk of complications. We describe the long-term outcomes of 16 years of experience in 76 kidney transplantations with MRAs. In a new reconstruction technique, we remove arterial clamps after anastomosing the donor to the recipient′s main renal vessels, which cause backflow from accessory arteries to prevent thrombosis. By this technique, we reduce the ischemic times as well as the operating times. Both in live or cadaver donor kidneys, lower polar arteries were anastomosed to the inferior epigastric artery and upper polar arteries were anastomosed to the superior epigastric arteries. Injection of Papaverine and ablation of sympathic nerves of these arteries dilate and prevent them from post-operative spasm. Follow-up DTPA renal scan in all patients showed good perfusion and function of the transplanted kidney, except two cases of polar arterial thrombosis. Mean creatinine levels during at least two years of follow-up remained acceptable. Patient and graft survival were excellent. No cases of ATN, hypertension, rejection and urologic complications were found. In conclusion, this technique can be safely and successfully utilized for renal transplantation with kidneys having MRAs, and may be associated with a lower complication rate and better graft function compared with the existing techniques.

  15. Giant renal artery aneurysm: A case report. (United States)

    Cindolo, Luca; Ingrosso, Manuela; De Francesco, Piergustavo; Castellan, Pietro; Berardinelli, Francesco; Fiore, Franco; Schips, Luigi


    A case of a 12 cm giant renal artery aneurysm (RAA) in an 59-year-old woman is reported. The patient was referred to our hospital for flank pain and spot hematuria. Ultrasonography (US) revealed some wide lacunar areas in her right kidney and a thin cortex. Three-dimensional computed tomography (3D-CT) revealed a giant right renal arteriovenous malformation (AVM). AngioCT scan showed a pervious right renal artery. The cavities of the right kidney were dilated and the parenchyma was markedly reduced. Two months later the patient underwent an open resection of the aneurysm and a right nephrectomy. She had an uneventful recovery and a healthy status (last follow-up: 9 month). In this particular case, a safe approach is the transabdominal approach since the aneurysm was very large, friable, and located on the right side. This report confirms the opportunity of a planned nephrectomy once there is adequate renal reserve in the opposite kidney using a midline approach.

  16. Giant renal artery aneurysm: A case report

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    Luca Cindolo


    Full Text Available A case of a 12 cm giant renal artery aneurysm (RAA in an 59-year-old woman is reported. The patient was referred to our hospital for flank pain and spot hematuria. Ultrasonography (US revealed some wide lacunar areas in her right kidney and a thin cortex. Three-dimensional computed tomography (3D-CT revealed a giant right renal arteriovenous malformation (AVM. AngioCT scan showed a pervious right renal artery. The cavities of the right kidney were dilated and the parenchyma was markedly reduced. Two months later the patient underwent an open resection of the aneurysm and a right nephrectomy. She had an uneventful recovery and a healthy status (last follow-up: 9 month. In this particular case, a safe approach is the transabdominal approach since the aneurysm was very large, friable, and located on the right side. This report confirms the opportunity of a planned nephrectomy once there is adequate renal reserve in the opposite kidney using a midline approach.

  17. Tenofovir-related nephrotoxicity in human immunodeficiency virus-infected patients: three cases of renal failure, Fanconi syndrome, and nephrogenic diabetes insipidus. (United States)

    Karras, Alexandre; Lafaurie, Matthieu; Furco, André; Bourgarit, Anne; Droz, Dominique; Sereni, Daniel; Legendre, Christophe; Martinez, Frank; Molina, Jean-Michel


    We report 3 cases of renal toxicity associated with use of the antiviral agent tenofovir. Renal failure, proximal tubular dysfunction, and nephrogenic diabetes insipidus were observed, and, in 2 cases, renal biopsy revealed severe tubular necrosis with characteristic nuclear changes. Patients receiving tenofovir must be monitored closely for early signs of tubulopathy (glycosuria, acidosis, mild increase in the plasma creatinine level, and proteinuria).

  18. Screening and Management of Asymptomatic Renal Stones in Astronauts (United States)

    Reyes, David; Locke, James; Sargsyan, Ashot; Garcia, Kathleen


    Management guidelines were created to screen and manage asymptomatic renal stones in U.S. astronauts. The true risk for renal stone formation in astronauts due to the space flight environment is unknown. Proper management of this condition is crucial to mitigate health and mission risks. The NASA Flight Medicine Clinic electronic medical record and the Lifetime Surveillance of Astronaut Health databases were reviewed. An extensive review of the literature and current aeromedical standards for the monitoring and management of renal stones was also done. This work was used to develop a screening and management protocol for renal stones in astronauts that is relevant to the spaceflight operational environment. In the proposed guidelines all astronauts receive a yearly screening and post-flight renal ultrasound using a novel ultrasound protocol. The ultrasound protocol uses a combination of factors, including: size, position, shadow, twinkle and dispersion properties to confirm the presence of a renal calcification. For mission-assigned astronauts, any positive ultrasound study is followed by a low-dose renal computed tomography scan and urologic consult. Other specific guidelines were also created. A small asymptomatic renal stone within the renal collecting system may become symptomatic at any time, and therefore affect launch and flight schedules, or cause incapacitation during a mission. Astronauts in need of definitive care can be evacuated from the International Space Station, but for deep space missions evacuation is impossible. The new screening and management algorithm has been implemented and the initial round of screening ultrasounds is under way. Data from these exams will better define the incidence of renal stones in U.S. astronauts, and will be used to inform risk mitigation for both short and long duration spaceflights.

  19. Screening and Management of Asymptomatic Renal Stones in Astronauts (United States)

    Reyes, David; Locke, James; Sargsyan, Ashot; Garcia, Kathleen


    Management guidelines were created to screen and manage asymptomatic renal stones in U.S. astronauts. The true risk for renal stone formation in astronauts due to the space flight environment is unknown. Proper management of this condition is crucial to mitigate health and mission risks. The NASA Flight Medicine Clinic electronic medical record and the Lifetime Surveillance of Astronaut Health databases were reviewed. An extensive review of the literature and current aeromedical standards for the monitoring and management of renal stones was also done. This work was used to develop a screening and management protocol for renal stones in astronauts that is relevant to the spaceflight operational environment. In the proposed guidelines all astronauts receive a yearly screening and post-flight renal ultrasound using a novel ultrasound protocol. The ultrasound protocol uses a combination of factors, including: size, position, shadow, twinkle and dispersion properties to confirm the presence of a renal calcification. For mission-assigned astronauts, any positive ultrasound study is followed by a low-dose renal computed tomography scan and urologic consult. Other specific guidelines were also created. A small asymptomatic renal stone within the renal collecting system may become symptomatic at any time, and therefore affect launch and flight schedules, or cause incapacitation during a mission. Astronauts in need of definitive care can be evacuated from the International Space Station, but for deep space missions evacuation is impossible. The new screening and management algorithm has been implemented and the initial round of screening ultrasounds is under way. Data from these exams will better define the incidence of renal stones in U.S. astronauts, and will be used to inform risk mitigation for both short and long duration spaceflights.

  20. Induction of trismus by sunitinib and pazopanib in metastatic renal cell carcinoma

    Directory of Open Access Journals (Sweden)

    Ridhima Iyer


    Full Text Available Tyrosine kinase inhibitors sunitinib and pazopanib are used as first-line agents in the treatment of metastatic renal cell carcinoma. Treatment-related toxicities have been described with both these drugs. This report describes a patient with metastatic renal carcinoma who developed trismus while being treated with these agents and is, to the best of our knowledge, the first such case to be reported.

  1. Sugammadex in patients with chronic renal failure: two case reports

    Directory of Open Access Journals (Sweden)

    Gwi Eun Yeo


    Full Text Available Rocuronium is a non-depolarizing aminosteroidal neuromuscular blocking agent that is widely used in general anesthesia. Its effects may be prolonged in patients with renal disease, especially renal failure, due to reduced clearance of the drug. Sugammadex, a modified γ-cyclodextrin, is known to be a highly effective reversal agent for rocuronium-induced muscle relaxation. However, the administration of sugammadex for reversal of rocuronium-induced neuromuscular block in patients with renal disease is controversial. Recently, we administered rocuronium for neuromuscular blockade during the surgery of two patients with chronic renal failure, instead of cisatracurium, a benzylisoquinoline compound. Therefore, we had to administer sugammadex to ensure maximum alleviation of residual neuromuscular blockade risk after surgery. Although the effect of rocuronium was prolonged during surgery, sugammadex quickly and completely restored the response of train-of-four stimulation postoperatively. There were no residual neuromuscular block signs or symptoms observed in these patients throughout the postoperative period. In this report, we share our experience with these cases, and discuss the effectiveness and safety of sugammadex in the context of chronic renal failure.   Keywords: Neuromuscular blockade; Neuromuscular monitoring; Renal failure; Residual neuromuscular blockade; Rocuronium; Sugammadex

  2. Radioprotective Agents (United States)


    claimed to be effective are gallic acid derivatives, eg, sodium gallate 12053-21-61 (295-297) and propyl gallate 1121-79-91 (298). p...inhibition of a-adrenergic receptors can be achieved through the use of the antiradiation agents 2-(5-aminopentylamino)ethanephos- phorothioic acid ...tissue was ap- preciated immediately as a potential medical set, and they were put to use en- thusiastically. Early workers did notice an erythematous

  3. Renal scintigraphy in veterinary medicine. (United States)

    Tyson, Reid; Daniel, Gregory B


    Renal scintigraphy is performed commonly in dogs and cats and has been used in a variety of other species. In a 2012 survey of the members of the Society of Veterinary Nuclear Medicine, 95% of the respondents indicated they perform renal scintigraphy in their practice. Renal scintigraphy is primarily used to assess renal function and to evaluate postrenal obstruction. This article reviews how renal scintigraphy is used in veterinary medicine and describes the methods of analysis. Species variation is also discussed.

  4. Dual-energy computed tomography angiography for evaluating the renal vascular variants

    Institute of Scientific and Technical Information of China (English)

    TAO Xiao-feng; ZHU Jing-qi; WU Ying-wei; TANG Guang-yu; SHI Yu-zhen; ZHANG Lei; LIN Yi


    Background Recognizing renal vascular variants preoperatively is important in order to avoid vascular complications during surgery.This study aimed to investigate the renal vascular variants with dual-energy computed tomography (DECT) angiography to provide valuable information for surgery.Methods A total of 378 patients underwent DECT.The number,size,course and relationships of the renal vessels were retrospectively observed from the scans.Anomalies of renal arteries and veins were recorded and classified.Multiplanar reformations (MPR),maximum intensity projections (MIP),and volume renderings (VR) were used for analysis.Results In 378 patients (756 kidneys),renal artery variations were discovered and recorded in 123 kidneys (16.3%,123/756) of 106 patients (28.0%,106/378).Type IB (early branches of the only one main renal artery) and IC (accessory renal artery with only one main renal artery) were found most frequently with an incidence of 11.4% (43/378) and 14.5%(55/378).The incidence of renal artery variations in the left kidney was not statistically different than in the right kidney (12.4% vs.11.1%).The incidence of renal vein variations was detected in 104 patients (27.5%,104/378).The incidence of venous variants in the right kidney was higher than in the left kidney (20.1% vs.7.4%),but left renal vein variations were more complex.Variants of the left renal vein were detected in 28 patients including type 1 (circumaortic left renal vein) in eight cases,type 2 (retroaortic left renal vein) in seven cases,type 3 (abnormal reflux) in six cases,type 4 (late venous confluence of left renal vein) in five cases,and type 5 (rare type) in two cases.The frequency of left renal vein variation associated with the left renal accessory artery was significantly higher than with early branches of the left renal artery (P=0.037).Conclusions The renal vascular variants are rather common and complex.DECT angiography can demonstrate the precise anatomy of the

  5. Aneurisma da Artéria Renal: caso clínico Renal Artery Aneurysm

    Directory of Open Access Journals (Sweden)

    Joana Moreira


    Full Text Available Apresenta-se o caso clínico de um doente com volumoso aneurisma da artéria renal esquerda. Do sexo masculino, de 22 anos de idade, com lombalgia à esquerda com algumas semanas de evolução. Recorreu ao médico assistente que solicitou estudo imagiológico por ecografia abdominal. Detectada imagem sugestiva de aneurisma da aorta abdominal. Este achado motivou a transferência para o nosso Hospital onde foi admitido consciente e orientado, hemodinamicamente estável, apresentando uma massa pulsátil epigástrica, com frémito e sopro sistólico à auscultação. Angio-TC revelou um aneurisma da artéria renal esquerda com 16 cm de diâmetro. Dada a estabilidade clínica e topografia lesional optou-se por tentar embolizar, sem sucesso, o tronco da artéria renal esquerda antes da abordagem cirúrgica. O doente foi então submetido a Nefrectomia total esquerda por via toraco-abdominal. Pós-operatório sem complicações, locais ou sistémicas. Alta ao 8ºdia, mantendo boa função renal e com níveis normais de hemoglobina. Diagnóstico de aneurisma da artéria renal confirmado por estudo anátomo-patológico da peça operatória.One case of a large left renal artery aneurysm in a young patient 22 years old is presented. He appealed to his assistant physician a few weeks after development of left back pain. Abdominal ultrasound imaging study has been requested. Suggestive abdominal aortic aneurysm was detected. This finding led to the transfer to our hospital where he was admitted conscious and hemodynamically stable. A pulsatile epigastric mass with a systolic murmur on auscultation and thrill were detected. Angio-CT scan revealed a left renal artery aneurysm, 16 cm in diameter. Given the clinical stability and lesional topography we decide a previous embolization of left renal artery, unsuccessfully. The patient underwent then left total nephrectomy, through thoraco-abdominal incision. No local or systemic complications in the postoperative

  6. Frequency scanning microstrip antennas

    DEFF Research Database (Denmark)

    Danielsen, Magnus; Jørgensen, Rolf


    The principles of using radiating microstrip resonators as elements in a frequency scanning antenna array are described. The resonators are cascade-coupled. This gives a scan of the main lobe due to the phase-shift in the resonator in addition to that created by the transmission line phase...

  7. Scanning laser Doppler vibrometry

    DEFF Research Database (Denmark)

    Brøns, Marie; Thomsen, Jon Juel

    With a Scanning Laser Doppler Vibrometer (SLDV) a vibrating surface is automatically scanned over predefined grid points, and data processed for displaying vibration properties like mode shapes, natural frequencies, damping ratios, and operational deflection shapes. Our SLDV – a PSV-500H from...

  8. Vascular reactivity of rabbit isolated renal and femoral resistance arteries in renal wrap hypertension. (United States)

    Khammy, Makhala M; Angus, James A; Wright, Christine E


    In rabbits with cellophane renal wrap hypertension, hindquarter and total vascular resistance changes to pressor and depressor agents are amplified compared to those of normotensive rabbits. The aim of the present study was to evaluate the in vitro pharmacodynamics of hypertensive and normotensive rabbit small artery segments isolated from the renal and hindquarter vascular beds. Using wire myography, the full range (Emax) and sensitivity (EC50) to a range of agonists of segments of renal interlobar (≈ 600 µm i.d.), renal arcuate (≈ 250 µm i.d.) and deep femoral branch (≈ 250 µm i.d.) arteries were assessed under normalised conditions of passive tension. Interlobar arteries from hypertensive rabbits were more sensitive (EC50) than those from normotensive rabbits to noradrenaline (6-fold), methoxamine (3-fold) and angiotensin II (3-fold). Arcuate artery reactivity was largely unaffected by hypertension. Deep femoral arteries from hypertensive rabbits had enhanced sensitivity only to noradrenaline (2-fold) and methoxamine (4-fold). Sensitivity to relaxation by acetylcholine was unaffected by hypertension in all arteries. Deep femoral arteries from hypertensive rabbits were more sensitive to sodium nitroprusside than normotensive counterparts. Adenosine caused little relaxation in renal arteries, but full relaxation in deep femoral arteries, unaltered by hypertension. This study found substantial heterogeneity in the pharmacodynamic profile of vessels isolated from different vascular beds and between arterial segments within the kidney. These profiles were differentially affected by hypertension suggesting that hypertension per se is not a resultant of general vascular dysfunction.

  9. MR to assess renal function in children

    Energy Technology Data Exchange (ETDEWEB)

    Rohrschneider, Wiltrud K.; Troeger, Jochen [Department of Pediatric Radiology, Radiological Clinic, University of Heidelberg, Im Neuenheimer Feld 153, 69120, Heidelberg (Germany); Haufe, Sabine [Department of Nuclear Medicine, Radiological University Clinic Heidelberg, Im Neuenheimer Feld 153, 69120, Heidelberg (Germany); Clorius, John H. [Department of Nuclear Medicine, German Cancer Research Institute, 69120, Heidelberg (Germany)


    Renal function evaluation in the pediatric patient is generally based on scintigraphic examinations where a baseline gamma-camera renography is used to determine single kidney function, and diuresis renography is obtained to assess urinary drainage from the pelvicalyceal system. Magnetic resonance imaging also permits the evaluation of renal functional processes using fast dynamic sequences. Principally, an agent cleared by renal excretion is intravenously injected and its cortical uptake, parenchymal transport, and eventually its urinary excretion are followed with serial images. Different approaches have been presented most of which are based on T1-weighted gradient-recalled echo sequences with short TR and TE and a low flip angle obtained after intravenous injection of Gd-DTPA or Gd-DOTA. These techniques permit renal functional assessment using different qualitative and quantitative parameters; however, most of these methods are not suitable for the evaluation of urinary tract dilatation in infants and children. For the diagnostic work-up of children with congenital urinary tract obstruction and malformation a technique was developed which permits quantitative determination of single kidney function, in addition to evaluating urinary excretion disturbances analogous to that possible with scintigraphy. (orig.)

  10. Brucellosis in a renal transplant recipient. (United States)

    Ting, I W; Ho, M W; Sung, Y J; Tien, N; Chi, C Y; Ho, H C; Huang, C C


    Brucellosis is one of the most common systemic zoonotic diseases transmitted by consumption of unpasteurized dairy products or by occupational contact with infected animals. Brucellosis is rare in renal transplant recipients. Only 3 cases have been reported in the literature. We report a case of brucellosis with hematologic and hepatobiliary complications in a patient 3 years after renal transplantation. The mean time from transplantation to the diagnosis of brucellosis in these 4 reported patients was 5.1 years (range 17 months to 13 years). All patients had fever and constitutional symptoms, and all attained clinical cure after combination antibiotic therapy. Given the small number of patients, further study is needed to identify the characteristics of brucellosis in renal transplant recipients. Drug interactions and acute renal failure developed in our patient during antibiotic treatment. Therefore, we should monitor the levels of immunosuppressive agents frequently. Several studies have shown in vitro susceptibilities of Brucella melitensis to tigecycline. In our patient, fever finally subsided after tigecycline administration. The minimum inhibitory concentration of tigecycline using Etest was 0.094 μg/mL. Tigecycline may be a potential option for treatment of brucellosis in the setting of transplantation.

  11. The cardio-renal anemia syndrome

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    Dimković Siniša


    Full Text Available Introduction. The problem of anemia in congestive heart failure and chronic kidney disease was thought to be insignificant for a long period of time. Recent investigations pointed out that the problem of anemia should be defined in the context of the cardio-renal anemia syndrome. A positive feedback mechanism indicates that cardio-renal anemia syndrome is due to an interaction between congestive heart failure, chronic renal failure and anemia. The aim of the study was to present the possible pathophysiological mechanisms of this syndrome, epidemiological characteristics and therapeutic results of the former investigations. Results. The results of the retrospective and prospective controlled trails have shown that management of anemia with subcutaneous administration of recombinant human erythropoietin together with intravenous iron infusion for at least 3-6 months lead to: relief of symptoms (improved NYHA functional class; increased left ventricular ejection fraction; reduced cardiovascular morbidity and mortality; reduced number of rehospitalizations; reduced requirements for usual therapeutic agents (especially diuretics; and improved renal function. Conclusion. In patients with heart and kidney disease anemia should be routinely identified and appropriately treated. Subcutaneous recombinant erythropoietin and intravenous iron may significantly improve overall survival and quality of life of these patients. .

  12. Sunitinib for advanced renal cell cancer

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    Chris Coppin


    Full Text Available Chris CoppinBC Cancer Agency and University of British Columbia, Vancouver, CanadaAbstract: Renal cell cancer has been refractory to drug therapy in the large majority of patients. Targeted agents including sunitinib have been intensively evaluated in renal cell cancer over the past 5 years. Sunitinib is an oral small molecule inhibitor of several targets including multiple tyrosine kinase receptors of the angiogenesis pathway. This review surveys the rationale, development, validation, and clinical use of sunitinib that received conditional approval for use in North America and Europe in 2006. In patients with the clear-cell subtype of renal cell cancer and metastatic disease with good or moderate prognostic factors for survival, sunitinib 50 mg for 4 weeks of a 6-week cycle provides superior surrogate and patient-reported outcomes when compared with interferon-alfa, the previous commonly used first-line drug. Overall survival has not yet shown improvement over interferon and is problematic because of patient crossover from the control arm to sunitinib at disease progression. Toxicity is significant but manageable with experienced monitoring. Sunitinib therapy is an important step forward for this condition. High cost and limited efficacy support the ongoing search for further improved therapy.Keywords: renal cell cancer, targeted therapy, sunitinib

  13. Persistent renal hyperparathyroidism caused by intrathyroidal parathyroid glands. (United States)

    Chen, Chin-Li; Lin, Shih-Hua; Yu, Jyh-Cherng; Shih, Ming-Lang


    Renal hyperparathyroidism usually occurs in chronic renal failure patients on regular dialysis. However, renal hyperparathyroidism resulting from intrathyroidal parathyroid glands is an uncommon condition. We herein present the case of a 35-year-old woman who has been on hemodialysis for 20 years. She had renal hyperparathyroidism with generalized weakness and bone pain for 2 years. The patient initially underwent parathyroidectomy at a local institution, during which two large parathyroid glands were resected from the right side (no parathyroid glands were found on the left side); however, the surgical procedure was unsuccessful, and the patient had persistent renal hyperparathyroidism after the operation. She was then transferred to our hospital and ectopic intrathyroidal parathyroid glands were localized by neck ultrasonography and technetium-99m sestamibi scans with single-photon emission computed tomography imaging preoperatively. A left thyroid lobectomy was performed and two intrathyroidal parathyroid glands were found. The patient recovered uneventfully and her symptoms resolved. Therefore, clinicians should be aware of the possibility of renal hyperparathyroidism resulting from intrathyroidal parathyroid glands in cases where the renal hyperparathyroidism persists after parathyroidectomy.

  14. Rhabdomyolysis and unilateral renal infarction after a motor vehicle crash. (United States)

    Sanai, Toru; Yokoyama, Masaaki; Murata, Akinari; Ukon, Kei; Fuchigami, Kazumi


    A 46-year-old man with no previous history of abnormal urinalysis findings or renal dysfunction was admitted to a local hospital because of a motor vehicle crash. An open laparotomy was performed to treat a perforation of the small intestine. After operation, oliguria and renal dysfunction developed, and he was admitted to our hospital because of acute renal failure after trauma. Acute renal failure was assumed to be due to rhabdomyolysis with elevated serum creatinine, blood urea nitrogen, and creatine kinase levels and myoglobinemia. Left flank pain occurred several days after admission, and the serum alkaline phosphatase level increased between days 5 and 12 following admission. Although hemodialysis was performed 9 times and the urine output was satisfactory, the creatinine clearance levels increased only to about 50 mL/min/1.73 m2 (0.84 mL/s/m2) at 6 weeks following admission. As a result, a diagnosis of renal infarction due to acute renal artery occlusion was considered. The left kidney was atrophic on an abdominal computed tomographic scan and was nonfunctioning on a renogram. This case shows the importance of not overlooking the possibility of a renal infarction associated with rhabdomyolysis after a motor vehicle crash. In particular, the changes in the serum alkaline phosphatase levels were important in making a correct diagnosis in this case.

  15. Clinical practice: Obstructive renal candidiasis in infancy. (United States)

    Bisht, Veena; Voort, Judith VanDer


    Renal candidiasis is an increasingly common condition affecting predominantly premature infants receiving neonatal intensive care or term infants with urogenital tract anomalies. Multiple risk factors are usually present. Although rare, some infants develop an obstructive uropathy due to fungal balls, and this requires prompt detection and intervention to preserve kidney function. The management of obstructive renal bezoars is challenging and not well summarised in the past. This is mainly due to scarce literature confined to case reports or case series only. This review clarifies various definitions used in relation to renal candidiasis and identifies infants particularly at risk of obstruction. Clinical presentation, diagnosis and the role of imaging are discussed. A summary of the recent literature is provided to outline the range of existing treatment options available with published drug dosages and mode of delivery used. No single approach is successful in all cases and clinicians need to be aware of the different options available: apart from adequate urinary drainage and use of systemic +/- local antifungal agents, additional treatment with fibrinolytic agents and/or endoscopic or open surgical removal may be required. A new simplified algorithm for use in management is proposed. We hope this review will help clinicians in their management of patients presenting with this complex and challenging diagnosis.

  16. Primary renal synovial sarcoma

    Directory of Open Access Journals (Sweden)

    Girish D. Bakhshi


    Full Text Available Primary Renal Sarcoma is rare tumor comprising only 1% of all renal tumours. Synovial sarcomas are generally deep-seated tumors arising in the proximity of large joints of adolescents and young adults and account for 5-10% of all soft tissue tumours. Primary synovial sarcoma of kidney is rare and has poor prognosis. It can only be diagnosed by immunohistochemistry. It should be considered as a differential in sarcomatoid and spindle cell tumours. We present a case of 33-year-old female, who underwent left sided radical nephrectomy for renal tumour. Histopathology and genetic analysis diagnosed it to be primary renal synovial sarcoma. Patient underwent radiation therapy and 2 years follow up is uneventful. A brief case report with review of literature is presented.

  17. Renal protection in diabetes

    DEFF Research Database (Denmark)

    Parving, H H; Tarnow, L; Rossing, P


    BACKGROUND: The combination of diabetes and hypertension increases the chances of progressive renal disorder and, ultimately, renal failure. Roughly 40% of all diabetics, whether insulin-dependent or not, develop diabetic nephropathy. Diabetic nephropathy is the single most important cause of end......-stage renal disease in the Western world and accounts for more than a quarter of all end-stage renal diseases. Diabetic nephropathy is a major cause of increased morbidity and mortality in diabetic patients. Increased arterial blood pressure is an early and common phenomenon in incipient and overt diabetic...... nephropathy. The relationship between arterial blood pressure and diabetic nephropathy is a complex one, with diabetic nephropathy increasing blood pressure and blood pressure accelerating the course of nephropathy. OVERVIEW: Calcium antagonists antagonize preglomerular vasoconstriction. Additional putative...

  18. Renal primitive neuroectodermal tumors. (United States)

    Bartholow, Tanner; Parwani, Anil


    Primitive neuroectodermal tumors exist as a part of the Ewing sarcoma/primitive neuroectodermal tumor family. These tumors most commonly arise in the chest wall and paraspinal regions; cases with a renal origin are rare entities, but have become increasingly reported in recent years. Although such cases occur across a wide age distribution, the average age for a patient with a renal primitive neuroectodermal tumor is the mid- to late 20s, with both males and females susceptible. Histologically, these tumors are characterized by pseudorosettes. Immunohistochemically, CD99 is an important diagnostic marker. Clinically, these are aggressive tumors, with an average 5-year disease-free survival rate of only 45% to 55%. Given that renal primitive neuroectodermal tumor bears many similarities to other renal tumors, it is important to review the histologic features, immunostaining profile, and genetic abnormalities that can be used for its correct diagnosis.

  19. Renal vein thrombosis (United States)

    ... Saunders; 2012:chap 34. Read More Acute kidney failure Arteriogram Blood clots Dehydration Nephrotic syndrome Pulmonary embolus Renal Tumor Review Date 5/19/2015 Updated by: Charles Silberberg, ...

  20. Eligibility for renal denervation

    DEFF Research Database (Denmark)

    Persu, Alexandre; Jin, Yu; Baelen, Marie;


    -resistant hypertension (ENCOReD). The analysis included 731 patients. Age averaged 61.6 years, office blood pressure at screening was 177/96 mm Hg, and the number of blood pressure-lowering drugs taken was 4.1. Specialists referred 75.6% of patients. The proportion of patients eligible for renal denervation according......Based on the SYMPLICITY studies and CE (Conformité Européenne) certification, renal denervation is currently applied as a novel treatment of resistant hypertension in Europe. However, information on the proportion of patients with resistant hypertension qualifying for renal denervation after...... undetected secondary causes of hypertension (11.1%). In conclusion, after careful screening and treatment adjustment at hypertension expert centers, only ≈40% of patients referred for renal denervation, mostly by specialists, were eligible for the procedure. The most frequent cause of ineligibility...

  1. Complete renal recovery from severe acute renal failure after thrombolysis of bilateral renal vein thrombosis. (United States)

    Ramadoss, Suresh; Jones, Robert G; Foggensteiner, Lukas; Willis, Andrew P; Duddy, Martin J


    A previously healthy young man presented with acute renal failure due to extensive spontaneous deep vein thrombosis, including the inferior vena cava (IVC) and both renal veins. The patient was treated with selectively delivered thrombolytic therapy over a 7-day-period, which resulted in renal vein patency and complete recovery of renal function. A stent was placed over a segment stenosis of the IVC. No thrombophilic factors were identified. Bilateral renal vein thrombosis in young fit individuals is an unusual cause of acute renal failure. Thrombolytic therapy, even with delay, can completely restore renal function.

  2. Usefulness of resistive index on spectral Doppler ultrasonography in the detection of renal cell carcinoma in patients with end-stage renal disease

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sang Youn; Woo, Sung Min; Cho, Jeong Yeon; Kim, Seung Hyup [Dept. of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of); Hwang, Sung Il; Lee, Hak Jong [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Moon, Min Hoan; Sung, Chang Kyu [Dept. of adiology, Seoul National University Boramae Hospital, Seoul (Korea, Republic of)


    The aim of this study was to explore the usefulness of the resistive index (RI) on spectral Doppler ultrasonography (US) in the detection of renal cell carcinoma (RCC) in patients with end-stage renal disease (ESRD). Seventeen ESRD patients with kidneys in which renal masses were suspected in routine US were subjected. They underwent computed tomography scans and additional Doppler US for the characterization of the detected lesions. All underwent radical nephrectomy with the suspicion of RCC. Fourteen patients finally were included. RI measurements were conducted in the region of the suspected renal mass and the background renal parenchyma. The intra class correlation coefficient was used to assess the reproducibility of the RI measurement. A paired t-test was used to compare the RI values between the renal mass and the background renal parenchyma (P<0.05). The RI values measured at the RCCs were significantly lower than those measured at the background renal parenchyma (0.41-0.65 vs. 0.75-0.89; P<0.001). The intrareader reproducibility proved to be excellent and good for the renal masses and the parenchyma, respectively (P<0.001). RI on spectral Doppler US is useful in detecting RCC in patients with ESRD. The RI values measured at the RCCs were significantly lower than those measured at the background renal parenchyma.

  3. Signaling Pathways Involved in Renal Oxidative Injury: Role of the Vasoactive Peptides and the Renal Dopaminergic System

    Directory of Open Access Journals (Sweden)

    N. L. Rukavina Mikusic


    Full Text Available The physiological hydroelectrolytic balance and the redox steady state in the kidney are accomplished by an intricate interaction between signals from extrarenal and intrarenal sources and between antinatriuretic and natriuretic factors. Angiotensin II, atrial natriuretic peptide and intrarenal dopamine play a pivotal role in this interactive network. The balance between endogenous antioxidant agents like the renal dopaminergic system and atrial natriuretic peptide, by one side, and the prooxidant effect of the renin angiotensin system, by the other side, contributes to ensuring the normal function of the kidney. Different pathological scenarios, as nephrotic syndrome and hypertension, where renal sodium excretion is altered, are associated with an impaired interaction between two natriuretic systems as the renal dopaminergic system and atrial natriuretic peptide that may be involved in the pathogenesis of renal diseases. The aim of this review is to update and comment the most recent evidences about the intracellular pathways involved in the relationship between endogenous antioxidant agents like the renal dopaminergic system and atrial natriuretic peptide and the prooxidant effect of the renin angiotensin system in the pathogenesis of renal inflammation.


    Directory of Open Access Journals (Sweden)



    Full Text Available Renal failure in obstetrics is rare but important complication, associated with significant mortality and long term morbidity.1,2 It includes acute renal failure due to obstetrical complications or due to deterioration of existing renal disease. AIMS AND OBJECTIVES: To evaluate the etiology and outcome of renal failure in obstetric patients. METHODS: We prospectively analyzed 30 pregnant and puerperal women with acute renal failure or pre-existing renal disease developing renal failure during pregnancy between November 2007 to sep-2009. Patients who presented/developed ARF during the hospital stay were included in this study. RESULTS: Among 30 patients, mean age was 23 years and 33 years age group. 12 cases (40% patients were primigravidae and 9(30% patients were multigravidae and 9 cases (30% presented in post-partum period. Eighteen cases (60% with ARF were seen in third trimester, followed by in postpartum period 9 cases (30%. Most common contributing factors to ARF were Pre-eclampsia, eclampsia and HELLP syndrome 60%, sepsis 56.6%, post abortal ARF 10%. DIC 40%. Haemorrhage as the aetiology for ARF was present 46%, APH in 20% and PPH in 26.6%. The type of ARF was renal in (63% and prerenal (36%; Oliguric seen in 10 patients (33% and high mortality (30%. Among the 20 pregnant patients with ARF, The average period of gestation was 33±2 weeks (30 -36 weeks, 5 cases (25% presented with intrauterine fetal demise and 18 cases (66% had preterm vaginal delivery and 2 cases (10% had induced abortion. And the average birth weight was 2±0.5 kg (1.5 kg. Eight cases (26% required dialysis. 80% of patients recovered completely of renal functions. 63% patients recovered without renal replacement therapy whereas 17% required dialysis. the maternal mortality was 20%, the main reason for mortality was septic shock and multi organ dysfunction (66%. CONCLUSION: ARF related pregnancy was seen commonly in the primigravidae and in the third trimester, the most


    Directory of Open Access Journals (Sweden)

    V. V. Elizarov


    Full Text Available Subject of Research. The results of lidar combined scanning unit development for locating leaks of hydrocarbons are presented The unit enables to perform high-speed scanning of the investigated space in wide and narrow angle fields. Method. Scanning in a wide angular field is produced by one-line scanning path by means of the movable aluminum mirror with a frequency of 20Hz and amplitude of 20 degrees of swing. Narrowband scanning is performed along a spiral path by the deflector. The deflection of the beam is done by rotation of the optical wedges forming part of the deflector at an angle of ±50. The control function of the scanning node is performed by a specialized software product written in C# programming language. Main Results. This scanning unit allows scanning the investigated area at a distance of 50-100 m with spatial resolution at the level of 3 cm. The positioning accuracy of the laser beam in space is 15'. The developed scanning unit gives the possibility to browse the entire investigated area for the time not more than 1 ms at a rotation frequency of each wedge from 50 to 200 Hz. The problem of unambiguous definition of the beam geographical coordinates in space is solved at the software level according to the rotation angles of the mirrors and optical wedges. Lidar system coordinates are determined by means of GPS. Practical Relevance. Development results open the possibility for increasing the spatial resolution of scanning systems of a wide range of lidars and can provide high positioning accuracy of the laser beam in space.

  6. Renal papillary necrosis

    Directory of Open Access Journals (Sweden)

    Stephen A. Geller


    Full Text Available In 1877, Dr. Nikolaus Friedreich (1825-1882; student of Virchow who became Professor of Pathology at Heidelberg and who also described Friedreich’s ataxia first described renal papillary necrosis (RPN in patients with prostatic hypertrophy and secondary hydronephrosis. Thereafter in 1937, Froboese and Günther emphasized the association of this entity with diabetes mellitus. These authors also observed renal papillary necrosis in cases of urinary tract obstruction even in the absence of diabetes mellitus.

  7. [Hyperuricemia and renal risk]. (United States)

    Viazzi, Francesca; Bonino, Barbara; Ratto, Elena; Desideri, Giovambattista; Pontremoli, Roberto


    Recent studies have revealed an association between elevated levels of uric acid and conditions correlated to chronic kidney diseases such as hypertension, cardiovascular and cerebral disease, insulin resistance. Several pathogenetic mechanisms at cellular and tissue levels could justify a direct correlation between serum uric acid levels and renal damage. Growing evidence indicating a correlation between urate lowering therapy and renal morbidity could encourage the use of urate lowering therapy in primary or secondary prevention in chronic kidney disease.

  8. Leiomyosarcoma presenting as a spontaneously ruptured renal tumor-case report

    Directory of Open Access Journals (Sweden)

    Ather M


    Full Text Available Abstract Background Ruptured renal neoplasms can be a catastrophic clinical presentation. Angiomyolipoma is the commonest renal tumor which presents in this fashion. Renal sarcomas are rare renal neoplasms. Renal leiomyosarcomas are the most common histological subtype of renal sarcomas, accounting for approximately 50–60% of the reported cases. These tumors are usually peripherally located and appear to arise from either the renal capsule or smooth muscle tissue in the renal pelvic wall. Case presentation A 70 years old male, with hypertension and ischemic disease, developed acute left flank pain. The general physician evaluated this using ultrasound, which showed a solid left renal mass. Two weeks later, he presented in the emergency room in a state of shock with a palpable flank mass. CT scan of the abdomen showed a large heterogeneous mass lesion in the left perinephric space with minimal post contrast enhancement. Per-operatively, large retroperitoneal hematoma was found within Gerota's fascia along with spleen plastered to the upper limit of hematoma. Nephrectomy and splenectomy were performed. Postoperative course was uneventful and patient was discharged on the 10th post-operative day. Histopathological evaluation of the specimen showed high-grade leiomyosarcoma Conclusions Spontaneous rupture of renal neoplasm is a rare clinical presentation. Angiomyolipoma is the commonest cause of spontaneous rupture of the kidney. Presentation of a leimyosarcoma as a ruptured renal neoplasm has not been previously reported in the English literature.

  9. Renal relevant radiology: radiologic imaging in autosomal dominant polycystic kidney disease. (United States)

    Rahbari-Oskoui, Frederic; Mittal, Ankush; Mittal, Pardeep; Chapman, Arlene


    Autosomal-dominant polycystic kidney disease is a systemic disorder and the most common hereditary renal disease, which is characterized by cyst growth, progressive renal enlargement, and development of renal failure. The cystic nature of autosomal dominant polycystic kidney disease and its renal and extrarenal complications (kidney stones, cyst hemorrhage, intracerebral aneurysm, liver cysts, cardiac valve abnormalities, etc.) give radiologic imaging studies a central role in the management of these patients. This article reviews the indications, comparative use, and limitation of various imaging modalities (ultrasonography, magnetic resonance imaging, computerized tomography scan, Positron emission tomography scan, and renal scintigraphy) for the diagnosis and management of complications in autosomal dominant polycystic kidney disease. Finally, this work provides evidence for the value of total kidney volume to predict disease progression in autosomal dominant polycystic kidney disease.

  10. Laparoscopic Renal Cryoablation (United States)

    Schiffman, Marc; Moshfegh, Amiel; Talenfeld, Adam; Del Pizzo, Joseph J.


    In light of evidence linking radical nephrectomy and consequent suboptimal renal function to adverse cardiovascular events and increased mortality, research into nephron-sparing techniques for renal masses widely expanded in the past two decades. The American Urological Association (AUA) guidelines now explicitly list partial nephrectomy as the standard of care for the management of T1a renal tumors. Because of the increasing utilization of cross-sectional imaging, up to 70% of newly detected renal masses are stage T1a, making them more amenable to minimally invasive nephron-sparing therapies including laparoscopic and robotic partial nephrectomy and ablative therapies. Cryosurgery has emerged as a leading option for renal ablation, and compared with surgical techniques it offers benefits in preserving renal function with fewer complications, shorter hospitalization times, and allows for quicker convalescence. A mature dataset exists at this time, with intermediate and long-term follow-up data available. Cryosurgical recommendations as a first-line therapy are made at this time in limited populations, including elderly patients, patients with multiple comorbidities, and those with a solitary kidney. As more data emerge on oncologic efficacy, and technical experience and the technology continue to improve, the application of this modality will likely be extended in future treatment guidelines. PMID:24596441

  11. Neonatal renal vein thrombosis. (United States)

    Brandão, Leonardo R; Simpson, Ewurabena A; Lau, Keith K


    Neonatal renal vein thrombosis (RVT) continues to pose significant challenges for pediatric hematologists and nephrologists. The precise mechanism for the onset and propagation of renal thrombosis within the neonatal population is unclear, but there is suggestion that acquired and/or inherited thrombophilia traits may increase the risk for renal thromboembolic disease during the newborn period. This review summarizes the most recent studies of neonatal RVT, examining its most common features, the prevalence of acquired and inherited prothrombotic risk factors among these patients, and evaluates their short and long term renal and thrombotic outcomes as they may relate to these risk factors. Although there is some consensus regarding the management of neonatal RVT, the most recent antithrombotic therapy guidelines for the management of childhood thrombosis do not provide a risk-based algorithm for the acute management of RVT among newborns with hereditary prothrombotic disorders. Whereas neonatal RVT is not a condition associated with a high mortality rate, it is associated with significant morbidity due to renal impairment. Recent evidence to evaluate the effects of heparin-based anticoagulation and thrombolytic therapy on the long term renal function of these patients has yielded conflicting results. Long term cohort studies and randomized trials may be helpful to clarify the impact of acute versus prolonged antithrombotic therapy for reducing the morbidity that is associated with neonatal RVT.

  12. Targeting Strategies for Renal Cell Carcinoma: From Renal Cancer Cells to Renal Cancer Stem Cells


    Zhi-xiang Yuan; Jingxin Mo; Guixian Zhao; Gang Shu; Hua-lin Fu; Wei Zhao


    Renal cell carcinoma (RCC) is a common form of urologic tumor that originates from the highly heterogeneous epithelium of renal tubules. Over the last decade, targeting therapies to renal cancer cells have transformed clinical care for RCC. Recently, it was proposed that renal cancer stem cells (CSCs) isolated from renal carcinomas were responsible for driving tumor growth and resistance to conventional chemotherapy and radiotherapy, according to the theory of CSCs; this has provided the rati...


    Directory of Open Access Journals (Sweden)

    Elisangela Giachini


    Full Text Available The aim of this study is to evaluate the incidence and prevalence of malignant kidney tumors, to contribute to identifying factors which the diagnosis of renal cell carcinomas. Through this study, we understand that kidney disease over the years had higher incidence rates, especially in adults in the sixth decade of life. The renal cell carcinoma (RCC is the third most common malignancy of the genitourinary tract, affecting 2% to 3% of the population. There are numerous ways of diagnosis; however, the most important are ultrasonography, magnetic resonance imaging and computed tomography. In general most of the patients affected by the CCR, have a good prognosis when diagnosed early and subjected to an effective treatment. This study conducted a literature review about the CCR, through this it was possible to understand the development needs of the imaging methods used for precise diagnosis and classification of RCC through the TNM system.

  14. [Renal protection in intensive care : Myths and facts]. (United States)

    John, S


    Acute kidney injury (AKI) is a common and severe complication in patients on the intensive care unit with a significant impact on patient mortality, morbidity and costs of care; therefore, renal protective therapy is most important in these severely ill patients. Many renal protective strategies have been postulated during the last decades, which are sometimes still in place as a kind of "myth" but which are not always proven by evidence-based "facts". The aim of this review is therefore to question and compare some of these "myths" with the available "facts". Most important for renal protection is the early identification of patients at risk for AKI or with acute kidney damage before renal function deteriorates further. A stage-based management of AKI comprises more general measures, such as discontinuation of nephrotoxic agents and adjustment of diuretic doses but most importantly early hemodynamic stabilization with crystalloid volume replacement solutions and vasopressors, such as noradrenaline. The aim is to ensure optimal renal perfusion and perfusion pressure. Patients with known arterial hypertension potentially need higher perfusion pressures. Large amounts of hyperchloremic solutions should be avoided. Volume overload and renal vasodilatory substances can also lead to further deterioration of kidney function. There is still no specific pharmacological therapy for renal protection.

  15. Reduction of renal uptake of radiolabeled octreotate by amifostine coadministration

    NARCIS (Netherlands)

    M.L. Melis (Marleen); R. Valkema (Roelf); E.P. Krenning (Eric); M. de Jong (Marcel)


    textabstractMegalin-mediated renal retention of radiolabeled somatostatin analogs may lead to nephrotoxicity during peptide receptor radionuclide therapy (PRRT). The cytoprotective agent amifostine protected rats from long-term nephrotoxicity after PRRT with 177Lu-DOTA,Tyr3-octreotate. This study de

  16. Laser Scanning in Forests

    Directory of Open Access Journals (Sweden)

    Håkan Olsson


    Full Text Available The introduction of Airborne Laser Scanning (ALS to forests has been revolutionary during the last decade. This development was facilitated by combining earlier ranging lidar discoveries [1–5], with experience obtained from full-waveform ranging radar [6,7] to new airborne laser scanning systems which had components such as a GNSS receiver (Global Navigation Satellite System, IMU (Inertial Measurement Unit and a scanning mechanism. Since the first commercial ALS in 1994, new ALS-based forest inventory approaches have been reported feasible for operational activities [8–12]. ALS is currently operationally applied for stand level forest inventories, for example, in Nordic countries. In Finland alone, the adoption of ALS for forest data collection has led to an annual savings of around 20 M€/year, and the work is mainly done by companies instead of governmental organizations. In spite of the long implementation times and there being a limited tradition of making changes in the forest sector, laser scanning was commercially and operationally applied after about only one decade of research. When analyzing high-ranked journal papers from ISI Web of Science, the topic of laser scanning of forests has been the driving force for the whole laser scanning research society over the last decade. Thus, the topic “laser scanning in forests” has provided a significant industrial, societal and scientific impact. [...

  17. Resonant scanning mechanism (United States)

    Wallace, John; Newman, Mike; Gutierrez, Homero; Hoffman, Charlie; Quakenbush, Tim; Waldeck, Dan; Leone, Christopher; Ostaszewski, Miro


    Ball Aerospace & Technologies Corp. developed a Resonant Scanning Mechanism (RSM) capable of combining a 250- Hz resonant scan about one axis with a two-hertz triangular scan about the orthogonal axis. The RSM enables a rapid, high-density scan over a significant field of regard (FOR) while minimizing size, weight, and power requirements. The azimuth scan axis is bearing mounted allowing for 30° of mechanical travel, while the resonant elevation axis is flexure and spring mounted with five degrees of mechanical travel. Pointing-knowledge error during quiescent static pointing at room temperature across the full range is better than 100 μrad RMS per axis. The compact design of the RSM, roughly the size of a soda can, makes it an ideal mechanism for use on low-altitude aircraft and unmanned aerial vehicles. Unique aspects of the opto-mechanical design include i) resonant springs which allow for a high-frequency scan axis with low power consumption; and ii) an independent lower-frequency scan axis allowing for a wide FOR. The pointing control system operates each axis independently and employs i) a position loop for the azimuth axis; and ii) a unique combination of parallel frequency and amplitude control loops for the elevation axis. All control and pointing algorithms are hosted on a 200-MHz microcontroller with 516 KB of RAM on a compact 3"×4" digital controller, also of Ball design.

  18. Trading Agents

    CERN Document Server

    Wellman, Michael


    Automated trading in electronic markets is one of the most common and consequential applications of autonomous software agents. Design of effective trading strategies requires thorough understanding of how market mechanisms operate, and appreciation of strategic issues that commonly manifest in trading scenarios. Drawing on research in auction theory and artificial intelligence, this book presents core principles of strategic reasoning that apply to market situations. The author illustrates trading strategy choices through examples of concrete market environments, such as eBay, as well as abst

  19. MR evaluation of renal allografts; Rola badania MR w ocenie nerki przeszczepionej

    Energy Technology Data Exchange (ETDEWEB)

    Slapa, R.Z.; Jakubowski, W.; Tyminska, B. [Zaklad Diagnostyki Obrazowej, Wojewodzki Zespol Publicznych Zakladow Opieki Zdrowotnej, Warsaw (Poland)


    The paper presents state of the art in MR evaluation of renal allografts. MRI is very sensitive in diagnosis of renal allograft rejection. This diagnosis is mainly based on evaluation of cortico-medullary differentiation. MRI has potential for differential diagnosis of pathological perirental fluid collections. T2-weighted images and paramagnetic contrast agent studies diagnosis of allograft necrosis. MRA is useful for evaluation of possible vascular surgical complications. New applications of MR technique for evaluation of renal allograft as dynamic contrast agent studies and spectroscopy are under investigation. (author) 15 refs, 2 figs

  20. CT scan of choristoma

    Energy Technology Data Exchange (ETDEWEB)

    Moriki, A.; Morimoto, M.; Sada, Y.; Kurisaka, M.; Mori, K.


    Choristoma is a rare tumor that occurs in the pituitary gland. The case presented here is a 44-year-old male. A plain CT scan demonstrated a slight high-density mass near the posterior clinoid of the sella turcica, while a moderate and homogeneous enhancing effect and a clear borderline were shown by an enhanced CT scan. A cornal CT scan study showed that the tumor extended from the intrasellar to the suprasellar region. The diagnosis of choristoma was made by means of histology.

  1. Radiocontrast-induced acute renal failure. (United States)

    Weisbord, Steven D; Palevsky, Paul M


    The intravascular administration of iodinated radiocontrast media can lead to acute renal dysfunction. Even small changes in renal function have been associated with increased morbidity and mortality, making the prevention of radiocontrast nephropathy of paramount importance. This review summarizes the principal risk factors for radiocontrast nephropathy and evidence-based preventive strategies that should be used to limit its occurrence. Risk factors for radiocontrast nephropathy include preexistent kidney disease, diabetes mellitus, dose of radiocontrast used, advanced congestive heart failure, and intravascular volume depletion. Proven preventive measures include volume expansion with intravenous saline or sodium bicarbonate and the use of low-osmolar or iso-osmolar radiocontrast media. Studies evaluating N-acetylcysteine have been conflicting, with meta-analyses suggesting a small beneficial effect. Studies of other pharmacologic agents have not demonstrated clinical benefit.

  2. Early detection of femoral head avascular necrosis by bone SPECT compared to MRI in renal allograft recipients

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Do Young; Yang, Seoung Oh; Lee, Hee Kyung; Han, Duck Jong; Shin, Myung Jin [Asan Mecical Center, Seoul (Korea, Republic of)


    The prevalence of avascular necrosis (AVN) of femoral head in patients who receive immunosuppresive agents after renal transplantation is reported to be 4-29%. Among patients who develop AVN after renal transplantation, 80% become symptomatic within 2 years after transplantation. As the number of renal transplantation has been increased recently, early detection of femoral head AVN is very important because early surgical core decompression of femoral head can prevent collapse of the head. MRI is known to be very sensitive to diagnose femoral head AVN. However in three cases we report here, bone SPECT showed early changes of femoral head AVN, whereas MRI showed no specific abnormality. Case 1. A 53-year-old female received an allograft kidney transplantation in 1994. Preoperative bone scan was normal. She complained of both hip pain on Mar. 18 1997. Bone SPECT showed cold defect in both femoral heads but MRI showed no abnormality. After 3 months, bone SPECT and MRI showed AVN of both femoral heads. She underwent bilateral total hip replacement arthroplasty. AVN of femoral heads was confirmed by microscopic examination. Case 2. A 38-year-old female received an allograft kidney transplantation in Feb. 27 1997. Preoperative bone scan was normal. She ran a fever and creatinine was elevated from 1.2 to 2.8 mg/dL. She took high dose methylprednisolone therapy for acute reanl rejection. After two days, she complained pain in both hip joints and knee joints. Bone SPECT showed cold defects in both femoral heads but MRI showed no abnormality. A follow-up bone SPECT and MRI 20 days later revealed AVN of both femoral heads. Case 3. A 50-year-old male received an allograft kidney transplantation on Jul. 12 1995. Preoperative bone scan was normal. He complained of right hip pain on Jul, 26 1995. His bone SPECT showed cold defects in both femoral heads while MRI showed only minimal hip joint effusion. He also complained of left hip pain on Oct. 2 1995. He was admitted on Mar 17

  3. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... Uptake? A thyroid scan is a type of nuclear medicine imaging. The radioactive iodine uptake test (RAIU) ... of thyroid function, but does not involve imaging. Nuclear medicine is a branch of medical imaging that ...

  4. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... which are encased in metal and plastic and most often shaped like a box, attached to a ... will I experience during and after the procedure? Most thyroid scan and thyroid uptake procedures are painless. ...

  5. The conical scan radiometer (United States)

    Prosch, T.; Hennings, D.


    A satellite-borne conical scan radiometer (CSR) is proposed, offering multiangular and multispectral measurements of Earth radiation fields, including the total radiances, which are not available from conventional radiometers. Advantages of the CSR for meteorological studies are discussed. In comparison to conventional cross track scanning instruments, the CSR is unique with respect to the selected picture element size which is kept constant by means of a specially shaped detector matrix at all scan angles. The conical scan mode offers the chance to improve angular sampling. Angular sampling gaps of previous satellite-borne radiometers can be interpolated and complemented by CSR data. Radiances are measured through 10 radiometric channels which are selected to study cloudiness, water vapor, ozone, surface albedo, ground and mean stratospheric temperature, and aerosols.

  6. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... scan and uptake uses small amounts of radioactive materials called radiotracers, a special camera and a computer ... last two months that used iodine-based contrast material. Your doctor will instruct you on how to ...

  7. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... of page What are some common uses of the procedure? The thyroid scan is used to determine ... you are undergoing. top of page What does the equipment look like? Special camera or imaging devices ...

  8. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... Uptake? A thyroid scan is a type of nuclear medicine imaging. The radioactive iodine uptake test (RAIU) ... of thyroid function, but does not involve imaging. Nuclear medicine is a branch of medical imaging that ...

  9. Pediatric CT Scans (United States)

    The Radiation Epidemiology Branch and collaborators have initiated a retrospective cohort study to evaluate the relationship between radiation exposure from CT scans conducted during childhood and adolescence and the subsequent development of cancer.

  10. Shoulder MRI scan (United States)

    ... finding on an x-ray or bone scan Shoulder pain and fever Decreased motion of the shoulder joint ... of the shoulder joint Shoulder instability Shoulder weakness Shoulder pain and a history of cancer Shoulder pain that ...

  11. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... a computer to provide information about your thyroid’s size, shape, position and function that is often unattainable ... The thyroid scan is used to determine the size, shape and position of the thyroid gland. The ...

  12. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... as an overactive thyroid gland, a condition called hyperthyroidism , cancer or other growths assess the nature of ... an x-ray or CT scan, surgeries or treatments using iodinated contrast material within the last two ...

  13. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... eat for several hours before your exam because eating can affect the accuracy of the uptake measurement. ... often unattainable using other imaging procedures. For many diseases, nuclear medicine scans yield the most useful information ...

  14. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... regulates the rate at which the body converts food to energy. top of page What are some ... often unattainable using other imaging procedures. For many diseases, nuclear medicine scans yield the most useful information ...

  15. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... called hyperthyroidism , cancer or other growths assess the nature of a nodule discovered in the gland detect ... CT scan, surgeries or treatments using iodinated contrast material within the last two months. are taking medications ...

  16. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... are noninvasive and, with the exception of intravenous injections, are usually painless medical tests that help physicians ... before the scan. The radiotracer given by intravenous injection is usually given up to 30 minutes prior ...

  17. Scanning Auger Electron Microscope (United States)

    Federal Laboratory Consortium — A JEOL model 7830F field emission source, scanning Auger microscope. Specifications / Capabilities: Ultra-high vacuum (UHV), electron gun range from 0.1 kV to 25 kV,...

  18. Photothermal imaging scanning microscopy (United States)

    Chinn, Diane; Stolz, Christopher J.; Wu, Zhouling; Huber, Robert; Weinzapfel, Carolyn


    Photothermal Imaging Scanning Microscopy produces a rapid, thermal-based, non-destructive characterization apparatus. Also, a photothermal characterization method of surface and subsurface features includes micron and nanoscale spatial resolution of meter-sized optical materials.

  19. Scanning Auger Electron Microscope (United States)

    Federal Laboratory Consortium — A JEOL model 7830F field emission source, scanning Auger microscope.Specifications / Capabilities:Ultra-high vacuum (UHV), electron gun range from 0.1 kV to 25 kV,...

  20. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... A thyroid scan is a type of nuclear medicine imaging. The radioactive iodine uptake test (RAIU) is ... thyroid function, but does not involve imaging. Nuclear medicine is a branch of medical imaging that uses ...

  1. Slow Scan Telemedicine (United States)


    Originally developed under contract for NASA by Ball Bros. Research Corporation for acquiring visual information from lunar and planetary spacecraft, system uses standard closed circuit camera connected to a device called a scan converter, which slows the stream of images to match an audio circuit, such as a telephone line. Transmitted to its destination, the image is reconverted by another scan converter and displayed on a monitor. In addition to assist scans, technique allows transmission of x-rays, nuclear scans, ultrasonic imagery, thermograms, electrocardiograms or live views of patient. Also allows conferencing and consultation among medical centers, general practitioners, specialists and disease control centers. Commercialized by Colorado Video, Inc., major employment is in business and industry for teleconferencing, cable TV news, transmission of scientific/engineering data, security, information retrieval, insurance claim adjustment, instructional programs, and remote viewing of advertising layouts, real estate, construction sites or products.

  2. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... evaluate changes in the gland following medication use, surgery, radiotherapy or chemotherapy top of page How should ... such as an x-ray or CT scan, surgeries or treatments using iodinated contrast material within the ...

  3. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... of page What are some common uses of the procedure? The thyroid scan is used to determine ... you are undergoing. top of page What does the equipment look like? The special camera and imaging ...

  4. Cervical spine CT scan (United States)

    ... defects of the cervical spine Bone problems Fracture Osteoarthritis Disc herniation Risks Risks of CT scans include: ... Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, ...

  5. Malignant renal tumors in children

    Directory of Open Access Journals (Sweden)

    Justin Scott Lee


    Full Text Available Renal malignancies are common in children. While the majority of malignant renal masses are secondary to Wilms tumor, it can be challenging to distinguish from more aggressive renal masses. For suspicious renal lesions, it is crucial to ensure prompt diagnosis in order to select the appropriate surgical procedure and treatment. This review article will discuss the common differential diagnosis that can be encountered when evaluating a suspicious renal mass in the pediatric population. This includes clear cell sarcoma of the kidney, malignant rhabdoid tumor, renal medullary carcinoma and lymphoma. 

  6. A rare entity of acute bilateral cortical renal necrosis following acute pancreatitis

    Directory of Open Access Journals (Sweden)

    Kruti D Dave


    Full Text Available Acute bilateral renal cortical necrosis following acute pancreatitis is extremely rare condition. Among all cases of acute renal failure, the incidence of renal cortical necrosis was 3.8% in one of the study in North India. Till date, only eight cases of bilateral cortical necrosis following acute pancreatitis were reported in the literature. We report a case of a 27-year-old male patient with abdominal pain, nausea and vomiting since 2 days duration and anuria since 24 h. Serum amylase and lipase were raised, and elevated serum creatinine was noted on admission. Contrast-enhanced computed tomography scan of the abdomen revealed changes of acute pancreatitis with hypoenhancement of renal cortex compared to medulla on both sides (reverse rim sign-stronger enhancement of the renal medulla compared to cortex, suggest an acute renal cortical necrosis.

  7. Scanning laser Doppler vibrometry



    With a Scanning Laser Doppler Vibrometer (SLDV) a vibrating surface is automatically scanned over predefined grid points, and data processed for displaying vibration properties like mode shapes, natural frequencies, damping ratios, and operational deflection shapes. Our SLDV – a PSV-500H from Polytec Inc. – was acquired and put to operation in October 2014, paid by a sub-donation of DKK 1,5 mill. of the total VILLUM CASMaT grant. Opening possibilities of measuring complicated vibration shapes...

  8. Advanced Network Scanning

    Directory of Open Access Journals (Sweden)

    Ashiqur Rahman


    Full Text Available Network scanning is à procedure for identifying active hosts on a network, either for the purpose of attacking them or for network security assessment. Scanning procedures, such as ping sweeps and port scans, return information about which IP addresses map to live hosts that are active on the Internet and what services they offer. Another scanning method, inverse mapping, returns information about what IP addresses do not map to live hosts; this enables an attacker to make assumptions about viable addresses. Scanning is one of three components of intelligence gathering for an attacker. In the foot printing phase, the attacker creates a profile of the target organization, with information such as its domain name system (DNS and e-mail servers, and its IP address range. Most of this information is available online. In the scanning phase, the attacker finds information about the specific IP addresses that can be accessed over the Internet, their operating systems, the system architecture, and the services running on each computer. In the enumeration phase, the attacker gathers information such as network user and group names, routing tables, and Simple Network Management Protocol (SNMP data

  9. Renal Cell Carcinoma Mimicking Adrenal Tumor

    Directory of Open Access Journals (Sweden)

    Mohammad Kazem Moslemi


    Full Text Available There are a variety of causes of adrenal pseudotumors on computerized tomography (CT scan, including upper-pole renal mass, gastric diverticulum, prominent splenic lobulation, pancreatic mass, hepatic mass, and periadrenal varices. We present a case of a large subhepatic mass that discrimination of its origin from neighborhood organs was difficult preoperatively. Our patient was a 58 years old man, that three months after an unsuccessful operation in another center for a pseudoadrenal mass underwent a very difficult subcapsular tumorectomy in our center.

  10. Percutaneous renal tumour biopsy. (United States)

    Delahunt, Brett; Samaratunga, Hemamali; Martignoni, Guido; Srigley, John R; Evans, Andrew J; Brunelli, Matteo


    The use of percutaneous renal tumour biopsy (RTB) as a diagnostic tool for the histological characterization of renal masses has increased dramatically within the last 30 years. This increased utilization has paralleled advances in imaging techniques and an evolving knowledge of the clinical value of nephron sparing surgery. Improved biopsy techniques using image guidance, coupled with the use of smaller gauge needles has led to a decrease in complication rates. Reports from series containing a large number of cases have shown the non-diagnostic rate of RTB to range from 4% to 21%. Re-biopsy has been shown to reduce this rate, while the use of molecular markers further improves diagnostic sensitivity. In parallel with refinements of the biopsy procedure, there has been a rapid expansion in our understanding of the complexity of renal cell neoplasia. The 2013 Vancouver Classification is the current classification for renal tumours, and contains five additional entities recognized as novel forms of renal malignancy. The diagnosis of tumour morphotype on RTB is usually achievable on routine histology; however, immunohistochemical studies may be of assistance in difficult cases. The morphology of the main tumour subtypes, based upon the Vancouver Classification, is described and differentiating features are discussed.

  11. Comparison between doppler ultrasonography and renal scintigraphy in assessment of post-transplant renal function

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Yeo Chang; Shin, Byung Seok; Ohm, Joon Young; Kim, Seong Min; Ahn, Moon Sang; Yang, Shin Seok [Chungnam National University Hospital, Daejeon (Korea, Republic of); Park, Mi Hyun [Dept. of Radiology, Dankook University Hospital, Cheonan (Korea, Republic of)


    To compare the usefulness of Doppler ultrasonography and renal scintigraphy in the assessment of short- and long-term function of transplanted kidneys. We retrospectively reviewed the cases of 79 patients who underwent Doppler ultrasonography and technetium-99m diethylene triamine pentaacetic acid renal scintigraphy on the same day, within 4 days of renal transplantation. Image parameters were evaluated for statistical differences. There was a strong positive correlation between the glomerular filtration rate (GFR) as measured by renal scintigraphy and the estimated GFR (eGFR) based on serum creatinine levels (correlation coefficient = 0.71). Scan grade according to the time-activity curve, resistive index, and end diastolic velocity showed moderate correlations with the eGFR (correlation coefficients = -0.557, -0.329, and 0.370, respectively) in the early post-transplantation period. The mean survival time was longer in patients with lower resistive indices (≤ 0.68, 54.9 months vs. > 0.68, 29.5 months) and lower pulsatility indices (≤ 1.32, 53.8 months vs. > 1.32, 28.7 months); however, there were no statistically significant differences in the long-term follow-up period (p = 0.121 for resistive index and p = 0.074 for pulsatility index). Renal scintigraphy is a more sensitive method than Doppler ultrasonography for assessing transplanted kidney function in the early post-transplantation period. Doppler ultrasonography might reflect the long-term survival time. However, it is difficult to predict long-term renal function using either method.

  12. Insulin-like growth factor I preserves renal function postoperatively. (United States)

    Franklin, S C; Moulton, M; Sicard, G A; Hammerman, M R; Miller, S B


    Deterioration of renal function, which can lead to postoperative renal failure, is a complication of surgery involving the suprarenal aorta and surgery involving the renal arteries. Fifty-four patients who were at risk for developing this complication were enrolled in a double-blind, randomized, placebo-controlled trial of insulin-like growth factor (IGF-I) as a therapeutic agent to prevent the decline in renal function. The primary end point was the incidence of renal dysfunction, defined as a reduction of the glomerular filtration rate (creatinine clearance) at each of three measurements over 72 h. IGF-I (100 microg/kg subcutaneously every 12 h for 6 doses) or placebo was administered on admission to the intensive care unit immediately postoperatively. IGF-I- and placebo-treated groups were well matched for sex, age, type of surgery, renal ischemic time during surgery (ischemic index), baseline creatinine clearance, and baseline serum creatinine. No patient in the study developed acute renal failure postoperatively. IGF-I was well tolerated. A smaller proportion of patients in the IGF-I group had a postoperative decline in renal function (22%) than in the placebo-treated group (33%). There were no significant differences in levels of serum creatinine at time of discharge, length of hospital stay, length of intensive care unit stay, length of intubation, or incidence of dialysis or death. Our findings establish the feasibility and potential utility for the use of IGF-I to reduce the incidence of postoperative renal dysfunction in high-risk patients.

  13. T2 weighted MRI for assessing renal lesions in transgenic mouse models of tuberous sclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Kalogerou, Maria; Zhang, Yadan; Yang, Jian; Garrahan, Nigel [Institute of Medical Genetics, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN (United Kingdom); Paisey, Stephen; Tokarczuk, Paweł; Stewart, Andrew [School of Bioscience, Cardiff University, Museum Avenue, Cardiff CF10 3AX (United Kingdom); Gallacher, John [Department of Primary Care and Public Health, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4YS (United Kingdom); Sampson, Julian R. [Institute of Medical Genetics, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN (United Kingdom); Shen, Ming Hong, E-mail: [Institute of Medical Genetics, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN (United Kingdom)


    Objective: Transgenic mouse models of tuberous sclerosis (TSC) develop renal cysts, cystadenomas, solid adenomas and carcinomas. Identification and characterisation of these lesions in vivo may help in TSC pre-clinical trials. This study was to evaluate T2 weighted MRI for assessment of renal lesions in two Tsc mouse models. Materials and Methods: Tsc1{sup +/−}, Tsc2{sup +/−} and wild type mice were subjected to a first MRI scan at 12 months of age and a second scan 2 months later. One Tsc2{sup +/−} mouse was treated with rapamycin for two months after the initial scan. Immediately following the second scan, mice were sacrificed and MRI images were compared to renal histological findings. Results: MRI identified all types of Tsc-associated renal lesions in both Tsc1{sup +/−} and Tsc2{sup +/−} mice. The smallest detectable lesions were <0.1 mm{sup 3}. Eighty three percent of all renal lesions detected in the first scan were re-identified in the second scan. By MRI, these lesions demonstrated significant growth in the 9 untreated Tsc1{sup +/−} and Tsc2{sup +/−} mice but shrinkage in the rapamycin treated Tsc2{sup +/−} mouse. Between the two scans, MRI also revealed significant increase in both the total number and volume of lesions in untreated mice and decrease in the rapamycin treated mouse, respectively. In comparison to histological analysis MRI detected most cysts and cystadenomas (66%) but only a minority of solid tumours (29%). Conclusion: These results suggest that T2 weighted MRI may be a useful tool for assessing some renal lesions in pre-clinical studies using Tsc mouse models. However, improved sensitivity for T2 weighted MRI is required, particularly for solid renal lesions.

  14. Can renal infarction occur after renal cyst aspiration? Case report. (United States)

    Emre, Habib; Soyoral, Yasemin Usul; Tanik, Serhat; Gecit, Ilhan; Begenik, Huseyin; Pirincci, Necip; Erkoc, Reha


    Renal infarction (RI) is a rarely seen disorder, and the diagnosis is often missed. The two major causes of RI are thromboemboli originhating from a thrombus in the heart or aorta, and in-situ thrombosis of a renal artery. We report a case of RI that developed due to renal artery and vein thrombosis, as confirmed by pathological evaluation of the nephrectomy material, three weeks after renal cyst aspiration.

  15. Predictive efficacy of radioisotope voiding cystography for renal outcome

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seok Ki; Lee, Dong Soo; Kim, Kwang Myeung; Choi, Whang; Chung, June Key; Lee, Myung Chul [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)


    As vesicoureteral reflux (VUR) could lead to renal functional deterioration when combined with urinary tract infection, we need to decide whether operative anti-reflux treatment should be performed at the time of diagnosis of VUR. Predictive value of radioisotope voiding cystography (RIVCG) for renal outcome was tested. In 35 children (18 males, 17 females), radiologic voiding cystoure-thrography (VCU), RIVCG and DMSA scan were performed. Change in renal function was evaluated using the follow-up DMSA scan, ultrasonography, and clinical information. Discriminant analysis was performed using individual or integrated variables such as reflux amount and extent at each phase of voiding on RIVCG, in addition to age, gender and cortical defect on DMSA scan at the time of diagnosis. Discriminant function was composed and its performance was examined. Reflux extent at the filling phase and reflux amount and extent at postvoiding phase had a significant prognostic value. Total reflux amount was a composite variable to predict prognosis. Discriminant function composed of reflux extent at the filling phase and reflux amount and extent at postvoiding phase showed better positive predictive value and specificity than conventional reflux grading. RIVCG could predict renal outcome by disclosing characteristic reflux pattern during various voiding phases.

  16. Imaging chronic renal disease and renal transplant in children

    Energy Technology Data Exchange (ETDEWEB)

    Carmichael, Jim; Easty, Marina [Great Ormond Street Hospital, Radiology Department, London (United Kingdom)


    At Great Ormond Street Hospital we have the highest number of paediatric renal transplant patients in Europe, taking cases from across the United Kingdom and abroad. Our caseload includes many children with rare complicating medical problems and chronic renal failure related morbidity. This review aims to provide an overview of our experience of imaging children with chronic renal failure and transplants. (orig.)

  17. Renal sympathetic denervation: MDCT evaluation of the renal arteries.

    LENUS (Irish Health Repository)

    Hutchinson, Barry D


    Percutaneous transluminal renal sympathetic denervation is a new treatment of refractory systemic hypertension. The purpose of this study was to assess the clinical utility of MDCT to evaluate the anatomic configuration of the renal arteries in the context of renal sympathetic denervation.

  18. Screening renal stone formers for distal renal tubular acidosis

    DEFF Research Database (Denmark)

    Osther, P J; Hansen, A B; Røhl, H F


    A group of 110 consecutive renal stone formers were screened for distal renal tubular acidosis (RTA) using morning fasting urinary pH (mfUpH) levels followed by a short ammonium chloride loading test in patients with levels above 6.0. In 14 patients (12.7%) a renal acidification defect was noted...

  19. Renal Tumor Biopsy Technique

    Institute of Scientific and Technical Information of China (English)

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


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

  20. Dyslipoproteinemia in renal transplantation.

    Directory of Open Access Journals (Sweden)

    Gunjotikar R


    Full Text Available Twenty-seven live related donor renal allograft recipients were evaluated for dyslipoproteinemia. Twenty-two patients received dual immunosuppression with prednisolone and azathioprine. Five patients received cyclosporin as well. Total cholesterol (Tch, triglycerides (TG, HDL cholesterol (HDLch, LDL cholesterol (LDLch and VLDL cholesterol (VLDLch levels were estimated. Fifteen (56% patients showed significant lipoprotein abnormalities. Renal allograft recipients showed significantly lower levels of Tch (p < 0.05 and LDLch (p < 0.05 and higher levels of TG (p < 0.005 and HDLch (p < 0.05. Diet and beta blockers did not influence lipoprotein levels. A significant negative correlation was noted between post-transplant duration and Tch, TG and VLDLch levels. Increased TG levels were associated with increase in weight and higher daily prednisolone dosage at the time of evaluation. The study confirms the existence of dyslipoproteinemia in renal allograft recipients.

  1. Renal (Kidney) Manifestations in TSC (United States)

    ... International TSC Research Conference Text Size Get Involved RENAL (KIDNEY) MANIFESTATIONS IN TSC Download a PDF of ... sclerosis complex (TSC) will develop some form of renal (kidney) disease during their lifetime. There are three ...

  2. Renal involvement in antiphospholipid syndrome. (United States)

    Pons-Estel, Guillermo J; Cervera, Ricard


    Renal involvement can be a serious problem for patients with antiphospholipid syndrome (APS). However, this complication has been poorly recognized and studied. It can be present in patients who have either primary or systemic lupus erythematosus-associated APS. Clinical and laboratory features of renal involvement in APS include hypertension, hematuria, acute renal failure, and progressive chronic renal insufficiency with mild levels of proteinuria that can progress to nephrotic-range proteinuria. The main lesions are renal artery stenosis, venous renal thrombosis, and glomerular lesions (APS nephropathy) that may be acute (thrombotic microangiopathy) and/or chronic (arteriosclerosis, arterial fibrous intimal hyperplasia, tubular thyroidization, arteriolar occlusions, and focal cortical atrophy). APS can also cause end-stage renal disease and allograft vascular thrombosis. This article reviews the range of renal abnormalities associated with APS, and their diagnosis and treatment options.

  3. [Renal transplantation and urinary lithiasis]. (United States)

    Lechevallier, E; Saussine, C; Traxer, O


    Renal lithiasis in renal donors is rare. A renal stone in a donor, or in a renal transplant, is not a contraindication for harvesting nor transplantation. If possible, the stone must be removed at the time of the transplantation. The risk of lithiasis is increased in the renal transplant recipient, with a frequency of 2-6%. Metabolic abnormalities for lithiasis are frequent and can be induced by the immunosuppressive treatment, anticalcineurins. Lithiasis can have a poor prognosis in the renal recipient with a risk for infection or renal dysfunction. Small (renal transplant can be followed-up. Stones of 0.5-1.5cm need an extracorporeal lithotripsy with a previous safety JJ stent. Stones greater than 1.5cm can be treated by ureteroscopy or percutaneous surgery.

  4. Grade 4 renal injury: current trend of management and

    Directory of Open Access Journals (Sweden)

    Ho Yiu Ming


    Full Text Available 【Abstract】The management of blunt renal trauma has been evolving. The past management largely based on American Association for Surgery of Trauma (AAST grading system, i.e. necessitated a computed tomography (CT scan. Although the CT scan use is increasing and becomes the standardized mode of investigation, AAST grading no longer plays the sole role in the decision of surgical interventions. Two case reports of blunt renal trauma managed successfully by conservative methods are presented. Case one was an 18 year-old boy who had a fall when riding a motorbike at 20 km/h with a helmet and full protective equipments. He was landed by his left flank onto a rock. Contrast abdominal CT revealed a 4 cm, grade III splenic tear and a grade IV left kidney injury with large perirenal haematoma. His international severity score (ISS was 34. He was managed conservatively with bed rest and frequent serum haemoglobin monitoring. Subsequent CT with delayed contrast revealed stable perirenal haematoma with urine extravasation which was consistent with a grade IV renal injury. Case two was a 40 year-old male who had a motor bike accident on a racetrack when he was driving at 80 to 100 km/h, wearing a helmet. He lost control and hit onto the sidewall of the racetrack. Contrast abdominal CT revealed a grade IV left renal injury with a large urine extravasation. His renal injury was managed conservatively with interval delayed phase CT of the abdomen. A repeat CT on abdomen was performed five months after the initial injury which revealed no residual urinoma. In this study, moreover, a review of the literature to the management of blunt renal trauma was conducted to demonstrate the trend of increasing conservative management of such traumas. Extra radiological parameters may guide future decision making. However, the applicability of data may be limited until randomized trials are available. Key words: Renal trauma; International classification of diseases

  5. Renal denervation and hypertension. (United States)

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


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

  6. Renal Artery Stent Outcomes (United States)

    Murphy, Timothy P.; Cooper, Christopher J.; Matsumoto, Alan H.; Cutlip, Donald E.; Pencina, Karol M.; Jamerson, Kenneth; Tuttle, Katherine R.; Shapiro, Joseph I.; D’Agostino, Ralph; Massaro, Joseph; Henrich, William; Dworkin, Lance D.


    BACKGROUND Multiple randomized clinical trials comparing renal artery stent placement plus medical therapy with medical therapy alone have not shown any benefit of stent placement. However, debate continues whether patients with extreme pressure gradients, stenosis severity, or baseline blood pressure benefit from stent revascularization. OBJECTIVES The study sought to test the hypothesis that pressure gradients, stenosis severity, and/or baseline blood pressure affects outcomes after renal artery stent placement. METHODS Using data from 947 patients with a history of hypertension or chronic kidney disease from the largest randomized trial of renal artery stent placement, the CORAL (Cardiovascular Outcomes in Renal Atherosclerotic Lesions) study, we performed exploratory analyses to determine if subsets of patients experienced better outcomes after stent placement than the overall cohort. We examined baseline stenosis severity, systolic blood pressure, and translesion pressure gradient (peak systolic and mean) and performed interaction tests and Cox proportional hazards analyses for the occurrence of the primary endpoint through all follow-up, to examine the effect of these variables on outcomes by treatment group. RESULTS There were no statistically significant differences in outcomes based on the examined variables nor were there any consistent nonsignificant trends. CONCLUSIONS Based on data from the CORAL randomized trial, there is no evidence of a significant treatment effect of the renal artery stent procedure compared with medical therapy alone based on stenosis severity, level of systolic blood pressure elevation, or according to the magnitude of the transstenotic pressure gradient. (Benefits of Medical Therapy Plus Stenting for Renal Atherosclerotic Lesions [CORAL]; NCT00081731) PMID:26653621

  7. Renal cell carcinoma: complete pathological response in a patient with gastric metastasis of renal cell carcinoma. (United States)

    García-Campelo, Rosario; Quindós, Maria; Vázquez, Diana Dopico; López, Margarita Reboredo; Carral, Alberto; Calvo, Ovidio Fernández; Soto, José Manuel Rois; Grande, Enrique; Durana, Jesús; Antón-Aparicio, Luis Miguel


    A 75-year-old-man, with a 2-month history of abdominal pain, underwent a standard diagnostic workup that included a CT scan that showed a large right renal mass and subcentimeter nodes in the right and left lung lobes. In December 2003, the patient underwent right nephrectomy with adrenalectomy and a diagnosis of renal cell carcinoma (pT3N0M0 stage) was made. No further treatment was proposed and patient was followed up regularly. In October 2006, the annual gastrointestinal endoscopy showed asymptomatic multilobulated and polypoid masses in the gastric fundus and gastric body that corresponded to metastasis of the renal carcinoma that had been resected three years ago. Surgical treatment was refused and oral treatment with sunitinib (50 mg/day consecutively for 4 weeks followed by 2 weeks off) was initiated. Patient completed one cycle and development of acute toxicity (grade 3 asthenia, anorexia and mucositis) led to treatment interruption. After recovering from acute toxicity, the patient was proposed to reinitiate treatment with dose reduction, but he refused any medical treatment. At the follow-up visit, three months later, the gastrointestinal endoscopy showed four unspecific 2 mm nodules without malignant evidence. The whole-body CT did not reveal any other abnormality except for the known lung nodes. PET scan six months after treatment confirmed complete gastric response.

  8. Confocal Line Scanning Sensor

    Energy Technology Data Exchange (ETDEWEB)

    Chanbai, S; Wiora, G; Wewer, L [NanoFocus AG, Lindnerstr. 98, 46149 Oberhausen (Germany); Zafarullah, I [Applied Scientific Imaging Inc., Toronto (Canada); Roth, H, E-mail:, E-mail: [Institute of Automatic Control Engineering, University of Siegen, Hoelderlinstr. 3, 57068 Siegen (Germany)


    We have developed a novel confocal-based imaging sensor for surface characterization. In this case, a tilted-plane technique is incorporated in a confocal imaging system to create a new parallel scanning scheme, enabling the sensor to be designed and developed as a robust and simple configuration. With a tilted disk consisting of in-line pinholes, a motionless parallel z scanning scheme is manifested when the specimen is transversely scanned through the stationary diffraction-foci projecting at different depths. This sensor uses a line scanning approach, so that it is entitled as a Confocal Line Scanning Sensor (CLSS). In this paper, the CLSS principle, the concept of data processing, and major calibration are described. The sensor was first developed as a two-dimensional profiler to cover the measurement ranges of up to 50 {mu}m in depth and up to 15 mm in lateral length. Experimental results were carried out using calibrated specimens for roughness measurement. In this system, the optical lateral resolution is 0.5 {mu}m, and the depth resolution, defined by noise-limited approach, is 15 nm.

  9. Isolated renal hydatid cyst managed by laparoscopic transperitoneal nephrectomy

    Directory of Open Access Journals (Sweden)

    Kartik J Shah


    Full Text Available Hydatid disease is a cyclozoonotic parasitic infestation caused by the cestode Echinococcus granulosus. Isolated renal involvement is extremely rare. A 45-year-old female, working as a farmer, presented with vague abdominal pain and hydatiduria. Ultrasonography of the abdomen revealed hydatid cyst arising from the right kidney. Computerized tomography scan of the abdomen confirmed the findings. Laparoscopic transperitoneal nephrectomy was performed. Isolated right renal hydatid cyst was removed in toto. Microscopic examination confirmed the diagnosis of hydatid cyst. Transperitoneal laparoscopic approach gives a better working space which helped us to remain outside Gerota′s fascia and prevent subsequent cyst rupture.

  10. CT appearance of renal hemorrhage after extracorporeal shock wave lithotripsy

    Energy Technology Data Exchange (ETDEWEB)

    Kanazawa, Susumu; Araki, Toru; Takamoto, Hitoshi; Hata, Kazuhiro


    Computed Tomography (CT) was performed in three patients who were suspicious of renal hemorrhage after extracorporeal shock wave lithotripsy (ESWL). Post-ESWL scans demonstrated subcapsular hematoma in all three cases, and intrarenal hemorrhage in two cases, one of which had fluid collection in the pararenal space and hemorrhage in the posterior pararenal space on CT. Thickening of gerota fascia and bridging septa in the perirenal space was visualized on CT in all of them. CT demonstrated clearly the anatomic distribution and extent of renal hemorrhage, and it is important to comprehend the imaging anatomy of the perirenal area for CT evaluation.

  11. Renal Failure in Pregnancy. (United States)

    Balofsky, Ari; Fedarau, Maksim


    Renal failure during pregnancy affects both mother and fetus, and may be related to preexisting disease or develop secondary to diseases of pregnancy. Causes include hypovolemia, sepsis, shock, preeclampsia, thrombotic microangiopathies, and renal obstruction. Treatment focuses on supportive measures, while pharmacologic treatment is viewed as second-line therapy, and is more useful in mitigating harmful effects than treating the underlying cause. When supportive measures and pharmacotherapy prove inadequate, dialysis may be required, with the goal being to prolong pregnancy until delivery is feasible. Outcomes and recommendations depend primarily on the underlying cause.

  12. Renal lithiasis and nutrition. (United States)

    Grases, Felix; Costa-Bauza, Antonia; Prieto, Rafel M


    Renal lithiasis is a multifactorial disease. An important number of etiologic factors can be adequately modified through diet, since it must be considered that the urine composition is directly related to diet. In fact, the change of inappropriate habitual diet patterns should be the main measure to prevent kidney stones. In this paper, the relation between different dietary factors (liquid intake, pH, calcium, phosphate, oxalate, citrate, phytate, urate and vitamins) and each type of renal stone (calcium oxalate monohydrate papillary, calcium oxalate monohydrate unattached, calcium oxalate dihydrate, calcium oxalate dihydrate/hydroxyapatite, hydroxyapatite, struvite infectious, brushite, uric acid, calcium oxalate/uric acid and cystine) is discussed.

  13. Pediatric Renal Neoplasms. (United States)

    Ranganathan, Sarangarajan


    Renal tumors in childhood consist of a diverse group of tumors ranging from the most common Wilms' tumor, to the uncommon and often fatal rhabdoid tumor. Diagnosis is based on morphologic features and aided by ancillary techniques such as immunohistochemistry and cytogenetics. Molecular techniques have helped identify a group of pediatric renal cell carcinomas that have specific translocations, called translocation-associated carcinomas. Differential diagnosis of the various tumors is discussed. Pathogenesis and nephroblastomatosis, the precursor lesions of Wilms tumor, also are discussed briefly, as are the handling of these tumor specimens and prognostic factors. Copyright © 2009 Elsevier Inc. All rights reserved.

  14. Gravidez e transplante renal


    Andrade, Joana Rita Ferreira


    Enquadramento: A gravidez é rara em mulheres com Doença Renal Crónica, sobretudo em estadio avançado, em virtude de várias condicionantes como a disfunção ovárica, hemorragias vaginais anovulatórias e amenorreia. Contudo, após transplante renal é possível alimentar o sonho de constituir família, mas é preciso considerar os riscos aumentados para o enxerto e a maior susceptibilidade para complicações da gravidez. Objectivo: Avaliar os riscos e identificar as variáveis que influenciam o suce...

  15. Renal lithiasis and nutrition

    Directory of Open Access Journals (Sweden)

    Prieto Rafel M


    Full Text Available Abstract Renal lithiasis is a multifactorial disease. An important number of etiologic factors can be adequately modified trough diet, since it must be considered that the urine composition is directly related to diet. In fact, the change of inappropriate habitual diet patterns should be the main measure to prevent kidney stones. In this paper, the relation between different dietary factors (liquid intake, pH, calcium, phosphate, oxalate, citrate, phytate, urate and vitamins and each type of renal stone (calcium oxalate monohydrate papillary, calcium oxalate monohydrate unattached, calcium oxalate dihydrate, calcium oxalate dihydrate/hydroxyapatite, hydroxyapatite, struvite infectious, brushite, uric acid, calcium oxalate/uric acid and cystine is discussed.

  16. [The acute renal and cerebral toxicity of lithium: a cerebro-renal syndrome? A case report]. (United States)

    Prencipe, M; Cicchella, A; Del Giudice, A; Di Giorgio, A; Scarlatella, A; Vergura, M; Aucella, F


    This descriptive report describes the case of a 50 year-old woman with bipolar disorder, whose maintenance therapy comprised risperidone, sodium valproato and lithium carbonate without any past occurrence of toxicity. Her past medical history was significant for hypertension, cardiopathy and obesity. She presented with a 1-week history of fever, increasing confusion and slurred speech. At presentation, the patient was somnolent. Laboratory investigations revealed a serum creatinine of 3,6 mg/dl, BUN 45 mg/dl serum lithium 3,0 mEq/L with polyuria defined as more than 3 litres a day. EEG and ECG were abnormal. CT brain scanning and lumbar puncture were negative for brain haemorrage or infection. Lithium toxicity causes impairment of renal concentration and encephalopathy due to lithium recirculation, a mechanism responsible for the so-called cerebro-renal syndrome, where dialysis plays an important role in treatment.The patient was treated with continous veno-venous haemodiafiltration (CVVHDF) over 35 hours with gradual improvement of her general condition and efficacy of renal concentration. Our case highlights a few important points. Lithium nefrotoxicity and neurotoxicity can cause a cerebro-renal syndrome even when serum lithium levels are not particularly raised (2,5-3,5 mEq/L). Haemodialysis is the treatment of choice to reduce the molecular mechanisms of lithium-related changes in urinary concentration and reinstate dopaminergic activity in the brain.

  17. New therapeutic agents in diabetic nephropathy (United States)

    Kim, Yaeni; Park, Cheol Whee


    Studies investigating diabetic nephropathy (DN) have mostly focused on interpreting the pathologic molecular mechanisms of DN, which may provide valuable tools for early diagnosis and prevention of disease onset and progression. Currently, there are few therapeutic drugs for DN, which mainly consist of antihypertensive and antiproteinuric measures that arise from strict renin-angiotensin-aldosterone system inactivation. However, these traditional therapies are suboptimal and there is a clear, unmet need for treatments that offer effective schemes beyond glucose control. The complexity and heterogeneity of the DN entity, along with ambiguous renal endpoints that may deter accurate appraisal of new drug potency, contribute to a worsening of the situation. To address these issues, current research into original therapies to treat DN is focusing on the intrinsic renal pathways that intervene with intracellular signaling of anti-inflammatory, antifibrotic, and metabolic pathways. Mounting evidence in support of the favorable metabolic effects of these novel agents with respect to the renal aspects of DN supports the likelihood of systemic beneficial effects as well. Thus, when translated into clinical use, these novel agents would also address the comorbid factors associated with diabetes, such as obesity and risk of cardiovascular disease. This review will provide a discussion of the promising and effective therapeutic agents for the management of DN. PMID:28049280

  18. 低渗非离子型造影剂对2型糖尿病及Ⅰ~Ⅲ期糖尿病肾病患者肾功能的影响研究%Impact of Hypotonic Non - ionic Contrast Agents on Renal Function in Patients with Type 2 Diabetes Mellitus or StageⅠ-Ⅲ Diabetic Nephropathy

    Institute of Scientific and Technical Information of China (English)

    刘春斌; 李凯; 黄松


    Objective To investigate the effect of hypotonic non - ionic contrast agents on renal function in patients with type 2 diabetes mellitus(T2DM)or stageⅠ - Ⅲ diabetic nephropathy(DN). Methods From September 2011 to August 2013,25 patients with T2DM or stageⅠ - Ⅲ DN(study group),25 healthy subjects(control group)underwent CT perfusion imaging of kidney. The incidence of contrast - induced nephropathy(CIN),fasting blood glucose(FBG),24 h urine albu-min,24 h urine protein quantitation( UPQ),blood urea nitrogen( BUN),creatinine( Cr),uric acid( UA),estimated glomerular filtration rate(C - GFR)and contrast - related complications were observed before infusion and on days 1,3 after infusion. Results CIN did not occurred in 2 groups. There was significant difference in FBG,24 h urine albumin,24 h UPQ, BUN,Cr,C - GFR between 2 groups(P ﹤ 0. 05),there was no in UA(P ﹥ 0. 05). In intra - group comparison,there was no difference in all indicators except in FBG,UA(P ﹥ 0. 05). No contrast - related complication occurred in 2 groups. Con-clusion T2DM and stage Ⅰ - Ⅲ DN are not absolute contraindications of renal CT perfusion imaging. Based on patients′screening and adequate hydration therapy,hypotonic non - ionic contrast agents is safe without obvious effects on patients′renal function,not to increase CIN risks.%目的:探讨低渗非离子型造影剂对2型糖尿病(T2DM)及Ⅰ~Ⅲ期糖尿病肾病(DN)患者肾功能的影响。方法选择2011年9月-2013年8月在广西医科大学第一附属医院行肾脏 CT 灌注成像检查的患者50例,其中T2DM 及Ⅰ~Ⅲ期 DN 患者25例(观察组),健康志愿者25例(对照组)。观察两组受试者造影剂肾病(CIN)发生情况,灌注前及灌注后第1、3天空腹血糖、24 h 尿微量清蛋白、24 h 尿蛋白定量、血尿素氮、血肌酐、血尿酸、估算肾小球滤过率(C - GFR)及造影相关并发症情况。结果两组受试者均未发生 CIN。两

  19. Branchio-oto-renal syndrome. (United States)

    Jalil, Jawad; Basheer, Faisal; Shafique, Mobeen


    The association of branchial arch anomalies (branchial cysts, branchial fistulas), hearing loss and renal anomalies constitutes the branchio-oto-renal (BOR) syndrome also known as Melnick Fraser syndrome. We present a case of this rare disorder in a girl child who presented with profound deafness, preauricular pits, branchial sinuses and renal hypoplasia.

  20. Drug-induced renal disease. (United States)

    Curtis, J R


    The clinical manifestations of drug-induced renal disease may include all the manifestations attributed to natural or spontaneous renal diseases such as acute renal failure, chronic renal failure, acute nephritic syndrome, renal colic, haematuria, selective tubular defects, obstructive nephropathy, etc. It is therefore vital in any patient with renal disease whatever the clinical manifestations might be, to obtain a meticulous drug and toxin inventory. Withdrawal of the offending drug may result in amelioration or cure of the renal disorder although in the case of severe renal failure it may be necessary to utilise haemodialysis or peritoneal dialysis to tide the patient over the period of acute renal failure. Analgesic nephropathy is an important cause of terminal chronic renal failure and it is therefore vital to make the diagnosis as early as possible. The pathogenesis of some drug-induced renal disorders appears to be immunologically mediated. There are many other pathogenetic mechanisms involved in drug-induced renal disorders and some drugs may under appropriate circumstances be responsible for a variety of different nephrotoxic effects. For example, the sulphonamides have been incriminated in examples of crystalluria, acute interstitial nephritis, acute tubular necrosis, generalised hypersensitivity reactions, polyarteritis nodosa and drug-induced lupus erythematosus.

  1. Management of chronic renal failure.

    NARCIS (Netherlands)

    de Zeeuw, D.; Apperloo, AJ; de Jong, P.


    There is growing evidence that treatment of patients with renal function impairment will undergo a major shift within the next few years. Along with more or less successful attempts to alleviate the signs and symptoms of reduced renal function, new insights into renal pathophysiology as well as new

  2. Femtosecond scanning tunneling microscope

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, A.J.; Donati, G.P.; Rodriguez, G.; Gosnell, T.R.; Trugman, S.A.; Some, D.I.


    This is the final report of a three-year, Laboratory Directed Research and Development (LDRD) project at the Los Alamos National Laboratory (LANL). By combining scanning tunneling microscopy with ultrafast optical techniques we have developed a novel tool to probe phenomena on atomic time and length scales. We have built and characterized an ultrafast scanning tunneling microscope in terms of temporal resolution, sensitivity and dynamic range. Using a novel photoconductive low-temperature-grown GaAs tip, we have achieved a temporal resolution of 1.5 picoseconds and a spatial resolution of 10 nanometers. This scanning tunneling microscope has both cryogenic and ultra-high vacuum capabilities, enabling the study of a wide range of important scientific problems.

  3. Gallium-67 citrate scan in extrapulmonary tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Lin Wanyu [Taichung Veterans General Hospital (Taiwan). Dept. of Nuclear Medicine; Hsieh Jihfang [Chi-Mei Foundation Hospital, Tainan (Taiwan)


    Aim: Whole-body gallium scan was performed to evaluate the usefulness of gallium scan for detecting extrapulmonary tuberculosis (TB) lesions. Methods: Thirty-seven patients with extrapulmonary TB were included in this study. Four patients were found to have two lesions. Totally, 41 lesions were identified, including 19 TB arthritis, 8 spinal TB, 5 TB meningitis, 3 TB lymphadenopathy, 2 TB pericarditis, 1 TB peritonitis, 1 intestinal TB, 1 skin TB and 1 renal TB. Results: Of the 41 extrapulmonary TB lesions, gallium scan detected 32 lesions with a sensitivity of 78%. All the patients with TB meningitis showed negative gallium scan. When the five cases of TB meningitis were excluded, the detection sensitivity of gallium scan increased to 88.9% (32/36). Conclusion: Our data revealed that gallium scan is a convenient and useful method for evaluating extrapulmonary TB lesions other than TB-meningitis. We suggest that gallium scan be included in the clinical routine for patients with suspected extrapulmonary TB. (orig.) [German] Ziel: Es wurden Ganzkoerper-Gallium-Szintigramme angefertigt, um den Nutzen der Gallium-Szintigraphie zur Erfassung von extrapulmonalen Tuberkuloseherden (TB) zu erfassen. Methoden: 37 Patienten mit extrapulmonaler TB wurden eingeschlossen. 4 Patienten hatten 2 Laesionen. Insgesamt wurden 41 Laesionen identifiziert, hierunter 19 TB-Arthritis, 8 spinale TB, 5 TB-Meningitis, 3 TB-Lymphadenopathie, 2 TB-Perikarditis, 1 TB-Peritonitis, 1 intestinale TB, 1 Haut-TB und eine Nieren-TB. Ergebnisse: Von den 41 extrapulmonalen TB-Herden erfasste die Gallium-Szintigraphie 32 Herde mit einer Sensitivitaet von 78%. Alle Patienten mit TB-Meningitis zeigten einen negativen Gallium-Scan. Wenn die 5 Faelle mit TB-Meningitis ausgeschlossen wurden, stieg die Sensitivititaet der Gallium-Szintigraphie auf 88,9% (32/36). Schlussfolgerung: Die Daten zeigen, dass die Gallium-Szintigraphie eine einfache und nuetzliche Methode zur Erfassung extrapulmonaler TB-Herde ist

  4. Bilateral Psoas Haematomata Complicating Renal Transplantation

    Directory of Open Access Journals (Sweden)

    Jacob A. Akoh


    Full Text Available Background. The challenge in managing patients undergoing renal transplantation is how to achieve optimum levels of anticoagulation to avoid both clotting and postoperative bleeding. We report a rare case of severe postoperative retroperitoneal bleeding including psoas haematomata complicating renal transplantation. Case Report. SM, a 55-year-old female, had a past history of aortic valve replacement, cerebrovascular event, and thoracic aortic aneurysm and was on long-term warfarin that was switched to enoxaparin 60 mg daily a week prior to her living donor transplantation. Postoperatively, she was started on a heparin infusion, but this was complicated by a large retroperitoneal bleed requiring surgical evacuation on the first postoperative day. Four weeks later, she developed features compatible with acute femoral neuropathy and a CT scan revealed bilateral psoas haematomata. Following conservative management, she made steady progress and was discharged home via a community hospital 94 days after transplantation. At her last visit 18 months after transplantation, she had returned to full fitness with excellent transplant function. Conclusion. Patients in established renal failure who require significant anticoagulation are at increased risk of bleeding that may involve prolonged hospitalisation and more protracted recovery and patients should be carefully counselled about this.

  5. Scanning the phenomenological MSSM

    CERN Document Server

    Wuerzinger, Jonas


    A framework to perform scans in the 19-dimensional phenomenological MSSM is developed and used to re-evaluate the ATLAS experiments' sensitivity to R-parity-conserving supersymmetry with LHC Run 2 data ($\\sqrt{s}=13$ TeV), using results from 14 separate ATLAS searches. We perform a $\\tilde{t}_1$ dedicated scan, only considering models with $m_{\\tilde{t}_1}<1$ TeV, while allowing both a neutralino ($\\tilde{\\chi}_1^0$) and a sneutrino ($\\tilde{\

  6. Adaptive Optical Scanning Holography (United States)

    Tsang, P. W. M.; Poon, Ting-Chung; Liu, J.-P.


    Optical Scanning Holography (OSH) is a powerful technique that employs a single-pixel sensor and a row-by-row scanning mechanism to capture the hologram of a wide-view, three-dimensional object. However, the time required to acquire a hologram with OSH is rather lengthy. In this paper, we propose an enhanced framework, which is referred to as Adaptive OSH (AOSH), to shorten the holographic recording process. We have demonstrated that the AOSH method is capable of decreasing the acquisition time by up to an order of magnitude, while preserving the content of the hologram favorably. PMID:26916866

  7. Comparison of the renal hyperemic effects of papaverine and dopamine in patients with renal artery stenosis. (United States)

    Protasiewicz, Marcin; Początek, Karol; Poręba, Rafał; Derkacz, Arkadiusz; Podgórski, Maciej; Gosławska, Katarzyna; Szymańska-Chabowska, Anna; Mazur, Grzegorz; Mysiak, Andrzej; Witkowski, Adam


    The purpose of this study was to assess the hyperemic effects of papaverine and dopamine in the renal microcirculation of hypertensive patients with renal artery stenosis (RAS). Although a poor correlation between angiographic lesion assessment and its hemodynamic significance is known, angiography is a major criterion for the decision of renal artery stenting. Assessment of the hyperemic translesional pressure gradient was recently shown to be conducive in identifying patients who may benefit from renal revascularization. The study included 14 patients (mean age, 66 ± 11.2 years) with resistant hypertension and moderate RAS. Using a pressure-sensing catheter, systolic, diastolic, and mean translesional pressure gradients, and the distal pressure (Pd):aortic pressure (Pa) ratio (Pd/Pa) were analyzed at baseline and after administration of 40 mg papaverine and 50 μg/kg dopamine. We did not observe significant changes in DG. Dopamine administration resulted in significant changes in systolic and mean translesional pressure gradients and Pd/Pa when compared with baseline (P dopamine or papaverine bolus administration.This study indicates that, compared with papaverine, the intrarenal bolus of dopamine in hypertensive patients with RAS remains a more powerful hyperemic agent.

  8. Renal artery stenosis: comparative assessment by unenhanced renal artery mra versus contrast-enhanced MRA

    Energy Technology Data Exchange (ETDEWEB)

    Khoo, Michael M.Y.; Deeab, Dhafer; Gedroyc, Wladyslaw M.W.; Dick, Elizabeth A. [St Mary' s Hospital, Imperial College NHS Trust, Department of MRI, London (United Kingdom); Duncan, Neil; Taube, David [Hammersmith Hospital, Imperial College NHS Trust, Department of Nephrology, London (United Kingdom)


    To evaluate steady-state free precession (SSFP) non-contrast-enhanced MR angiography (Unenhanced-MRA) versus conventional contrast-enhanced MR angiography (CE-MRA) in the detection of renal artery stenosis (RAS). Retrospective analysis of 70 consecutive patients referred for suspected RAS, examined by SSFP Unenhanced-MRA and CE-MRA. Image quality, quality of visible renal arterial segments, presence and grade of RAS were evaluated. The Unenhanced-MRA were compared against reference standard CE-MRA results. 149 renal arteries were assessed with 21 haemodynamically significant stenoses ({>=}50% stenosis) demonstrated by CE-MRA. Combined sensitivity and specificity for RAS detection by Unenhanced-MRA was 72.8% and 97.8% respectively. There is substantial correlation for RAS detection between Unenhanced-MRA and CE-MRA with kappa values of between 0.64 and 0.74. There was excellent inter-observer correlation for RAS on Unenhanced-MRA (kappa values 0.82-1.0). Our study has shown Unenhanced-MRA to be a viable alternative to CE-MRA, yielding images equal in quality without the requirement for gadolinium contrast agents. The sensitivity and specificity for the detection of haemodynamically significant stenoses are comparable to CE-MRA. Potentially, Unenhanced-MRA could be used as an initial investigation to avoid performing CE-MRA in patients with normal renal arteries, however we suggest that its real value will lie in being complementary to CE-MRA. (orig.)

  9. Galacto-oligosaccharides attenuate renal injury with microbiota modification. (United States)

    Furuse, Satoshi U; Ohse, Takamoto; Jo-Watanabe, Airi; Shigehisa, Akira; Kawakami, Koji; Matsuki, Takahiro; Chonan, Osamu; Nangaku, Masaomi


    Tubulointerstitial injury is central to the progression of end-stage renal disease. Recent studies have revealed that one of the most investigated uremic toxins, indoxyl sulfate (IS), caused tubulointerstitial injury through oxidative stress and endoplasmic reticulum (ER) stress. Because indole, the precursor of IS, is synthesized from dietary tryptophan by the gut microbiota, we hypothesized that the intervention targeting the gut microbiota in kidney disease with galacto-oligosaccharides (GOS) would attenuate renal injury. After 2 weeks of GOS administration for 5/6 nephrectomized (Nx) or sham-operated (Sham) rats, cecal indole and serum IS were measured, renal injury was evaluated, and the effects of GOS on the gut microbiota were examined using pyrosequencing methods. Cecal indole and serum IS were significantly decreased and renal injury was improved with decreased infiltrating macrophages in GOS-treated Nx rats. The expression levels of ER stress markers and apoptosis were significantly increased in the Nx rats and decreased with GOS. The microbiota analysis indicated that GOS significantly increased three bacterial families and decreased five families in the Nx rats. In addition, the analysis also revealed that the bacterial family Clostridiaceae was significantly increased in the Nx rats compared with the Sham rats and decreased with GOS. Taken altogether, our data show that GOS decreased cecal indole and serum IS, attenuated renal injury, and modified the gut microbiota in the Nx rats, and that the gut microbiota were altered in kidney disease. GOS could be a novel therapeutic agent to protect against renal injury.

  10. Clostridium difficile causing acute renal failure: Case presentation and review

    Institute of Scientific and Technical Information of China (English)

    Jasmin Arrich; Gottfried H. Sodeck; Gürkan Seng(o)lge; Christoforos Konnaris; Marcus Müllner; Anton N. Laggner; Hans Domanovits


    AIM: Clostridium difficile infection is primarily a nosocomial infection but asymptomatic carriers of Clostridium difficile can be found in up to 5% of the general population.Ampicillin, cephalosporins and clindamycin are the antibiotics that are most frequently associated with Clostridium difficile-associated diarrhea or colitis. Little is known about acute renal failure as a consequence of Clostridium difficile-associated diarrhea.METHODS: In this case report, we describe the course of Clostridium difficile-associated diarrhea in an 82-yearold patient developing acute renal failure. Stopping the offending agent and symptomatic therapy brought a rapid improvement of diarrhea and acute renal failure, full recovery was gained 18 d after admission. In a systematic review we looked for links between the two conditions.RESULTS: The link between Clostridium difficilr-associated diarrhea and acute renal failure in our patient was most likely volume depletion. However, in experimental studies a direct influence of Clostridium difficile toxins on renal duct cells could be shown.CONCLUSION: Rapid diagnosis, nonspecific supportive treatment and specific antibiotic treatment, especially in the elderly, may lower excess mortality Clostridium difficile-associated diarrhea and renal failure being possible complications.

  11. Cinnabar Induces Renal Inflammation and Fibrogenesis in Rats

    Directory of Open Access Journals (Sweden)

    Ying Wang


    Full Text Available The purpose of this study was to investigate whether cinnabar causes renal inflammation and fibrosis in rats. Rats were dosed orally with cinnabar (1 g/kg/day for 8 weeks or 12 weeks. The control rats were treated with solvent (5% carboxymethylcellulose solution over the same time periods, respectively. Renal mercury (RHg, urinary mercury (UHg, serum creatinine (SCr, urine kidney injury molecule 1 (KIM-1, renal pathology, and renal mediators were examined. At both 8 weeks and 12 weeks, RHg, UHg, and urine KIM-1 were significantly higher in the cinnabar group than in the control group, although SCr was unchanged. Kidney lesions in the cinnabar-treated rats occurred mainly in the tubules and interstitium, including vacuolization, protein casts, infiltration of inflammatory cells, and slight increase in interstitial collagen. In addition, mild mesangial proliferation was observed in glomeruli. Moreover, the expression of inflammatory and fibrogenic mediators was upregulated in the cinnabar group. In conclusion, cinnabar may cause kidney damage due to the accumulation of mercury, and renal inflammation and slight fibrogenesis may occur in rats. In the clinic, the potential risk of renal injury due to the prolonged consumption of cinnabar should be considered even though the agent is relatively nontoxic.

  12. Corticosteroids for renal scar prevention in children with acute pyelonephritis. (United States)

    Sakulchit, Teeranai; Goldman, Ran D


    Question Acute pyelonephritis in children is of great concern and I usually refer these patients to a pediatrician or send them to the emergency department owing to the risk of renal scarring. Are steroids an acceptable treatment to reduce risk of scarring? Answer Several agents have been studied in an effort to prevent renal scar formation following acute pyelonephritis in children. Use of corticosteroids, in conjunction with standard therapy for acute pyelonephritis, shows promising findings. However, evidence is very limited and steroids should not be offered on a regular basis as part of treatment. Copyright© the College of Family Physicians of Canada.

  13. [Hypertension and renal disease

    DEFF Research Database (Denmark)

    Kamper, A.L.; Pedersen, E.B.; Strandgaard, S.


    hypertension. Mild degrees of chronic kidney disease (CKD) can be detected in around 10% of the population, and detection is important as CKD is an important risk factor for atherosclerotic cardiovascular disease. Conversely, heart failure may cause an impairment of renal function. In chronic progressive...

  14. Insuficiencia renal aguda.

    Directory of Open Access Journals (Sweden)

    Carlos Hernán Mejía


    Full Text Available La insuficiencia renal aguda se diagnostica aproximadamente en 5% de los pacientes hospitalizados. Sus principales causas se relacionan con la alteración del flujo sanguíneo renal, sea por depleción de volumen, baja perfusión renal o por distribución intrarrenal inadecuada y obstrucción del árbol urinario. El diagnóstico parte de la historia clínica y un buen examen físico que corrobore el estado de volemia del paciente y se complementa con el uso adecuado de los índices urinarios (excreción de sodio y osmolaridad, el uroanálisis y la ecografía renal. Su tratamiento consiste en una adecuada recuperación del volumen, manejo de los diuréticos, soporte nutricional, conservación del equilibrio hidroelectrolítico y brindar terapia de diálisis si hay toxicidad urémica, hipercaliemia severa (>6.5 mEq/l, acidosis metabólica o sobrecarga severa de volumen.

  15. Management of Renal Cysts (United States)

    Nalbant, Ismail; Can Sener, Nevzat; Firat, Hacer; Yeşil, Süleyman; Zengin, Kürşad; Yalcınkaya, Fatih; Imamoglu, Abdurrahim


    Background and Objectives: Renal cysts have a high prevalence in the general population, and their estimated incidence increases with age. Renal cyst aspiration (usually with sclerotherapy) or open/laparoscopic decortication is a generally effective and safe method in the treatment of symptomatic simple renal cysts. The success rates of laparoscopic decortication and percutaneous aspiration-sclerotherapy were compared to assist in the decision making for the procedure. Methods: A total of 184 patients with symptomatic simple renal cysts were treated with either laparoscopic decortication in 149 cases or percutaneous aspiration-sclerotherapy in 35 cases. The follow-up period was approximately 35 months, and the symptomatic and radiologic success rates of the 2 techniques were compared retrospectively. Results: Laparoscopic decortication was found to have high success rates, a low recurrence rate, and minimal morbidity. Percutaneous aspiration-sclerotherapy is an outpatient procedure with a minimally higher recurrence rate. Conclusion: When a symptomatic cyst is encountered and treatment of the cyst is indicated, laparoscopic decortication is a more efficient method that offers better results than percutaneous aspiration-sclerotherapy. PMID:25848184

  16. Rupture of Renal Transplant

    Directory of Open Access Journals (Sweden)

    Shona Baker


    Full Text Available Background. Rupture of renal allograft is a rare and serious complication of transplantation that is usually attributed to acute rejection, acute tubular necrosis, or renal vein thrombosis. Case Presentation. LD, a 26-year-old male with established renal failure, underwent deceased donor transplantation using kidney from a 50-year-old donor with acute kidney injury (Cr 430 mmol/L. LD had a stormy posttransplant recovery and required exploration immediately for significant bleeding. On day three after transplant, he developed pain/graft swelling and another significant haemorrhage with cardiovascular compromise which did not respond to aggressive resuscitation. At reexploration, the renal allograft was found to have a longitudinal rupture and was removed. Histology showed features of type IIa Banff 97 acute vascular rejection, moderate arteriosclerosis, and acute tubular necrosis. Conclusion. Possible ways of avoiding allograft rupture include use of well-matched, good quality kidneys; reducing or managing risk factors that would predispose to delayed graft function; ensuring a technically satisfactory transplant procedure with short cold and warm ischemia times; and avoiding large donor-recipient age gradients.

  17. Primary renal graft thrombosis

    NARCIS (Netherlands)

    Bakir, N; Sluiter, WJ; Ploeg, RJ; van Son, WJ; Tegzess, Adam


    Background. Renal allograft thrombosis is a serious complication of kidney transplantation that ultimately leads to graft loss. Its association with acute and hyperacute rejection is well documented; however, in a large proportion of patients the precise cause remains obscure. The exact incidence an

  18. Safety and efficacy of liraglutide in patients with type 2 diabetes and end-stage renal disease

    DEFF Research Database (Denmark)

    Idorn, Thomas; Knop, Filip K; Jørgensen, Morten;


    Diabetes is the leading cause of end-stage renal disease (ESRD). Owing to renal clearance, several antidiabetic agents cannot be used in patients with ESRD. The present protocol describes an investigator-initiated trial aiming to test safety and efficacy of treatment with the glucagon-like peptide...

  19. Renal lesions associated with autoimmune pancreatitis: CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Triantopoulou, Charikleia; Maniatis, Petros; Siafas, Ioannis; Papailiou, John (CT and Radiology Dept., ' Konstantopouleion' General Hospital, Athens (Greece)), e-mail:; Malachias, George; Anastopoulos, John (Radiology Dept., ' Sismanogleio' General Hospital, Athens (Greece))


    Background: Autoimmune pancreatitis (AIP) is a chronic inflammatory condition characterized by IgG4-positive plasma cells. Recent evidence suggests that it is a systemic disease affecting various organs. Tubulointerstitial nephritis has been reported in association with AIP. Purpose: To investigate the incidence and types of renal involvement in patients with AIP. Material and Methods: Eighteen patients with no history of renal disease and a diagnosis of AIP (on the basis of histopathologic findings or a combination of characteristic imaging features, increased serum IgG4 levels, and response to steroid treatment) were included. All patients underwent computed tomography (CT) imaging and follow-up ranged from 6 months to 2 years. CT images were reviewed for the presence of renal lesions. Results: Seven patients had renal involvement (38.8%). None of the lesions was visible on non-contrast-enhanced CT scan. Parenchymal lesions appeared as multiple nodules showing decreased enhancement (four cases). Pyelonephritis, lymphoma, and metastases were considered in the differential diagnosis. An ill-defined low-attenuation mass-like lesion was found in one patient, while diffuse thickening of the renal pelvis wall was evident in the last two cases. Renal lesions regressed in all patients after steroid treatment, the larger one leaving a fibrous cortical scar. Conclusion: Different types of renal lesions in patients with AIP are relatively common, appearing as multiple nodules with decreased enhancement. These findings support the proposed concept of an IgG4-related systemic disease. Autoimmune disease should be suspected in cases of renal involvement in association with pancreatic focal or diffuse enlargement.

  20. Applications. SCANS Plans Portfolio. (United States)

    Sample, Barbara

    This guide assists English-as-a-Second-Language educators in helping students fill out simple application forms. The guide discusses performance outcomes, communications teaching points, SCANS (Secretary's Committee on Achieving Necessary Skills) competencies, classroom configurations, materials, and procedures. Blank forms, suitable for…

  1. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Thyroid Scan ... often unattainable using other imaging procedures. Tell your doctor if there’s a possibility you are pregnant or ...

  2. Scanning bubble chamber pictures

    CERN Multimedia


    These were taken at the 2 m hydrogen bubble chamber. The photo shows an early Shiva system where the pre-measurements needed to qualify the event were done manually (cf photo 7408136X). The scanning tables were located in bld. 12. Gilberte Saulmier sits on foreground, Inge Arents at centre.

  3. Sinus MRI scan (United States)

    ... A CT scan may be preferred in emergency cases, since it is faster and often available in the emergency room. Note: MRI is not as effective as CT in defining the anatomy of the sinuses, and therefore is not typically used for suspected acute sinusitis.



    Breitenstein, O.


    Scanning Deep Level Transient Spectroscopy (SDLTS) is a current SEM technique for the detection of the local distribution of deep level centres in semiconductors. The contribution deals with the physical foundations of the SDLTS technique and it discusses the demands on the instrumentation. The measurement practice is described and illustrated by several experimental examples. Finally, the possibilities and limitations of SDLTS are critically reviewed.

  5. ``Aggressive`` renal angiomyolipoma

    Energy Technology Data Exchange (ETDEWEB)

    Cittadini, G. Jr. [Univ. of Genoa (Italy). Dept. of Radiology; Pozzi Mucelli, F. [Univ. of Trieste (Italy). Dept. of Radiology; Danza, F.M. [Catholic Sacro Cuore Univ., Rome (Italy). Dept. of Radiology; Derchi, L.E. [Univ. of Genoa (Italy). Dept. of Radiology; Pozzi Mucelli, R.S. [Univ. of Trieste (Italy). Dept. of Radiology


    We describe the US and CT examinations of 4 patients with renal angiomyolipoma with an `aggressive` appearance, and review the literature. The imaging findings in 4 patients with benign renal angiomyolipomas associated with thrombosis of the renal vein and/or inferior vena cava are presented. CT demonstrated fat densities within both tumor and thrombus. In one patient, small lymph nodes with low density internal areas were detected in the para-aortic region. When considering our patients together with those reported in the literature, we found that most angiomyolipomas with venous invasion were large and centrally located within the kidney. Venous thrombosis was observed in 9 lesions of the right kidney, and in only 4 of the left one. One patient only had symptoms due to the thrombus; 10 had problems due to the tumor; and 3 were asymptomatic. Only 4 patients with pararenal enlarged lymph nodes have been reported on in the imaging literature. Fat-containing nodes were detected by CT in one case only; the others had enlarged nodes of soft-tissue density. In one patient the diagnosis of hamartomatous lymph node invasion was established by angiography. In patients with renal angiomyolipoma, demonstration of both fatty thrombus and the fatty infiltration of lymph nodes of the renal hilum cannot be regarded as an indication of malignancy, but only of local aggessive behavior. Conservative treatment seems possible. Detection of enlarged lymph nodes of soft tissue density may cause difficult diagnostic problems, with the diagnosis addressed only by the presence of associated lesions. (orig./MG).

  6. Acute effects of ferumoxytol on regulation of renal hemodynamics and oxygenation (United States)

    Cantow, Kathleen; Pohlmann, Andreas; Flemming, Bert; Ferrara, Fabienne; Waiczies, Sonia; Grosenick, Dirk; Niendorf, Thoralf; Seeliger, Erdmann


    The superparamagnetic iron oxide nanoparticle ferumoxytol is increasingly used as intravascular contrast agent in magnetic resonance imaging (MRI). This study details the impact of ferumoxytol on regulation of renal hemodynamics and oxygenation. In 10 anesthetized rats, a single intravenous injection of isotonic saline (used as volume control) was followed by three consecutive injections of ferumoxytol to achieve cumulative doses of 6, 10, and 41 mg Fe/kg body mass. Arterial blood pressure, renal blood flow, renal cortical and medullary perfusion and oxygen tension were continuously measured. Regulation of renal hemodynamics and oxygenation was characterized by dedicated interventions: brief periods of suprarenal aortic occlusion, hypoxia, and hyperoxia. None of the three doses of ferumoxytol resulted in significant changes in any of the measured parameters as compared to saline. Ferumoxytol did not significantly alter regulation of renal hemodynamics and oxygenation as studied by aortic occlusion and hypoxia. The only significant effect of ferumoxytol at the highest dose was a blunting of the hyperoxia-induced increase in arterial pressure. Taken together, ferumoxytol has only marginal effects on the regulation of renal hemodynamics and oxygenation. This makes ferumoxytol a prime candidate as contrast agent for renal MRI including the assessment of renal blood volume fraction. PMID:27436132

  7. Renal effects of nabumetone, a COX-2 antagonist: impairment of function in isolated perfused rat kidneys contrasts with preserved renal function in vivo. (United States)

    Reichman, J; Cohen, S; Goldfarb, M; Shina, A; Rosen, S; Brezis, M; Karmeli, F; Heyman, S N


    The constitutive cyclooxygenase (COX)-1 enzyme has been considered the physiologically important isoform for prostaglandin synthesis in the normal kidney. It has, therefore, been suggested that selective inhibitors of the 'inducible' isoform (COX-2) may be free from renal adverse effects. We studied the renal effects of the predominantly COX-2 antagonist nabumetone in isolated perfused kidneys. As compared with controls, kidneys removed after in vivo administration of oral nabumetone (15 mg/kg) disclosed altered renal function with reduced glomerular filtration rate, filtration fraction, and urine volume and enhanced hypoxic outer medullary tubular damage. By contrast, renal function and morphology were not affected in vivo by nabumetone or its active metabolite 6-methoxy-2-naphthylacetic acid. The latter agent (10-20 mg/kg i.v.) did not significantly alter renal microcirculation, as opposed to a selective substantial reduction in medullary blood flow noted with the nonselective COX inhibitor indomethacin (5 mg/kg i.v.). In a rat model of acute renal failure, induced by concomitant administration of radiocontrast, nitric oxide synthase, and COX inhibitors, the decline in kidney function and the extent of hypoxic medullary damage with oral nabumetone (80 mg/kg) were comparable to a control group, and significantly less than those induced by indomethacin. In rats subjected to daily oral nabumetone for 3 consecutive weeks, renal function and morphology were preserved as well. Both nabumetone and 6-methoxy-2-naphthylacetic acid reduced renal parenchymal prostaglandin E2 to the same extent as indomethacin. It is concluded that while nabumetone adversely affects renal function and may intensify hypoxic medullary damage ex vivo, rat kidneys are not affected by this agent in vivo, both in acute and chronic studies. COX selectivity may not explain the renal safety of nabumetone.

  8. Percutaneous coronary interventions and antiplatelet therapy in renal transplant recipients. (United States)

    Summaria, Francesco; Giannico, Maria Benedetta; Talarico, Giovanni Paolo; Patrizi, Roberto


    Cardiovascular disease is the leading cause of mortality and morbidity following renal transplantation (RT), accounting for 40-50% of all deaths. After renal transplantation, an adverse cardiovascular event occurs in nearly 40% of patients; given the dialysis vintage and the average wait time, the likelihood of receiving coronary revascularization is very high. There is a significant gap in the literature in terms of the outcomes of prophylactic coronary revascularization in renal transplantation candidates. Current guidelines on myocardial revascularization stipulate that renal transplant patients with significant coronary artery disease (CAD) should not be excluded from the potential benefit of revascularization. Compared with percutaneous coronary intervention (PCI), however, coronary artery bypass grafting is associated with higher early and 30-day mortality. About one-third of renal transplant patients with CAD have to be treated invasively and so PCI is currently the most popular mode of revascularization in these fragile and compromised patients. A newer generation drug-eluting stent (DES) should be preferred over a bare metal stent (BMS) because of its lower risk of restenosis and improved safety concerns (stent thrombosis) compared with first generation DES and BMS. Among DES, despite no significant differences being reported in terms of efficacy, the newer everolimus and zotarolimus eluting stents should be preferred given the possibility of discontinuing, if necessary, dual antiplatelet therapy before 12 months. Since there is a lack of randomized controlled trials, the current guidelines are inadequate to provide a specifically tailored antiplatelet therapeutic approach for renal transplant patients. At present, clopidogrel is the most used agent, confirming its central role in the therapeutic management of renal transplant patients undergoing PCI. While progress in malignancy-related mortality seems a more distant target, a slow but steady reduction in

  9. TGF-β/Smad signaling in renal fibrosis

    Directory of Open Access Journals (Sweden)

    Xiao-Ming eMeng


    Full Text Available TGF-β (transforming growth factor-β is well identified as a central mediator in renal fibrosis. TGF-β initiates canonical and non-canonical pathways to exert multiple biological effects. Among them, Smad signaling is recognized as a major pathway of TGF- signaling in progressive renal fibrosis. During fibrogenesis, Smad3 is highly activated, which is associated with the down-regulation of an inhibitory Smad7 via an ubiquitin E3-ligases-dependent degradation mechanism. The equilibrium shift between Smad3 and Smad7 leads to accumulation and activation of myofibroblasts, overproduction of ECM (extracellular matrix, and reduction in ECM degradation in the diseased kidney. Therefore, overexpression of Smad7 has been shown to be a therapeutic agent for renal fibrosis in various models of kidney diseases. In contrast, another downstream effecter of TGF-β/Smad signaling pathway, Smad2, exerts its renal protective role by counter-regulating the Smad3. Furthermore, recent studies demonstrated that Smad3 mediates renal fibrosis by down-regulating miR-29 and miR-200 but up-regulating miR-21 and miR-192. Thus, overexpression of miR-29 and miR-200 or down-regulation of miR-21 and miR-192 is capable of attenuating Smad3-mediated renal fibrosis in various mouse models of chronic kidney diseases. Taken together, TGF-/Smad signaling plays an important role in renal fibrosis. Targeting TGF-β/Smad3 signaling may represent a specific and effective therapy for chronic kidney diseases associated with renal fibrosis.

  10. The grade of vesicoureteral reflux in voiding cystourethrography: comparison with ultrasonography and Tc99m-DMSA renal scintigraphy

    Energy Technology Data Exchange (ETDEWEB)



    To evaluate the prevalence of abnormalities seen on sonography and renal scintigraphy, according to the grade of vesicoureteral reflux (VUR) on in voiding cystourethrography(VCUG). One hundred and forty-nine patients (age range: 1 months-10 years) with urinary tract infection underwent sonography, VCUG, and renal scans, and 32 showed VUR on VCUG. We retrospectively evaluated the frequency and characteristic findings of sonographic abnormalities according to the grade of VUR, and also the frequency of cortical defects seen on renal scans of 32 patients with VUR. The remaining 117 patients without VUR were also evaluated for the frequency of abnormal findings seen on sonography and renal scans. Among 32 patients (49 kidneys) with VUR, abnormal findings were not detected in 17 (29 kidneys) on sonography; thus, findings were abnormal in 15 (20 kidneys, 41%). Among these 20 kidneys, renal calyceal and/or pelvic dilatation and dilatation of distal ureter were seen in 11, all of which were grade 4-5 VUR. Renal pelvic dilatation only was noted in eight kidneys; two were grade 1-3 and six were grade 4-5 VUR. Nineteen patients (24 kidneys, 49%) showed focal cortical defects on renal scintigraphy. Six kidneys were grade 1-3, and 18 kidneys were grade 4-5 VUR. Of 117 patients without VUR, 34 patients (29%) showed renal pelvic dilatation on sonography and in 14 patients (12%), cortical defects were seen on renal scintigraphy. Among 32 patients with VUR, 41% showed abnormal sonographic findings and in 49%, cortical defects were seen on renal scintigraphy. With a higher grade of VUR, the prevalence of abnormalities increased on both sonography and renal scintigraphy. Sonographic demonstration of renal caliceal and/or pelvic dilatation associated with ipsilateral distal ureteric dilatation was the characteristic finding in high grade VUR.=20.

  11. Chronic renal disease in pregnancy. (United States)

    Ramin, Susan M; Vidaeff, Alex C; Yeomans, Edward R; Gilstrap, Larry C


    The purpose of this review was to examine the impact of varying degrees of renal insufficiency on pregnancy outcome in women with chronic renal disease. Our search of the literature did not reveal any randomized clinical trials or meta-analyses. The available information is derived from opinion, reviews, retrospective series, and limited observational series. It appears that chronic renal disease in pregnancy is uncommon, occurring in 0.03-0.12% of all pregnancies from two U.S. population-based and registry studies. Maternal complications associated with chronic renal disease include preeclampsia, worsening renal function, preterm delivery, anemia, chronic hypertension, and cesarean delivery. The live birth rate in women with chronic renal disease ranges between 64% and 98% depending on the severity of renal insufficiency and presence of hypertension. Significant proteinuria may be an indicator of underlying renal insufficiency. Management of pregnant women with underlying renal disease should ideally entail a multidisciplinary approach at a tertiary center and include a maternal-fetal medicine specialist and a nephrologist. Such women should receive counseling regarding the pregnancy outcomes in association with maternal chronic renal disease and the effect of pregnancy on renal function, especially within the ensuing 5 years postpartum. These women will require frequent visits and monitoring of renal function during pregnancy. Women whose renal disease is further complicated by hypertension should be counseled regarding the increased risk of adverse outcome and need for blood pressure control. Some antihypertensives, especially angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers, should be avoided during pregnancy, if possible, because of the potential for both teratogenic (hypocalvaria) and fetal effects (renal failure, oliguria, and demise).

  12. Modifying cyclosporine associated renal allograft dysfunction

    Directory of Open Access Journals (Sweden)

    Mohapatra N


    Full Text Available Transplantation is accepted therapy for chronic kidney disease. However the essential immuno-suppressive agents for graft survival have their own side-effects. Renal biopsy is a reliable tool for diagnosing cyclosporine (CsA nephrotoxicity. To present our observations on CsA toxicity in renal allograft biopsies, we studied prospectively 207 renal allograft biopsies performed for graft dysfunction as per Ahmedabad Tole-rance Induction Protocol (ATIP and compared them to 50 controls from January to October 2007. The ATIP comprised donor specific leucocyte infusions, low dose target specific irradiation; non-myeloablative condi-tioning with Anti-T ± B cell antibodies followed by intraportal administration of cultured donor bone marrow (BM ± adipose tissue derived mesenchymal stem cells. Renal transplantation was performed following nega-tive lymphocytotoxicity cross-matching. The post-transplant immunosuppressive agents included CsA 2.5 ± 0.5 mg/kg BW/day and prednisone 0.2 mg/kg BW/day. The controls were transplanted using standard triple immunosuppressive agents including CsA 5 ± 1 mg/Kg BW/day, prednisone 0.6 mg/kg BW/day, and MMF/ Azathioprine. The Institutional Review Board approved the ATIP. The biopsies were categorized into 2 groups; group A (N=97: performed < 6 months, group B (N= 160, > 6 months posttransplant. Acute CsA toxicity was observed in group A: 2.5% ATIP and 11.1% controls; group B: 16.2% ATIP and 8.8% controls. Chronic CsA toxicity was observed in group B: 10.8 % ATIP and 17.6 % controls. Acute toxicity was more in the ATIP, while chronic toxicity was more in the controls. CsA doses were reduced post-biopsy and resulted in improved graft function evaluated by serum creatinine. We conclude that CsA nephrotoxicity evaluated by allograft biopsy resulted in allograft function recovery by decreasing the cyclosporine dose, and the ATIP decreased the incidence of CsA nephrotoxicity.


    Directory of Open Access Journals (Sweden)

    R. Suganya Gnanadeepam


    Full Text Available BACKGROUND The kidney and the skin are the two large networks of the body with abundant blood supply associated with various cutaneous manifestations. This study aims to detect the various cutaneous manifestations and its incidence in patients with chronic renal failure and renal transplantation. MATERIALS AND METHODS This study was done for a period of 1 year from January 2016 to December 2016 at Nephrology OPD ward and Medicine wards, Government KAPV Medical College Hospital, Trichy. During this period, 100 patients who had the presence of skin manifestations were selected and studied (80 renal failure patients and 20 renal transplantation patients. RESULTS Most of the specific cutaneous manifestations of chronic renal failure and renal transplantation were noted in this study. Pruritus and xerosis were the most common manifestations noted in chronic renal failure while infections was commonly noted in renal transplantation patients. CONCLUSION Pruritus and xerosis were the most common among the specific cutaneous manifestations in chronic renal failure followed by nail abnormalities and pigmentary changes. Cutaneous manifestations of renal transplantation were mostly due to infections of which fungal infection is the most common followed by viral infection.

  14. Transarterial embolization for serious renal hemorrhage following renal biopsy. (United States)

    Zeng, Dan; Liu, Guihua; Sun, Xiangzhou; Zhuang, Wenquan; Zhang, Yuanyuan; Guo, Wenbo; Yang, Jianyong; Chen, Wei


    The goal of this study is to evaluate the feasibility and efficacy of percutaneous transarterial embolization for the treatment of serious renal hemorrhage after renal biopsy. Nine patients with renal hemorrhage had frank pain and gross hematuria as main symptoms after renal biopsy. Intrarenal arterial injuries and perinephric hematoma were confirmed by angiography in all cases. The arterial injuries led to two types of renal hemorrhage, Type I: severe renal injure or intrarenal renal artery rupture (n=5), with contrast medium spilling out of the artery and spreading into renal pelvis or kidney capsule in angiography; Type II, pseudo aneurysm or potential risk of intrarenal artery injure (n=4), where contrast medium that spilled out of intraartery was retained in the parenchyma as little spots less than 5 mm in diameter in angiography. Transcatheter superselective intrarenal artery embolization was performed with coils or microcoils (Type I intrarenal artery injure) and polyvinyl alcohol particles (Type II injure). The intrarenal arterial injuries were occluded successfully in all patients. Light or mild back or abdominal pain in the side of the embolized kidney was found in three patients following embolization procedures and disappeared 3 days later. Serum creatinine and perinephric hematoma were stable, and gross hematuresis stopped immediately (n=4) or 3-5 days (n=3) after embolization. In conclusions, transcatheter superselective intrarenal artery embolization as a minimally invasive therapy is safe and effective for treatment of serious renal hemorrhage following percutaneous renal biopsy.

  15. Morphological characteristics of spermatozoa before and after renal transplantation

    Institute of Scientific and Technical Information of China (English)

    Long-Gen Xu; Shi-Fang Shi; Xiao-Ping Qi; Xiao-Feng Huang; Hui-Ming Xu; Qi-Zhe Song; Xing-Hong Wang; Zong-Fu Shao; Jun-Rong Zhang


    Aim: To investigate the changes of the spermatozoa ultrastructures before and after renal transplantation in uremic patients. Methods: The sperm of five uremic patients before and after transplantation and four healthy volunteers were collected and examined by scanning electron microscopy. Results: Abnormal spermatozoa were found in patients pre-transplantation; abnormalities included deletion of the acrosome, absence of the postacrosomal and postnuclear ring, dumbbell-like changes of the head, tail curling, and absence of the mitochondrial sheath in the midsegment. After renal transplantation, most of the spermatozoa became normal. Conclusion: There are many abnormalities with regard to the appearance and structure of the head, acrosome, mitochondria and tail of the spermatozoa in uremic patients. The majority of the spermatozoa returned to normal after renal transplantation, but a few still presented some abnormalities possibly relating to the administration of immunosuppressants.





    Mobile agent technology has been promoted as an emerging technology that makes it much easier to design, implement, and maintain distributed systems, introduction to basic concepts of mobile agents like agent mobility, agent types and places and agent communication. Then benefits of the usage of mobile agents are summarized and illustrated by selected applications. The next section lists requirements and desirable properties for mobile agent languages and systems. We study the main features, ...

  17. Investigation in uro-nephrology (2): renal cortical scintigraphy using {sup 99m}Tc-Dmsa in children; Enquete en uro-nephrologie (2): la scintigraphie renale au 99mTc-DMSA chez l'enfant

    Energy Technology Data Exchange (ETDEWEB)

    Archambaud, F. [Centre Hospitalier Universitaire de Bicetre, 94 - Le Kremlin-Bicetre (France); Olivier, P. [Centre Hospitalier Universitaire Nancy-Brabois, 54 - Vandoeuvre-les-Nancy (France); Guillet, J. [Centre Hospitalier Universitaire, 47 - Agen (France); Wioland, M. [Centre Hospitalier Universitaire Armand Trousseau, 75 - Paris (France); Bonnin, F. [Centre Hospitalier Universitaire Beaujon, 92 - Clichy (France)


    We present the results of a national investigation about the daily practice of renal cortical scintigraphy using {sup 99m}Tc-DMSA in children by comparison with the recommendations of the international consensus from the experts designated by the Scientific Committee of 'Radionuclides in Nephrology'. Questions were related to radiopharmaceutical image acquisition, processing and visualisation, relative renal function determination and indications of renal scan in urinary tract infection. National daily practice are similar to the one suggested by the international consensus about many aspects. However, a controversy exists between the experts in acquiring pinhole or tomographic images. Similarly to the international consensus, {sup 99m}Tc-DMSA renal scan is widely performed for detection of renal sequelae, while its indication in acute pyelonephritis remains to define. (authors)

  18. Horizon Scanning for Pharmaceuticals

    DEFF Research Database (Denmark)

    Lepage-Nefkens, Isabelle; Douw, Karla; Mantjes, GertJan

    will collect country-specific information, liaise between the central HS unit and country-specific clinical and other experts, coordinate the national prioritization process (to select products for early assessment), and communicate the output of the HSS to national decision makers.  The outputs of the joint...... for a joint horizon scanning system (HSS).  We propose to create a central “horizon scanning unit” to perform the joint HS activities (a newly established unit, an existing HS unit, or a third party commissioned and financed by the collaborating countries). The unit will be responsible for the identification...... and filtration of new and emerging pharmaceutical products. It will maintain and update the HS database, organise company pipeline meetings, and disseminate the HSS’s outputs.  The HS unit works closely together with the designated national HS experts in each collaborating country. The national HS experts...

  19. Scanning Quantum Decoherence Microscopy



    The use of qubits as sensitive magnetometers has been studied theoretically and recent demonstrated experimentally. In this paper we propose a generalisation of this concept, where a scanning two-state quantum system is used to probe the subtle effects of decoherence (as well as its surrounding electromagnetic environment). Mapping both the Hamiltonian and decoherence properties of a qubit simultaneously, provides a unique image of the magnetic (or electric) field properties at the nanoscale....

  20. Scanning micro-sclerometer (United States)

    Oliver, Warren C.; Blau, Peter J.


    A scanning micro-sclerometer measures changes in contact stiffness and correlates these changes to characteristics of a scratch. A known force is applied to a contact junction between two bodies and a technique employing an oscillating force is used to generate the contact stiffness between the two bodies. As the two bodies slide relative to each other, the contact stiffness changes. The change is measured to characterize the scratch.

  1. Macroscopic Hydatiduria: An Uncommon Pathognomonic Pres-enta¬tion of Renal Hydatid Disease

    Directory of Open Access Journals (Sweden)



    Full Text Available Isolated renal hydatid disease is a rare endemic infestation caused by larval form of Echinococcus granulosus. Hydatiduria is an uncommon presentation of renal hydatid disease. In 2012 a 34-year-old female referred to Razi Hospital, Rasht, Iran with complaints of right flank pain and grape-like material in urine. Diagnosis was made by ultrasonography and CT scan. The patient was treated surgically with nephrectomy in combination with perioperative chemotherapy with albendazol.  

  2. Scanning ultrafast electron microscopy. (United States)

    Yang, Ding-Shyue; Mohammed, Omar F; Zewail, Ahmed H


    Progress has been made in the development of four-dimensional ultrafast electron microscopy, which enables space-time imaging of structural dynamics in the condensed phase. In ultrafast electron microscopy, the electrons are accelerated, typically to 200 keV, and the microscope operates in the transmission mode. Here, we report the development of scanning ultrafast electron microscopy using a field-emission-source configuration. Scanning of pulses is made in the single-electron mode, for which the pulse contains at most one or a few electrons, thus achieving imaging without the space-charge effect between electrons, and still in ten(s) of seconds. For imaging, the secondary electrons from surface structures are detected, as demonstrated here for material surfaces and biological specimens. By recording backscattered electrons, diffraction patterns from single crystals were also obtained. Scanning pulsed-electron microscopy with the acquired spatiotemporal resolutions, and its efficient heat-dissipation feature, is now poised to provide in situ 4D imaging and with environmental capability.

  3. Scanning ultrafast electron microscopy (United States)

    Yang, Ding-Shyue; Mohammed, Omar F.; Zewail, Ahmed H.


    Progress has been made in the development of four-dimensional ultrafast electron microscopy, which enables space-time imaging of structural dynamics in the condensed phase. In ultrafast electron microscopy, the electrons are accelerated, typically to 200 keV, and the microscope operates in the transmission mode. Here, we report the development of scanning ultrafast electron microscopy using a field-emission-source configuration. Scanning of pulses is made in the single-electron mode, for which the pulse contains at most one or a few electrons, thus achieving imaging without the space-charge effect between electrons, and still in ten(s) of seconds. For imaging, the secondary electrons from surface structures are detected, as demonstrated here for material surfaces and biological specimens. By recording backscattered electrons, diffraction patterns from single crystals were also obtained. Scanning pulsed-electron microscopy with the acquired spatiotemporal resolutions, and its efficient heat-dissipation feature, is now poised to provide in situ 4D imaging and with environmental capability. PMID:20696933

  4. Forensic Scanning Electron Microscope (United States)

    Keeley, R. H.


    The scanning electron microscope equipped with an x-ray spectrometer is a versatile instrument which has many uses in the investigation of crime and preparation of scientific evidence for the courts. Major applications include microscopy and analysis of very small fragments of paint, glass and other materials which may link an individual with a scene of crime, identification of firearms residues and examination of questioned documents. Although simultaneous observation and chemical analysis of the sample is the most important feature of the instrument, other modes of operation such as cathodoluminescence spectrometry, backscattered electron imaging and direct x-ray excitation are also exploited. Marks on two bullets or cartridge cases can be compared directly by sequential scanning with a single beam or electronic linkage of two instruments. Particles of primer residue deposited on the skin and clothing when a gun is fired can be collected on adhesive tape and identified by their morphology and elemental composition. It is also possible to differentiate between the primer residues of different types of ammunition. Bullets may be identified from the small fragments left behind as they pass through the body tissues. In the examination of questioned documents the scanning electron microscope is used to establish the order in which two intersecting ink lines were written and to detect traces of chemical markers added to the security inks on official documents.

  5. Acute renal failure in the intensive care unit. (United States)

    Weisbord, Steven D; Palevsky, Paul M


    Acute renal failure (ARF) is a common complication in critically ill patients, with ARF requiring renal replacement therapy (RRT) developing in approximately 5 to 10% of intensive care unit (ICU) patients. Epidemiological studies have demonstrated that ARF is an independent risk factor for mortality. Interventions to prevent the development of ARF are currently limited to a small number of settings, primarily radiocontrast nephropathy and rhabdomyolysis. There are no effective pharmacological agents for the treatment of established ARF. Renal replacement therapy remains the primary treatment for patients with severe ARF; however, the data guiding selection of modality of RRT and the optimal timing of initiation and dose of therapy are inconclusive. This review focuses on the epidemiology and diagnostic approach to ARF in the ICU and summarizes our current understanding of therapeutic approaches including RRT.

  6. [Renal risks of dietary complements: a forgotten cause]. (United States)

    Dori, Olympia; Humbert, Antoine; Burnier, Michel; Teta, Daniel


    The use of dietary complements like vitamins, minerals, trace elements, proteins, aminoacids and plant-derived agents is prevalent in the general population, in order to promote health and treat diseases. Dietary complements are considered as safe natural products and are easily available without prescription. However, these can lead to severe renal toxicity, especially in cases of unknown pre-existing chronic kidney disease (CKD). In particular, Chinese herbs including aristolochic acid, high doses of vitamine C, creatine and protein complements may lead to acute and chronic renal failure, sometimes irreversible. Dietary complement toxicity should be suspected in any case of unexplained renal impairement. In the case of pre-existing CKD, the use of potentially nephrotoxic dietary complements should be screened for.

  7. Amastigotes forms of Trypanosoma cruzi detected in a renal allograft

    Directory of Open Access Journals (Sweden)

    CARVALHO Maria Fernanda C.


    Full Text Available Trypanosoma cruzi, the causative agent of Chagas?disease assumes two distinct forms in vertebrate hosts: circulating trypomastigote and tissular amastigote. This latter form infects predominantly the myocardium, smooth and skeletal muscle, and central nervous system. The present work describes for the first time the detection of amastigote forms of T. cruzi in the renal parenchyma of a kidney graft recipient one month after transplantation. The patient was serologically negative for Chagas?disease and received no blood transfusion prior to transplant. The cadaver donor was from an endemic area for Chagas?disease. The recipient developed the acute form of the disease with detection of amastigote forms of T. cruzi in the renal allograft biopsy and circulating trypomastigote forms. The present report demonstrates that T. cruzi can infect the renal parenchyma. This mode of transmission warrants in endemic areas of Chagas?disease

  8. Problemas renales de la cirrosis Renal problems of cirrhosis

    Directory of Open Access Journals (Sweden)

    Alvaro García


    Full Text Available Presentamos una revisión actualizada y condensada acerca de los problemas renales más relevantes que ocurren en la cirrosis tales como las alteraciones en el manejo del sodio y del agua, el tratamiento de la ascitis y el edema y el enfoque de la falla renal que ocurre en esta enfermedad, es decir síndrome hepato-renal y necrosis tubular aguda.

    We present a condensed and updated review on the most common renal problems occurring in cirrhosis such as the handling of sodium and water, the treatment of ascites and edema and the approach to the renal failure that frequently takes place in this disease, namely hepato-renal syndrome and acute tubular necrosis.

  9. MR imaging findings of renal infarction induced by renal artery

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jun Woo; Kim, Suck; Kim, Yong Woo; Hu, Jin Sam; Choi, Sang Yoel; Moon, Tae Yong; Lee, Suck Hong; Kim, Byung Su; Lee, Chang Hun [Pusan National Univ., Pusan (Korea, Repulic of). Coll. of Medicine


    To assess the usefulness of diffusion-weighted imaging (DWI) in evaluating serial parenchymal changes in renal infarction induced by renal artery ligation, by comparing this with the conventional spin echo technique and correlating the results with the histopathological findings. In 22 rabbits, renal infarction was induced by ligation of the renal artery. Spin-echo T1-weighted imaging (T1WI), turbo spin-echo (TSE) T2-weighted imaging (T2WI), and DWI were performed, using a 1.5-T superconductive unit, at 30 minutes, 1 hour, 2,3,6, 12 and 24 hours, and 2, 3, 7 and 20 days after left renal artery ligation. Changes in signal intensity on T1WI, T2WI, and DWI were correlated with histopathologic findings. Diffusion-weighted imaging is useful for the detection of hyperacute renal infarction, and the apparent diffusion coefficient may provide additional information concerning its evolution. (author). 21 refs., 9 figs.

  10. Bioprotective agents in safety control

    Directory of Open Access Journals (Sweden)

    Dimitrijević-Branković Suzana I.


    Full Text Available Food poisoning is the one of the main health hazards even today. More than 200 known diseases are transmitted through food. The causes of foodborne illness include viruses, bacteria, parasites, toxins, metals, and prions and the symptoms of foodborne illness range from mild gastroenteritis to life-threatening neurological, hepatic and renal syndromes.The prevention of food poisonings represents very serious task for food manufacturers. Beside food control according to the concept "from the farm to the table" there is increased need for the development of new technology for longer shelf lifes of food. Food fermented by lactic acid bacteria (LAB and traditionally considered to be safe. There are many substances produced by LAB that affect the shelf life of fermented food, by active suppression of poisoning microorganisms growth. Because of that, the LAB is recently considered as bioprotective agents that have important role in food safety.

  11. Automatic classification of DMSA scans using an artificial neural network (United States)

    Wright, J. W.; Duguid, R.; Mckiddie, F.; Staff, R. T.


    DMSA imaging is carried out in nuclear medicine to assess the level of functional renal tissue in patients. This study investigated the use of an artificial neural network to perform diagnostic classification of these scans. Using the radiological report as the gold standard, the network was trained to classify DMSA scans as positive or negative for defects using a representative sample of 257 previously reported images. The trained network was then independently tested using a further 193 scans and achieved a binary classification accuracy of 95.9%. The performance of the network was compared with three qualified expert observers who were asked to grade each scan in the 193 image testing set on a six point defect scale, from ‘definitely normal’ to ‘definitely abnormal’. A receiver operating characteristic analysis comparison between a consensus operator, generated from the scores of the three expert observers, and the network revealed a statistically significant increase (α network and operators. A further result from this work was that when suitably optimized, a negative predictive value of 100% for renal defects was achieved by the network, while still managing to identify 93% of the negative cases in the dataset. These results are encouraging for application of such a network as a screening tool or quality assurance assistant in clinical practice.

  12. Prognostic value of the acute DMSA scan in hospitalized children with urinary tract infection

    Directory of Open Access Journals (Sweden)

    Hashemian H


    Full Text Available "nBackground: Urinary Tract Infection (UTI is one of the major etiological factors of permanent kidney impairment, resulting in renal scarring and severe and pernicious side effects, such as arterial hypertension and renal failure. The purpose of this study was to clarify the impression of renal parenchyma involvement by first UTI (on the basis of acute DMSA scan and vesicoureteral reflux (VUR-on the basis of VCUG/ RNC on the renal scar formation (on the basis of late DMSA scan. "nMethods: Children diagnosed with their first UTI at the Children's Hospital Medical Center, Tehran, Iran, were evaluated. For each patient, we recorded age, sex, results of VCUG/RNCs and acute DMSA scan, as well as those of a late DMSA scan performed 4-6 months later. The results of acute and late DMSA scans were compared along with the results of VCUG/RNCs. "nResults: This study included a total of 103 children, of whom 16 (15.5% were boys and 87 (84.5% were girls. The mean age was 27.2±27.7 months. The frequency of renal scars in kidneys with mild (28.6%, 8.7% and moderate (33.3%, 18.2% pyelonephritis with or without VUR was not significantly different, while the frequency of renal scars in kidneys with severe pyelonephritis (84.6%, 23.1% in the presence of VUR was significantly higher than non-refluxing kidneys with severe pyelonephritis (p=0.005. Furthermore, the frequency of renal scars in refluxing kidneys increased significantly with the severity of pyelonephritis (normal 8.3%, mild 28.6%, moderate 33.3%, and severe 84.6%; p=0.001. This pattern was not significant in non-refluxing kidneys (0%, 10.3%, 18.2%, and 23.1%, respectively; p=0.062. "nConclusion: The present study indicates that the incidence of renal scarring increases with pyelonephritis severity in patients with VUR. Furthermore, we can estimate the risk of renal scar formation from the results of acute DMSA scan and VCUG/RNC.

  13. Renal abscess after the Fontan procedure: a case report

    Directory of Open Access Journals (Sweden)

    Kumar Suresh


    Full Text Available Abstract Introduction The Fontan procedure is an intervention that helps to correct single ventricle physiology. There are many known long-term complications of 'Fontan physiology'. However, the occurrence of renal abscess in such patients has not yet been reported in the literature. The first generation of adults has now undergone the procedure and it is necessary to be aware of the long-term outcomes and complications associated with it. Case presentation We report the case of a 22-year-old South Indian man who had developed a staphylococcal renal abscess against a background of xanthogranulomatous pyelonephritis, nine years after Fontan surgery. He presented to our hospital with a high-grade fever of 25-days duration but with no other symptoms. Physical examination identified costovertebral angle tenderness and pedal edema. An ultrasound scan revealed a mass in his left kidney. The results of a computed tomography scan were consistent with a renal abscess. Despite treatment with the appropriate parenteral antibiotics, there was no change in the size of the abscess and a left nephrectomy was performed as a curative procedure. Conclusions The learning points here are manifold. It is important to be aware of the possibility of renal abscess in a post-procedural patient. The early diagnosis of a septic focus in the kidneymay help to prevent the rare outcome of nephrectomy.

  14. Incidental finding of malignant renal cystic tumour diagnosed sonographically

    Directory of Open Access Journals (Sweden)

    Stojanović Milan


    Full Text Available Introduction Malignant cystic renal tumor is a rare variant of renal malignancy. Cystic neoplasm results from haemorrhage, necrosis and colliquation of a solid tumour or tumour occurring within the wall of a cyst. That pathoanatomic substratum reflects characteristic sonographic features indicating its malignant nature. It is important to distinguish a simple cyst (not requiring surgery from intracystic malignant lesion because it requires surgery. Case Outline The authors present a 59-year-old woman with a sonographic finding of a simple cyst in the upper pole of the right kidney revealed during gynaecological ultrasonography. Immediately afterwards, the radiologist performed renal sonography and its finding was a cystic lesion suggestive of malignancy. Further evaluation by CT scan showed that the lesion was clearly malignant. After surgery, the histological finding verified cystic renal cancer. Conclusion Ultrasonography may reveal a complex cyst and solid mass but requires an experienced sonographer. Contrast CT scan would be performed to examine the "suspicious" lesion because it clearly shows if a cystic lesion is benign or malignant. .

  15. Peptostreptococcus asaccharolyticus renal abscess: a rare cause of fever of unknown origin. (United States)

    Casullo, V A; Bottone, E; Herold, B C


    Renal abscess is uncommon in pediatrics and is rarely a cause of fever of unknown origin. We recently cared for a patient who presented with a 3-week history of fever. An indium scan ultimately led to the diagnosis of a renal abscess. Aspiration yielded Peptostreptococcus asaccharolyticus. This unusual case prompted a review of the clinical and microbiologic features of renal abscess in pediatric patients at our hospital over the past 10 years. Seven additional patients with a discharge diagnosis of renal abscess were identified. Only 2 of the patients had identifiable risk factors (diabetes mellitus and polycystic kidneys). Staphylococcus aureus or Enterobacteriaceae were responsible for most infections, consistent with hematogenous and urinary tract sources, respectively. No other cases of anaerobic abscess were identified. This case highlights the importance of considering a renal abscess in the differential diagnosis of fever of unknown origin and of processing specimens for both aerobic and anaerobic organisms.

  16. Left adrenal tumor extending into the renal vein: surgical management with ipsilateral kidney preservation. (United States)

    Doerfler, Arnaud; Vaudreuil, Lionel; Le Gal, Sophie; Lebreton, Gil; Tillou, Xavier


    If single adrenal metastasis surgery is well admitted, no recommendation exists about the management of a renal vein tumor thrombus, even though the actual consensual attitude consists in a nephrectomy associated to an adrenalectomy. We report, here, the case of a 74-year-old man with a suspected adrenal metastasis of a lung carcinoma associated with a left adrenal and renal vein tumor thrombus treated by adrenalectomy and renal vein thrombectomy and ipsilateral kidney sparing. The postoperative computed tomography scan showed no thrombus in the left renal vein. Doppler ultrasound performed 1 month after adrenalectomy proved a good left renal vein flux. At 36 months of follow-up, the patient is alive without signs of recurrence. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author 2015.

  17. Renal subcapsular haematoma: an unusual complication of renal artery stenting

    Institute of Scientific and Technical Information of China (English)

    XIA Dan; CHEN Shan-wen; ZHANG Hong-kun; WANG Shuo


    After successful renal artery angioplasty and stent placement, a patient in a fully anticoagulated state developed hypotension and flank pain. Computed tomography (CT) of the abdomen revealed a large renal subcapsular haematoma which was successfully managed conservatively without embolotherapy and surgical intervention. To prevent hemorrhage after renal artery stenting, it is necessary to underscore the importance of reducing the contrast volume and pressure of angiography, controlling systemic blood pressure, and monitoring guide wire position at all times.

  18. Towards Culturally-Aware Virtual Agent Systems

    DEFF Research Database (Denmark)

    Endrass, Birgit; André, Elisabeth; Rehm, Matthias


    of different systems using virtual agents need to be considered. Therefore, the authors reflect in this chapter on how virtual agents can help to learn about culture, scan definitions of culture from the social sciences, give an overview on how multiagent systems developed over time and classify the state...... of the art that integrates culture in multiagent systems. In addition, an approach of simulating culture-specific behavior using such a multiagent system is introduced and future trends in enculturating virtual agent systems are outlined....

  19. Dopamins renale virkninger

    DEFF Research Database (Denmark)

    Olsen, Niels Vidiendal


    Dopamine is an endogenic catecholamine which, in addition to being the direct precursor of noradrenaline, has also an effect on peripheral dopaminergic receptors. These are localized mainly in the heart, splanchnic nerves and the kidneys. Dopamine is produced in the kidneys and the renal metaboli...... dialysis unnecessary in a number of patients on account of increased diuresis and natriuresis. The effect of GFR and the significance for the prognosis are not known....

  20. Renal lithiasis and nutrition


    Prieto Rafel M; Costa-Bauza Antonia; Grases Felix


    Abstract Renal lithiasis is a multifactorial disease. An important number of etiologic factors can be adequately modified trough diet, since it must be considered that the urine composition is directly related to diet. In fact, the change of inappropriate habitual diet patterns should be the main measure to prevent kidney stones. In this paper, the relation between different dietary factors (liquid intake, pH, calcium, phosphate, oxalate, citrate, phytate, urate and vitamins) and each type of...