WorldWideScience

Sample records for vertebrate primary ureter

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

    DEFF Research Database (Denmark)

    Haugan, Birgitte M; Halberg, Kenneth Agerlin; Jespersen, Åse

    2010-01-01

    Background Three kidney systems appear during vertebrate development: the pronephroi, mesonephroi and metanephroi. The pronephric duct is the first or primary ureter of these kidney systems. Its role as a key player in the induction of nephrogenic mesenchyme is well established. Here we investiga...

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

    Directory of Open Access Journals (Sweden)

    Prehn Lea R

    2010-05-01

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

  3. Ion transport by the amphibian primary ureter

    DEFF Research Database (Denmark)

    Møbjerg, Nadja

    2008-01-01

    and it is furthermore a key player in the induction of these kidney generations. Whether the ureter participates in urine modification, remains to be elucidated. In amphibians the pronephros is a large organ, which is functional for a considerable time before it degenerates. The aim of this study was to investigate...... putative ion transport mechanisms in the primary ureter of the freshwater amphibian Ambystoma mexicanum (axolotl). Primary ureters isolated from axolotl larvae were perfused in vitro and single cells were impaled across the basal cell membrane with glass microelectrodes. In 42 cells the membrane potential...

  4. Primary Leiomyosarcoma of the Ureter

    Directory of Open Access Journals (Sweden)

    Chen Lv

    2008-10-01

    Full Text Available Leiomyosarcoma is a rarely seen neoplasm of the ureter, with less than 20 cases being reported in the literature to date. It is important to distinguish leiomyosarcoma from rhabdomyosarcoma, with the aid of immunohistochemical markers. We report the clinical features, histology, imaging and treatment of ureteral leiomyosarcoma in a female patient.

  5. Primary Papillary Mucinous Adenocarcinoma of the Ureter Mimicking Genitourinary Tuberculosis

    Directory of Open Access Journals (Sweden)

    Hanni Gulwani

    2010-01-01

    Full Text Available Primary adenocarcinomas of the renal pelvis and ureter are rare and account for less than 1% of all malignancies at this site. We report a case of primary papillary mucinous adenocarcinoma of the ureter that clinically mimicked genitourinary tuberculosis. Early diagnosis is important for the better outcome.

  6. Primary leiomyoma of ureter coexisting with renal cell carcinoma: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Seung Hwan; Kim, Hee Jin; Han, Hyun Young [Dept. of Radiology, Eulji University Hospital, Daejeon (Korea, Republic of)

    2014-12-15

    Mesenchymal origin of ureter tumors account for less than 3 percent of all primary ureteral tumors. Among mesenchymal tumors, primary leiomyoma of ureter is extremely rare. Here, we present a case of primary leiomyoma of ureter coexisting with renal cell carcinoma. When encountering well-defined homogeneously enhanced mass of ureter on computed tomography, radiologist should keep in mind that ureteral leiomyoma should be considered as differential diagnosis.

  7. [A case of primary leiomyosarcoma of the ureter].

    Science.gov (United States)

    Shirotake, Suguru; Sumitomo, Makoto; Asakuma, Jyunichi; Asano, Tomohiko; Aiko, Satoshi; Hayakawa, Masamichi

    2006-01-01

    A 60-year-old woman was admitted to our hospital with pain in the left flank. Retrograde pyelography, computed tomographic scan, and magnetic resonance imaging demonstrated left hydronephrosis due to a 7 cm retroperitoneal mass involving the left ureter. Left nephroureterectomy and partial resection of the mesentery revealed a primary ureteral leiomyosarcoma. Three months postoperatively, the patient received systemic chemotherapy (CYVADIC; cyclophosphamide, vincristine, adriamycin and DTIC) for a recurrent tumor. Two courses of chemotherapy reduced the tumor by nearly 60%. Then we performed surgery in an attempt to resect the residual disease. However, the tumor continued to progress and the patient died approximately one year after diagnosis.

  8. Primary congenital bladder diverticula: Where does the ureter drain?

    Directory of Open Access Journals (Sweden)

    Antonio Macedo

    2015-01-01

    Full Text Available Background: Primary congenital bladder diverticulum (PCBD is related to a deficient detrusor layer allowing out-pouching of the bladder mucosa through the inadequate muscularis wall. We aimed to review our experience with symptomatic PCBD in order to correlate clinical findings with anatomical aspects and to present late outcome. Materials and Methods: We reviewed all patients operated in our institution since 2004. We evaluated the charts for complaints, radiological exams, method of treatment, complications and length of follow-up. Results: We treated 10 cases (11 renal units - [RU], predominantly males (9/10, mean age at surgery of 5.3 years. All patients had significant urological complaints presenting either with antenatal hydronephrosis (4 or febrile urinary tract infection (5 and urinary retention in one. The ureter was found implanted inside the diverticulum in 8/11 RU. An extravesical psoas-hitch ureteroneocystostomy and diverticulum resection was performed in 10/11 cases, whereas 1 case was treated intravesically based on surgeon′s preference without performing cystoscopy. Mean follow-up was 34.1 months (1-120 without complications. Conclusions: PCBD is an uncommon diagnosis and has a high probability of drainage inside the diverticulum (72.7%. We recommend the extravesical approach associated with diverticulectomy and ureteroneocystostomy as the preferred technique to treat this abnormality.

  9. Primary mesenchymal chondrosarcoma of the kidney with synchronous implant and infiltrating urothelial carcinoma of the ureter

    Directory of Open Access Journals (Sweden)

    Xu Hua

    2012-09-01

    Full Text Available Abstract Primary mesenchymal chondrosarcoma of the kidney is rare, and it shows distinct undifferentiated tumor cells and well differentiated cartilagenous components. Also assident infiltrating urothelial carcinoma of the ureter is an extremely rare cancer. We report a case of primary mesenchymal chondrosarcoma occurring in the left kidney with an ipsilateral and distinct distal ureteric implant, and a coexisting infiltrating urothelial carcinoma of the ureter in a 64-year-old man. Histopathological examination and immunohistochemical studuies showed the classic features of mesenchymal chondrosarcoma in kidney, as well as a few infiltrating urothelial in ureter. Multitarget fluorescence in situ hybridization (FISH suggested that the development of the urothelial carcinoma in the ureter may be triggered or induced by the chondrosarcoma component. The patient died 2 month after left nephro-ureterectomy. This is the first reported case of a primary mesenchymal chondrosarcoma of the kidney with coexisting infiltrating urothelial carcinoma of the ureter. Virtual Slides The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1522835667751019

  10. Primary mesenchymal chondrosarcoma of the kidney with synchronous implant and infiltrating urothelial carcinoma of the ureter.

    Science.gov (United States)

    Xu, Hua; Shao, MuMin; Sun, HuiLi; Li, ShunMin

    2012-09-21

    Primary mesenchymal chondrosarcoma of the kidney is rare, and it shows distinct undifferentiated tumor cells and well differentiated cartilagenous components. Also assident infiltrating urothelial carcinoma of the ureter is an extremely rare cancer. We report a case of primary mesenchymal chondrosarcoma occurring in the left kidney with an ipsilateral and distinct distal ureteric implant, and a coexisting infiltrating urothelial carcinoma of the ureter in a 64-year-old man. Histopathological examination and immunohistochemical studuies showed the classic features of mesenchymal chondrosarcoma in kidney, as well as a few infiltrating urothelial in ureter. Multitarget fluorescence in situ hybridization (FISH) suggested that the development of the urothelial carcinoma in the ureter may be triggered or induced by the chondrosarcoma component. The patient died 2 month after left nephro-ureterectomy. This is the first reported case of a primary mesenchymal chondrosarcoma of the kidney with coexisting infiltrating urothelial carcinoma of the ureter. The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1522835667751019.

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

    Science.gov (United States)

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

    2014-03-01

    Primary epithelial tumor of the renal pelvis is rare and only 100 cases are reported in the literature [1]. Histological examination of the tumor showed glands, cysts, and papillae lined by pseudostratified columnar epithelium with hyperchromatic nuclei. Scattered signet ring-type cells were also seen floating in large pools of extracellular mucin. Sections from the ureter showed a component of adenocarcinoma in situ. No invasive tumor was identified in ureteric tissue. One case was reported with carcinoma in situ of the ureter (2). Immunohistochemically: The tumor showed positivity for CK7, CK20, CK8/18, GATA-3, MSH-2, MSH-6, MLH-1, Ber-EP4, and S-100-P with focal positivity for CDX-2, weak positivity for PMS-2 and negativity in TTF-1 and Her-2. Molecular pathological analysis revealed microsatellite stability and without mutation in K-ras-gene. Thus, a diagnosis of mucinous adenocarcinoma of the renal pelvis with in situ adenocarcinoma of the ureter was made. Copyright © 2014. Production and hosting by Elsevier B.V.

  12. Primary bone lymphoma with multiple vertebral involvement

    Directory of Open Access Journals (Sweden)

    Showkat Hussain Dar

    2013-01-01

    Full Text Available A 20-year-old student presented with 2 months history of fever and night sweats, 15 days history of low backache, progressive weakness of both limbs of 7 days duration, and urinary retention for last 24 h. Examination revealed a sensory level at D 10 dermatome and grade two power in both the lower limbs with absent reflexes. Examination of spine revealed a knuckle at T8 level, which was tender on palpation. MRI spine showed erosion of D11-12 and L1 in vertebral bodies with destruction of left pedicles, transverse processes and lamina, and a prominent psoas abscess. Post gadolinium study revealed ring-enhancing lesions in the D11-12 and L1 vertebrae as well as the dural sac. Fine needle aspiration cytology (FNAC and bone biopsy demonstrated a non-Hodgkin′s lymphoma (NHL, large cell high-grade of the spine (primary, which as per age is the youngest case of NHL ever reported in literature with multiple vertebral involvement.

  13. Primary Mucinous Adenocarcinoma of a Seminal Vesicle Cyst Associated with Ectopic Ureter and Ipsilateral Renal Agenesis: a Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Byung Hoon; Seo, Jung Wook; Han, Yoon Hee; Kim, Yong Hoon; Cha, Soon Joo [Inje University School of Medicine, Ilsan (Korea, Republic of)

    2007-06-15

    We report here on a case of primary mucinous adenocarcinoma arising from a seminal vesicle cyst that was associated with an ectopic ureter opening and ipsilateral renal agenesis, which is a very rare condition indeed. The lesion was depicted on transrectal ultrasonography, contrast enhanced CT and MRI as a papillary solid mass originating from the wall of the left seminal vesicle cyst.

  14. Circumcaval ureter.

    Directory of Open Access Journals (Sweden)

    Pandya J

    1998-01-01

    Full Text Available We report a case of circumcaval ureter diagnosed preoperatively by ′fish-hook′ appearance on intravenous pyelogram. At surgery, patient was treated by ′Anderson Hones′ pyeloplasty leaving the retrocaval segment in-situ.

  15. Primary Ewing's sarcoma of the vertebral column

    Energy Technology Data Exchange (ETDEWEB)

    Ilaslan, Hakan; Sundaram, Murali [Department of Radiology, Mayo Clinic, Ch2-290 200 First Street, SW, Rochester, 55905, MN (United States); Unni, K.Krishnan [Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street, SW, 55905, Rochester, MN (United States); Dekutoski, Mark B. [Department of Orthopedic Surgery, Mayo Clinic, 200 First Street, SW, 55905, Rochester, MN (United States)

    2004-09-01

    To determine the demographics, imaging findings, clinical symptoms, and prognosis of primary vertebral Ewing's sarcoma (PVES). A retrospective review of medical records and radiological studies of patients diagnosed with PVES from 1936 through 2001 in our institution and Department of Pathology consultation files was undertaken. Metastatic and soft tissue Ewing's sarcoma cases were excluded. From a total of 1,277 cases of Ewing's sarcoma, 125 (9.8%) had a primary vertebral origin. There were 48 females and 76 males. Patient ages ranged from 4 to 54 (mean 19.3, standard deviation 10.7, median 16) years. Vertebral column distribution was four cervical (3.2%), 13 thoracic (10.5%), 31 lumbar (25%), and 67 sacrum (53.2%). More than one vertebral segment was involved in ten cases (8%). Satisfactory imaging studies were available in 51 patients: 49 radiographs, 27 computerized tomography (CT), and 23 magnetic resonance imaging (MRI) studies. The majority of tumors were lytic (93%). Three cases were mixed lytic and sclerotic (6%) and one sclerotic. In the nonsacral spine, the majority of lesions (12/20) involved the posterior elements with extension into the vertebral body. Five cases were centered in the vertebral body with extension into the posterior elements. Two cases were limited to the posterior elements, and one case solely involved the vertebral body. Ala was the most frequently affected site in the sacrum (18/26). Spinal canal invasion was frequent (91%). Detailed clinical information was available in 53 patients. Duration of symptoms ranged from 1 to 30 (mean 7) months. Local pain was the first symptom and seen in all cases. Neurological deficits were present in 21 (40%) cases. All patients received radiation in various dosages; 70% additionally received chemotherapy. Twenty-five patients had surgery, and two patients received bone marrow transplantation. Forty-five patients had follow-up; the five-year disease-free survival probability is 0

  16. Cancer - renal pelvis or ureter

    Science.gov (United States)

    ... Kidney cancer - renal pelvis; Ureter cancer Images Kidney anatomy References National Cancer Institute. PDQ transitional cell cancer of the renal pelvis and ureter treatment. Bethesda, MD: National Cancer ...

  17. Treatment Challenges of a Primary Vertebral Artery Aneurysm Causing Recurrent Ischemic Strokes

    Directory of Open Access Journals (Sweden)

    Davide Strambo

    2017-01-01

    Full Text Available Background. Extracranial vertebral artery aneurysms are a rare cause of embolic stroke; surgical and endovascular therapy options are debated and long-term complication may occur. Case Report. A 53-year-old man affected by neurofibromatosis type 1 (NF1 came to our attention for recurrent vertebrobasilar embolic strokes, caused by a primary giant, partially thrombosed, fusiform aneurysm of the left extracranial vertebral artery. The aneurysm was treated by endovascular approach through deposition of Guglielmi Detachable Coils in the proximal segment of the left vertebral artery. Six years later the patient presented stroke recurrence. Cerebral angiography and Color Doppler Ultrasound well characterized the unique hemodynamic condition developed over the years responsible for the new embolic event: the aneurysm had been revascularized from its distal portion by reverse blood flow coming from the patent vertebrobasilar axis. A biphasic Doppler signal in the left vertebral artery revealed a peculiar behavior of the blood flow, alternately directed to the aneurysm and backwards to the basilar artery. Surgical ligation of the distal left vertebral artery and excision of the aneurysm were thus performed. Conclusion. This is the first described case of NF1-associated extracranial vertebral artery aneurysm presenting with recurrent embolic stroke. Complete exclusion of the aneurysm from the blood circulation is advisable to achieve full resolution of the embolic source.

  18. Motility of ureter

    Energy Technology Data Exchange (ETDEWEB)

    Schroth, H.J.; Steinstraesser, A.; Berberich, R.; Kloss, G.

    1985-01-01

    Motility of ureter. Changes of secretion-phase during sequential scintigraphy of the kidneys under the influence of Metamizol - a parameter to study the effect of Metamizol: The aim of the study is to get quantitative information about the effect of Metamizol (Novalgin) on the motility of the ureter. We compared the renal excretion of 99m-Tc-MDP (Tecebon) and the extent of flowing off towards gravity through the ureter with and without Metamizol. The effect of Metamizol is shown in comparing the final amplitudes of nephrograms recorded during sequential scintigraphy of the kidneys and comparing the integrals of these curves before and after injection of Metamizol. It can be demonstrated that the flow off towards gravity through the ureter is significantly diminished under Metamizol caused by its spasmolytic effect.

  19. Retrocaval ureter: a case report; Ureter retrocava: relato de caso

    Energy Technology Data Exchange (ETDEWEB)

    Machado, Marcio Martins; Rosa, Ana Claudia Ferreira; Lemes, Marcella Stival [Universidade Federal de Goias (UFG), Goiania, GO (Brazil). Faculdade de Medicina] (and others). E-mail: marciommachado@ibest.com.br

    2006-10-15

    The authors report a case of a patient with Retrocaval ureter found out in an excretory urography and confirmed with abdominal computerized tomography. The computerized tomography is necessary to confirm the position of the ureter and to exclude other diseases which are associated with hydronefrosis, the main imaging finding, when there is a symptomatic retrocaval ureter. (author)

  20. Radiological evaluation of retrocaval ureter

    Energy Technology Data Exchange (ETDEWEB)

    Imai, Yutaka; Sone, Shusuke; Watanabe, Toshikazu; Okazaki, Yoichi; Yamashita, Kunihiko; Yamaguchi, Kenji; Oguchi, Masahiko; Wako, Tadashi.

    1988-06-01

    Radiological findings of three cases with retrocaval ureter are reviewed. CT images provide a precise anatomical interrelations between the right ureter and the vena cava or psoas muscle. CT scans performed following intravenous pyelography add a confirmative information to make a diagnosis of retrocaval ureter.

  1. Nontraumatic Multiple Vertebral Compression Fractures Induced by Primary Hyperparathyroidism: A Case Report and Literature Review.

    Science.gov (United States)

    Choi, Man Kyu; Kim, Sung Min

    2017-12-01

    Primary hyperparathyroidism (PHPT) is one of the causes of osteoporosis and is known to increase the fracture risk of bone. However, multiple vertebral compression fracture because of PHPT is extremely rare. A case of acute multiple vertebral compression fracture in a patient with PHPT is described. The fracture occurred suddenly without trauma. The patient had a low T score (-4.4), and serum hypercalcemia and phosphatemia were evident. On examination, serum parathyroid hormone was found to be elevated, and PHPT was diagnosed by neck sonography and technetium-99m methoxyisobutylisonitrile scan. Once the patient was diagnosed with PHPT, we performed subtotal parathyroidectomy and corrective spinal surgery for multiple compression fractures. When a patient has multiple compression fractures without any trauma history and a very low T score, the presence of other underlying diseases should be investigated. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Ureter growth and differentiation.

    Science.gov (United States)

    Bohnenpoll, Tobias; Kispert, Andreas

    2014-12-01

    The mammalian ureter is a slender tube that connects the renal pelvis with the bladder. It allows the unidirectional movement of urine by means of a peristaltically active smooth muscle layer that together with fibroelastic material ensheathes a water-impermeable multilayered urothelium. The ureteric urothelium as well as the outer mesenchymal coat arise from undifferentiated precursor tissues, the distal ureteric bud and its surrounding mesenchyme, respectively. Specification, growth and differentiation of these ureteric precursor tissues are tightly linked to each other, and are highly integrated with those of the adjacent rudiments of kidney and bladder. Here, we review the current knowledge on the cellular mechanisms as well as the molecular players that guide development of the tissue architecture of the ureter and its peristalsis. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. [Primary sleep in vertebrates and its role in the genesis of hypobiosis in poikilotherms and hibernation in mammals].

    Science.gov (United States)

    Karmanova, I G

    1984-01-01

    New data are presented on the homology between winter hibernation and hypobiosis in poikilotherms, as well as one of the resting forms of the primary sleep in vertebrates. Different stages of formation of a cycle "awakefulness-sleep" in evolution of vertebrates are discussed. On the basis of universal behavioural, somato-vegetative, neurophysiological, neurochemical correlates of resting forms, hypobiosis and winter hibernation, a discussion is made of the problem of genetic fixation in the genotype and phenotype of heterothermic mammals (hibernating ones) of those characters which are typical of the sleep in homoiothermic and poikilothermic vertebrates.

  4. Congenital malformations of the ureter: anatomical studies.

    Science.gov (United States)

    Dorko, František; Tokarčík, Ján; Výborná, Eva

    2016-06-01

    The ureter is a derivate of the Wolffian mesonephric duct and undergoes complex changes during development. The most common developmental anomaly is complete duplication of the ureter. Duplication of the ureter may be complete or incomplete. Incomplete duplication of ureter is well known as bifid ureter. Presence of various anomalies of the ureter is associated with increased risk of urinary tract infections and many other clinical complications.

  5. RETROCAVAL URETER: TWO CASE REPORTS

    African Journals Online (AJOL)

    2011-12-01

    Dec 1, 2011 ... SUMMARY. Retrocaval ureter also referred to as pre-ureteral vena cava is a rare congenital anomaly with the ureter pass- ing posterior to the inferior vena cava. Though it is a congenital anomaly, patients do not normally present with symptoms until the 3rd and 4th decades of life from a resulting ...

  6. Primary vertebral and spinal epidural non-Hodgkin`s lymphoma with spinal cord compression

    Energy Technology Data Exchange (ETDEWEB)

    Boukobza, M. [Department of Neuroradiology, Hopital La Pitie, F-75012 Paris (France); Mazel, C. [Department of Orthopaedic Surgery and Traumatology, Hopital La Pitie, F-75012 Paris (France); Touboul, E. [Department of Cancerology and Radiotherapy B, Hopital Tenon, F-75020 Paris (France)

    1996-05-01

    We examined eight patients with primary spinal epidural non-Hodgkin`s lymphoma presenting with spinal cord compression and proven histologically after laminectomy (7 cases) or biopsy (1 case) by MRI. The most common findings were an isointense or low signal relative to the spinal cord on T1-weighted images (T1WI) and high signal on T2-weighted images (T2WI). Spinal cord compression, vertebral bone marrow and paravertebral extension were assessed. Contrast enhancement was intense in seven of the eight cases and homogeneous in all of them. T2WI (performed in 2 cases) may be useful to distinguish metastatic carcinomas and sarcomas. T1WI demonstrated the full extent of the epidural lesion, which was well-delineated in all cases. When the paravertebral extension is not well-defined, a study with contrast medium should be performed. (orig.). With 3 figs., 1 tab.

  7. Duplication of the ureter with extravesical termination

    Energy Technology Data Exchange (ETDEWEB)

    Steidle, B.; Wolf, K.J.

    1984-02-01

    The renal segment supplying an ectopic ureter is nearly always dysplastic. Usually the ureters cross and the ectopic ureter terminates caudally in relation to the ureter from the normal portion of the kidney. Extravesical termination in women leads to urinary incontinence, since it frequently ends in the vagina or the labia. In men, the effects are much less noticeable. The ureters usually terminate in the urethra, the seminal vesicles, the ductus deferens or the epididymis. Duplication of a ureter or mega-ureter with dysplasia of the appropriate part of the kidney can be readily explained embryologically.

  8. Comprehensive data analysis of human ureter proteome

    OpenAIRE

    Magdeldin, Sameh; Hirao, Yoshitoshi; El Guoshy, Amr; Xu, Bo; Zhang, Ying; Fujinaka, Hidehiko; Yamamoto, Keiko; Yates, John R.; Yamamoto, Tadashi

    2016-01-01

    Comprehensive human ureter proteome dataset was generated from OFFGel fractionated ureter samples. Our result showed that among 2217 non-redundant ureter proteins, 751 protein candidates (33.8%) were detected in urine as urinary protein/polypeptide or exosomal protein. On the other hand, comparing ureter protein hits (48) that are not shown in corresponding databases to urinary bladder and prostate human protein atlas databases pinpointed 21 proteins that might be unique to ureter tissue. In ...

  9. Lateral Transpsoas Approach to the Lumbar Spine and Relationship of the Ureter: Anatomic Study with Application to Minimizing Complications.

    Science.gov (United States)

    Voin, Vlad; Kirkpatrick, Christina; Alonso, Fernando; Rustagi, Tarush; Sanders, Filipe H; Drazin, Doniel; Oskouian, Rod J; Tubbs, R Shane

    2017-08-01

    Complications from lateral lumbar interbody fusion procedures range from neurologic deficits to organ and blood vessel injuries. Injury to the ureter has been reported though uncommon. The present study was performed to elucidate the anatomic relationship of the ureter to this surgical approach. Eight adult cadavers (16 sides) were placed in the full lateral position, and the distal ureter was cannulated with a metal wire that was passed up to the kidney. Fluoroscopy was used to establish the position of the ureter in relation to the bony anatomy in this region. In the lumbar region, there was a posterior to anterior course of the left and right ureter. From the direct lateral position, the ureter was found to lie at or posterior to the anterior edge of the lumbar vertebral bodies. On 87.5% of sides, the ureter was on average 2.5 cm posterior to the anterior border of the vertebral bodies at L2, 3 cm posterior at L3, 1.0 cm posterior at L4, and on the margin of the anterior vertebral bodies at L5. In general, the ureter, from a lateral perspective, crossed the posterior third of the upper lumbar vertebrae, approached the middle third at L3, and reached the anterior third at L4/L5 before descending into the pelvis. Owing to the proximity of the ureter to the lumbar vertebral bodies, it is imperative to verify that this structure is not in the surgical trajectory during lateral lumbar interbody fusion procedures if injury is to be avoided. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Comprehensive data analysis of human ureter proteome

    Directory of Open Access Journals (Sweden)

    Sameh Magdeldin

    2016-03-01

    Full Text Available Comprehensive human ureter proteome dataset was generated from OFFGel fractionated ureter samples. Our result showed that among 2217 non-redundant ureter proteins, 751 protein candidates (33.8% were detected in urine as urinary protein/polypeptide or exosomal protein. On the other hand, comparing ureter protein hits (48 that are not shown in corresponding databases to urinary bladder and prostate human protein atlas databases pinpointed 21 proteins that might be unique to ureter tissue. In conclusion, this finding offers future perspectives for possible identification of ureter disease-associated biomarkers such as ureter carcinoma. In addition, Cytoscape GO annotation was examined on the final ureter dataset to better understand proteins molecular function, biological processes, and cellular component. The ureter proteomic dataset published in this article will provide a valuable resource for researchers working in the field of urology and urine biomarker discovery.

  11. Thoracic Temporal Subtraction Three Dimensional Computed Tomography (3D-CT: Screening for Vertebral Metastases of Primary Lung Cancers.

    Directory of Open Access Journals (Sweden)

    Shingo Iwano

    Full Text Available We developed an original, computer-aided diagnosis (CAD software that subtracts the initial thoracic vertebral three-dimensional computed tomography (3D-CT image from the follow-up 3D-CT image. The aim of this study was to investigate the efficacy of this CAD software during screening for vertebral metastases on follow-up CT images of primary lung cancer patients.The interpretation experiment included 30 sets of follow-up CT scans in primary lung cancer patients and was performed by two readers (readers A and B, who each had 2.5 years' experience reading CT images. In 395 vertebrae from C6 to L3, 46 vertebral metastases were identified as follows: osteolytic metastases (n = 17, osteoblastic metastases (n = 14, combined osteolytic and osteoblastic metastases (n = 6, and pathological fractures (n = 9. Thirty-six lesions were in the anterior component (vertebral body, and 10 lesions were in the posterior component (vertebral arch, transverse process, and spinous process. The area under the curve (AUC by receiver operating characteristic (ROC curve analysis and the sensitivity and specificity for detecting vertebral metastases were compared with and without CAD for each observer.Reader A detected 47 abnormalities on CT images without CAD, and 33 of them were true-positive metastatic lesions. Using CAD, reader A detected 57 abnormalities, and 38 were true positives. The sensitivity increased from 0.717 to 0.826, and on ROC curve analysis, AUC with CAD was significantly higher than that without CAD (0.849 vs. 0.902, p = 0.021. Reader B detected 40 abnormalities on CT images without CAD, and 36 of them were true-positive metastatic lesions. Using CAD, reader B detected 44 abnormalities, and 39 were true positives. The sensitivity increased from 0.783 to 0.848, and AUC with CAD was nonsignificantly higher than that without CAD (0.889 vs. 0.910, p = 0.341. Both readers detected more osteolytic and osteoblastic metastases with CAD than without CAD

  12. Bolus propagation in pig ureter in vitro

    NARCIS (Netherlands)

    R. van Mastrigt (Ron); E.A. Tauecchio

    1984-01-01

    textabstractPig ureters were made to propagate injected fluid boluses by electrical stimulation in vitro. The propagation velocity was determined from EMG measurements made at several points along the ureter. It was found that this velocity varied both along the ureter and as a function of time, and

  13. Spontaneous rupture of the ureter

    Science.gov (United States)

    Eken, Alper; Akbas, Tugana; Arpaci, Taner

    2015-01-01

    Spontaneous rupture of the ureter is a very rare condition and usually results from ureteral obstruction by a calculus. Only theoretical mecha­nisms have been proposed and no possible explanation has yet been reported in the literature. Intravenous contrast-enhanced computed tomography is the most informative study with high sensitivity. Treatment should be individualised, and depends on the state of the patient. Minimally invasive endourological procedures with double-J catheter placement and percutaneous drainage offer excellent results. Conservative management with analgesics and antibiotic coverage may be an alternative to surgery. Herein, we present a case of spontaneous rupture of the proximal ureter with no evidence of an underlying pathological condition. PMID:25715862

  14. A proteomic glimpse into human ureter proteome.

    Science.gov (United States)

    Magdeldin, Sameh; Hirao, Yoshitoshi; Elguoshy, Amr; Xu, Bo; Zhang, Ying; Fujinaka, Hidehiko; Yamamoto, Keiko; Yates, John R; Yamamoto, Tadashi

    2016-01-01

    Urine has evolved as one of the most important biofluids in clinical proteomics due to its noninvasive sampling and its stability. Yet, it is used in clinical diagnostics of several disorders by detecting changes in its components including urinary protein/polypeptide profile. Despite the fact that majority of proteins detected in urine are primarily originated from the urogenital (UG) tract, determining its precise source within the UG tract remains elusive. In this article, we performed a comprehensive analysis of ureter proteome to assemble the first unbiased ureter dataset. Next, we compared these data to urine, urinary exosome, and kidney mass spectrometric datasets. Our result concluded that among 2217 nonredundant ureter proteins, 751 protein candidates (33.8%) were detected in urine as urinary protein/polypeptide or exosomal protein. On the other hand, comparing ureter protein hits (48) that are not shown in corresponding databases to urinary bladder and prostate human protein atlas databases pinpointed 21 proteins that might be unique to ureter tissue. In conclusion, this finding offers future perspectives for possible identification of ureter disease-associated biomarkers such as ureter carcinoma. In addition, the ureter proteomic dataset published in this article will provide a valuable resource for researchers working in the field of urology and urine biomarker discovery. All MS data have been deposited in the ProteomeXchange with identifier PXD002620 (http://proteomecentral.proteomexchange.org/dataset/PXD002620). © 2015 The Authors. Proteomics published by Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  15. Retrocaval ureter with ureterohydronephrosis | Tegegne | East and ...

    African Journals Online (AJOL)

    Retrocaval ureter is one of the rarest congenital anomaly. We report a case of retrocaval ureter who presented to us with right lumbar pain, with ureterohydronephrosis. The intravenous urography showed dilated proximal ureteric segment with moderate hydronephrosis. The patient was operated, findings were Retrocaval ...

  16. Transitional cell carcinoma of the ureter and struvite calculi

    Directory of Open Access Journals (Sweden)

    Danielo Garcia de Freitas

    1999-05-01

    Full Text Available CONTEXT: The association of primary carcinoma of the ureter and lithiasis is extremely rare. We report a rare case of a primary carcinoma of the ureter with corariform calculus. CASE REPORT: 60-year-old phaeodermal female, reported a history of right-side nephritic colic, hyperthermia and pyuria during the past 20 years and had received treatment for urinary infections a number of times. The first clinical presentation was related to lithiasis and the tumor had not been shown up by excretory urography, cystoscopy or ultrasonography. Two months after the calculus had been eliminated, the patient began to have serious symptoms and a grade III transitional cell carcinoma of the ureter was discovered. Total nephroureterectomy and M.V.A.C. (Metotrexate + Vinblastina + Doxo Rubicina + Cisplatina chemotherapy were tried unsuccessfully. In this report we emphasize the diagnostic difficulty caused by the concomitant presence of the two pathologies. In our opinion, the rapid evolution in this case is directly related to the high grade of the tumor.

  17. Effects of parathyroidectomy versus observation on the development of vertebral fractures in mild primary hyperparathyroidism

    DEFF Research Database (Denmark)

    Lundstam, Karolina; Heck, Ansgar; Mollerup, Charlotte

    2015-01-01

    CONTEXT: Mild primary hyperparathyroidism (PHPT) is a common disease especially in middle-aged and elderly women. The diagnosis is frequently made incidentally and treatment strategies are widely discussed. OBJECTIVE: To study the effect of parathyroidectomy (PTX) compared with observation (OBS...

  18. Retrocaval ureter with vesicoureteric reflux, a very rare entity | Arya ...

    African Journals Online (AJOL)

    Introduction: A circumcaval ureter is a rare congenital anomaly in which the ureter passes behind inferior vena cava. VUR is rarely found in association with retrocaval ureter. Diagnosis and management are difficult. To our knowledge, we report a second case of retrocaval ureter with ipsilateral VUR. Observation: A ...

  19. Pure transperitoneal laparoscopic correction of retrocaval ureter.

    Science.gov (United States)

    Ding, Guo-Qing; Xu, Li-Wei; Li, Xin-de; Li, Gong-Hui; Yu, Yan-Lan; Yu, Da-Min; Zhang, Zhi-Gen

    2012-07-01

    Retrocaval ureter is a rare congenital abnormality. Operative repair is always suggested in cases of significant functional obstruction. Laparoscopic procedures have been employed as the minimally invasive therapeutic option for retrocaval ureter. However, the laparoscopic techniques for retrocaval ureter might be technically challenging to some surgeons. The aim of this article was to present our experience and surgical techniques of pure transperitoneal laparoscopic pyelopyelostomy and ureteroureterostomy in nine patients with retrocaval ureter. A total of nine patients of retrocaval ureter underwent pure laparoscopic pyelopyelostomy or ureteroureterostomy. The operation was performed with the patients placed in the 70-degree lateral decubitus position via a three port transperitoneal approach with two 10-mm and one 5-mm ports. The distal part of the dilated renal pelvis was transected at the ureteropelvic junction and the ureter was relocated anterior to the inferior vena cava. The tension-free pyeloureteral or ureteroureteral anastomosis was completed with the intracorporal freehand suturing and in situ knot-tying techniques combined with interrupted and continuous fashion. A double J ureteral stent was inserted in an antegrade manner during laparoscopy. Intravenous urography or computerized tomography and renal ultrasonography were performed after 3 months postoperatively. All operations were completed laparoscopically, and no open conversion was required. The mean operative time was 135 minutes (range, 70 - 250 minutes), with minimal blood loss (less than 60 ml). No intra-operative complications or significant bleeding occurred. All patients presented mild postoperative pain and quick convalescence. The symptoms disappeared and hydronephrosis decreased substantially after surgery. Pure transperitoneal laparoscopic correction for retrocaval ureter was associated with an excellent outcome, minimal invasiveness and short hospital stay. It is technically feasible

  20. Minimally Invasive Approach of a Retrocaval Ureter

    Directory of Open Access Journals (Sweden)

    Nuno Fidalgo

    2016-01-01

    Full Text Available The retrocaval ureter is a rare congenital entity, classically managed with open pyeloplasty techniques. The experience obtained with the laparoscopic approach of other more frequent causes of ureteropelvic junction (UPJ obstruction has opened the method for the minimally invasive approach of the retrocaval ureter. In our paper, we describe a clinical case of a right retrocaval ureter managed successfully with laparoscopic dismembered pyeloplasty. The main standpoints of the procedure are described. Our results were similar to others published by other urologic centers, which demonstrates the safety and feasibility of the procedure for this condition.

  1. Transcaval Ureter: Multidetector Computed Tomography Demonstration.

    Science.gov (United States)

    Sofia, Carmelo; Racchiusa, Sergio; Magno, Carlo; Inferrera, Antonino; Donato, Rocco; Mucciardi, Giuseppe; Mazziotti, Silvio; Ascenti, Giorgio

    2015-07-01

    Transcaval ureter is a rare congenital anomaly characterized by an inferior cava vein duplication producing a vascular ring around the right ureter, usually determining hydroureteronephrosis. The knowledge of this vascular anomaly on imaging examinations permits to avoid erroneous diagnosis of retroperitoneal masses or adenopathy and preoperatively advise the surgeon of potential sources of complications. We describe a case of transcaval ureter studied with multidetector computed tomography. To our knowledge, this is the first case in which computed tomography multiplanar and volume-rendering reconstructions show this rare anomaly. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Excretion in the house cricket (Acheta domesticus): ultrastructure of the ampulla and ureter.

    Science.gov (United States)

    Spring, J H; Parker, S W; Hazelton, S R

    1988-01-01

    An ultrastructural analysis of the ampulla and ureter of the cricket, Acheta domesticus, is presented. The excretory system of the cricket is unusual in that the 112 Malpighian tubules do not attach directly to the gut, but fuse to form a bladder-like ampulla which is joined to the colon by a muscular ureter. The ampulla consists of two cell types, primary and regenerative. Primary cells secrete large numbers of membrane-bound vesicles into the lumen and also appear to be involved in fluid reabsorption. Regenerative cells are very small and form a layer just beneath the basal lamina of the ampulla. They are believed to differentiate and replace sloughed off primary cells. The ureter is a muscular tube lined with cuticle which connects the ampulla (endoderm) with the colon (ectoderm). The probable origin and significance of the morphological modifications of the excretory system are discussed.

  3. Retrocaval ureter: the importance of intravenous urography.

    Science.gov (United States)

    Hassan, Radhiana; Aziz, Azian Abd; Mohamed, Siti Kamariah Che

    2011-10-01

    Retrocaval ureter is a rare cause of hydronephrosis. Its rarity and non-specific presentation pose a challenge to surgeons and radiologists in making the correct diagnosis. Differentiation from other causes of urinary tract obstruction, especially the more common urolithiasis, is important for successful surgical management. Current practice has seen multislice computed tomography (MSCT) rapidly replaces intravenous urography (IVU) in the assessment of patients with hydronephrosis due to suspected urolithiasis, especially ureterolithiasis. However, MSCT, without adequate opacification of the entire ureter, may allow the physician to overlook a retrocaval ureter as the cause of hydronephrosis. High-resolution IVU images can demonstrate the typical appearance that leads to the accurate diagnosis of a retrocaval ureter. We reported a case that illustrates this scenario and highlights the importance of IVU in the assessment of a complex congenital disorder involving the urinary tract.

  4. Hypoplastic right kidney with ectopic nonduplicated ureter

    Energy Technology Data Exchange (ETDEWEB)

    Limbert, D.J.

    1975-09-01

    Hypoplastic kidney with an ectopic ureter can produce urinary incontinence with its known psychologic disturbances. By diligent urologic workup, the diagnosis may be made preoperatively and appropriate surgical correction undertaken.

  5. Origin and nature of pelvic ureter innervation.

    Science.gov (United States)

    Zaitouna, Mazen; Alsaid, Bayan; Lebacle, Cédric; Timoh, Krystel Nyangoh; Benoît, Gérard; Bessede, Thomas

    2017-02-01

    Innervation of the pelvic ureter traditionally comes from the pelvic plexus. This innervation is independent: adrenergic and cholinergic. The purpose of this study was to describe more precisely the origin and nature of its innervation (adrenergic, cholinergic, nitrergic, and somatic). Six specimens of normal human fetal pelvis (four male and two female) from 20 to 30 weeks gestation were studied. The sections of these fetuses, carried out every 5 µm without interval, were treated with Hematoxylin Eosin (HE), with Masson's trichrome (TriM), immunolabeling of smooth muscle cells with smooth anti-actin, of nerves with anti-S100 protein, anti-tyrosine hydroxylase, anti-VAChT, anti-nNOS, and with anti- peripheral myelin protein 22 (PMP 22). The slides were scanned and two-dimensional images reconstructed in 3D, and analyzed. The terminal pelvic ureter travels above and inside the inferior hypogastric plexus (IHP). The nerve fibers that innervate the ureterovesical junction come mainly from the superior hypogastric plexus (SHP) which gives off the hypogastric nerves and pelvic branches of the sacral plexus that form the IHP. Most nerve fibers meet below the ureter, behind the bladder to form an ascending bundle, which innervates the pelvic ureter. Immunohistochemical analysis shows that the nerves of the pelvic ureter consist of adrenergic, cholinergic, and nitrergic fibers. The innervation of the distal ureter depends mainly on the SHP. This innervation is adrenergic, cholinergic, and nitrergic. It innervates the pelvic ureter in an ascending manner. This anatomical information can change rectal resection and ureteral reimplantation techniques and drug treatments for pelvic ureter stones. Neurourol. Urodynam. 36:271-279, 2017. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  6. Thulium fiber laser damage to the ureter

    Science.gov (United States)

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

    2015-07-01

    Our laboratory is studying experimental thulium fiber laser (TFL) as a potential alternative lithotripter to the clinical gold standard Holmium:YAG laser. Safety studies characterizing undesirable Holmium laser-induced damage to ureter tissue have been previously reported. Similarly, this study characterizes TFL induced ureter and stone basket damage. A TFL beam with pulse energy of 35 mJ, pulse duration of 500 μs, and pulse rates of 150-500 Hz was delivered through a 100-μm-core, low-OH, silica optical fiber to the porcine ureter wall, in vitro. Ureter perforation times were measured and gross, histological, and optical coherence tomography images of the ablation zone were acquired. TFL operation at 150, 300, and 500 Hz produced mean ureter perforation times of 7.9, 3.8, and 1.8 s, respectively. Collateral damage averaged 510, 370, and 310 μm. TFL mean perforation time exceeded 1 s at each setting, which is a greater safety margin than previously reported during Holmium laser ureter perforation studies.

  7. Tissue engineering and ureter regeneration: is it possible?

    Science.gov (United States)

    Kloskowski, Tomasz; Kowalczyk, Tomasz; Nowacki, Maciej; Drewa, Tomasz

    2013-06-25

    Large ureter damages are difficult to reconstruct. Current techniques are complicated, difficult to perform, and often associated with failures. The ureter has never been regenerated thus far. Therefore the use of tissue engineering techniques for ureter reconstruction and regeneration seems to be a promising way to resolve these problems. For proper ureter regeneration the following problems must be considered: the physiological aspects of the tissue, the type and shape of the scaffold, the type of cells, and the specific environment (urine). 
This review presents tissue engineering achievements in the field of ureter regeneration focusing on the scaffold, the cells, and ureter healing.

  8. Validation of an osteoporosis self-assessment tool to identify primary osteoporosis and new osteoporotic vertebral fractures in postmenopausal Chinese women in Beijing

    Science.gov (United States)

    2013-01-01

    Background This study aimed to validate the effectiveness of the Osteoporosis Self-assessment Tool for Asians (OSTA) in identifying postmenopausal women at increased risk of primary osteoporosis and painful new osteoporotic vertebral fractures in a large selected Han Chinese population in Beijing. Methods We assessed the performance of the OSTA in 1201 women. Subjects with an OSTA index > -1 were classified as the low risk group, and those with an index ≤ -1 were classified as the increased risk group. Osteoporosis is defined by a T-score ≤ 2.5 standard deviations according to the WHO criteria. All painful, new vertebral fractures were identified by X-ray and MRI scans with correlating clinical signs and symptoms. We determined the sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve for correctly selecting women with osteoporosis and painful new vertebral fractures. Results Of the study subjects, 29.3% had osteoporosis, and the prevalence of osteoporosis increased progressively with age. The areas under the ROC curves of the OSTA index (cutoff = -1) to identify osteoporosis in the femoral neck, total hip, and lumbar spine were 0.824, 0.824, and 0.776, respectively. The sensitivity and specificity of the OSTA index (cutoff = -1) to identify osteoporosis in healthy women were 66% and 76%, respectively. With regard to painful new vertebral fractures, the area under the ROC curve relating the OSTA index (cutoff = -1) to new vertebral fractures was 0.812. Conclusions The OSTA may be a simple and effective tool for identifying the risk of osteoporosis and new painful osteoporotic vertebral fractures in Han Chinese women. PMID:24053509

  9. Transperitoneal laparoscopic approach for retrocaval ureter

    Directory of Open Access Journals (Sweden)

    Nagraj H

    2006-01-01

    Full Text Available We had a 14 year old boy, who presented with recurrent attacks of right loin pain. Investigations revealed a retrocaval ureter. A transperitoneal three port laparoscopic approach was undertaken. The retrocaval portion of ureter was excised. A double J stent was placed laparoscopically and ureteroureterostomy was done with intracorporeal suturing. The patient was discharged after 72 hours and the stent was removed on the 15th day. Follow up showed regression of hydronephrosis. We recommend this approach compared to open surgery, as it offers several advantages compared to conventional open surgery like decreased postoperative pain, decreased hospital stay and a cosmetically more acceptable surgical scar.

  10. Indocyanine green for intraoperative localization of ureter.

    Science.gov (United States)

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

    2014-10-01

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

  11. Transurethral distal ureter balloon occlusion and detachment: a simple means of managing the distal ureter during radical nephroureterectomy

    NARCIS (Netherlands)

    Cormio, Luigi; Selvaggio, Oscar; Di Fino, Giuseppe; Massenio, Paolo; Annese, Pasquale; de la Rosette, Jean; Carrieri, Giuseppe

    2013-01-01

    Distal ureter bladder cuff (DUBC) excision is an essential part of radical nephroureterectomy (RNU), but the technique to accomplish it remains controversial. We describe a novel technique of transurethral distal ureter balloon occlusion before detachment (TUDUBOD) whereby the affected ureter is

  12. COMPASS-based ureter segmentation in CT urography (CTU)

    Science.gov (United States)

    Zick, David; Hadjiiyski, Lubomir; Chan, Heang-Ping; Cohan, Richard H.; Caoili, Elaine M.; Zhou, Chuan; Wei, Jun

    2014-03-01

    We are developing a computerized system for automated segmentation of ureters in CT urography (CTU), referred to as COmbined Model-guided Path-finding Analysis and Segmentation System (COMPASS). Ureter segmentation is a critical component for computer-aided diagnosis of ureter cancer. A challenge for ureter segmentation is the presence of regions not well opacified with intravenous (IV) contrast. COMPASS consists of three stages: (1) adaptive thresholding and region growing, (2) path-finding and propagation, and (3) edge profile extraction and feature analysis. One hundred fourteen ureters in 74 CTU scans with IV contrast were collected from 74 patient files. On average, the ureters spanned 283 CT slices (range: 116 to 399, median: 301). More than half of the ureters contained malignant or benign lesions and some had ureter wall thickening due to malignancy. A starting point for each of the 114 ureters was selected manually to initialize the tracking by COMPASS. Path-finding and segmentation were guided by the anatomical knowledge of ureters in CTU. The segmentation performance was quantitatively assessed by estimating the percentage of the length that was successfully tracked and segmented for each ureter. Of the 114 ureters, 110 (96%) were segmented completely (100%), 111 (97%) were segmented through at least 70% of its length, and 113 (99%) were segmented at least 50%. In comparison, using our previous method, 79 (69%) ureters were segmented completely (100%), 92 (81%) were segmented through at least 70% of its length, and 98 (86%) were segmented at least 50%. COMPASS improved significantly the ureter tracking, including regions across ureter lesions, wall thickening and the narrowing of the lumen.

  13. Computerized segmentation of ureters in CT urography (CTU) using COMPASS

    Science.gov (United States)

    Hadjiiski, Lubomir M.; Chan, Heang-Ping; Niland, Luke; Cohan, Richard H.; Caoili, Elaine M.; Zhou, Chuan; Wei, Jun

    2013-03-01

    We are developing a computerized system for automated segmentation of ureters on CTU, as a critical component for computer-aided diagnosis of ureter cancer. A challenge for ureter segmentation is the presence of regions not well opacified with intravenous (IV) contrast. We propose a COmbined Model-guided Path-finding Analysis and Segmentation System (COMPASS) to track the ureters in CTU. COMPASS consists of three stages: (1) adaptive thresholding and region growing, (2) edge profile extraction and feature analysis, and (3) path-finding and propagation. 114 ureters, filled with IV contrast material, on 74 CTU scans from 74 patients were segmented. On average the ureter occupied 286 CT slices (range:164 to 399, median:301). More than half of the ureters contained malignant or benign lesions and some had ureter wall thickening due to malignancy. A starting point for each of the 114 ureters was selected manually, which served as an input to the COMPASS, to initialize the tracking. The path-finding and segmentation are guided by anatomical knowledge of the ureters in CTU. The segmentation performance was quantitatively assessed by estimating the percentage of the length that was successfully tracked and segmented for each ureter. Of the 114 ureters, 75 (66%) were segmented completely (100%), 99 (87%) were segmented through at least 70% of its length, and 104 (91%) were segmented at least 50%. Previously, without the model-guided approach, 61 (54%) ureters were segmented completely (100%), 80 (70%) were segmented through at least 70% of its length, and 96 (84%) were segmented at least 50%. COMPASS improved the ureter tracking, including regions across ureter lesions, wall thickening and the narrowing of the lumen.

  14. Ileal Augmentation Cystoplasty Combined with Ileal Ureter Replacement After Radical Treatment for Cervical Cancer.

    Science.gov (United States)

    Jeong, In Gab; Han, Kyung-Sik; Park, Sang Hyun; Song, Sang Hoon; Song, Geehyun; Park, Hyung Keun; Choo, Myung-Soo; Hong, Bumsik

    2016-05-01

    This study reviewed the outcomes for patients who underwent simultaneous bladder and ureter reconstructive surgery using the ileum after radical treatment for cervical cancer. The medical records of seven patients who underwent augmentation ileocystoplasty with ileal ureter replacement between September 2006 and May 2013 were reviewed. Data on indications for surgery, underlying urologic comorbidities, type of ureteral replacement, postoperative complications, and changes in renal function were obtained. The median age of the patients was 56 years. The primary tumor was cervical cancer in all the patients, and the majority of the patients (4/7, 57.1 %) were previously treated with radical hysterectomy plus radiotherapy. Ileal ureter replacement was performed on 11 renal units, and bilateral ileal ureter substitution was performed for four patients, with the largest ureteral defect being 15 cm. The median length of the ileum used for augmentation and ureter substitution was 30 cm (range 15-40 cm), and the median hospital stay was 23 days (range 18-47 days). The overall rate of major complications (grade ≥3) was 57.1 % (4 of 7 patients). The median preoperative and immediate postoperative serum creatinine levels were respectively 1.2 mg/dL and 0.9 mg/dL. During a mean follow-up duration of 38 months, none of the patients experienced deterioration of renal function after surgery. Ileal ureter substitution combined with augmentation ileocystoplasty is a useful surgical technique for bridging long ureteral defects caused by ureteric stenosis from surgery, radiotherapy, or both for pelvic tumors in contracted low-compliance bladders.

  15. Retrocaval ureter: a report on two neonates

    African Journals Online (AJOL)

    creatinine continued to increase. Abdominal ultrasono- graphy showed a slightly dilated upper calyx measuring. 9 mm noted in the .... Patient 2 (a) plain abdominal X ray showing a double-bubble sign and a duodenoduodenostomy was performed. (b) Intravenous urography (IVU) showed a 'reverse J'-shaped right ureter ...

  16. Diversification of Cell Lineages in Ureter Development.

    Science.gov (United States)

    Bohnenpoll, Tobias; Feraric, Sarah; Nattkemper, Marvin; Weiss, Anna-Carina; Rudat, Carsten; Meuser, Max; Trowe, Mark-Oliver; Kispert, Andreas

    2017-06-01

    The mammalian ureter consists of a mesenchymal wall composed of smooth muscle cells and surrounding fibrocytes of the tunica adventitia and the lamina propria and an inner epithelial lining composed of layers of basal, intermediate, and superficial cells. How these cell types arise from multipotent progenitors is poorly understood. Here, we performed marker analysis, cell proliferation assays, and genetic lineage tracing to define the lineage relations and restrictions of the mesenchymal and epithelial cell types in the developing and mature mouse ureter. At embryonic day (E) 12.5, the mesenchymal precursor pool began to subdivide into an inner and outer compartment that began to express markers of smooth muscle precursors and adventitial fibrocytes, respectively, by E13.5. Smooth muscle precursors further diversified into lamina propria cells directly adjacent to the ureteric epithelium and differentiated smooth muscle cells from E16.5 onwards. Uncommitted epithelial progenitors of the ureter differentiated into intermediate cells at E14.5. After stratification into two layers at E15.5 and three cell layers at E18.5, intermediate cells differentiated into basal cells and superficial cells. In homeostasis, proliferation of all epithelial and mesenchymal cell types remained low but intermediate cells still gave rise to basal cells, whereas basal cells divided only into basal cells. These studies provide a framework to further determine the molecular mechanisms of cell differentiation in the tissues of the developing ureter. Copyright © 2017 by the American Society of Nephrology.

  17. Circumcaval ureter with synchronous ipsilateral transitional cell ...

    African Journals Online (AJOL)

    We report a case of concomitant transitional cell carcinoma (TCC) in a circumcaval ureter and invasive bladder cancer. The diagnosis was based on the findings of excretory urography (IVU) and contrast-enhanced computed tomography (CT). IVU showed a typical J-shaped deformity in the dilated right proximal ureteric ...

  18. Circumcaval Ureter with Synchronous Ipsilateral Transitional Cell ...

    African Journals Online (AJOL)

    mn

    We report a case of concomitant transitional cell carcinoma (TCC) in a circumcaval ureter and invasive bladder cancer. The diagnosis was based on the findings of excretory urography (IVU) and contrast-enhanced computed tomography (CT). IVU showed a typical J-shaped deformity in the dilated right proximal ureteric ...

  19. Magnetic resonance imaging and immunohistochemistry of primary vertebral hemangiosarcoma in a dog and implications for diagnosis and therapy.

    Science.gov (United States)

    Pérez-Martínez, Claudia; Regueiro-Purriños, Marta; Fernández-Martínez, Beatriz; Altónaga, José R; Gonzalo-Orden, José M; García-Iglesias, María J

    2016-12-01

    A vertebral mass in a dog with an acute onset paraparesis was identified by magnetic resonance imaging. A poorly differentiated hemangiosarcoma was diagnosed by histopathology and immunohistochemistry. Endothelial nitric oxide synthase could be a new differential marker for poorly differentiated hemangiosarcoma in dogs. Immunohistochemical detection of p53 phosphorylated at Serine 392 , p53, CD117, and CD44 suggest targets for design of therapeutic strategies.

  20. Polyuria due to vasopressin V2 receptor antagonism is not associated with increased ureter diameter in ADPKD patients

    Science.gov (United States)

    Casteleijn, Niek F.; Messchendorp, A. Lianne; Bae, Kyong T.; Higashihara, Eiji; Kappert, Peter; Torres, Vicente; Meijer, Esther; Leliveld, Anna M.

    2017-01-01

    Background Tolvaptan, a vasopressin V2 receptor antagonist, has been shown to reduce the rates of growth in total kidney volume (TKV) and renal function loss in ADPKD patients, but also leads to polyuria because of its aquaretic effect. Prolonged polyuria can result in ureter dilatation with consequently renal function loss. Therefore, we aimed to investigate the effect of tolvaptan-induced polyuria on ureter diameter in ADPKD patients. Methods 70 ADPKD patients were included (51 were randomized to tolvaptan and 19 to placebo). At baseline and after 3 years of treatment renal function was measured (mGFR) and MRI was performed to measure TKV and ureter diameter at the levels of renal pelvis and fifth lumbar vertebral body (L5). Results In these patients [65.7 % male, age 41 ± 9 years, mGFR 74 ± 27 mL/min/1.73 m2 and TKV 1.92 (1.27–2.67) L], no differences were found between tolvaptan and placebo-treated patients in 24-h urine volume at baseline (2.5 vs. 2.5 L, p = 0.8), nor in ureter diameter at renal pelvis and L5 (4.0 vs. 4.2 mm, p = 0.4 and 3.0 vs. 3.1 mm, p = 0.3). After 3 years of treatment 24-h urine volume was higher in tolvaptan-treated patients when compared to placebo (4.7 vs. 2.3 L, p ureter diameter between both groups (renal pelvis: 4.2 vs. 4.4 mm, p = 0.4 and L5: 3.1 vs. 3.3 mm, p = 0.4). Conclusions Tolvaptan-induced polyuria did not lead to an increase in ureter diameter, suggesting that tolvaptan is a safe therapy from a urological point of view. PMID:27339446

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

    Science.gov (United States)

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

    2013-05-01

    α1 -adrenoceptor (-AR) antagonists may facilitate ureter stone passage in humans. We aimed to study effects by the α1 A -AR selective antagonist silodosin (compared to tamsulosin and prazosin) on ureter pressures in a rat model of ureter obstruction, and on contractions of human and rat isolated ureters. After ethical approval, ureters of male rats were cannulated beneath the kidney pelvis for in vivo ureteral intraluminal recording of autonomous peristaltic pressure waves. A partial ureter obstruction was applied to the distal ureter. Mean arterial blood pressure (MAP) was recorded. Approximate clinical and triple clinical doses of the α1 -AR antagonists were given intravenously. Effects by the α1 -AR antagonists on isolated human and rat ureters were studied in organ baths. Intravenous silodosin (0.1-0.3 mg kg(-1) ) or prazosin (0.03-0.1 mg kg(-1) ) reduced obstruction-induced increases in intraluminal ureter pressures by 21-37% or 18-40% respectively. Corresponding effects by tamsulosin (0.01 or 0.03 mg kg(-1) ) were 9-20%. Silodosin, prazosin and tamsulosin reduced MAP by 10-12%, 25-26% (P ureter pressures were expressed as a function of MAP, silodosin had six- to eightfold and 2.5- to eightfold better efficacy than tamsulosin or prazosin respectively. Silodosin effectively reduced contractions of both human and rat isolated ureters. Silodosin inhibits contractions of the rat and human isolated ureters and has excellent functional selectivity in vivo to relieve pressure-load of the rat obstructed ureter. Silodosin as pharmacological ureter stone expulsive therapy should be clinically further explored. © 2013 The Authors. British Journal of Pharmacology © 2013 The British Pharmacological Society.

  2. Xanthogranulomatous Pyelonephritis with Incomplete Double Ureter

    Directory of Open Access Journals (Sweden)

    Yutaro Hayashi

    2017-01-01

    Full Text Available Introduction. Xanthogranulomatous pyelonephritis (XGP is a type of chronic renal inflammation that usually occurs in immunocompromised middle-aged women with chronic urinary tract infection or ureteral obstruction induced by the formation of ureteral stones. XGP with an incomplete double ureter is extremely rare. Case Presentation. A 76-year-old woman was referred to our department to undergo further examination for a left renal tumor that was detected by ultrasonography. Dynamic contrast computed tomography (CT revealed an enhanced tumor in the upper renal parenchyma. Laparoscopic radical nephrectomy was performed based on a preoperative diagnosis of renal cell carcinoma. Histological sections showed the aggregation of foam cells; thus, XGP was diagnosed. Conclusion. We herein report a rare case of XGP in the upper pole of the kidney, which might have been associated with an incomplete double ureter.

  3. Giant fibroepithelial polyp of the ureter.

    Science.gov (United States)

    Gupta, Mayank; Roy, Sanjeet; Wann, Cornerstone; Eapen, Anu

    2017-04-07

    Giant fibroepithelial polyp is a rare cause of ureteric/ureteropelvic junction (UPJ) obstruction. We report a rare case of giant fibroepithelial polyp in a 32-year-old woman involving the whole length of the ureter, reaching up to the UPJ which was clinically and radiologically considered to be urothelial carcinoma. Frozen section showed a polypoid lesion lined by urothelium with no evidence of dysplasia or malignancy. Subsequently, nephroureterectomy was done as there was marked renal hydronephrosis and it was impossible to separate the polyp from the wall of the ureter. Histopathological examination and immunohistochemistry confirmed the diagnosis of giant fibroepithelial polyp, ruling out malignancy. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  4. Physical forces may cause Hox gene collinearity in the primary and secondary axes of the developing vertebrates.

    Science.gov (United States)

    Papageorgiou, Spyros

    2011-01-01

    The features of spatial and temporal Hox gene collinearity along the anteroposterior and secondary axes of vertebrate development have been extensively studied. However, the understanding of these features remains problematic. Some genetic engineering experiments were performed and the consequent modifications of the Hoxd gene expressions in the vertebrate limb and trunk were presented. A two-phases model was proposed to describe the above results but still many data cannot be explained. In the present work a different mechanism is put forward in order to deal with the above experiments. This alternative mechanism (coined biophysical model), is based on the hypothesis that physical forces decondense and 'loop out' the chromatin fiber causing the observed Hox gene collinearity phenomena at the early stages of axonal development. The two models are compared in detail. The biophysical model adequately explains the data even in cases where the results are characterized as unexpected. Furthermore, the biophysical model predicts that the Hox gene expressions are entangled in space and time and this coupling is compatible with the data of the early developmental stages. Additional experiments are proposed for a direct test of this model. © 2011 The Author. Journal compilation © 2011 Japanese Society of Developmental Biologists.

  5. Double obstruction of ureter: A diagnostic challenge

    Directory of Open Access Journals (Sweden)

    Pankaj Halder

    2014-01-01

    Full Text Available Introduction: Isolated obstruction of the ureteropelvic junction and the vesico-ureteric junction are the two most common causes of hydronephrosis in a pediatric population. [1] They do not pose diagnostic difficulties when are present alone but when together can be difficult to diagnose. Here, we discuss the problems we faced when we encountered these two anomalies in the same ureter and the way in which we managed them. Aim: To assess the difficulties in diagnosis of pediatric patients who present with both ureteropelvic junction obstruction (UPJO and vesico-ureteric junction obstruction (VUJO in the ipsilateral ureter and their management protocol. Materials and Methods: This is a retrospective study. The study period is from 1 January 2004 to 31 December 2011. Out of 254 children who were diagnosed to have hydronephrosis due to UPJO in our institute, 5 patients (in the age range of 5 to 10 years had both UPJO and VUJO in the ipsilateral ureter. The problems we faced in diagnosing the two conditions are mentioned with a literature review. Results: Operative intervention was used in four out of five patients; none of the patients had an accurate diagnosis before surgery. All patients were suspected of having double obstruction during pyeloplasty when appropriate size double J stent could not be negotiated through the vesicoureteric junction into the bladder. Postoperative nephrostogram confirmed the diagnosis in all patients. Conclusion: Children with double obstruction of the ipsilateral ureter present as a diagnostic dilemma. Because of the rarity of this condition it can escape the eye of even an astute clinician. Early diagnosis can be made if this condition is kept in mind while treating any hydronephrosis due to UPJO or UVJO.

  6. Understanding the Ureter: Challenges and Opportunities.

    Science.gov (United States)

    Park, Alyssa; Venkatesh, Ramakrishna

    2016-05-01

    The ureter is possibly the least studied and most poorly understood organ of the urinary tract. The pathophysiologic basis underlying the use of α-blockers to improve ureteral stone passage or to treat ureteral stent symptoms is poorly understood. This, in part, may explain why clinical studies of medical expulsive therapy for ureteral stone passage are fraught with conflicting data. Methods to study human ureter in vivo are few and challenging. The findings of many of the ureteral studies are from observational in vitro studies and were evaluated in other animal species that may not be applicable in human beings. There are few mechanistic studies evaluating the underlying molecular pathophysiologic mechanisms of human ureter. This is critical to our understanding and treatment of stent symptoms, including the development of a patient friendly ureteral stent and for the pharmacologic modulation of ureteral activity. The following is an overview of some of the observational and mechanistic ureteral studies evaluating the pharmacologic and stent effects, including potential areas for further research.

  7. Duplicated Renal System with H Shaped Ureter: An Extraordinary Anomaly

    Directory of Open Access Journals (Sweden)

    Fatih Akbulut

    2016-01-01

    Full Text Available Duplex collecting systems are the most commonly encountered anomaly of the urinary system. Complete duplex system with an H shaped ureter is a very rare situation. There are only two reported H ureter cases in the literature. Herein, we aimed to present an H shaped ureter case, which was identified while performing ureterorenoscopy to a 48-year-old female patient due to a right distal ureteral stone.

  8. Ultrasonographic diagnosis of unilateral ectopic ureter in a Labrador dog

    Directory of Open Access Journals (Sweden)

    P.A. Oglesby

    2003-07-01

    Full Text Available A 3-month-old, Labrador bitch presented with urinary incontinence. A unilateral, ectopic ureter was diagnosed with ultrasound without the aid of additional contrast radiographic techniques. Ipsilateral hydroureter and mild hydronephrosis were also present.At the level of the bladder trigone the ectopic ureter became intramural and this was clearly demonstrable with ultrasound. The opening of the ectopic ureter into the proximal urethra was, however, not visualised owing to its intrapelvic location.

  9. Analysis of Urine Flow in Three Different Ureter Models.

    Science.gov (United States)

    Kim, Kyung-Wuk; Choi, Young Ho; Lee, Seung Bae; Baba, Yasutaka; Kim, Hyoung-Ho; Suh, Sang-Ho

    2017-01-01

    The ureter provides a way for urine to flow from the kidney to the bladder. Peristalsis in the ureter partially forces the urine flow, along with hydrostatic pressure. Ureteral diseases and a double J stent, which is commonly inserted in a ureteral stenosis or occlusion, disturb normal peristalsis. Ineffective or no peristalsis could make the contour of the ureter a tube, a funnel, or a combination of the two. In this study, we investigated urine flow in the abnormal situation. We made three different, curved tubular, funnel-shaped, and undulated ureter models that were based on human anatomy. A numerical analysis of the urine flow rate and pattern in the ureter was performed for a combination of the three different ureters, with and without a ureteral stenosis and with four different types of double J stents. The three ureters showed a difference in urine flow rate and pattern. Luminal flow rate was affected by ureter shape. The side holes of a double J stent played a different role in detour, which depended on ureter geometry.

  10. Evaluation of Risk Factors for Vertebral Compression Fracture after Carbon-Ion Radiotherapy for Primary Spinal and Paraspinal Sarcoma

    Directory of Open Access Journals (Sweden)

    Yoshihiro Matsumoto

    2017-01-01

    Full Text Available Background and Purpose. Carbon-ion radiotherapy (C-ion RT was effective therapy for inoperable spinal and paraspinal sarcomas. However, a significant adverse event following radiotherapies is vertebral compression fractures (VCFs. In this study, we investigated the incidence of and risk factors for post-C-ion RT VCFs in patients with spinal or paraspinal sarcomas. Material and Methods. Thirty consecutive patients with spinal or paraspinal sarcomas treated with C-ion RT were retrospectively reviewed. Various clinical parameters and the Spinal Instability Neoplastic Score (SINS were used to evaluate the risk factors for post-C-ion RT VCFs. Results. The overall incidence of VCFs was 23% (median time: 7 months. Patients with VCFs showed a markedly higher SINS score (median value, 9 points than those without VCF (5 points. The area under the receiver operating characteristic curve for the SINS score was 0.88, and the optimum SINS cut-off score was 8 points. The cumulative incidence of VCFs at 1 year was 9% for patients with a SINS score under 8 points, versus 80% for those with a SINS score of 8 points or higher (p<0.0001. Conclusions. In patients with a SINS score of 8 points or higher, referral to a spine surgeon for stabilization and multidisciplinary discussion is appropriate.

  11. A case report of a bifid ureter and renal pelvis

    Directory of Open Access Journals (Sweden)

    zahed Safikhani

    2004-11-01

    Conclusion: The majority of the investigations have reported this anomaly in association with other disease conditions but the present case is the unilateral incomplete bifid ureter & pelvis were associated with no other abnormality. The possible embryological reasons for the formation of bifid ureter are discussed.

  12. Bilateral extraluminal ectopic ureters in a Maine Coon cat

    Directory of Open Access Journals (Sweden)

    L.Z. Crivellenti

    2013-06-01

    Full Text Available Ectopic ureters are rarely observed in cats. Therefore, for a better chance of success in the corrective surgical procedure and survival of the patient, diagnosis should be confirmed early. This report illustrates the occurrence of bilateral ectopic ureters in a seven month old Maine Coon cat and describes the medical and surgical management adopted for correction of the abnormality.

  13. Structure of the pelvic ureter in an adult Kenyan population ...

    African Journals Online (AJOL)

    Alterations in histomorphological features of the pelvic ureter such as muscle fiber orientation have been implicated in the etiology of vesicoureteric reflux. Consequently, anatomical sex differences in the histomorphology of the pelvic ureter may explain the female predisposition to this disease. Reports of these differences ...

  14. Segmental dilatation of ureter: Report of two cases

    Directory of Open Access Journals (Sweden)

    Hemonta Kr. Dutta

    2014-01-01

    Full Text Available Segmental dilatation of ureter is a giant, focal segmental ureteral dilatation producing an elongated and distorted ureter. Two children presented with this condition, one had ipsilateral megacalycosis and contralateral vesicoureteric reflux. The other had duplication of the kidney. The non-functioning lower moiety showed structure of xanthogranulomatous pyelonephritis.

  15. Ureter tracking and segmentation in CT urography (CTU) using COMPASS

    Energy Technology Data Exchange (ETDEWEB)

    Hadjiiski, Lubomir, E-mail: lhadjisk@umich.edu; Zick, David; Chan, Heang-Ping; Cohan, Richard H.; Caoili, Elaine M.; Cha, Kenny; Zhou, Chuan; Wei, Jun [Department of Radiology, University of Michigan, Ann Arbor, Michigan 48109-5842 (United States)

    2014-12-15

    Purpose: The authors are developing a computerized system for automated segmentation of ureters in CTU, referred to as combined model-guided path-finding analysis and segmentation system (COMPASS). Ureter segmentation is a critical component for computer-aided diagnosis of ureter cancer. Methods: COMPASS consists of three stages: (1) rule-based adaptive thresholding and region growing, (2) path-finding and propagation, and (3) edge profile extraction and feature analysis. With institutional review board approval, 79 CTU scans performed with intravenous (IV) contrast material enhancement were collected retrospectively from 79 patient files. One hundred twenty-four ureters were selected from the 79 CTU volumes. On average, the ureters spanned 283 computed tomography slices (range: 116–399, median: 301). More than half of the ureters contained malignant or benign lesions and some had ureter wall thickening due to malignancy. A starting point for each of the 124 ureters was identified manually to initialize the tracking by COMPASS. In addition, the centerline of each ureter was manually marked and used as reference standard for evaluation of tracking performance. The performance of COMPASS was quantitatively assessed by estimating the percentage of the length that was successfully tracked and segmented for each ureter and by estimating the average distance and the average maximum distance between the computer and the manually tracked centerlines. Results: Of the 124 ureters, 120 (97%) were segmented completely (100%), 121 (98%) were segmented through at least 70%, and 123 (99%) were segmented through at least 50% of its length. In comparison, using our previous method, 85 (69%) ureters were segmented completely (100%), 100 (81%) were segmented through at least 70%, and 107 (86%) were segmented at least 50% of its length. With COMPASS, the average distance between the computer and the manually generated centerlines is 0.54 mm, and the average maximum distance is 2

  16. Ureter tracking and segmentation in CT urography (CTU) using COMPASS.

    Science.gov (United States)

    Hadjiiski, Lubomir; Zick, David; Chan, Heang-Ping; Cohan, Richard H; Caoili, Elaine M; Cha, Kenny; Zhou, Chuan; Wei, Jun

    2014-12-01

    The authors are developing a computerized system for automated segmentation of ureters in CTU, referred to as combined model-guided path-finding analysis and segmentation system (COMPASS). Ureter segmentation is a critical component for computer-aided diagnosis of ureter cancer. COMPASS consists of three stages: (1) rule-based adaptive thresholding and region growing, (2) path-finding and propagation, and (3) edge profile extraction and feature analysis. With institutional review board approval, 79 CTU scans performed with intravenous (IV) contrast material enhancement were collected retrospectively from 79 patient files. One hundred twenty-four ureters were selected from the 79 CTU volumes. On average, the ureters spanned 283 computed tomography slices (range: 116-399, median: 301). More than half of the ureters contained malignant or benign lesions and some had ureter wall thickening due to malignancy. A starting point for each of the 124 ureters was identified manually to initialize the tracking by COMPASS. In addition, the centerline of each ureter was manually marked and used as reference standard for evaluation of tracking performance. The performance of COMPASS was quantitatively assessed by estimating the percentage of the length that was successfully tracked and segmented for each ureter and by estimating the average distance and the average maximum distance between the computer and the manually tracked centerlines. Of the 124 ureters, 120 (97%) were segmented completely (100%), 121 (98%) were segmented through at least 70%, and 123 (99%) were segmented through at least 50% of its length. In comparison, using our previous method, 85 (69%) ureters were segmented completely (100%), 100 (81%) were segmented through at least 70%, and 107 (86%) were segmented at least 50% of its length. With COMPASS, the average distance between the computer and the manually generated centerlines is 0.54 mm, and the average maximum distance is 2.02 mm. With our previous method

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

    Science.gov (United States)

    Kowalczyk, Tomasz; Nowacki, Maciej; Bodnar, Magdalena; Marszałek, Andrzej; Pokrywczyńska, Marta; Frontczak-Baniewicz, Małgorzata; Kowalewski, Tomasz A.; Chłosta, Piotr; Drewa, Tomasz

    2014-01-01

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

  18. Duplicated ectopic ureter in a nine-year-old Labrador.

    Science.gov (United States)

    Novellas, R; Stone, J; Pratschke, K; Hammond, G

    2013-07-01

    A nine-year-old male neutered Labrador retriever presented with a history of chronic urinary tract infections and occasional dribbling of urine. Abdominal ultrasound showed changes suggestive of a left ectopic ureter. A pneumocystogram revealed an air-filled distended tubular and tortuous structure extending from the region of the prostatic urethra to the left kidney, consistent with an ectopic ureter. Intravenous urography depicted the presence of an additional left ureter with only slightly larger diameter than the right and with normal insertion in the bladder neck. A duplicated ectopic left ureter was suspected and confirmed during surgery. To the authors' knowledge, this is the first description of a duplicated ectopic ureter in the canine species. The combination of ultrasound and contrast radiography was important to reach the diagnosis. © 2013 British Small Animal Veterinary Association.

  19. Automatic detection of ureter lesions in CT urography

    Science.gov (United States)

    Exell, Trevor; Hadjiiski, Lubomir; Chan, Heang-Ping; Cha, Kenny H.; Caoili, Elaine M.; Cohan, Richard H.; Wei, Jun; Zhou, Chuan

    2016-03-01

    We are developing a CAD system for automated detection of ureter abnormalities in multi-detector row CT urography (CTU). Our CAD system consists of two stages. The first stage automatically tracks the ureter via the previously proposed COmbined Model-guided Path-finding Analysis and Segmentation System (COMPASS). The second stage consists of lesion enhancement filtering, adaptive thresholding, edge extraction, and noise removal. With IRB approval, 36 cases were collected from patient files, including 15 cases (17 ureters with 32 lesions) for training, and 10 abnormal cases (11 ureters with 17 lesions) and 11 normal cases (22 ureters) for testing. All lesions were identified by experienced radiologists on the CTU images and COMPASS was able to track the ureters in 100% of the cases. The average lesion size was 5.1 mm (range: 2.1 mm - 21.9 mm) for the training set and 6.1 mm (range: 2.0 mm - 18.9 mm) for the test set. The average conspicuity was 4.1 (range: 2 to 5) and 3.9 (range: 1 to 5) on a scale of 1 to 5 (5 very subtle), for the training and test sets, respectively. The system achieved 90.6% sensitivity at 2.41 (41/17) FPs/ureter for the training set and 70.6% sensitivity at 2 (44/22) FPs/normal ureter for the test set. These initial results demonstrate the feasibility of the CAD system to track the ureter and detect ureter cancer of medium conspicuity and relatively small sizes.

  20. Ureter smooth muscle cell orientation in rat is predominantly longitudinal.

    Science.gov (United States)

    Spronck, Bart; Merken, Jort J; Reesink, Koen D; Kroon, Wilco; Delhaas, Tammo

    2014-01-01

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

  1. [Fibroepithelial polyps of renal pelvis and ureter].

    Science.gov (United States)

    Guliev, B G; Komyakov, B K; Al-Attar, T Kh

    2016-04-01

    To analyze the results of surgical treatment of patients with long ureteral fibroepithelial polyps (FEP). From 2005 to 2014 three patients (1 man and 2 women) with large FEP were observed in our hospital. In 2 patients the base of the polyp was located in the proximal ureter and in 1 patient in the middle calyx of the single kidney. The fibroepithelial polyps were long and extended down to the lower third of the ureter (2) or protruded into the bladder (1). Endoscopic resection of the polyp was made in 1patient, resection of parenchyma in the middle calyx along with the base of FEP in 1 patient with the single kidney, and another patient underwent laparoscopic nephrectomy due to the absence of kidney function. Endoscopic resection was successful; the operation lasted 45 minutes without complications. In the patients with a single right kidney operative time was 3.5 hours; during the operation, she received a blood transfusion. In the postoperative period, she underwent two hemodialysis sessions due to acute renal failure. Subsequently, her kidney function was restored. No FEP recurrences occurred in cases of organ sparing operations during follow-up. The postoperative period of the third patient submitted to laparoscopic nephrectomy was uneventful, creatinine levels remained in the normal range. For long, large ureteral FEPs with a broad base the choice of surgical option depends on possibility of tumor visualization and functional state of the kidney.

  2. Vertebral chondroblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Ilaslan, Hakan; Sundaram, Murali [Department of Radiology, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905 (United States); Unni, Krishnan K. [Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905 (United States)

    2003-02-01

    To determine the age distribution, gender, incidence, and imaging findings of vertebral chondroblastoma, and to compare our series with findings from case reports in the world literature.Design and patients Case records and imaging findings of nine histologically documented vertebral chondroblastomas were retrospectively reviewed for patient age, gender, vertebral column location and level, morphology, matrix, edema, soft tissue mass, spinal canal invasion, and metastases. Our findings were compared with a total of nine patients identified from previous publications in the world literature. The histologic findings in our cases was re-reviewed for diagnosis and specifically for features of calcification and secondary aneurysmal bone cyst (ABC). Clinical follow-up was requested from referring institutions. Nine of 856 chondroblastomas arose in vertebrae (incidence 1.4%; thoracic 5, lumbar 1, cervical 2, sacral 1). There were six males and three females ranging in age from 5 to 41 years (mean 28 years). Satisfactory imaging from seven patients revealed the tumor to arise from the posterior elements in four and the body in three. All tumors were expansive, six of seven were aggressive, and the spinal canal was significantly narrowed by bone or soft tissue mass in six. In one patient canal invasion was minimal. Calcification was pronounced in two and subtle in four. The sole nonaggressive-appearing tumor was heavily mineralized. Bony edema and secondary ABC were not seen on MR imaging. None of the cases had microscopic features of significant secondary ABC. Calcification, and specifically ''chicken wire'' calcification, was identified in two patients. Pulmonary metastases occurred in none. Vertebral chondroblastoma is a rare neoplasm that presents later in life than its appendicular counterpart. On imaging it is aggressive in appearance with bone destruction, soft tissue mass, and spinal canal invasion. The lesions contain variable amounts of mineral

  3. GLI3 repressor controls functional development of the mouse ureter

    Science.gov (United States)

    Cain, Jason E.; Islam, Epshita; Haxho, Fiona; Blake, Joshua; Rosenblum, Norman D.

    2011-01-01

    Obstructive and nonobstructive forms of hydronephrosis (increased diameter of the renal pelvis and calyces) and hydroureter (dilatation of the ureter) are the most frequently detected antenatal abnormalities, yet the underlying molecular mechanisms are largely undefined. Hedgehog (Hh) proteins control tissue patterning and cell differentiation by promoting GLI-dependent transcriptional activation and by inhibiting the processing of GLI3 to a transcriptional repressor. Genetic mutations that generate a truncated GLI3 protein similar in size to the repressor in humans with Pallister-Hall syndrome (PHS; a disorder whose characteristics include renal abnormalities) and hydroureter implicate Hh-dependent signaling in ureter morphogenesis and function. Here, we determined that Hh signaling controls 2 cell populations required for the initiation and transmission of coordinated ureter contractions. Tissue-specific inactivation of the Hh cell surface effector Smoothened (Smo) in the renal pelvic and upper ureteric mesenchyme resulted in nonobstructive hydronephrosis and hydroureter characterized by ureter dyskinesia. Mutant mice had reduced expression of markers of cell populations implicated in the coordination of unidirectional ureter peristalsis (specifically, Kit and hyperpolarization-activation cation–3 channel [Hcn3]), but exhibited normal epithelial and smooth muscle cell differentiation. Kit deficiency in a mouse model of PHS suggested a pathogenic role for GLI3 repressor in Smo-deficient embryos; indeed, genetic inactivation of Gli3 in Smo-deficient mice rescued their hydronephrosis, hydroureter, Kit and Hcn3 expression, and ureter peristalsis. Together, these data demonstrate that Hh signaling controls Kit and Hcn3 expression and ureter peristalsis. PMID:21339645

  4. Evidence for Alpha Receptors in the Human Ureter

    Science.gov (United States)

    Madeb, Ralph; Knopf, Joy; Golijanin, Dragan; Bourne, Patricia; Erturk, Erdal

    2007-04-01

    An immunohistochemical and western blot expression analysis of human ureters was performed in order to characterize the alpha-1-adrenergic receptor distribution along the length of the human ureteral wall. Mapping the distribution will assist in understanding the potential role alpha -1-adrenergic receptors and their subtype density might have in the pathophysiology of ureteral colic and stone passage. Patients diagnosed with renal cancer or bladder cancer undergoing nephrectomy, nephroureterectomy, or cystectomy had ureteral specimens taken from the proximal, mid, distal and tunneled ureter. Tissues were processed for fresh frozen examination and fixed in formalin. None of the ureteral specimens were involved with cancer. Serial histologic sections and immunohistochemical studies were performed using antibodies specific for alpha-1-adrenergic receptor subtypes (alpha 1a, alpha 1b, alpha 1d). The sections were examined under a light microscope and scored as positive or negative. In order to validate and quantify the alpha receptor subtypes along the human ureter. Western blotting techniques were applied. Human ureter stained positively for alpha -1-adrenergic receptors. Immunostaining appeared red, with intense reaction in the smooth muscle of the ureter and endothelium of the neighboring blood vessels. There was differential expression between all the receptors with the highest staining for alpha-1D subtype. The highest protein expression for all three subtypes was in the renal pelvis and decreased with advancement along the ureter to the distal ureter. At the distal ureter, there was marked increase in expression as one progressed towards the ureteral orifice. The same pattern of protein expression was exhibited for all three alpha -1-adrenergic receptor subtypes. We provide preliminary evidence for the ability to detect and quantify the alpha-1-receptor subtypes along the human ureter which to the best of our knowledge has never been done with

  5. Double, ectopic blind-end ureter: a case report.

    Science.gov (United States)

    Hudolin, Tvrtko; Kastelan, Zeljko; Goluza, Eleonora; Basić-Jukic, Nikolina; Sosić, Hrvoje; Padovan-Stern, Ranka; Pasini, Josip

    2010-06-01

    We report a case of a complete, ectopic blind-ending ureteral duplication in a 26-year-old man who presented with the symptoms of an acute urinary tract infection for the first time. Since anamnestic data and clinical examination indicated a complicated urinary infection he was referred for further examination. On the left side, the imaging studies revealed a normal ureter draining the lower pole of the kidney and a blind-ending ureter with ectopia in the seminal vesicle. The patient recovered completely following surgical removal of the blind-ending ureter.

  6. Four cases of lowered urethral pressure in canine ectopic ureter.

    Science.gov (United States)

    Koie, H; Yamaya, Y; Sakai, T

    2000-11-01

    To evaluate the function of the constrictor urethrae of dogs that had urinary incontinence and were diagnosed as having ectopic ureter, the urethral pressure profile (UPP) was measured by means of a microchip catheter transducer. The UPPs (14.5 +/- 3.3 mmHg) of the four dogs suffering from ectopic ureter were much lower (pdogs (35.3 +/- 5.7 mmHg). In the cases of ectopic ureter, it was shown that the UPP was lowered, and it was suggested that this would lead to the expression of urinary incontinence.

  7. Transcaval ureter: a rare embryological anomaly causing obstructive uropathy.

    Science.gov (United States)

    Giddy, Stephanie; Thangasamy, Isaac; Vega Vega, Antonio

    2015-02-18

    A 21-year-old woman presented with a longstanding history of episodic right flank pain related to fluid consumption and recurrent urinary tract infections. On examination, there was right costovertebral angle tenderness. Renal tract ultrasound demonstrated hydronephrosis and CT urography confirmed transcaval ureter. The patient's clinical presentation was likely due to obstruction associated with the right ureter passing through the opening created by the duplicated segment of the inferior vena cava. While asymptomatic transcaval ureter can be managed conservatively, severe symptoms or complications of ureteric obstruction may require surgical treatment. In this case, treatment comprised a laparoscopic ureteroureterostomy with an end-to-end anastomosis between the proximal and distal sections of the right ureter. The patient's postoperative recovery was uneventful and she reported resolution of the flank pain during the one year of follow-up. 2015 BMJ Publishing Group Ltd.

  8. Brg1 Determines Urothelial Cell Fate during Ureter Development

    Science.gov (United States)

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

    2013-01-01

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

  9. Peritoneal implantation of ureter in cadaveric renal transplant.

    Science.gov (United States)

    Tsang, C F; Ma, W K; Cheung, F K

    2015-06-01

    We report here a case of complication of peritoneal implantation of ureter in cadaveric renal transplant. The patient presented with anuria and delayed graft function. The diagnosis was suspected upon physical examination and radiological investigation. The complication was managed with reimplantation of the ureter into the bladder and the patient recovered with good graft function. We discuss this case, review the literature on this rare complication, and share our suggestions on how it can be prevented.

  10. Unusual Complication of Bladder Catheterization in Child: Catheterization of Ureter

    Directory of Open Access Journals (Sweden)

    Tamer Sekmenli

    2015-01-01

    Full Text Available Bladder probing is an invasive procedure that is often used by paediatric and other surgeons. We present a case who was ureter catheterized accidentally while placing a probe into the right ureter in an 18 months old female. If different catheter localization is determined during the examination, the process must be terminated immediately and the relevant specialist should be informed right away.

  11. Ureter Injury as a Complication of Oblique Lumbar Interbody Fusion.

    Science.gov (United States)

    Lee, Hyeong-Jin; Kim, Jin-Sung; Ryu, Kyeong-Sik; Park, Choon Keun

    2017-06-01

    Oblique lumbar interbody fusion is a commonly used surgical method of achieving lumbar interbody fusion. There have been some reports about complications of oblique lumbar interbody fusion at the L2-L3 level. However, to our knowledge, there have been no reports about ureter injury during oblique lumbar interbody fusion. We report a case of ureter injury during oblique lumbar interbody fusion to share our experience. A 78-year-old male patient presented with a history of lower back pain and neurogenic intermittent claudication. He was diagnosed with spinal stenosis at L2-L3, L4-L5 level and spondylolisthesis at L4-L5 level. Symptoms were not improved after several months of medical treatments. Then, oblique lumbar interbody fusion was performed at L2-L3, L4-L5 level. During the surgery, anesthesiologist noticed hematuria. A retrourethrogram was performed immediately by urologist, and ureter injury was found. Ureteroureterostomy and double-J catheter insertion were performed. The patient was discharged 2 weeks after surgery without urologic or neurologic complications. At 2 months after surgery, an intravenous pyelogram was performed, which showed an intact ureter. Our study shows that a low threshold of suspicion of ureter injury and careful manipulation of retroperitoneal fat can be helpful to prevent ureter injury during oblique lumbar interbody fusion at the upper level. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Retrocaval ureter presenting at 6 years of age in a girl child - An extreme rarity.

    Science.gov (United States)

    Kajal, Pradeep; Rattan, Kamal; Sangwan, Vijender; Bhutani, Namita

    2016-04-01

    Retrocaval ureter is one of the very rare congenital anomalies. We report a case of retrocaval ureter in a 6-year-old girl who presented with right flank pain and hydronephrosis. The diagnosis was made on intravenous urography which showed typical "J" shape deformity in the proximal dilated ureter with moderate hydronephrosis. CT scan delineated the course of ureter. The patient was operated and findings were confirmed. The ureter was transected near the pelvis and a pyeloureteric anastomosis with pre-caval transposition of the ureter was performed and the patient was discharged in fair health.

  13. Retrocaval ureter presenting at 6 years of age in a girl child – An extreme rarity

    Directory of Open Access Journals (Sweden)

    Pradeep Kajal

    2016-04-01

    Full Text Available Retrocaval ureter is one of the very rare congenital anomalies. We report a case of retrocaval ureter in a 6-year-old girl who presented with right flank pain and hydronephrosis. The diagnosis was made on intravenous urography which showed typical “J” shape deformity in the proximal dilated ureter with moderate hydronephrosis. CT scan delineated the course of ureter. The patient was operated and findings were confirmed. The ureter was transected near the pelvis and a pyeloureteric anastomosis with pre-caval transposition of the ureter was performed and the patient was discharged in fair health.

  14. Carcinoma of the renal pelvis and ureter

    Directory of Open Access Journals (Sweden)

    Fernando Korkes

    2006-12-01

    Full Text Available OBJECTIVE: To assess the occurrence of upper urinary tract urothelial tumors (UUTT in Brazil. MATERIALS AND METHODS: We performed a clinical and histopathologic study of 33 patients who were diagnosed with a malignant neoplasm in the renal pelvis or ureter in the period of 1994 to 2004, in a single institution. RESULTS: Among the patients with upper urinary tract carcinoma, 70% were males and 30% females, with mean age of 65 ± 16 years (ranging from 31 to 91 years. Nineteen patients presented renal pelvis tumor (58%, 9 ureteral tumor (27% and 5 synchronic pelvic and ureteral tumors (15%. Renal pelvis tumors represented 2.8% of all the urothelial neoplasms, and 11.4% of all renal neoplasms treated in the same period. Ureteral tumors represented 1.6% of all the urothelial malignancies surgically managed in these 11 years. Tobacco smoking was the most common risk factor, and analgesic abuse was not reported by those patients. Most carcinomas were high-grade and muscle-invasive. Mean time to diagnosis was 7 months, being hematuria the most common symptom. CONCLUSIONS: A high association was also found between UUTT and bladder urothelial carcinoma. UUTT were mostly seen in men in their seventies and related to a high overall and cancer-related mortality rate. The overall disease-specific survival was 40%, much lower than found in most of the reported series.

  15. [Hydropneumatic dilatation of the ureter: A technical option in ureteropyeloplasty].

    Science.gov (United States)

    Gallego-Grijalva, Jorge E; Jaimes-Jiménez, Ricardo; Alvarado-García, Rafael; Terriquez-Rodríguez, Sergio

    2003-01-01

    The pyeloureteric junction (UP) is the site of obstruction commonest in the upper tract urinary. Several surgical techniques exist and the main complication is the stricture by the disproportion between both ends. The hydropneumatic dilatation of the ureteric would increase of the 5:1 to 2:1 the light of the ureter, improving technically anastomosis and reducing complications. They studied 27 patients with diagnose of Estenosis UP in the Paediatric Urologist Service of CMN 20 of November of the ISSSTE, being made dismembered Pyeloplasty pyeloureteric in all, introducing Fogarty catheter in the Ureter carrying out the hydropneumatic dilatation of the same one, introduction of catheter double J in ureter and in the last patient without this, previous one to the anastomosis. All had a pursuit of 6 months. Of the 27 patients, 21 masculine ones (77.78%), 6 feminine ones (22.22%), of the right side 10 (37.04%), left 14 (51.85%) and bilateral 3 (11.11%). In the 27 studied patients postoperating complications did not appear. To all the patients I am made the dilatation to them hydropneumatics of the Ureter during UP plasty, did not present/display postoperating complications, the anastomosis is carried out with greater technical facility since the light of the Ureteric increase from 5:1 in 2:1, and in I complete case without ferulization of the Ureter, I do not present/display complications. DOSCUSSION: The hydropneumatics dilatation of the Ureter is a technical option in the Surgical handling of stricture UP, facilitating the anastomosis, diminishing the postoperating complications, making the ferulization do withoutible of the Ureter.

  16. Single surgeon experience with robot-assisted ureteroureterostomy for pathologies at the proximal, middle, and distal ureter in adults.

    Science.gov (United States)

    Lee, Ziho; Llukani, Elton; Reilly, Christopher E; Mydlo, Jack H; Lee, David I; Eun, Daniel D

    2013-08-01

    To describe our initial experience with robot-assisted ureteroureterostomy (RUU) at the proximal, middle, and distal ureter. Twelve consecutive patients underwent RUU by a single surgeon (D.D.E.) between July 2009 and November 2012. Indications included three iatrogenic injuries, two impacted stones, two ureterovaginal fistulas, two idiopathic ureteral strictures refractory to conservative treatment, one primary transitional cell carcinoma of the ureter, one colon cancer metastasis to the ureter, and one invasive endometriosis. There were two proximal, three middle, and seven distal ureteral pathologies. Tension-free anastomosis was achieved in all 12 patients. All patients with proximal and middle ureteral pathology received concomitant downward nephropexy (DN) as a standard part of RUU. Mean age of patients at the time of surgery was 52 years (range 30-69), mean body mass index was 30.0 kg/m(2) (range 21-38), mean operative room time was 190 minutes (range 104-354), mean estimated blood loss was 181 mL (range 50-400), and mean length of excised ureter on pathologic analysis was 2.0 cm (range 1.0-4.5). There was one intraoperative complication in which liver and gallbladder laceration occurred during trocar placement. Mean length of hospital stay was 1.4 days (range 1-5), and there were no postoperative complications. Mean follow up was 10 months (range 3-36). One patient had a ureteral stricture recurrence at 7 months postoperatively that led to renal unit loss and eventual nephrectomy. RUU is feasible, safe, and demonstrates good outcomes for pathologies at the proximal, middle, and distal ureter. Concomitant DN during RUU may assist in achieving a tension-free anastomosis for proximal and middle ureteral repairs.

  17. Pelvicalyceal system duplication with ectopic ureter – diagnostic difficulties associated with the imaging procedure. Two cases report

    Directory of Open Access Journals (Sweden)

    Agnieszka Pukajło-Marczyk

    2014-09-01

    Full Text Available Urinary tract abnormalities are the most frequently occurring developmental anomaly in children. Pelvicalyceal system duplication is one of them and signifies the existence of two urine diverting separate systems. This anomaly occurs in 10% of population, usually in girls, and is associated with complete or partial ureter duplication. The frequency of total ureter duplication, which in 20–40% of patients is found as bilateral, is 1:125 children (0.8% of the population. The most frequent malformation is asymptomatic, diagnosed coincidentally casually and does not require any treatment. In some patients with pelvicalyceal system duplication, vesicoureteral reflux (VUR and ectopic ureter may coexist. Malposition of ureter’s orifice into the bladder predispose to urinary retention, development of hydronephrosis and urinary tract infection (UTI. Ectopic ureterocele is recognized in 6–20% of children with recurrent UTI. The reason why children are referred to the hospital is UTI or hydronephrosis revealed by ultrasound imaging. When the ultrasound image of pelvicalyceal system duplication is ambiguous, micturating cystourethrography (MCU and scintigraphy become the primary diagnostic procedure, or urography – in more complicated cases. In the case of ectopic ureter, the danger of inappropriate catheterization, i.e. directly into its lumen, may occur. Though very rare, this may cause some diagnostic difficulties and lead to injury of the urinary tract. For this reason, we want to further discuss this complication following a diagnostic procedure on the example of two cases of pelvicalyceal system duplication with ectopic ureter.

  18. TCC in Transplant Ureter--When and When Not to Preserve the Transplant Kidney.

    Science.gov (United States)

    Olsburgh, J; Zakri, R H; Horsfield, C; Collins, R; Fairweather, J; O'Donnell, P; Koffman, G

    2016-02-01

    We present four cases of transitional cell carcinoma of the transplant ureter (TCCtu). In three cases, localized tumor resection and a variety of reconstructive techniques were possible. Transplant nephrectomy with cystectomy was performed as a secondary treatment in one locally excised case. Transplant nephroureterectomy was performed as primary treatment in one case. The role of oncogenic viruses and genetic fingerprinting to determine the origin of TCCtu are described. Our cases and a systematic literature review illustrate the surgical, nephrological, and oncological challenges of this uncommon but important condition. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

  19. Fluid Structural Analysis of Urine Flow in a Stented Ureter.

    Science.gov (United States)

    Gómez-Blanco, J Carlos; Martínez-Reina, F Javier; Cruz, Domingo; Pagador, J Blas; Sánchez-Margallo, Francisco M; Soria, Federico

    2016-01-01

    Many urologists are currently studying new designs of ureteral stents to improve the quality of their operations and the subsequent recovery of the patient. In order to help during this design process, many computational models have been developed to simulate the behaviour of different biological tissues and provide a realistic computational environment to evaluate the stents. However, due to the high complexity of the involved tissues, they usually introduce simplifications to make these models less computationally demanding. In this study, the interaction between urine flow and a double-J stented ureter with a simplified geometry has been analysed. The Fluid-Structure Interaction (FSI) of urine and the ureteral wall was studied using three models for the solid domain: Mooney-Rivlin, Yeoh, and Ogden. The ureter was assumed to be quasi-incompressible and isotropic. Data obtained in previous studies from ex vivo and in vivo mechanical characterization of different ureters were used to fit the mentioned models. The results show that the interaction between the stented ureter and urine is negligible. Therefore, we can conclude that this type of models does not need to include the FSI and could be solved quite accurately assuming that the ureter is a rigid body and, thus, using the more simple Computational Fluid Dynamics (CFD) approach.

  20. Inguino-scrotal herniation of the ureter containing stones.

    Science.gov (United States)

    Prete, F P; Pezzolla, A; De Leo, V; Di Palma, G; Prete, F

    2016-12-01

    Inguino-scrotal herniation of the ureter is a rare and difficult situation for a surgeon, especially if only recognized during inguinal hernia repair. An 83-year-old gentleman, with a previous history of radiation treatment for squamous anal cancer, presented with a large left inguinoscrotal hernia causing occasional pain at the base of the scrotum. Follow-up, post-radiation therapy CT scan showed a hernia sac containing the bladder and large bowel. Calcifications in the sac were interpreted as bladder stones, in keeping with the history of left renal calculi. During hernia repair careful dissection revealed a herniated portion of the left ureter located alongside a large hernia sac, complicated by ureteral calculi. Following stones extraction and ureteral repair, hernia repair with mesh was successfully accomplished. Pathogenesis of ureteric herniation is reviewed. A herniated ureter is potentially a source of serious renal or ureteral complications. When discovered, ureteric hernias should be surgically repaired. If preoperative detection of a ureter herniation alongside an inguinal hernia is missed, awareness of the existence of this condition may help avoid iatrogenic ureteral damage injury during a complex hernioplasty. Documentation of unexplained, sizeable and distinct calcifications in an inguino-scrotal hernia sac, particularly in a patient with a history of urolithiasis, may suggest the presence of a herniated, calculus-filled ureter. In such cases, retrograde pyelograms may be considered for a definitive diagnosis prior to surgery.

  1. Fstl1 Antagonizes BMP Signaling and Regulates Ureter Development

    Science.gov (United States)

    Gong, Jianfeng; Yu, Mingyan; Zhang, Fangxiong; Sha, Haibo; Gao, Xiang

    2012-01-01

    Bone morphogenetic protein (BMP) signaling pathway plays important roles in urinary tract development although the detailed regulation of its activity in this process remains unclear. Here we report that follistatin-like 1 (Fstl1), encoding a secreted extracellular glycoprotein, is expressed in developing ureter and antagonizes BMP signaling activity. Mouse embryos carrying disrupted Fstl1 gene displayed prominent hydroureter arising from proximal segment and ureterovesical junction defects. These defects were associated with significant reduction in ureteric epithelial cell proliferation at E15.5 and E16.5 as well as absence of subepithelial ureteral mesenchymal cells in the urinary tract at E16.5 and E18.5. At the molecular level, increased BMP signaling was found in Fstl1 deficient ureters, indicated by elevated pSmad1/5/8 activity. In vitro study also indicated that Fstl1 can directly bind to ALK6 which is specifically expressed in ureteric epithelial cells in developing ureter. Furthermore, Sonic hedgehog (SHH) signaling, which is crucial for differentiation of ureteral subepithelial cell proliferation, was also impaired in Fstl1-/- ureter. Altogether, our data suggest that Fstl1 is essential in maintaining normal ureter development by antagonizing BMP signaling. PMID:22485132

  2. Electrical propagation in the renal pelvis, ureter and bladder.

    Science.gov (United States)

    Hammad, F T

    2015-02-01

    Under normal conditions, following the passage of urine from the collecting duct, the urine is stored briefly in the renal pelvis before being transported through the ureter to the bladder where the urine is stored for a longer time (hours) before being voided through the urethra. The transport of urine from the renal pelvis to the bladder occurs spontaneously due to contractions of the muscles in the wall of the pelvis and ureter. Spontaneous contractions also occur in the detrusor muscle and are responsible for maintaining the bladder shape during the filling phase. These muscle contractions occur as result of electrical impulses, which are generated and propagated through different parts of the urinary tract. The renal pelvis and the ureter differ from the bladder in relation to the origin, characteristics and propagation of these electrical impulses. In the ureter, the electrical impulses originate mainly at the proximal region of the renal pelvis and are transmitted antegradely down the length of the ureter. The electrical impulses in the bladder, on the other hand, originate at any location in the bladder wall and can be transmitted in different directions with the axial direction being the prominent one. In this manuscript, an overview of the current state of research on the origin and propagation characteristics of these electrical impulses in the normal and pathological conditions is provided. © 2014 Scandinavian Physiological Society. Published by John Wiley & Sons Ltd.

  3. DMRT genes in vertebrate gametogenesis.

    Science.gov (United States)

    Zarkower, David

    2013-01-01

    Genes containing the DM domain DNA-binding motif regulate sex determination and sexual differentiation in a broad variety of metazoans, including nematodes, insects, and vertebrates. They can function in primary sex determination or downstream in sexual differentiation, and they can act either throughout the body or in highly restricted cell types. In vertebrates, several DM domain genes--DMRT genes--play critical roles in gonadal differentiation or gametogenesis. DMRT1 has the most prominent role and likely regulates testicular differentiation in all vertebrates. In the mammalian gonad, DMRT1 exerts both intrinsic and extrinsic control of gametogenesis; it is required for germ cell differentiation in males and regulates meiosis in both sexes, and it is required in supporting cells for the establishment and maintenance of male fate in the testis. These varied functions of DMRT1 serve to coordinate gonadal development and function. In other vertebrates, DMRT1 regulates gonadal differentiation, and it also appears to have played a central role in the evolution of new sex-determining mechanisms in at least three vertebrate clades. This chapter focuses on the regulation of vertebrate gametogenesis by DMRT1. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Primary

    Directory of Open Access Journals (Sweden)

    Mahmoud Abbas

    2014-03-01

    Immunohistochemically: The tumor showed positivity for CK7, CK20, CK8/18, GATA-3, MSH-2, MSH-6, MLH-1, Ber-EP4, and S-100-P with focal positivity for CDX-2, weak positivity for PMS-2 and negativity in TTF-1 and Her-2. Molecular pathological analysis revealed microsatellite stability and without mutation in K-ras-gene. Thus, a diagnosis of mucinous adenocarcinoma of the renal pelvis with in situ adenocarcinoma of the ureter was made.

  5. Villous Adenoma of the Ureter with Manifestation of Mucus Hydroureteronephrosis

    Directory of Open Access Journals (Sweden)

    Chi-Min Shih

    2007-01-01

    Full Text Available Ureteral tumor is prone to result in lumen obstruction. Villous adenoma is most frequently found in the colon and rectum, seldom in the urinary tract and even more rarely in the ureter or pelvis. Herein, we present a case of bilateral renal stones of more than 10 years' duration with the chief complaint of right flank pain. Obstruction of the right upper ureter with hydroureteronephrosis was observed on sonography, computed tomography and retrograde pyelography. Ureteroscopy revealed papillary tumor obstructing the upper third of the ureter and inducing hydroureteronephrosis with abundant mucoid content. The ureteral tumor proved to be villous adenoma by pathologic examination. It should be noted that ureteral villous adenoma may be related to previous enteric-type metaplastic mucosa or ureteritis glandularis, demonstrates profuse production of mucus, and may eventually undergo malignant transformation.

  6. Stone/ureter identification during alexandrite laser lithotripsy

    Science.gov (United States)

    Scheu, M.; Flemming, Gabriela; Engelhardt, Ralf

    1991-07-01

    A spectroscopic stone/ureter identification system is already in clinical use for pulsed dye laser lithotripters (590 nm). Alexandrite lasers are believed to be a solid-state laser alternative to pulsed dye lasers in lithotripsy. We investigated different spectroscopic stone/ureter detection schemes for the q-switched alexandrite laser (750 nm and 375 nm), including plasma detection, spectral LIF analysis, and time resolved LIF intensity analysis. Additionally, we investigated the possibility to identify different stone types using laser induced fluorescence exited at UV wavelengths.

  7. Peristomal pagetoid spread of urothelial carcinoma of the ureter

    Directory of Open Access Journals (Sweden)

    Fumio Ito

    2013-09-01

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

  8. Carcinosarcoma of the Ureter and Urinary Bladder: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Cha, Yoon Ki; Kim, Soo Hyun; Kang, Mi Jin; Kim, Ji Young; Kim, Soung Hee; Cho, Hyun Sun; Jeong, Myeong Ja [Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

    2010-12-15

    Carcinosarcoma is biphasic neoplasm with distinct carcinomatous and sarcomatous components. Carcinosarcoma arising from the urinary system is extremely rare and only 14 such cases of the ureteral carcinosarcoma have been reported in the medical literature. We experienced a case of surgically proven carcinosarcoma of the ureter and urinary bladder and we report here on the computed tomography findings of this rare neoplasm

  9. Retrocaval ureter with vesicoureteric reflux, a very rare entity

    African Journals Online (AJOL)

    M.C. Arya

    2016-12-26

    Dec 26, 2016 ... Therefore, we are following up with options of extravesical ureteric reimplanation or subureteric teflon injection in case he presents with recurrent urinary tract infection. In these types of situations we should treat the obstructive lesion first, followed by treatment of reflux if needed, without severing the ureter.

  10. Retrocaval ureter: a report on two neonates | Bassiouny | Annals of ...

    African Journals Online (AJOL)

    Retrocaval ureter is a relatively rare anomaly that usually manifests in the third or the fourth decade of life. Its symptoms are because of ureteric obstruction, caused extrinsically by an abnormal inferior vena cava, intrinsically by ureteric hypoplasia, or both. Surgery is needed for symptomatic patients and involves transection ...

  11. [Avoidance and management of complications in open surgical ureter reconstruction].

    Science.gov (United States)

    Lazica, D A; Brandt, A S; Roth, S

    2014-07-01

    Open surgical reconstruction of the ureter is a urological procedure with a potentially high risk of complications. The correct selection of patients and time of operation are important aspects regarding the treatment strategy. Position and length of the affected ureter segment to be reconstructed determine the surgical intervention possibilities. The psoas hitch procedure is a well-established technique for distal reconstruction of the ureter where most iatrogenic injuries occur. In more proximal or complex defects, several procedures are available. Partial or complete replacement of the ureter with bowel is still considered the standard for bridging long ureteral defects but is accompanied with higher intra- and postoperative complication rates. In specific patients and situations, autotransplantation of the kidney and subcutaneous pyelovesical bypasses are clinical options. Using mucosal grafts or tissue engineering may be new therapeutic prospects to cover ureteral defects but the clinical impact still needs to be clarified. All therapeutic strategies share the fact that great surgical expertise and experience are necessary as the operative technique must be mastered to avoid severe complications.

  12. Robotic repair of retrocaval ureter: A case series | Nayak | African ...

    African Journals Online (AJOL)

    Subjects and methods: This is a prospective case series of five consecutive patients who underwent robotic retrocaval ureter repair at our institute from August 2006 to September 2009. Pre-operative imaging included intravenous urogram, contrast enhanced CT scan and diuretic renography. All cases were done through a ...

  13. Effects of transforming growth factor on the developing embryonic ureter: An in-vitro megaureter model in mice.

    Science.gov (United States)

    Ozturk, E; Telli, O; Gokce, M I; Ozcan, C; Okutucu, T M; Soygur, T; Burgu, B

    2016-10-01

    -vitro megaureter model. The finding that TGF-β is highest in embryonic ureters in vivo and decreased postnatally suggests that a pathological persistence might potentially explain the pathogenesis of primary megaureters. Copyright © 2016 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  14. A Case Report of an Incidentally Diagnosed Blind-ending Bifid Ureter in a Patient with Ovarian Cancer.

    Science.gov (United States)

    Enkhbaatar, Nandin E; Ono, Shun; Ichikawa, Tamaki; Hoshi, Akio; Terachi, Toshiro; Ogura, Go; Kondo, Yusuke; Ikeda, Masae; Imai, Yutaka

    2016-03-20

    A 58-year-old Japanese female was admitted to our hospital for treatment of ovarian cancer. She had no urinary tract symptoms at the time of presentation. Preoperative CT (Computed Tomography) was performed for surgical planning, and it revealed two left-sided ureters including a short ureter with a blind, cystic ending and a short ureter joined to the main ureter before entering into the bladder. On CT urography, these radiological findings were compatible with a blind-ending bifid ureter. Preoperatively, a double J stent was inserted into the normal left ureter, and then the blind-ending bifid ureter was resected before an ovarian cancer operation.

  15. Hydrogen sulfide plays a key role in the inhibitory neurotransmission to the pig intravesical ureter.

    Science.gov (United States)

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

    2014-01-01

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

  16. Primary culture of avian embryonic heart forming region cells to study the regulation of vertebrate early heart morphogenesis by vitamin A.

    Science.gov (United States)

    Cakstina, Inese; Riekstina, Una; Boroduskis, Martins; Nakurte, Ilva; Ancans, Janis; Zile, Maija H; Muiznieks, Indrikis

    2014-02-19

    Important knowledge about the role of vitamin A in vertebrate heart development has been obtained using the vitamin A-deficient avian in ovo model which enables the in vivo examination of very early stages of vertebrate heart morphogenesis. These studies have revealed the critical role of the vitamin A-active form, retinoic acid (RA) in the regulation of several developmental genes, including the important growth regulatory factor, transforming growth factor-beta2 (TGFβ2), involved in early events of heart morphogenesis. However, this in ovo model is not readily available for elucidating details of molecular mechanisms determining RA activity, thus limiting further examination of RA-regulated early heart morphogenesis. In order to obtain insights into RA-regulated gene expression during these early events, a reliable in vitro model is needed. Here we describe a cell culture that closely reproduces the in ovo observed regulatory effects of RA on TGFβ2 and on several developmental genes linked to TGFβ signaling during heart morphogenesis. We have developed an avian heart forming region (HFR) cell based in vitro model that displays the characteristics associated with vertebrate early heart morphogenesis, i.e. the expression of Nkx2.5 and GATA4, the cardiogenesis genes, of vascular endothelial growth factor (VEGF-A), the vasculogenesis gene and of fibronectin (FN1), an essential component in building the heart, and the expression of the multifunctional genes TGFβ2 and neogenin (NEO). Importantly, we established that the HFR cell culture is a valid model to study RA-regulated molecular events during heart morphogenesis and that the expression of TGFβ2 as well as the expression of several TGFβ2-linked developmental genes is regulated by RA. Our findings reported here offer a biologically relevant experimental in vitro system for the elucidation of RA-regulated expression of TGFβ2 and other genes involved in vertebrate early cardiovascular morphogenesis.

  17. A Novel Endoscope System for Position Detection and Depth Estimation of the Ureter.

    Science.gov (United States)

    Song, Enmin; Yu, Feng; Liu, Hong; Cheng, Ning; Li, Yunlong; Jin, Lianghai; Hung, Chih-Cheng

    2016-12-01

    Iatrogenic injury of ureter occurs occasionally in the clinical laparoscopic surgery. The ureter injury may cause the serious complications and kidney damage. To avoid such an injury, it is necessary to detect the ureter position in real-time. Currently, the endoscope cannot perform this type of function in detecting the ureter position in real-time. In order to have the real-time display of ureter position during the surgical operation, we propose a novel endoscope system which consists of a modified endoscope light and a new lumiontron tube with the LED light. The endoscope light is modified to detect the position of ureter by using our proposed dim target detection algorithm (DTDA). To make this new system functioning, two algorithmic approaches are proposed for the display of ureter position. The horizontal position of ureter is detected by the center line extraction method and the depth of ureter is estimated by the depth estimation method. Experimental results demonstrate that the proposed endoscope system can extract the position and depth information of ureter and exhibit superior performance in terms of accuracy and stabilization.

  18. Automated detection of ureter abnormalities on multi-detector row CT urography

    Science.gov (United States)

    Hadjiiski, Lubomir; Sahiner, Berkman; Caoili, Elaine M.; Cohan, Richard H.; Chan, Heang-Ping

    2006-03-01

    We are developing a CAD system for automated detection of ureter abnormalities on multi-detector row CT urography, which potentially can assist radiologists in detecting ureter cancer. In the first stage of the CAD system, given an initial starting point, the ureter is tracked based on the CT values of the contrast-filled lumen. In the second stage, lesion candidates are detected using histogram and shape analysis to separate the abnormality from the background, which is the ureter filled with contrast material. A uniformity measure is designed to detect non-uniformity of the CT values within the ureter volume. If a ureter abnormality is present, the CT values uniformity will be distorted, resulting in a reduced uniformity measure. The smoothness of the ureter wall is also estimated using a shape measure. A rule-based system is used to combine the two measures. In this pilot study, a limited data set of 11 patients with biopsy-proven lesions was used. Nine patients had 12 ureter cancers and 6 benign lesions and the remaining two patients had 2 benign lesions. The average lesions size for the 12 cancers was 7.8mm (range: 2.1mm-9.5mm). The tracking program successfully tracked the ureters in 10 of the patients. Our system detected 75% (15/20) of the ureter lesions with 2.6 (28/11) false positives per patient. 83% (10/12) of the ureter cancers were detected. The preliminary results show that our detection system can track the ureter and detect ureter cancer of medium conspicuity and relatively small size.

  19. Study of the ureter structure in anencephalic fetuses

    Directory of Open Access Journals (Sweden)

    Suelen Costa

    2013-12-01

    Full Text Available Purpose The objective of this paper is to analyze the structure of the ureter in normal and anencephalic human fetuses. Materials and Methods We studied 16 ureters from 8 human fetuses without congenital anomalies aged 16 to 27 weeks post-conception (WPC and 14 ureters from 7 anencephalic fetuses aged 19 to 33 WPC. The ureters were dissected and embedded in paraffin, from which 5 µm thick sections were obtained and stained with Masson trichrome, to quantify smooth muscle cells (SMC and to determine the ureteral lumen area, thickness and ureteral diameter. The samples were also stained with Weigert Resorcin Fucsin (to study elastic fibers and Picro-Sirius Red with polarization and immunohistochemistry analysis of the collagen type III fibers to study collagen. Stereological analysis of collagen, elastic system fibers and SMC were performed on the sections. Data were expressed as volumetric density (Vv-%. The images were captured with an Olympus BX51 microscope and Olympus DP70 camera. The stereological analysis was done using the Image Pro and Image J programs. For biochemical analysis, samples were fixed in acetone, and collagen concentrations were expressed as micrograms of hydroxyproline per mg of dry tissue. Means were statistically compared using the unpaired t-test (p < 0.05. Results The ureteral epithelium was well preserved in the anencephalic and control groups. We did not observe differences in the transitional epithelium in the anencephalic and control groups. There was no difference in elastic fibers and total collagen distribution in normal and anencephalic fetuses. SMC concentration did not differ significantly (p = 0.1215 in the anencephalic and control group. The ureteral lumen area (p = 0.0047, diameter (p = 0.0024 and thickness (p = 0.0144 were significantly smaller in anencephalic fetuses. Conclusions Fetuses with anencephaly showed smaller diameter, area and thickness. These differences could indicate that anencephalic fetal

  20. Third-generation percutaneous vertebral augmentation systems.

    Science.gov (United States)

    Vanni, Daniele; Galzio, Renato; Kazakova, Anna; Pantalone, Andrea; Grillea, Giovanni; Bartolo, Marcello; Salini, Vincenzo; Magliani, Vincenzo

    2016-03-01

    Currently, there is no general consensus about the management of osteoporotic vertebral fractures (OVF). In the past, conservative treatment for at least one month was deemed appropriate for the majority of vertebral fractures. When pain persisted after conservative treatment, it was necessary to consider surgical interventions including: vertebroplasty for vertebral fractures with less than 30% loss of height of the affected vertebral body and kyphoplasty for vertebral fractures with greater than 30% loss of height. Currently, this type of treatment is not feasible. Herein we review the characteristics and methods of operation of three of the most common percutaneous vertebral augmentation systems (PVAS) for the treatment of OVF: Vertebral Body Stenting(®) (VBS), OsseoFix(®) and Spine Jack(®). VBS is a titanium device accompanied by a hydraulic (as opposed to mechanical) working system which allows a partial and not immediate possibility to control the opening of the device. On the other hand, OsseoFix(®) and Spine Jack(®) are accompanied by a mechanical working system which allows a progressive and controlled reduction of the vertebral fracture. Another important aspect to consider is the vertebral body height recovery. OsseoFix(®) has an indirect mechanism of action: the compaction of the trabecular bone causes an increase in the vertebral body height. Unlike the Vertebral Body Stenting(®) and Spine Jack(®), the OsseoFix(®) has no direct lift mechanism. Therefore, for these characteristics and for the force that this device is able to provide. In our opinion, Spine Jack(®) is the only device also suitable for the treatment OVF, traumatic fracture (recent, old or inveterate) and primary or secondary bone tumors.

  1. Ureteral transection due to intraperitoneal course of ureter after pediatric ureteral reimplantation.

    Science.gov (United States)

    Ritch, Jessica M B; Heidemann, Nicole L

    2014-02-01

    Traditional pediatric ureteral reimplantation involved blindly passing a clamp behind the bladder to guide the ureter into a new hiatal opening, potentially resulting in an intraperitoneal ureter. A 44-year-old woman with previous ureteral reimplantation underwent gynecologic laparoscopy. Two fibrous bands attached a segment of small bowel to the abdominal wall. One band was transected and ligated. Postoperative suspicion that the bands represented ureter prompted computed tomography imaging, showing high-grade ureteral obstruction. Retrograde pyelogram revealed urinary extravasation and no continuity with the ureter. Reoperation with ureteroneocystotomy confirmed the bands were ureter coursing through bowel, consistent with injury during ureteral reimplantation. Review of previous surgeries, a high index of suspicion, and prompt urologic consultation are recommended to identify and repair ureter injuries in abnormal anatomy cases.

  2. [Laparoscopic antevasal uretero-ureteral anastomosis for treating retrocaval ureter].

    Science.gov (United States)

    Komyakov, B K; Guliev, B G; Idrisov, Sh N; Shibliev, R G

    2017-07-01

    The article presents a case of laparoscopic antevasal correction of the retrocaval ureter in a 16 year old patient, who was admitted to the hospital with complaints of aching pain in the right lower back. His history was noteworthy of early age onset of intermittent fever accompanied by abdominal and lumbar pain. Blood count and urinalysis were within normal limits, and he was treated symptomatically. However, no renal ultrasound scan was done. Intravenous urography and MSCT showed a retrocaval ureter. The diagnosis was confirmed by retrograde ureteropyelography. With the patient placed in the lateral position, the right ureter was mobilized by transperitoneal access, transected and mobilized from under the inferior vena cava. Anterior uretero-ureteral anastomosis on the stent was performed, drainage was established. The operating time was 90 minutes, blood loss was 60 ml. There were no postoperative complications. Drainage was removed 2 days after surgery and the patient was discharged for outpatient treatment. The stent was removed 6 weeks postoperatively. Control urography showed normal function of both kidneys, no urodynamic abnormality of the upper urinary tract was identified.

  3. Single system ectopic ureter in females: A single center study

    Directory of Open Access Journals (Sweden)

    Gangopadhyaya A

    2007-01-01

    Full Text Available The purpose of this study was to inquire into the clinical features and methods for the diagnosis and management of single-system ectopic ureters associated with renal dysplasia. Materials and Methods: A total of 13 female patients were studied. Main stay of diagnosis was ultrasonography of KUB region and intravenous urography and renal scan was used to confirm the diagnosis. Histopathological evaluation was done in all cases for documentation of renal dysplasia. Result: In eight cases ectopic ureter with dysplastic kidney was seen on left side and in five it was on right side. All the patients were treated with nephroureterectomy of the affected side because of poor functioning of ipsilateral dysplastic kidney. Conclusion: Continuous urinary incontinence in females with a normal voiding pattern should prompt an evaluation for ureteric ectopia and when initial evaluation yields diagnosis of solitary kidney the clinician should be aware of the possibility of a hypoplastic and/or dysplastic on one side and normally functioning kidney on opposite side. Nephroureterectomy is the treatment of choice for unilateral single system ectopic ureter with renal dysplasia of affected side.

  4. A Rare Case of Right Retrocaval Ureter with Duplication of Infrarenal IVC

    Directory of Open Access Journals (Sweden)

    Anees Dudekula

    2014-01-01

    Full Text Available Retrocaval ureter, also known as circumcaval ureter, is a rare congenital anomaly which commonly presents with loin pain in middle age group. Here, ureter passes between the inferior vena cava (IVC and psoas muscle and gets compressed. Duplication of IVC is another rare congenital anomaly in the development of IVC. We present a case of a 49-year-old male who presented with loin pain and upon thorough investigation was found to have retrocaval ureter along with duplication of the infrarenal IVC. We bring forward this rare type of combination of two congenital malformations.

  5. Inguinal Herniation of a Transplant Ureter: Lessons Learned From a Case of "Water Over the Bridge".

    Science.gov (United States)

    Hakeem, Abdul R; Gopalakrishnan, Palanivel; Dooldeniya, Mohantha D; Irving, Henry C; Ahmad, Niaz

    2016-02-01

    Inguinal herniation of the transplant ureter is rare, and there is a paucity of reports in the literature. Herniation is usually secondary to implanting a long redundant ureter and may be precipitated by its course over the spermatic cord. Most often, there is loss of the allograft owing to delayed presentation and chronic ureteric obstruction. Here, we report a case of inguinal herniation of a transplant ureter with obstruction and graft dysfunction. A 72-year-old man presented 9 years after deceased-donor kidney transplant, with progressive graft dysfunction and a symptomatic right inguinal hernia. A nephrostogram and subsequent surgery confirmed herniation of a loop of transplant ureter into the inguinal canal with a proximal dilated ureter and hydronephrosis. A long and redundant ureter had been anastomosed "over" the spermatic cord to the bladder during the original operation. The ureter was shortened by excising the distal segment, and the proximal dilated ureter was anastomosed to the bladder passing it "underneath" the spermatic cord. We used a Vicryl (polyglactin 910) mesh to repair the hernia. The graft function improved to baseline levels after the nephrostomy and remained stable after the surgery. This case emphasizes the need to keep the ureter short, and the importance of passing it underneath the spermatic cord before anastomosing to the bladder. Transplant and general surgeons should be aware of such presentations of graft dysfunction with inguinal hernia to avoid delayed diagnosis and graft loss.

  6. Interaction of mid-infrared laser radiation with soft ureter tissue

    Science.gov (United States)

    Jelinkova, Helena; Kohler, Oto; Nemec, Michal; Koranda, Petr; Sulc, Jan; Drlik, Pavel; Miyagi, Mitsunobu; Shi, Yi-Wei; Matsuura, Yuji; Kokta, Milan R.; Hrabal, Petr

    2004-09-01

    Aim of the work was an investigation of ureter wall perforation possibility by various types of mid-infrared radiations (from 2.01 μm (Tm:YAG) up to 2.94 μm (Er:YAG)) and exploration of the interaction basic characteristic for ureter surface (epithelium) and its deep structures (mesenchym). From results follow that CTH:YAG, Er:YAG, and CTE:YAG laser radiations accomplish a good wall ureter perforation. A distinguished difference appeared in modifications of the ureter tissue - epithelium and mesenchym.

  7. An atrophic crossed fused kidney with an ectopic vaginal ureter causing urine incontinence.

    Science.gov (United States)

    Lin, Victor C; Weng, Hui-Ching; Kian-Lim, Eng; Lin, I-Chang; Yu, Tsan-Jung

    2010-07-01

    An ectopic vaginal ureter is an infrequent cause of urinary incontinence. Most cases are associated with a duplex kidney in which the lower moiety ureter drains into the bladder. Occasionally, some cases of ectopic kidney with single vaginal ectopic ureter can occur. In this study, we present a case of chronic continuous urine incontinence caused by the extremely rare combination of a fused-crossed kidney and a single vaginal ectopic ureter. Laparoscopic nephroureterectomy was carried out smoothly and uneventfully. In our experience, laparoscopic navigation and surgery can be valuable tools to delineate and manage unusual congenital anomalies. Copyright 2010 Elsevier Inc. All rights reserved.

  8. Percutaneous vertebroplasty in the treatment of vertebral body compression fracture secondary to osteogenesis imperfecta

    Energy Technology Data Exchange (ETDEWEB)

    Rami, Parag M.; Heatwole, Eric V.; Boorstein, Jeffrey M. [Center for Vascular and Interventional Radiology, St. Vincent Mercy Medical Center, Toledo, OH (United States); McGraw, Kevin J. [Riverside Methodist Hospital, Columbus, OH (United States)

    2002-03-01

    Percutaneous vertebroplasty, a minimally invasive interventional radiological procedure, has recently been used effectively for the treatment of symptomatic vertebral body compression fractures. Primary indications for vertebroplasty include osteoporotic compression fracture, osteolytic vertebral metastasis and myeloma, and vertebral hemangioma. We present a case and extend the indication of percutaneous vertebroplasty in a patient with a vertebral body compression fracture secondary to osteogenesis imperfecta. (orig.)

  9. A Clinical Prospective Observational Cohort Study on the Prevalence and Primary Diagnostic Accuracy of Occult Vertebral Fractures in Aged Women with Acute Lower Back Pain Using Magnetic Resonance Imaging

    Directory of Open Access Journals (Sweden)

    Atsushi Terakado

    2017-01-01

    Full Text Available Background. Elderly female patients complaints of acute low back pain (LBP may involve vertebral fracture (VF, among which occult VF (OVF: early-stage VF without any morphological change is often missed to be detected by primary X-ray examination. The current study aimed to investigate the prevalence of VF and OVF and the diagnostic accuracy of the initial X-ray in detecting OVF. Method. Subjects were elderly women (>70 years old complaining of acute LBP with an accurate onset date. Subjects underwent lumbar X-ray, magnetic resonance imaging (MRI, and bone mineral density (BMD measurement at their first visit. The distribution of radiological findings from X-ray and magnetic resonance imaging (MRI as well as the calculation of the prevalence of VF and OVF are investigated. Results. The prevalence of VF among elderly women with LBP was 76.5% and L1 was the most commonly injured level. Among VF cases, the prevalence of OVF was 33.3%. Furthermore, osteoporotic patients tend to show increased prevalence of VF (87.5%. The predictive values in detecting VF on the initial plain X-ray were as follows: sensitivity, 51.3%; specificity, 75.0%; and accuracy rate, 56.7%. Conclusions. Acute LBP patients may suffer vertebral injury with almost no morphologic change in X-ray, which can be detected using MRI.

  10. Utility of MR urography in children suspected of having ectopic ureter

    Energy Technology Data Exchange (ETDEWEB)

    Figueroa, Victor H.; Farhat, Walid [The Hospital for Sick Children and University Of Toronto, Department of Pediatric Urology, Toronto (Canada); Chavhan, Govind B.; Oudjhane, Kamaldine [The Hospital for Sick Children and University Of Toronto, Department of Diagnostic Imaging, Toronto (Canada)

    2014-08-15

    Conventional imaging modalities are limited in the assessment of complex lower urinary tract anomalies including ectopic insertion of ureters. MR urography can be useful in these situations. To share our experience with MR urography in assessing lower urinary tract anomalies and to determine its accuracy in depicting ectopic ureters. We conducted a retrospective review of all MR urography examinations done between November 2007 and March 2013 to note the presence or absence of duplex kidneys and insertion of ureters. We reviewed patient charts, surgical findings and results of other investigations including cystoscopy with retrograde ureterogram in order to establish presence or absence of ectopic ureter. This served as a reference standard against which we compared MR urography results. Of 22 MR urography examinations (3 boys, 19 girls; age range 3-16 years, mean 9.2 years) performed during the study period, 19 were performed to rule out ectopic ureters, two to assess complex anatomy and one to rule out crossing vessel in ureteropelvic junction obstruction. MR urography showed ectopic ureter in 9/19 children; one proved to be a false-positive. MR urography correctly showed normal insertion in 7/19 children. In the remaining 3/19 children distal ureter could not be seen, hence insertion was indeterminate on MR urography. One of these children had an ectopic ureter on cystoscopy and surgery. Statistical analysis showed MR urography's sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) to be 88.8-100%, 70-90%, 75-88.8% and 90-100% for the detection of ectopic ureter. MR urography is highly accurate in the assessment of ectopic ureters. In incontinent girls, MR urography should be the method of choice for depicting or ruling out ectopic ureter. (orig.)

  11. Utility of MR urography in children suspected of having ectopic ureter.

    Science.gov (United States)

    Figueroa, Victor H; Chavhan, Govind B; Oudjhane, Kamaldine; Farhat, Walid

    2014-08-01

    Conventional imaging modalities are limited in the assessment of complex lower urinary tract anomalies including ectopic insertion of ureters. MR urography can be useful in these situations. To share our experience with MR urography in assessing lower urinary tract anomalies and to determine its accuracy in depicting ectopic ureters. We conducted a retrospective review of all MR urography examinations done between November 2007 and March 2013 to note the presence or absence of duplex kidneys and insertion of ureters. We reviewed patient charts, surgical findings and results of other investigations including cystoscopy with retrograde ureterogram in order to establish presence or absence of ectopic ureter. This served as a reference standard against which we compared MR urography results. Of 22 MR urography examinations (3 boys, 19 girls; age range 3-16 years, mean 9.2 years) performed during the study period, 19 were performed to rule out ectopic ureters, two to assess complex anatomy and one to rule out crossing vessel in ureteropelvic junction obstruction. MR urography showed ectopic ureter in 9/19 children; one proved to be a false-positive. MR urography correctly showed normal insertion in 7/19 children. In the remaining 3/19 children distal ureter could not be seen, hence insertion was indeterminate on MR urography. One of these children had an ectopic ureter on cystoscopy and surgery. Statistical analysis showed MR urography's sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) to be 88.8-100%, 70-90%, 75-88.8% and 90-100% for the detection of ectopic ureter. MR urography is highly accurate in the assessment of ectopic ureters. In incontinent girls, MR urography should be the method of choice for depicting or ruling out ectopic ureter.

  12. Prevalence of Vertebral Fractures in Children with Suspected Osteoporosis.

    Science.gov (United States)

    Kyriakou, Andreas; Shepherd, Sheila; Mason, Avril; Ahmed, S Faisal

    2016-12-01

    To explore the prevalence and anatomic distribution of vertebral fractures in disease groups investigated for primary and secondary osteoporosis, using vertebral fracture assessment (VFA). VFA was performed independently by 2 nonradiologists, in 165 children (77 males, 88 females) as part of their investigation for osteoporosis. Vertebral bodies from T6 to L4 were assessed for vertebral fractures using the Genant scoring system. The common readings for the presence of vertebral fractures were used for evaluating the prevalence and anatomic distribution of vertebral fractures. The median age of the subjects was 13.4 years (range, 3.6, 18). Of the 165 children, 24 (15%) were being investigated for primary bone disease, and the remainder had a range of chronic diseases known to affect bone health. Vertebral fractures were identified in 38 (23%) children. The distribution of the vertebral fractures was bimodal, with vertebral fractures peaks centered at T9 and L4. Conditions associated with increased odds for vertebral fractures were inflammatory bowel disease (OR, 3.3; 95% CI, 1.4, 8.0; P = .018) and osteogenesis imperfecta (OR, 2.3; 95% CI, 1.04, 5.8; P = .022). Among children with vertebral fractures, those with Duchenne muscular dystrophy (P = .015) and osteogenesis imperfecta (P = .023) demonstrated higher number of vertebral fractures than the other disease groups. VFA identified the presence of vertebral fractures, in a bimodal distribution, in both primary bone disease and chronic disease groups. VFA is a practical screening tool for identification of vertebral fractures in children and adolescents at risk of fragility fractures. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Appearances of the circumcaval ureter on excretory urography and MR urography: A single-center case series

    OpenAIRE

    Muthusami, Prakash; Ramesh, Ananthakrishnan

    2013-01-01

    Objectives: To describe Magnetic Resonance Urography (MRU) appearances of the circumcaval ureter, a rare congenital cause of hydronephrosis. Materials and Methods: Seven cases of circumcaval ureter, suspected on intravenous urography (IVU), underwent subsequent static MRU using heavily T2-weighted sequences. Results: The various appearances of circumcaval ureter on IVU and MRU were studied and compared. The circumcaval portion of the ureter was especially well seen on axial MRU sections, thou...

  14. Interaction of Er:YAG laser radiation with ureter tissue

    Science.gov (United States)

    Jelínkova, Helena; Koranda, Petr; Němec, Michal; Šulc, Jan; Köhler, Oto; Drlík, Pavel; Miyagi, Mitsunobu; Shi, Yi-Wei; Matsuura, Yuji

    2005-11-01

    The aim of the work was to investigate the possibility of the ureter wall perforation by Er:YAG laser radiation and to explore the basic interaction characteristics for ureter surface and its deep structures. For these experiments Er:YAG laser system (wavelength 2.94 μm) working in free-running and Q-switched regime was utilized. Laser radiation was delivered to the investigated tissue by a special waveguide system. The basic part was a cyclic olefin polymer-coated silver hollow glass waveguide (inner/outer diameter 700/850 μm or 320/450 μm). Sealed cap of the waveguide was used for contact treatment. Maximum interaction pulse energy and length for free-running Er:YAG I laser with the 700μm waveguide were 100mJ and 200μs, respectively (corresponding intensity was 130 kW/cm2). Similarly the maximum interaction pulse energy and length for free-running Er:YAG II laser with the 320 μm waveguide were 80 mJ and 200 μs , respectively (corresponding intensity was 500 kW/cm2). Maximum interaction pulse energy and length in Q-switched regime were 17 mJ and 70 ns, respectively (corresponding intensity 63 MW/cm2). The number of pulses needed to perforate the ureter wall tissue (thickness ~1 mm) for using long 200 μs Er:YAG pulses (thermal ablation) and short 70 ns Er:YAG pulses (photoablation) was found. From the histological evaluation it follows that the application of Q-switched Er:YAG laser radiation on ureteral tissue resulted in minimum adjacent tissue alteration (up to 50μm from the surface) without any influence on the deeper layers.

  15. Is Ureter Visualization Possible on Tc-99m DMSA Scintigraphy with Vesicoureteral Reflux Patients?

    Directory of Open Access Journals (Sweden)

    Hasan Atilgan

    2014-12-01

    Full Text Available Aim: Ureter or pelvicalyceal system is not be vizualized with 99mTechnetium- dimercaptosuccinic acid (99mTc-DMSA which is accumulated by renal cortex normally. In this study the cases whose ureters are visible were reviewed with 99mTc-DMSA scintigraphy. Material and Method: 18 patients (5 females, 13 males with median age 3.5 years (min 2 months-max 18 years were included in this study. Twenty ureters and/or pelvis of 18 patients were visible in 99mTc-DMSA scintigraphy. In two patients%u2019s both ureters were visible. Vesicoureteral reflux (VUR grade, 99mTc-DMSA uptake, renal size, status of pelvicalyceal system, urea, creatinine levels were evaluated in all patients. Results: Three of the visible ureters were actually due to pelvicaliectasis. These pelvicaliectasic patients were excluded from the study. In the evaluation of the remaining 17 ureters of patients, congenital megaureter was present in three patients. Grade 3 VUR was detected in three patients, grade 4 was in three patients. VUR is seen as grade five in eight kidneys of seven patients because one of these patients has bilateral vizualized ureter. Discussion: In patients with congenital megaureter and VUR, ureters can be visible with 99mTc-DMSA scintigraphy and further imaging modalities are recommended for these patients.

  16. Duplicated ureters and renal transplantation: a case-control study and review of the literature

    NARCIS (Netherlands)

    Alberts, V. P.; Minnee, R. C.; van Donselaar-van der Pant, K. A. M. I.; Bemelman, F. J.; Zondervan, P. J.; Laguna Pes, M. P.; Idu, M. M.

    2013-01-01

    Complications of the transplant ureter are the most important cause of surgical morbidity after renal transplantation. The presence of ureteral duplication in the renal graft might result in an increased complication rate. We analyzed our data of double-ureter renal transplantations using a

  17. Kinking of the upper ureter in CT urography: anatomic and clinical significance.

    Science.gov (United States)

    Kamo, Minobu; Nozaki, Taiki; Yoshida, Kyoko; Tateishi, Ukihide; Akita, Keiichi

    2016-12-01

    Although the course of the ureter is described as a straight descent in the retroperitoneum, kinking of the upper ureter is often seen at imaging. The aim of this study was to investigate kinking of the ureter and its underlying anatomico-clinical significance. We evaluated 176 computed tomography (CT) images and classified kinking into three grades: no/mild kinking as Grade 1, moderate as Grade 2, and severe as Grade 3. We defined the "crossing point" (CP) as where the ureter crosses over the gonadal vein and assessed its relation to the kinking. Fourteen halves from seven cadavers were used for examination. Approaching anteriorly, we macroscopically observed the ureter and surrounding structures. On CT, the rate of the radiologically "significant" kinking classified into either Grade 2 or 3 was 18.4 % on the right and 21.8 % on the left. All kinking was either at or above the level of the CP. In cadavers, the ureter was relatively mobile in the perirenal fat and then beginning at approximately the level of the CP became firmly fixed to the anteromedial aspect of the psoas major muscle. Kinking of the upper ureter is not a clinically significant finding and arises from the ureter having a relatively mobile portion in the perirenal space compared to its caudal portion. The fixation boundary can be identified by observing the CP.

  18. Bone morphogenetic protein 4 regulates the budding site and elongation of the mouse ureter

    Science.gov (United States)

    Miyazaki, Yoichi; Oshima, Keisuke; Fogo, Agnes; Hogan, Brigid L.M.; Ichikawa, Iekuni

    2000-01-01

    In the normal mouse embryo, Bmp4 is expressed in mesenchymal cells surrounding the Wolffian duct (WD) and ureter stalk, whereas bone morphogenetic protein (BMP) type I receptor genes are transcribed either ubiquitously (Alk3) or exclusively in the WD and ureter epithelium (Alk6). Bmp4 heterozygous null mutant mice display, with high penetrance, abnormalities that mimic human congenital anomalies of the kidney and urinary tract (CAKUT), including hypo/dysplastic kidneys, hydroureter, ectopic ureterovesical (UV) junction, and double collecting system. Analysis of mutant embryos suggests that the kidney hypo/dysplasia results from reduced branching of the ureter, whereas the ectopic UV junction and double collecting system are due to ectopic ureteral budding from the WD and accessory budding from the main ureter, respectively. In the cultured metanephros deprived of sulfated glycosaminoglycans (S-GAGs), BMP4-loaded beads partially rescue growth and elongation of the ureter. By contrast, when S-GAGs synthesis is not inhibited, BMP4 beads inhibit ureter branching and expression of Wnt 11, a target of glial cell-derived neurotrophic factor signaling. Thus, Bmp4 has 2 functions in the early morphogenesis of the kidney and urinary tract. One is to inhibit ectopic budding from the WD or the ureter stalk by antagonizing inductive signals from the metanephric mesenchyme to the illegitimate sites on the WD. The other is to promote the elongation of the branching ureter within the metanephros, thereby promoting kidney morphogenesis. PMID:10749566

  19. Villous adenoma of the renal pelvis and ureter

    Directory of Open Access Journals (Sweden)

    Suresh Bhat

    2010-01-01

    Full Text Available Villous adenoma originating in the urinary tract is a rare condition. Mucus-filled kidney (muconephrosis, one of the manifestations of this condition, occurs due to intestinal type of metaplastic changes occurring in the urothelium. This condition is commonly associated with urolithiasis and/or chronic infection. Concomitant adenocarcinomatous changes in the urothelium may be present along with this and unless a careful search is made to identify this, this serious condition may be overlooked leading to an inappropriate follow-up and dire consequences. We are reporting the third case of muconephrosis due to villous adenomatous changes of the renal pelvis and ureter.

  20. Computed tomographic excretory urography features of intramural ectopic ureters in 10 dogs.

    Science.gov (United States)

    Fox, A J; Sharma, A; Secrest, S A

    2016-04-01

    To describe the morphologic and morphometric computed tomographic excretory urography features of intramural ectopic ureters in dogs. Retrospective evaluation of computed tomographic excretory urography studies in 10 dogs with surgical and/or cystoscopically confirmed intramural ectopic ureters. All studies were assessed for ureteral ectopia, dilatation, tortuosity, ureterovesicular junction morphology and ureteral orifice location. A total of 14 intramural ectopic ureters were confirmed at surgery/cystoscopy with reviewers correctly identifying 100% (14/14). Abnormalities on computed tomographic excretory urography included ureteral dilatation (7), ureteral tortuosity (3), lack of a normal ureterovesicular junction (14), urethral ureteral orifice location (14) and lack of ureteral divergence (14). Lack of a normal ureterovesicular junction, a urethral-ureteral orifice location and lack of ureteral divergence are common computed tomographic excretory urography findings in dogs with intramural ectopic ureters. This technique requires further investigation to determine whether it might allow differentiation of intramural and extramural ectopic ureters. © 2016 British Small Animal Veterinary Association.

  1. Ureter segmentation in CT urography (CTU) by COMPASS with multiscale Hessian enhancement

    Science.gov (United States)

    Fairbanks, Duncan; Hadjiiski, Lubomir; Zhou, Chuan; Chan, Heang-Ping; Cohan, Richard H.; Caoili, Elaine M.; Cha, Kenny

    2015-03-01

    We are developing an automated method for the segmentation of ureters in CTU, referred to as COmbined Modelguided Path-finding Analysis and Segmentation System (COMPASS). Ureter segmentation is a critical component for computer-aided detection of ureter cancer. A challenge for ureter segmentation is inconsistent opacification of the region of interest, which makes it difficult to be distinguished from other tissue in the surrounding area. COMPASS consists of four stages: (1) region finding and adaptive thresholding, (2) segmentation accuracy analysis, (3) potential backtracking and branching, and (4) edge profile extraction and feature analysis. In this study, we evaluated a new method in which CTU images were pre-processed with 3D multiscale Hessian filtering that enhances tubular structures. Our goal is to compare the performance of COMPASS with and without multiscale Hessian enhancement. With IRB approval, 79 cases with 124 ureters and 10 cases with 18 ureters were collected retrospectively from patient files as training and test sets, respectively. On average, the ureters spanned 289 CT slices (range: 115-405, median: 302). The segmentation performance was quantitatively assessed as the percentage of length of each ureter that was successfully tracked relative to manually tracking. COMPASS alone segmented, on average, 99.16% and 98.74% of each ureter in the training and test sets, respectively. COMPASS with Hessian enhancement segmented, on average, 97.89% and 99.63% of each ureter in the training and test sets, respectively. Although the difference did not reach statistical significance in this small test set, Hessian-enhanced tracking shows promise for overcoming certain types of difficult cases.

  2. Does Side Make a Difference? Anatomical Differences Between the Left and Right Ureter.

    Science.gov (United States)

    Odegard, Stephen E; Abernethy, Melinda G; Mueller, Elizabeth R

    2015-01-01

    Seventy to eighty percent of iatrogenic ureteral injuries involve the left ureter. We sought to evaluate potential anatomical differences between the left and right ureters that may contribute to this discrepancy. A retrospective image review was undertaken of women who underwent computed tomography urograms between 2012 and 2013. The distance to the ureters from the midline was measured at the level of the sacral promontory (S1) and the cervix. Cervical deviation from the midline was measured, and distance between the cervix and ureters was calculated. The anterior-posterior distance between ureters was also measured. Ninety-five computed tomography urograms were analyzed. The mean age was 56 years (range, 23-92 years). Mean cervical deviation was 2.9 mm left of the midline (P = 0.028). The left ureter was 4.2 mm more lateral than the right at S1 and 2.7 mm more lateral at the cervix (P = 0.000 and 0.001). There was no significant difference when accounting for cervical deviation (P = 0.220). The left ureter was 1.9 mm more anterior than the right at the cervix (P = 0.012). Age, body mass index, and ethnicity did not affect the ureteral position. Based on midline measurements, the left ureter courses 2 to 4 mm more lateral and anterior than does the right ureter. The cervix is also positioned 2 to 4 mm to the left side, and as a result, the ureters are actually symmetric to the cervix. Although seemingly small, 2 to 4 mm is the width range of a Heaney clamp. These anatomic differences may be a contributing factor to the increase in ureteral injuries on the left side compared with the right.

  3. Renal calculi with retrocaval ureter: is percutaneous nephrolithotomy sufficient?

    Science.gov (United States)

    Prakash, Jai; Raj, Anubhav; Sankhwar, Satyanarayan; Singh, Vishwajeet

    2013-03-26

    A 60-year-old woman presented with complaints of intermittent right flank pain which had begun one year ago. Ultrasonography and intravenous urogram showed right pelvic (15 mm) and inferior calyceal (6 mm) calculi along with suspected retrocaval course of right ureter, which was confirmed by contrast CT scan. Tc-99m diethylene-triamine-penta-acetic acid (DTPA) scan showed normal function and normal drainage of right kidney. Percutaneous nephrolithotomy (PCNL) was performed for right renal calculi. Because of curved ureteric course, negotiation of ureteric catheter in pelvis was anticipated to be troublesome, so intraoperative retrograde pyelogram (RGP) was performed to delineate the anatomy. Puncture was performed safely after air contrast pyelography. No complications occurred intraoperatively and postoperatively. On follow-up of up to 1 year patient was asymptomatic and renal scan showed normal function and drainage. So in the presence of retrocaval ureter and associated renal calculi, PCNL is a safe and optimal procedure and in condition of non-obstructive drainage, management of calculi only is adequate.

  4. Renal calculi with retrocaval ureter: is percutaneous nephrolithotomy sufficient?

    Science.gov (United States)

    Prakash, Jai; Raj, Anubhav; Sankhwar, Satyanarayan; Singh, Vishwajeet

    2013-01-01

    A 60-year-old woman presented with complaints of intermittent right flank pain which had begun one year ago. Ultrasonography and intravenous urogram showed right pelvic (15 mm) and inferior calyceal (6 mm) calculi along with suspected retrocaval course of right ureter, which was confirmed by contrast CT scan. Tc-99m diethylene-triamine-penta-acetic acid (DTPA) scan showed normal function and normal drainage of right kidney. Percutaneous nephrolithotomy (PCNL) was performed for right renal calculi. Because of curved ureteric course, negotiation of ureteric catheter in pelvis was anticipated to be troublesome, so intraoperative retrograde pyelogram (RGP) was performed to delineate the anatomy. Puncture was performed safely after air contrast pyelography. No complications occurred intraoperatively and postoperatively. On follow-up of up to 1 year patient was asymptomatic and renal scan showed normal function and drainage. So in the presence of retrocaval ureter and associated renal calculi, PCNL is a safe and optimal procedure and in condition of non-obstructive drainage, management of calculi only is adequate. PMID:23536623

  5. The Neurological Compromised Spine Due to Ewing Sarcoma. What First: Surgery or Chemotherapy? Therapy, Survival, and Neurological Outcome of 15 Cases With Primary Ewing Sarcoma of the Vertebral Column.

    Science.gov (United States)

    Mirzaei, Lida; Kaal, Suzanne E J; Schreuder, Hendrik W B; Bartels, Ronald H M A

    2015-11-01

    The vertebral column is an infrequent site of primary involvement in Ewing sarcoma. Yet when Ewing sarcoma is found in the spine, the urge for decompression is high because of the often symptomatic compression of neural structures. It is unclear in alleviating a neurological deficit whether chemotherapy is preferred over decompressive laminectomy. To underline, in this case series, the efficiency of initial chemotherapy before upfront surgery in the setting of high-grade spinal cord or cauda equina compression of primary Ewing sarcoma. Fifteen patients with Ewing sarcoma primarily located in the spine were treated at our institution between 1983 and 2015. Localization, neurological deficit expressed as Frankel grade, and outcome expressed as Rankin scale before and after initial chemotherapy, the recurrence rate, and overall survival were evaluated. The multidisciplinary approach of 1 case will be discussed in detail. Nine patients (60%) were female. The age at presentation was 15.0 ± 5.5 years (range: 0.9-22.8 years). Ten patients (67%) were initially treated with chemotherapy, and 1 patient (7%) was treated primarily with radiotherapy followed by chemotherapy. The remaining 4 patients (27%) were initially treated with decompressive surgery. All patients treated primarily nonsurgically improved neurologically at follow-up, showing the importance of chemotherapy as an effective initial treatment option. Adequate and quick decompression of neural structures with similar results can be achieved by chemotherapy and radiotherapy, avoiding the local spill of malignant cells.

  6. Case Report of Left Retrocaval Ureter: Pre-Transplant CT Urographic Findings and Post-Transplant Outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ah Yeong; Park, Byung Kwan; Kim, Chan Kyo; Park, Sung Yoon; Han, Deok Hyun [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2013-02-15

    A left retrocaval ureter is an extremely rare congenital anomaly, in which the left ureter passes behind the left inferior vena cava (IVC). The compression of the ureter between the IVC and the vertebrae results in a progressive hydronephrosis. Recently, the left kidney with a retrocaval ureter was detected on CT urographic images in a living-related donor and achieved a good outcome after allograft transplantation. We report the CT urographic findings of a left retrocaval ureter and the short-term outcome of allograft transplantation.

  7. Vertebral body stenting versus kyphoplasty for the treatment of osteoporotic vertebral compression fractures: a randomized trial.

    Science.gov (United States)

    Werner, Clément M L; Osterhoff, Georg; Schlickeiser, Jannis; Jenni, Raphael; Wanner, Guido A; Ossendorf, Christian; Simmen, Hans-Peter

    2013-04-03

    In the treatment of vertebral compression fractures, vertebral body stenting with an expandable scaffold inserted before application of the bone cement was developed to impede secondary loss of vertebral height encountered in patients treated with balloon kyphoplasty. The purpose of this study was to clarify whether there are relevant differences between balloon kyphoplasty and vertebral body stenting with regard to perioperative and postoperative findings. In a two-armed randomized controlled trial, patients with a total of 100 fresh osteoporotic vertebral compression fractures were treated with either balloon kyphoplasty or vertebral body stenting. The primary outcome was the post-interventional change in the kyphotic angle on radiographs. The secondary outcomes were the maximum pressure of the balloon tamp during inflation, radiation exposure time, perioperative complications, and cement leakage. The mean reduction (and standard deviation) of kyphosis (the kyphotic correction angle) was 4.5° ± 3.6° after balloon kyphoplasty and 4.7° ± 4.2° after vertebral body stenting (p = 0.972). The mean pressures were 24 ± 5 bar (348 ± 72 pounds per square inch [psi]) during vertebral body stenting and 16 ± 6 bar (233 ± 81 psi) during balloon kyphoplasty (p = 0.014). There were no significant differences in radiation exposure time.None of the patients underwent revision surgery, and postoperative neurologic sequelae were not observed. Cement leakage occurred at twenty-five of the 100 vertebral levels without significant differences between the two intervention arms (p = 0.230). Intraoperative material-related complications were observed at one of the fifty vertebral levels in the balloon kyphoplasty group and at nine of the fifty levels in the vertebral body stenting group. No beneficial effect of vertebral body stenting over balloon kyphoplasty was found among patients with painful osteoporotic vertebral fractures with regard to kyphotic correction, cement leakage

  8. Appearances of the circumcaval ureter on excretory urography and MR urography: A single-center case series

    Directory of Open Access Journals (Sweden)

    Prakash Muthusami

    2013-01-01

    Full Text Available Objectives: To describe Magnetic Resonance Urography (MRU appearances of the circumcaval ureter, a rare congenital cause of hydronephrosis. Materials and Methods: Seven cases of circumcaval ureter, suspected on intravenous urography (IVU, underwent subsequent static MRU using heavily T2-weighted sequences. Results: The various appearances of circumcaval ureter on IVU and MRU were studied and compared. The circumcaval portion of the ureter was especially well seen on axial MRU sections, though this portion was routinely not visualized on IVU. In one case with a ureteric calculus, MRU also depicted a circumcaval course of the ureter, thus providing a complete diagnosis. In yet another case, where a circumcaval ureter was suspected on IVU, MRU proved the actual cause of ureteric obstruction to be a crossing vessel. Conclusion: Static MRU using heavily T2-weighted coronal and axial sequences can make or exclude the diagnosis of circumcaval ureter unequivocally.

  9. Appearances of the circumcaval ureter on excretory urography and MR urography: A single-center case series.

    Science.gov (United States)

    Muthusami, Prakash; Ramesh, Ananthakrishnan

    2013-01-01

    To describe Magnetic Resonance Urography (MRU) appearances of the circumcaval ureter, a rare congenital cause of hydronephrosis. Seven cases of circumcaval ureter, suspected on intravenous urography (IVU), underwent subsequent static MRU using heavily T2-weighted sequences. The various appearances of circumcaval ureter on IVU and MRU were studied and compared. The circumcaval portion of the ureter was especially well seen on axial MRU sections, though this portion was routinely not visualized on IVU. In one case with a ureteric calculus, MRU also depicted a circumcaval course of the ureter, thus providing a complete diagnosis. In yet another case, where a circumcaval ureter was suspected on IVU, MRU proved the actual cause of ureteric obstruction to be a crossing vessel. Static MRU using heavily T2-weighted coronal and axial sequences can make or exclude the diagnosis of circumcaval ureter unequivocally.

  10. Circumcaval Ureter with Vesico Ureteral Reflux: The First Association in Literature

    Directory of Open Access Journals (Sweden)

    Ilhan Ciftci

    2012-06-01

    Full Text Available A circumcaval ureter is a rare congenital anomaly in which the ureter passes behind, and is compressed by, the inferior vena cava. Its etiology is assumed to be abnormal embryologic development of the inferior vena cava as a result of atrophy failure of the right subcardinal vein in the lumbar portion. A circumcaval ureter is also termed a retrocaval ureter. The right supracardinal system fails to develop, whereas the right posterior cardinal vein persists. With one reported exception, the anomaly always occurs on the right side. Patients with this anomaly may develop partial right ureteral obstruction or recurrent urinary tract infections. Therapeutic options include surgical relocation of the ureter anterior to the cava. A 14-year-old female patient came with complaints of fever, intermittent colic and dysuria 4 years ago. A right ureteric fourth-grade VUR and circumcaval ureter were established. An anomaly in which both of these are together could not be found in literature. If after the VUR treatment he has progressive abdomen pain and advancing hydronephrosis, a circumcaval ureter as an additive anomaly must not be forgotten. For that reason, in a patient having a urinary system anomaly, a likely extra anomaly should be searched. [Arch Clin Exp Surg 2012; 1(3.000: 191-194

  11. Retroperitoneal approach for laparoscopic nephroureterectomy with stripping technique: extracorporeal ligation of ureter and ureteral catheter.

    Science.gov (United States)

    Nakamura, K; Nagata, D; Kajikawa, K; Kobayashi, I; Zennami, K; Nishikawa, G; Yoshizawa, T; Tobiume, M; Aoki, S; Yamada, Y; Sumitomo, M

    2012-02-01

    The pluck and stripping techniques are used for lower ureter management in renal pelvic cancer patients. Herein, we report our experience of extracorporeal ligation of the ureter and the ureteral catheter through the trocar port, which differs from conventional laparoscopic ligation in the retroperitoneal space. This technique was selected to reduce the time needed for ureter management using the stripping technique and to provide secure ligation. We performed this stripping technique in patients with T1 and T2 stage renal pelvic cancer without imaging-evident lymph node metastasis. After transurethrally placing a ureteral catheter, we resected the circumference of the ureteral orifice. After laparoscopic nephrectomy via a retroperitoneal approach, the ureteral catheter and distal ureter were ligated extracorporeally. The catheter was pulled to invaginate the ureter so it could then be pulled through the external urethral orifice. This technique of extracorporeal ligation ensures more a secure ligation of the ureter and ureteral catheter. This modified stripping technique does not require lower ureter management with laparotomy, and it is also useful in shortening the operative time. This method is effective for relatively early stage renal pelvic cancer. © 2012 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Blackwell Publishing Asia Pty Ltd.

  12. Diagnostic work-up and laparoscopic correction of an ectopic ureter.

    Science.gov (United States)

    Cezarino, B N; Lopes, R I; Oliveira, L M; Dénes, F T; Srougi, M

    2015-10-01

    A duplex renal collecting system is a common congenital anomaly in children. Continuous dribbling (especially if after the toilet-training period) should raise suspicion of the presence of an ectopic ureter, which is most often associated with ureteral duplication. This video will demonstrate the complete diagnostic work-up necessary in these cases. A 10-year-old girl presented with continuous dribbling. Ultrasonography and computerized tomography depicted a duplex system on the left side, with the upper pole ureter ectopically inserting into the vaginal cavity and good upper pole renal parenchyma. A careful urethrocystoscopy showed a topic right ureteral orifice and a topic lower pole left ureteral orifice. Retrograde pyelography was performed and displayed normal left lower pole anatomy. A vaginography was performed, which showed reflux to the ectopic ureter. Vaginoscopy clearly identified the ectopic ureteral orifice. A guide wire was introduced through this meatus and retrograde contrast injection confirmed the diagnosis of an ectopic ureter. At laparoscopy, a larger upper pole ureter and a normal lower pole ureter on the left side were identified. A termino-lateral ureteroureteral anastomosis was performed. After the procedure, the child reported immediate resolution of urinary dribbling. In order to optimize its surgical correction, efforts should be made to appropriate localization of the ectopic ureter. Copyright © 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  13. Vertebral osteomyelitis without disc involvement

    Energy Technology Data Exchange (ETDEWEB)

    Kamani, I.; Syed, I.; Saifuddin, A. E-mail: asaifuddin@aol.com; Green, R.; MacSweeney, F

    2004-10-01

    Vertebral osteomyelitis is most commonly due to pyogenic or granulomatous infection and typically results in the combined involvement of the intervertebral disc and adjacent vertebral bodies. Non-infective causes include the related conditions of chronic recurrent multifocal osteomyelitis (CRMO) and SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome. Occasionally, these conditions may present purely within the vertebral body, resulting in various combinations of vertebral marrow oedema and sclerosis, destructive lesions of the vertebral body and pathological vertebral collapse, thus mimicking neoplastic disease. This review illustrates the imaging features of vertebral osteomyelitis without disc involvement, with emphasis on magnetic resonance imaging (MRI) findings.

  14. Evaluation of the tensile strength of the human ureter - Preliminary results.

    Science.gov (United States)

    Shilo, Yaniv; Pichamuthu, Joseph E; Averch, Timothy D; Vorp, David A

    2014-09-15

    Introduction: Ureteral injuries such as avulsion are directly related to mechanical damage of the ureter. Understanding the tensile strength of this tissue may assist in prevention of iatrogenic injuries. Few published studies have looked at the mechanical properties of the animal ureter, and of those none have determined the tensile strength of the human ureter. Therefore, the purpose of this work was to determine the tensile strength of the human ureter. Materials and Methods: We harvested 11 human proximal ureters from patients who were undergoing nephrectomy for either kidney tumors or non-functioning kidney. The specimens were then cut into multiple circumferentially and longitudinally-oriented tissue strips for tensile testing. Strips were uniaxially stretched to failure in a tensile testing machine. The corresponding force and displacement were recorded. Finally, stress at failure was noted as the tensile strength of the sample. Circumferential tensile strength was also compared in the proximal and distal regions of the specimens. Results: The tensile strength of the ureter in circumferential and longitudinal orientations was found to be 457.52±33.74 Ncm-2 and 902.43±122.08 Ncm-2, respectively (pstrength in the proximal portion of the ureter was 409.89±35.13 Ncm-2 in comparison to 502.89±55.85 Ncm-2 in the distal portion (p=0.08). Conclusions: The circumferential tensile strength of the ureter was found to be significantly lower than the longitudinal strength. Circumferential tensile strength was also lower with more proximal parts of the ureter. This information may be important for the design of "intelligent" devices and simulators in order to prevent complications.

  15. Withdraw of the Ureteroscope Causes Fragmented Ureter Stones to Disperse

    Directory of Open Access Journals (Sweden)

    Onder Canguven

    2013-09-01

    Full Text Available Introduction Ureteroscopy has improved from the first use of ureteroscope in the 1970's. Although the success rate increased in the last years, (1 new treatment techniques are being developed for impacted and large proximal ureter stones (2. Pneumatic lithotripsy has high efficiency with low complication rates (2. However, in case of steinstrasse and large (> 1 cm ureter stones, fragmented small stones may obstruct insertion of a ureteroscope after initial lithotripsy. In order to triumph over this issue, multiple ureteroscopic passages and manipulations needed for extraction of these small stones by forceps or basket catheters. The overall incidence of stricture was found upto 14.2% when the fragments were removed with a grasping forceps or a basket (3. We present our technique to disperse small fragmented stones in order to contact non-fragmented rest stone. Materials and Methods Ureteral lithotripsy was performed with an 8-9.8F semirigid ureteroscope using a pneumatic lithotripter (Swiss LithoClast, EMS, Nyon, Switzerland. The stone was fragmented into small pieces as small as 2-3 mm. by pneumatic lithotripter. Eventually, these fragmented stones interfered with vision and the lithotripter to get in touch with the rest stone. After fragmenting distal part of the large stone, the ureteroscope was pulled back out of ureter. While pulling back, the operating channel was closed and irrigation fluid was flowing in order not to decrease pressure behind the stones. Simultaneously, a person tilted the operating table to about 30° in reverse Trendelenburg position. When the ureteroscope was out of ureteral orifice, the operating channel was opened and irrigation fluid was stopped. This maneuver aided decreasing pressure in the bladder more rapidly in addition to feeding tube. Stone dust and antegrade fluid flow were easily seen out of the ureteral orifice. Ureteroscope was re-inserted after 30-60 seconds. While reaching the rest of the stone, small

  16. US and MDCT findings in a caudal blind ending bifid ureter with calculi

    Directory of Open Access Journals (Sweden)

    Caglar Uzun

    2011-09-01

    Full Text Available Herein we present a rare ureteric duplication anomaly; blind ending bifid ureter with calculi which is asymptomatic unless complicated by infection, reflux, calculi or malignancy. The diagnosis is often missed at intravenous urography (IVU and US because the ipsilateral ureter and kidney are grossly normal. In this case the diagnosis was established with ultrasound (US and mainly with multidetector computerized tomography (MDCT imaging using multiplanar reformats and 3-D reconstructions which were unique to this case. MDCT scans not only revealed the exact diagnosis and anatomic relationships but also ruled out other pathologies included in the differential diagnosis as well, such as ureter and bladder diverticula.

  17. US and MDCT findings in a caudal blind ending bifid ureter with calculi

    Directory of Open Access Journals (Sweden)

    Evren Ustuner

    2011-11-01

    Full Text Available Herein we present a rare ureteric duplication anomaly; blind ending bifid ureter with calculi which is asymptomatic unless complicated by infection, reflux, calculi or malignancy. The diagnosis is often missed at intravenous urography (IVU and US because the ipsilateral ureter and kidney are grossly normal. In this case the diagnosis was established with ultrasound (US and mainly with multidetector computerized tomography (MDCT imaging using multiplanar reformats and 3-D reconstructions which were unique to this case. MDCT scans not only revealed the exact diagnosis and anatomic relationships but also ruled out other pathologies included in the differential diagnosis as well, such as ureter and bladder diverticula.

  18. REIMPLANTAÇÃO DE URETER ECTÓPICO EM CADELA

    OpenAIRE

    Kosachenco, Beatriz Guilhembernard; Godoy, Carmen Lice Buchmann de; Schmitt, Izabela; Pellegrini, Luiz Carlos de; Campello, Rui Afonso Vieira

    1994-01-01

    RESUMO Relata-se um caso de ectopia uretral esquerda em cadela. Descreve-se os sintomas, diagnóstico radiológico e cirúrgico, anastomose vesicouretral com reimplante do ureter no trígono vesical e exame radiográfico pós-operatório através de urografia excretora para avaliação da função renal e ureteral. SUMMARY A case of an ectopic left ureter in a bitch is reported. The clinical symptoms, radiological and surgical diagnostic, ureterovesical anastomosis with ureter reimplantation at the ve...

  19. Surgical treatment of a duplicated and ectopic ureter in a dog.

    Science.gov (United States)

    Newman, M; Landon, B

    2014-09-01

    An eight-month old female bull mastiff was referred for evaluation of urinary incontinence. Contrast-enhanced computed tomography identified complete duplication of the left ureter with ectopic insertion of the duplicate ureter into the proximal urethra. Ureteroneocystostomy was performed, which improved but did not resolve urinary continence. To the authors' knowledge, this report details only the second reported case of duplicated ectopic ureter in the dog and the first documenting surgical reimplantation; thus, double-system ureteral ectopia should be considered as a possible differential diagnosis for urinary incontinence. © 2014 British Small Animal Veterinary Association.

  20. Computed Tomography Imaging Appearance of a Unique Variant of Retroiliac Ureter.

    Science.gov (United States)

    Tawfik, Ahmed M; Younis, M Hisham

    2016-02-01

    Retroiliac ureter is a rare condition where the ureter passes behind the iliac vessels. The diagnosis is usually intraoperative and the reports of preoperative imaging diagnosis are scarce. Herein, we report the computed tomography appearance of a unique variant in which the right ureter partially encircles the right common iliac artery bifurcation; passing first in front of the common iliac artery and then medial to the artery and finally posterior to the external iliac artery, and then regains its normal course in the pelvis. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Evaluation of transurethral cystoscopy and excretory urography for diagnosis of ectopic ureters in female dogs: 25 cases (1992-2000).

    Science.gov (United States)

    Cannizzo, Karin L; McLoughlin, Mary A; Mattoon, John S; Samii, Valerie F; Chew, Dennis J; DiBartola, Stephen P

    2003-08-15

    To evaluate transurethral cystoscopy and excretory urography for diagnosis of ectopic ureter in female dogs and identify concurrent urogenital abnormalities. Retrospective study. 25 female dogs. Medical records of female dogs that underwent transurethral cystoscopy, excretory urography, and ventral cystotomy were reviewed for signalment, history, physical examination findings, results of bacteriologic culture of urine, and surgical findings. Videotapes of transurethral cystoscopy and radiographic studies were reviewed systematically without knowledge of surgical findings. Ectopic ureters were diagnosed in 24 of 25 (96%) of the dogs, bilaterally in 22 of 24 (91.6%) dogs. Cystoscopic evaluation yielded a correct diagnosis in all dogs when results of ventral cystotomy were used as the diagnostic standard. Cystoscopic evaluation identified a terminal ureteral opening for all ureters. Urethral fenestrations, troughs, striping, and tenting were identified. Abnormalities of the vestibule were identified in all examinations available for review (24/25). The paramesonephric septal remnant and its association with ectopic ureters were identified and characterized by cystoscopy. Radiographic findings were discordant with surgical findings and correctly identified 36 of 46 (78.2%) ectopic ureters and 2 of 4 normal ureters. Hydroureter and renal abnormalities were associated with distal urethral ectopic ureters on radiographic evaluations. Transurethral cystoscopy was accurate and minimally invasive for identification and classification of ectopic ureters in dogs. Contrast radiography had limitations in diagnosis of ectopic ureters. Cystoscopic findings and associated vaginal and vestibular abnormalities support abnormal embryologic development in the pathogenesis of ectopic ureters.

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

    Science.gov (United States)

    ... dyes and chemicals used in making leather goods, textiles, plastics, and rubber. Signs and symptoms of transitional ... cancer of the renal pelvis and ureter. MRI (magnetic resonance imaging) : A procedure that uses a magnet, ...

  3. Initial Series of Four-Arm Robotic Completely Intracorporeal Ileal Ureter.

    Science.gov (United States)

    Chopra, Sameer; Metcalfe, Charles; Satkunasivam, Raj; Nagaraj, Shalini; Becker, Carlee; de Castro Abreu, Andre Luis; Azhar, Raed A; Gill, Inderbir; Desai, Mihir; Aron, Monish; Berger, Andre

    2016-04-01

    Ileal ureter formation has been found to be a suitable treatment option for long, chronic ureteral strictures not amendable to less invasive forms of repair. Minimally invasive surgical techniques for this condition have been investigated. We report the first series of robotic completely intracorporeal ileal ureter using a four-arm robotic technique. Three patients underwent this procedure, including one patient with a solitary kidney. All procedures were performed effectively with a median operative time of 450 minutes (range: 420-540) and median estimated blood loss of 100 mL (range: 50-200). Postoperatively, one patient suffered volvulus and subsequent necrosis of small bowel and ileal ureter, which required re-operation and small bowel resection, including the ileal ureter. The other two patients report no surgical complications to date. This early series represents preliminary technical procedure feasibility. Further experience is necessary.

  4. Long-term outcome of duplex kidney with ectopic ureter treated by antireflux ureterocystic reimplantation.

    Science.gov (United States)

    Gu, Baojun; Wang, Xiaolu; Xu, Yuemin

    2012-01-01

    We present our 35 years' experience of managing duplex kidneys with ectopic ureter by simple antireflux ureterocystic reimplantation. From December 1974 to April 2009, 36 female children, aged 10 months to 13 years, were treated. Hutch's antireflux ureterocystic reimplantation was performed after preoperative location and intraoperative identification of the unilateral or bilateral ectopic ureters. Thirty-one patients had follow-up data (range 11 months to 25 years). Postoperatively, there were no reports of dribbling incontinence, urinary frequency, lumbago or recurrent fever with the exception of urinary incontinence in 2 patients. Cystography and intravenous pyelography performed in 27 cases showed no or minimal bladder-ureter reflux. Superior kidney hydronephrosis improved in 12 cases and showed no change in the remaining patients. Antireflux ureterocystic reimplantation is a simple method to treat the duplex kidney with ectopic ureter with minimal induced trauma. Copyright © 2012 S. Karger AG, Basel.

  5. Success of rigid ureteroscopy according to the stone localization in the ureter

    Directory of Open Access Journals (Sweden)

    Oktay Üçer

    2010-03-01

    Full Text Available Objectives: We retrospectively evaluated our rigid ureteroscopy(URS treatment results in ureteric stones andassessed its effectiveness concerning ureteric stone localisation.Materials and methods: Overall, 101 patients were retrospectivelyevaluated including lower (n=69, mid (n=23and upper ureteric (n=9 stones which were treated withrigid URS (Wolf 8.0-9.8Fr, Germany in our hospital betweenJanuary 2007- June 2009. Stones were removedby stone forceps/basket catheter either as single pieceor fragmented by pneumatic lithotripsy (EMS-Swisslithoclast-Master.Results: Mean patient age was 45.1 (19-78 years.Stones were located in the right (n=52 and left (n=49 ureters,respectively. Mean stone size was 7,4 mm (5-15. Ofthe 9 patients with upper ureteric stones, 7 were (77.8%stone-free. However, stone migrated into renal pelvis intwo patients but passed into ureter again in the follow-upand removed by URS. Of the 23 patients with mid-uretericstones, 22 were (95.7% stone-free. Ureter perforationoccurred in one patient and ureteroneocystostomy wasperformed. Of the 69 patients with lower ureteric stones,68 were (98.6% stone-free. Ureter perforation occurredin one patient and healed spontaneously by ureter catheterreplacement. Stone was removed afterwards by URS.Overall (n=101, ureter perforation occurred in 1.9% (n=2in our series. Resistant urinary tract infection developedin one patient (0.9% (P.aeroginosa.Conclusion: Due to results of this preliminary study, rigidURS and pneumatic lithotripsy can be performed successfullyparticularly in lower ureteric stones. However,as stone location shifts to upper ureter, success rate decreases.Although URS can be performed safely with lowcomplication rates in the treatment of ureteric stones, severecomplications like ureter perforation might occur.

  6. Laparoscopic ureteric reimplantation of a single-system ectopic ureter in a girl: A rarity

    Directory of Open Access Journals (Sweden)

    Kumar Suresh

    2010-01-01

    Full Text Available A 14-year-old girl presented with continuous dribbling of urine along with normal voiding pattern since childhood. Cystourethroscopy showed absence of right ureteric opening, and vaginoscopy showed right ureter opening into vaginal vault. Radiological images showed small right kidney with normal excretory function with single-system ectopic ureter. Patient underwent laparoscopic transperitoneal extravesical ureteric reimplantation. At 3 months′ follow-up, intravenous urography (IVU and micturating cystourethrogram (MCU showed no obstruction and reflux.

  7. The effect of nitric oxide on the pressure of the acutely obstructed ureter.

    Science.gov (United States)

    Xingyu, Yan; Guoliang, Tan; Youmei, Cai; Honggen, Wang; Yihong, Guo; Junyi, Chen

    2012-04-01

    Acute ureteral obstruction leads to changes in pressure inside the ureter, interrupting ureter function. The aim of our study is to explore the relationship between nitric oxide (NO) concentration and pressure in the ureter and to observe the effects of nitric oxide on the revival of renal function. We created the animal models by embedding balloons in the lower ureters of anesthetized dogs and expanding them to simulate acute ureteral obstruction. First, the test animals were pre-treated intravenously with different doses of L-NAME (non-selective nitric oxide synthase inhibitor) to inhibit nitric oxide synthase (NOS), and 10 min later, each subject was administered an intravenous dose of isoproterenol (10 μg/kg). We measured ureter pressure (UP), total and peak concentrations of NO (using an NO monitor, model inNO-T) in ureteral urine, and the volume of the urine (UFV) leaking from the balloon edge. After a certain amount of time had elapsed, it became clear that the dose of L-NAME was inversely related to the total and peak concentrations of NO, the rate of change in UP, and the volume of urine produced. We conclude that L-NAME prevents the NOS from inhibiting the release of NO, then inhibits the effect of isoproterenol reducing the pressure of the acute obstructive ureter. Inversely, we think that NO can reduce the pressure of the acute obstructive ureter and make the obstructive ureter recanalization. And when more the concentration of nitric oxide, the more the pressure will be reduced, and more urine will be collected.

  8. Renal dysplasia with the ipsilateral ectopic ureter mimicking abscess of the prostate.

    Science.gov (United States)

    Grbić, Dragan; Jeremić, Dimitrije; Vojinov, Sasa; Popov, Milan; Marusić, Goran

    2014-02-01

    In males the ectopic ureter usually drains into the prostate (50%). During ureteric developement a thin membrane (Chawalla's membrane) separates the lumen of the ureter and the urogenital sinus at the point where the ureter joins the urogenital sinus. This membrane ruptures allowing urin to drain from the ureter to the urogenital sinus. The authors reported a case of renal dysplasia associated with ipsilateral uretral ectopia mimicking prostatic abscess. A subfebrile (37.3 degrees C), 23-year-old patient, otherwise healthy, presented with persistent ascending perineal pain non-responsive to antibiotics and analgetics. Digitorectal examination (DRE) showed asymmetric prostate with a soft, tender, buldging left lobe suggestive of prostatic abscess. The diagnosis was suspected using transrectal ultrasonography (TRUS), but the picture of the anechoic tubular structure in the left lobe of the prostate with a proximal undefined extraprostatic extension and a caudal intraprostatic blind end was incoclusive for the definitive diagnosis of prostatic abscess. Magnetic resonance imaging (MRI) was ordered and definitive diagnosis of renal dysplasia associated with the ipsilateral ectopic ureter filled with inflamed content mimicking prostatic abscess was made. Transurethral incision/minimal resection of the distal, blindly closed end of left ectopic ureter was done. Endoscopic surgical treatment was sufficient for relief of clinical symptoms. The patient's recovery was uneventful. To the best of our knowledge, a case of renal dysplasia with the ipsilateral ectopic ureter mimicking prostate abscess has not been reported so far. Cystic pelvic malformations in males may result from too cranial sprouting of the ureteral bud, with delayed absorption and ectopic opening of the distal end of the ureter.

  9. Meaning of ureter dilatation during ultrasonography in infants for evaluating vesicoureteral reflux

    Energy Technology Data Exchange (ETDEWEB)

    Park, Yae-won, E-mail: yaewonpark@yuhs.ac [Department of Radiology and Research Institute of Radiological Science, Severance Children' s Hospital, Yonsei University College of Medicine, 120-752 Seoul (Korea, Republic of); Kim, Myung-Joon, E-mail: mjkim@yuhs.ac [Department of Radiology and Research Institute of Radiological Science, Severance Children' s Hospital, Yonsei University College of Medicine, 120-752 Seoul (Korea, Republic of); Han, Sang Won, E-mail: swhan58@yuhs.ac [Department of Pediatric Urology, Severance Children' s Hospital, Yonsei University College of Medicine, 120-752 Seoul (Korea, Republic of); Kim, Dong Wook, E-mail: kimdw@yuhs.ac [Biostatistics Collaboration Unit, Yonsei University, College of Medicine, 120-752 Seoul (Korea, Republic of); Lee, Mi-Jung, E-mail: mjl1213@yuhs.ac [Department of Radiology and Research Institute of Radiological Science, Severance Children' s Hospital, Yonsei University College of Medicine, 120-752 Seoul (Korea, Republic of)

    2015-02-15

    Purpose: To investigate the meaning of ureter dilatation during ultrasonography (US) in infants for evaluating vesicoureteral reflux (VUR). Materials and methods: We retrospectively reviewed abdominal US images of infants who were diagnosed with urinary tract infection (UTI group) or only hydronephrosis without UTI (control group). Hydronephrosis (graded 0–4) and ureter dilatation (present or absent) were evaluated on each side with US. Voiding cystourethrography (VCUG) within 3 months time interval with US was also reviewed and VUR was graded (0–5) on each side. Hydronephrosis, ureter dilatation, and VUR were then compared between the two groups. Results: Four hundred and three infants (142 in the UTI group and 261 in the control group) were included and VCUG was performed in 129 infants (68 in UTI and 61 in control groups). VUR grades were not different between the two groups (p = 0.252). Hydronephrosis grade was not related to VUR in either group (p > 0.05). However, ureter dilatation had a significant relationship with VUR in the UTI group (p = 0.015), even among patients with a high-grade VUR (p = 0.005). Whereas, ureter dilatation was not associated with VUR in the control group (p = 0.744). The relationship between ureter dilatation and VUR was different between the two groups for both all grades (p = 0.014) and high-grade (p = 0.004) VUR. Ureter dilatation had 66.7% sensitivity, 80.3% specificity, and 79.4% accuracy for evaluating high-grade VUR in the UTI group. Conclusion: Ureter dilatation on US can be a helpful finding for detecting VUR in infants with UTI, but not infants without UTI.

  10. Meaning of ureter dilatation during ultrasonography in infants for evaluating vesicoureteral reflux.

    Science.gov (United States)

    Park, Yae-won; Kim, Myung-Joon; Han, Sang Won; Kim, Dong Wook; Lee, Mi-Jung

    2015-02-01

    To investigate the meaning of ureter dilatation during ultrasonography (US) in infants for evaluating vesicoureteral reflux (VUR). We retrospectively reviewed abdominal US images of infants who were diagnosed with urinary tract infection (UTI group) or only hydronephrosis without UTI (control group). Hydronephrosis (graded 0-4) and ureter dilatation (present or absent) were evaluated on each side with US. Voiding cystourethrography (VCUG) within 3 months time interval with US was also reviewed and VUR was graded (0-5) on each side. Hydronephrosis, ureter dilatation, and VUR were then compared between the two groups. Four hundred and three infants (142 in the UTI group and 261 in the control group) were included and VCUG was performed in 129 infants (68 in UTI and 61 in control groups). VUR grades were not different between the two groups (p=0.252). Hydronephrosis grade was not related to VUR in either group (p>0.05). However, ureter dilatation had a significant relationship with VUR in the UTI group (p=0.015), even among patients with a high-grade VUR (p=0.005). Whereas, ureter dilatation was not associated with VUR in the control group (p=0.744). The relationship between ureter dilatation and VUR was different between the two groups for both all grades (p=0.014) and high-grade (p=0.004) VUR. Ureter dilatation had 66.7% sensitivity, 80.3% specificity, and 79.4% accuracy for evaluating high-grade VUR in the UTI group. Ureter dilatation on US can be a helpful finding for detecting VUR in infants with UTI, but not infants without UTI. Copyright © 2014. Published by Elsevier Ireland Ltd.

  11. Renal dysplasia with the ipsilateral ectopic ureter mimicking abscess of the prostate

    Directory of Open Access Journals (Sweden)

    Grbić Dragan

    2014-01-01

    Full Text Available Introduction. In males the ectopic ureter usualy drains into the prostate (50%. During ureteric developement a thin membrane (Chawalla’s membrane separates the lumen of the ureter and the urogenital sinus at the point where the ureter joins the urogenital sinus. This membrane ruptures allowing urin to drain from the ureter to the urogenital sinus. The authors reported a case of renal dysplasia associated with ipsilateral uretral ectopia mimicking prostatic abscess. Case report. A subfebrile (37.3°C, 23-year-old patient, otherwise healthy, presented with persistent ascending perineal pain non-responsive to antibiotics and analgetics. Digitorectal examination (DRE showed asymmetric prostate with a soft, tender, buldging left lobe suggestive of prostatic abscess. The diagnosis was suspected using transrectal ultrasonography (TRUS, but the picture of the anechoic tubular structure in the left lobe of the prostate with a proximal undefined extraprostatic extension and a caudal intraprostatic blind end was incoclusive for the definitive diagnosis of prostatic abscess. Magnetic resonance imaging (MRI was ordered and definitive diagnosis of renal dysplasia associated with the ipsilateral ectopic ureter filled with inflamed content mimicking prostatic abscess was made. Transurethral incision/minimal resection of the distal, blindly closed end of left ectopic ureter was done. Endoscopic surgical treatment was sufficient for relief of clinical symptoms. The patient’s recovery was uneventful. Conclusion. To the best of our knowledge, a case of renal dysplasia with the ipsilateral ectopic ureter mimicking prostate abscess has not been reported so far. Cystic pelvic malformations in males may result from too craniall sprouting of the ureteral bud, with delayed absorption and ectopic opening of the distal end of the ureter.

  12. Evaluation of the tensile strength of the human ureter--preliminary results.

    Science.gov (United States)

    Shilo, Yaniv; Pichamuthu, Joseph E; Averch, Timothy D; Vorp, David A

    2014-12-01

    Ureteral injuries such as avulsion are directly related to mechanical damage of the ureter. Understanding the tensile strength of this tissue may assist in prevention of iatrogenic injuries. Few published studies have looked at the mechanical properties of the animal ureter and, of those, none has determined the tensile strength of the human ureter. Therefore, the purpose of this work was to determine the tensile strength of the human ureter. We harvested 11 human proximal ureters from patients who were undergoing nephrectomy for either kidney tumors or nonfunctioning kidney. The specimens were then cut into multiple circumferentially and longitudinally oriented tissue strips for tensile testing. Strips were uniaxially stretched to failure in a tensile testing machine. The corresponding force and displacement were recorded. Finally, stress at failure was noted as the tensile strength of the sample. Circumferential tensile strength was also compared in the proximal and distal regions of the specimens. The tensile strength of the ureter in circumferential and longitudinal orientations was found to be 457.52±33.74 Ncm(-2) and 902.43±122.08 Ncm(-2), respectively (Pureter was 409.89±35.13 Ncm(-2) in comparison with 502.89±55.85 Ncm(-2) in the distal portion (P=0.08). The circumferential tensile strength of the ureter was found to be significantly lower than the longitudinal strength. Circumferential tensile strength was also lower with more proximal parts of the ureter. This information may be important for the design of "intelligent" devices and simulators to prevent complications.

  13. Expression and functional role of β3 -adrenoceptors in the human ureter.

    Science.gov (United States)

    Matsumoto, Rikiya; Otsuka, Atsushi; Suzuki, Takahisa; Shinbo, Hitoshi; Mizuno, Takuji; Kurita, Yutaka; Mugiya, Soichi; Ozono, Seiichiro

    2013-10-01

    To investigate the presence of β-adrenoceptor subtypes in the human ureter, and to examine whether β(3) -adrenoceptors modulate relaxation of the human ureter. Expression of messenger ribonucleic acid of β-adrenoceptors in the human ureter was determined by reverse transcription polymerase chain reaction, and distribution of β-adrenoceptors was examined by immunohistochemistry. In functional studies, the relaxant effects of isoproterenol, procaterol, TRK-380, salbutamol and BRL 37344 on KCl-induced contraction of the human ureter were evaluated, and the inhibitory effects of isoproterenol, procaterol and TRK-380 on electrical field stimulation-induced contractions were determined. Expression of β(1) -, β(2) - and β(3) -adrenoceptor messenger ribonucleic acid in the human ureter was confirmed by reverse transcription polymerase chain reaction. Positive staining for β(1) -, β(2) - and β(3) -adrenoceptor was identified not only in smooth muscle, but also in the urothelium of the human ureter. All β-adrenoceptor agonists decreased the tone of KCl-induced contractions of the human ureter with a rank order of relaxant effects of isoproterenol > procaterol > TRK-380 > salbutamol > BRL 37344. Furthermore, isoproterenol, procaterol and TRK-380 significantly decreased the amplitude of electrical field stimulation-induced contractions with a rank order of inhibitory effects of isoproterenol > procaterol > TRK-380. Human ureteral relaxation is mediated by both β(2) - and β(3) -adrenoceptor stimulation. β(3) -Adrenoceptor agonists have the potential to relax the human ureter, and their clinical application in the treatment of ureteral stones is expected. © 2013 The Japanese Urological Association.

  14. Vertebral Fracture Prediction

    DEFF Research Database (Denmark)

    2008-01-01

    Vertebral Fracture Prediction A method of processing data derived from an image of at least part of a spine is provided for estimating the risk of a future fracture in vertebraeof the spine. Position data relating to at least four neighbouring vertebrae of the spine is processed. The curvature...

  15. Physiology and pharmacology of the human ureter: basis for current and future treatments.

    Science.gov (United States)

    Canda, A Erdem; Turna, Burak; Cinar, G Mehtap; Nazli, Oktay

    2007-01-01

    This article sets out to be a review regarding agents that affect contraction and relaxation of the ureter in order to establish a basis for current and future treatments for upper urinary tract obstruction. A complete review of the English literature using MEDLINE was performed between 1960 and 2007 on ureter physiology and pharmacology with special emphasis on signal transduction mechanisms involved in the contractile regulation of the human ureter. Activation of muscarinic and adrenergic receptors increases the amplitude of ureteral contractions. The sympathetic nerves modulate the contractions by alpha-adrenoceptors and relaxation by beta-adrenoceptors. The purinergic system is important in sensory/motor functions and ATP is an important non-adrenergic non-cholinergic (NANC) agent causing contraction. Nitric oxide (NO) is a major inhibitory NANC neurotransmitter causing relaxation. Serotonin causes contraction. Prostaglandin-F(2)alpha contracts whereas prostaglandin-E(1)/E(2) relaxes the ureter. Phosphodiesterases (PDE) and the Rho-kinase pathway have recently been identified in the human ureter. PDE-IV inhibitors, K(+) channel openers, calcium antagonists, alpha(1)-adrenoceptor antagonists and NO donors seem to be promising drugs in relieving obstruction and facilitating stone passage. Further understanding of the ureteral function and pharmacology may lead to the discovery of promising new drugs that could be useful in relieving ureteral colic, facilitating spontaneous stone passage, preparing the ureter for ureteroscopy as well as acting adjunctive to extracorporeal shock-wave lithotripsy.

  16. Identification of the narrow lumen of the ureter using a Fogarty catheter during laparoscopic pyeloplasty.

    Science.gov (United States)

    Tsuji, Yoshikazu; Kinukawa, Tsuneo; Suzuki, Akitaka; Ishida, Shohei; Fujita, Takashi; Komatsu, Tomonori; Kimura, Toru; Tanaka, Kuniaki; Hattori, Ryohei

    2013-04-01

    It is difficult to identify the narrow sites of the ureter from the outside while carrying out laparoscopic pyeloplasty in patients with ureteropelvic junction obstruction. We developed and named a new method, the Fogarty test, to identify the narrow sites of the ureter using a Fogarty catheter. A 4- to 5-Fr Fogarty catheter was inserted through an incision in the pelvis to the proximal ureter, inflated with air and withdrawn gently to determine resistance. The narrow lumen of the ureter was identified under direct vision and spatulated by laparoscopic scissors. This procedure was carried out repeatedly until the ureter was fully spatulated. By using the Fogarty test, we can visualize the narrow position and length of the ureter under direct vision, and confirm whether it is fully spatulated or not. This technique is very simple and easy to carry out. We believe it is useful for sufficient spatulation of intrinsic ureteral stricture, especially in patients where multiple narrow sites exist. © 2012 The Japanese Urological Association.

  17. Transvesical laparoscopic surgery for double renal pelvis and ureter with or without ureterocele.

    Science.gov (United States)

    Naitoh, Yasuyuki; Oishi, Masakatsu; Kobayashi, Kenichi; Yamada, Yasuhiro; Nakamura, Terukazu; Johnin, Kazuyoshi; Hongo, Fumiya; Naya, Yoshio; Okihara, Koji; Kawauchi, Akihiro

    2016-04-01

    To evaluate the performance of transvesical laparoscopic surgery for patients with complete double pelvis and ureter. A total of 10 patients were included in the present study: five had complete double pelvis and ureter with ureterocele (group A), and five did not have ureterocele (group B). Three small incisions of 5 mm were used, without incision in the lower abdomen. In group A patients, the ureterocele wall was resected, and two ureters were sufficiently detached as a combined ureteral complex. Ureterocele on the side of the bladder wall was sutured to the bladder neck, and the bladder wall was strengthened. According to the cross-trigonal technique, ureterocystoneostomy was carried out in two ureters as a combined ureteral complex. In group B patients, two ureters were sufficiently detached, and ureterocystoneostomy was carried out as in group A. In group A, the mean age was 13.4 years (range 2-34 years). The mean operation time was 304.6 min (242-346 min). In group B, the mean age was 16.6 years (range 2-48 years). The mean operation time was 207.8 min (150-249 min). There were no intraoperative and postoperative complications in both study groups. Transvesical laparoscopic surgery can be safely and effectively used in patients with double pelvis and ureter. © 2016 The Japanese Urological Association.

  18. A two-dimensional numerical study of peristaltic contractions in obstructed ureter flows.

    Science.gov (United States)

    Najafi, Z; Schwartz, B F; Chandy, A J; Mahajan, A M

    2018-01-01

    The flow of urine from the kidneys to the bladder is accomplished via peristaltic contractions in the ureters. The peristalsis of urine through the ureter can sometimes be accompanied, more specifically, obstructed to a certain degree, by entities such as kidney stones. In this paper, 2D axisymmetric computational fluid dynamics simulations are carried out using the commercial code ANSYS FLUENT[Formula: see text], to model the peristaltic movement of the ureter with and without stone. The peristaltic movement was assumed to be a sinusoidal wave on the boundary of the ureter with a specific physiological velocity. While the first part of the study considers flow in the ureter with prescribed peristaltic contractions in absence of any obstruction, the second part compares the effect of varying obstructions (0, 5, 15, and 35%) in terms of spherical stones of different sizes. Pressure contours, velocity vectors, and profiles of pressure gradient magnitudes and wall shear stresses are presented along one bolus of the ureter, during contraction and expansion of the ureteral wall, in order to understand backflow, trapping and reflux phenomena, as well as monitor the health of the ureteral wall in the presence of any obstruction. The 35% ureteral obstruction case resulted in a significant backflow at the inlet in comparison to the other cases, and also a wall shear stress that was up to 20x larger than the case without any obstruction.

  19. [Therapeutic mega-ureter primitive before one year of life, retrospective study of 20years].

    Science.gov (United States)

    Picart, B; Pons, M; Line, A; François, C; Poli Merol, M-L

    2017-02-01

    What is the proper way to manage complicated primary mega-ureter in infants under the age of one. This has already been discussed in the literature but the controversy remains. Evaluate the long-term results of the management of mega-ureter based support under the age of one. Single-center retrospective study from 1990 to 2010. All children under one year found were evaluated including clinical examination, ultrasound, scintigraphy and cystography. They were divided into two groups: group 1: children operated on before the age of one year, group 2 non-operated or operated children after the age of one year. We analyzed the long-term evolution of these children on the following criteria: reflux, pyelonephritis, changes in dilation, renal function, need for surgical revision or secondary surgery, and impact on bladder function. In total, 54 patients were included in group 1 and 56 patients in group 2. In a median follow-up of 12 years. A total of 101 boys and 9 girls (sex-ratio 11.22). There were 57 left MUP (52%), 22 right (20%) and 31 bilateral (28%). A total of 71% of antenatal diagnosis. No difference on the emergence of complications: 25 (group 1) versus 31 (group 2) OR=0.69; 95% (0.307; 1.574); P=0.44. No difference between secondary surgery and revision surgery: group 1=12, group 2=22, OR=0.45; 95% CI (0.17, 1.09); P=0.06. No difference for daytime incontinence: OR=1.04; 95% CI (0.14; 7.64); P=0.67. Seventy-six children (69%) were finally made, 12 children operated twice (10.9%) and 34 children (31%) never made. The main challenge of the MUP of management is the preservation of renal function. Sixty-nine percent of our children received surgery due to impaired renal function lower than 30% of urethral dilatation greater than 10mm associated with reflux or recurrent pyelonephritis. Clinical monitoring, regular ultrasound and isotopic testing are necessary and should be extended to adulthood. 5. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  20. Alça intestinal invertida como substituto do ureter: estudo experimental em cães Ureter replacement by inverted ileal seromuscular tube or patch

    Directory of Open Access Journals (Sweden)

    Antonio F. D. Maynard

    2002-01-01

    Full Text Available OBJETIVO: Pesquisar a viabilidade da alça ileal invertida como substituto ureteral. MÉTODOS: Quarenta cães foram divididos em 5 grandes grupos de 8 animais, cada um subdividido em 2 subgrupos de acordo com a data do sacrifício (I - sacrifício em 12-15 dias de pós-operatório, e II - 60 dias de pós-operatório. Nos grupos A e B fez-se a substituição ureteral parcial com selo de íleo invertido, após abertura lateral do ureter direito com 2 (Grupo A ou 4 cm (Grupo B de extensão. Nos demais grupos fez-se a substituição do segmento completo do ureter usando-se um tubo de íleo invertido de comprimento equivalente ao segmento do ureter ressecado com 2cm (Grupo C e 6cm (Grupos D e E de extensão. A mucosa ileal foi removida por raspagem ou diérese. A permeabilidade ureteral foi testada por urografia excretora e por exploração anatômica com cateter após o sacrifício. As peças foram estudas histologicamente após preparação e coloração com hematoxilina-eosina. RESULTADOS: O número de animais com urografia normal após o seguimento foi: A-2, B-2, C-3, D-2 e E- 2. A histologia revelou que a serosa ileal se reveste com urotélio, não como decorrência de metaplasia, mas do crescimento a partir da borda da mucosa ureteral. CONCLUSÃO: Conclui-se que o íleo invertido não é um bom substituto ureteral.OBJECTIVE: To investigate the outcome of ureter replacement with inverted seromuscular tube in dogs. METHODS: 40 adult mongrel dogs were divided in 5 groups of 8 animals. Each group was divided in 2 subgroups: 1 - sacrifice on 12-15 postoperative days, and 2 - sacrifice on the 60th postoperative day. In group A ureter longitudinal incision 2cm long was sewed with an inverted ileal seromuscular patch 2cm long. In group B ureter incision and patch size were 4cm long. In the remaining groups a ureter segment was replaced by an inverted ileal seromuscular tube 2cm long (group C or 6cm long (groups D and E. In all groups, except E, ileal

  1. Is visualising ureter before pyeloplasty necessary in adult patients?

    Science.gov (United States)

    Cakan, M; Yalçinkaya, F; Demirel, F; Satir, A

    2000-01-01

    In this study, we aimed to detect whether or not visualising ureter and ureteropelvic junction (UPJ) preoperatively is necessary in adult patients who have primer UPJ obstruction. Between January 1995 to June 1999, 46 renal units in 45 patients with primer UPJ obstruction were evaluated. The patients were separated into 2 groups. In group 1, intravenous pyelography (IVP) and renal scintigraphy were performed to 17 renal units preoperatively. In group 2, in addition to these methods, either retrograde pyelography (RGP) or antegrade pyelography (AGP) were performed to 29 renal units. Renal/bladder sonogram was used in patients with poor renal function in IVP or in renal scintigraphy. All the operations were performed through a flank incision. In group 2, additional information was gained for 8 (27.5%) of the renal units preoperatively. No additional information for this group found intraoperatively. In group 1, we found additional information in 4 (23.53%) of the units intraoperatively. All the pathologies in both groups were corrected intraoperatively. Double-J (D-J) stent was used in 6 (35.29%) of the units in group 1 and 8 (27.58%) of the units in group 2 intraoperatively (p > 0.05). In group 2, 4 (13.79%) preoperative complications were seen due to RGP and they were treated either medically or conservatively. In the early postoperative period, a complication observed in 1 (5.88%) of the patients in group 1 and 1 of the patients in group 2 (3.44%) (p > 0.05). The first patient was treated with inserting D-J and the latter one was treated conservatively. In the 3rd postoperative month, success rate was found to be 94.11% in group 1 and 96.55% in group 2 (p > 0.05). Additional pathologies in adult patients with primer UPJ obstruction can be corrected intraoperatively through a flank incision. Therefore, imaging of ureter and UPJ may not be necessary in these patients.

  2. Predicting vertebral bone strength by vertebral static histomorphometry

    DEFF Research Database (Denmark)

    Thomsen, Jesper Skovhus; Ebbesen, Ebbe Nils; Mosekilde, Lis

    2002-01-01

    The study investigates the relationship between static histomorphometry and bone strength of human lumbar vertebral bone. The ability of vertebral histomorphometry to predict vertebral bone strength was compared with that of vertebral densitometry, and also with histomorphometry and bone strength...... of the entire vertebral bodies (L-2) were used for histomorphometry. The other iliac crest biopsies and the L-3 were destructively tested by compression. High correlation was found between BV/TV or Tb.Sp and vertebral bone strength (absolute value of r = 0.86 in both cases). Addition of Tb.Th significantly...... of improving the prediction of bone strength of the vertebral body. The correlations between BV/TV of L-2 and bone strength of L-3 were comparable with the correlation obtained by quantitative computed tomography (QCT), peripheral QCT (pQCT), and dual-energy X-ray absorptrometry (DEXA) of L-3 and bone strength...

  3. First-ever Reported Obstructing Ureteral Nephrogenic Adenoma in a Child and Subsequent Robotic-assisted Laparoscopic Ileal Ureter.

    Science.gov (United States)

    Koenig, Joel F; Rensing, Adam; Austin, Paul F; Vricella, Gino

    2016-08-01

    To report the first known case of a completely intracorporeal robotic-assisted laparoscopic ileal ureter in the pediatric population, a 12-year-old boy with near-complete replacement of his right ureter with nephrogenic adenoma and resulting debilitating renal colic. Intracorporeal robotic-assisted laparoscopic ileal ureter was performed without complication. A detailed description of our surgical technique is included. The patient had improvement in hydronephrosis and complete resolution of renal colic symptoms with minimal incisional length compared to traditional laparotomy. Intracorporeal robotic-assisted laparoscopic ileal ureter provides the benefits of minimally invasive surgery when complete ureteral replacement is needed. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Transitional Cell Carcinoma of the Upper Ureter Metastatic to the Thoracic Spine Presenting as a Spinal Cord Compression

    Directory of Open Access Journals (Sweden)

    J. O. Larkin

    2008-01-01

    Full Text Available We performed a left nephroureterectomy for a gentleman with transitional cell carcinoma of the upper ureter. Histological analysis revealed it to be a T1 lesion, but to be highly mitotically active. The gentleman defaulted on adjuvant therapy and defaulted on follow-up. He represented with symptoms of acute spinal cord compression and magnetic resonance imaging demonstrated a lesion at T6/7. Neurosurgical resection of the lesion showed it to be a metastatic deposit from the ureteric primary. Despite surgical debulking and subsequent radiotherapy to the lesion, the patient died secondary to metastatic complications. This case report is of interest to the surgeon as it demonstrates both the high metastatic potential of upper tract carcinomas and educates the surgeon on the presentation of acute spinal cord compression.

  5. Vertebral Augmentation Involving Vertebroplasty or Kyphoplasty for Cancer-Related Vertebral Compression Fractures: A Systematic Review.

    Science.gov (United States)

    2016-01-01

    Cancers that metastasize to the spine and primary cancers such as multiple myeloma can result in vertebral compression fractures or instability. Conservative strategies, including bed rest, bracing, and analgesic use, can be ineffective, resulting in continued pain and progressive functional disability limiting mobility and self-care. Surgery is not usually an option for cancer patients in advanced disease states because of their poor medical health or functional status and limited life expectancy. The objectives of this review were to evaluate the effectiveness and safety of percutaneous image-guided vertebral augmentation techniques, vertebroplasty and kyphoplasty, for palliation of cancer-related vertebral compression fractures. We performed a systematic literature search for studies on vertebral augmentation of cancer-related vertebral compression fractures published from January 1, 2000, to October 2014; abstracts were screened by a single reviewer. For those studies meeting the eligibility criteria, full-text articles were obtained. Owing to the heterogeneity of the clinical reports, we performed a narrative synthesis based on an analytical framework constructed for the type of cancer-related vertebral fractures and the diversity of the vertebral augmentation interventions. The evidence review identified 3,391 citations, of which 111 clinical reports (4,235 patients) evaluated the effectiveness of vertebroplasty (78 reports, 2,545 patients) or kyphoplasty (33 reports, 1,690 patients) for patients with mixed primary spinal metastatic cancers, multiple myeloma, or hemangiomas. Overall the mean pain intensity scores often reported within 48 hours of vertebral augmentation (kyphoplasty or vertebroplasty), were significantly reduced. Analgesic use, although variably reported, usually involved parallel decreases, particularly in opioids, and mean pain-related disability scores were also significantly improved. In a randomized controlled trial comparing kyphoplasty

  6. Sex reversal in vertebrates

    OpenAIRE

    2016-01-01

    This special topic issue of Sexual Development gives an overview of sex reversal in vertebrates, from fishes naturally changing their sex, to rodents escaping the mammalian SRY-determining system. It offers eight up-to-date reviews on specific subjects in sex reversal, considering fishes, amphibians, reptiles, birds, marsupials, and placental mammals, including humans. The broad scope of represented animals makes this ideal for students and researchers, especially those interested in the...

  7. Stones lodge at three sites of anatomic narrowing in the ureter: clinical fact or fiction?

    Science.gov (United States)

    Ordon, Michael; Schuler, Trevor D; Ghiculete, Daniela; Pace, Kenneth T; Honey, R John D'A

    2013-03-01

    Abstract Background and Purpose: Throughout the literature, the ureter is described as having three anatomic sites of narrowing at which kidney stones typically become lodged: The ureteropelvic junction (UPJ), the ureteral crossing of the iliac vessels, and the ureterovesical junction (UVJ). There is little evidence to support this notion, however. The purpose of our study is to evaluate whether three peaks in stone distribution corresponding to these anatomic landmarks exist. We retrospectively reviewed the kidneys-ureters-bladder (KUB) films of 622 patients with solitary ureteral calculi referred for shockwave lithotripsy (SWL). Pretreatment KUB films were used to categorize the location of their ureteral stone relative to 1 of 19 levels referenced to the axial skeleton. CT scans of 74 patients were used to determine the location of the UPJ, ureteral crossing of the iliac vessels, and UVJ relative to the 19 levels on KUB radiography. Histograms were then constructed to plot the distribution of stones within the ureter relative to these 19 levels. The effect of sex, stone size and side, and presence of a stent on stone distribution were analyzed. There are two peaks in the distribution of stones within the ureter in patients referred for SWL that correspond to the UPJ/proximal ureter and intramural ureter/UVJ. In patients with larger stones (≥100 mm(2)) or a ureteral stent in place, stones were distributed more proximally (Pureter and the intramural ureter/UVJ. We failed to demonstrate a peak in stone distribution corresponding with the ureteral crossing of the iliac vessels.

  8. Laparoscopic Fluorescent Visualization of the Ureter With Intravenous IRDye800CW.

    Science.gov (United States)

    Korb, Melissa L; Huh, Warner K; Boone, Jonathan D; Warram, Jason M; Chung, Thomas K; de Boer, Esther; Bland, Kirby I; Rosenthal, Eben L

    2015-01-01

    Ureter injury is a serious complication of laparoscopic surgery. Current strategies to identify the ureters, such as placement of a ureteral stent, carry additional risks for patients. We hypothesize that the systemically injected near-infrared (NIR) dye IRDye800CW-CA can be used to visualize ureters intraoperatively. Adult female mixed-breed pigs weighing 24 to 41 kg (n = 2 per dose) were given a 30, 60, or 120 μg/kg systemic injection of IRDye800CW-CA. Using the Food and Drug Administration-cleared Pinpoint laparoscopic NIR system, images of the ureter and bladder were captured every 10 minutes for 60 minutes after injection. To determine the biodistribution of the dye, tissues were collected for ex vivo analysis with the Pearl Impulse system. ImageJ software was used to quantify fluorescence signal and signal-to-background ratio (SBR) for the intraoperative images. The ureter was identified in all pigs at each dose, with peak intensity reached by 30 minutes and remaining elevated throughout the duration of imaging (60 minutes). The 60 μg/kg dose was determined to be optimal for differentiating ureters according to absolute fluorescence (>60 counts/pixel) and SBR (3.1). Urine fluorescence was inversely related to plasma fluorescence (R(2) = -0.82). Ex vivo imaging of kidney, ureter, bladder, and abdominal wall tissues revealed low fluorescence. Systemic administration of IRDye800CW-CA shows promise in providing ureteral identification with high specificity during laparoscopic surgery. The low dose required, rapid time to visualization, and absence of invasive ureteral instrumentation inherent to this technique may reduce complications related to pelvic surgery. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

  9. Identification and characterisation of regional variations in the material properties of ureter according to microstructure.

    Science.gov (United States)

    Sokolis, Dimitrios P

    2014-11-01

    There are few previous studies on the elastic properties of ureter and most have been limited to essentially one-dimensional deformation measurements. The object of this study was, therefore, to identify regional variations in the multiaxial behaviour of rabbit ureter, subjected to in vitro inflation/extension testing under a physiological range of intraluminal pressures and longitudinal forces. A microstructure-motivated material model (via two- and four-fibre families in turn for elastin and collagen) was implemented and its capacity to mathematically characterise the experimental data contrasted favourably with that of the well-established phenomenological models, but it was compromised by parameter covariance. Extensive optimisation studies confirmed that the reduced model without contribution to the elastin and circumferential-fibre (collagen) families characterised the data equally well without over-parameterisation. In view of the fitted parameters, the ureteral tissue was stiffer longitudinally, justified by the preferential alignment of collagen along that axis and the lower ureter was stiffer than the upper ureter, justified by the histological observation of a thickest lamina propria, i.e. of highest collagen content, there. The lower ureter was less anisotropic than the upper ureter, possessing a comparatively larger amount of diagonally arranged collagen fibres in tunica mucosa, while having the usual amounts of longitudinally arranged fibres in tunica adventitia and of circumferentially arranged fibres in tunica muscularis. The present data may be used as inputs to mathematical models of the ureter, assessing regional and intramural stress distributions, through which it is hoped that an improved appreciation of ureteral function may be attained in both health and disease.

  10. Effects of thienorphine on the contraction of isolated ureter and bladder of guinea pigs.

    Science.gov (United States)

    Zhou, Peilan; Li, Yulei; Yong, Zheng; Yan, Hui; Su, Ruibin; Gong, Zehui

    2016-10-15

    Opioid analgesics are widely used in moderate to severe pain including renal colic. Morphine is believed to cause spasm of ureter and affect the bladder contractions. Thienorphine is a partial opioid agonist that is a good candidate for the treatment of opioid dependence and pain. This study examined the effects of thienorphine on the guinea pig isolated ureter and bladder. The contractile amplitude of isolated ureter induced by KCl (40mM) was not influenced by thienorphine or buprenorphine, whereas morphine increased the amplitude of the isolated ureter. Thienorphine, buprenorphine or naloxone concentration-dependently antagonized the isolated ureter contraction induced by morphine. Thienorphine (1.0-32.0μM) or buprenorphine (1.0-32.0μM) had no effects on the spontaneous or acetylcholine (Ach) induced contractions of isolated bladder, but decreased the amplitude of the contractions of isolated bladder at 100μM concentration. Morphine (0.1-3.2mM) concentration dependently increased the spontaneous movement and Ach (1μM) induced contractions of isolated bladder. The mRNA levels of μ receptor in the ureter and bladder was as the same as that in the frontal cortex. In comparison, the mRNA levels of κ receptor, δ receptor and N/OFQ receptor was fewer than that in the frontal cortex. In summary, thienorphine has little influence on the guinea pig isolated ureter and bladder compared with morphine, which may result in a lack of adverse renal colic effects. Copyright © 2016. Published by Elsevier B.V.

  11. Building the Vertebrate Spine

    Science.gov (United States)

    Pourquié, Olivier

    2008-03-01

    The vertebrate body can be subdivided along the antero-posterior (AP) axis into repeated structures called segments. This periodic pattern is established during embryogenesis by the somitogenesis process. Somites are generated in a rhythmic fashion from the paraxial mesoderm and subsequently differentiate to give rise to the vertebrae and skeletal muscles of the body. Somite formation involves an oscillator-the segmentation clock-whose periodic signal is converted into the periodic array of somite boundaries. This clock drives the dynamic expression of cyclic genes in the presomitic mesoderm and requires Notch and Wnt signaling. Microarray studies of the mouse presomitic mesoderm transcriptome reveal that the segmentation clock drives the periodic expression of a large network of cyclic genes involved in cell signaling. Mutually exclusive activation of the Notch/FGF and Wnt pathways during each cycle suggests that coordinated regulation of these three pathways underlies the clock oscillator. In humans, mutations in the genes associated to the function of this oscillator such as Dll3 or Lunatic Fringe result in abnormal segmentation of the vertebral column such as those seen in congenital scoliosis. Whereas the segmentation clock is thought to set the pace of vertebrate segmentation, the translation of this pulsation into the reiterated arrangement of segment boundaries along the AP axis involves dynamic gradients of FGF and Wnt signaling. The FGF signaling gradient is established based on an unusual mechanism involving mRNA decay which provides an efficient means to couple the spatio-temporal activation of segmentation to the posterior elongation of the embryo. Another striking aspect of somite production is the strict bilateral symmetry of the process. Retinoic acid was shown to control aspects of this coordination by buffering destabilizing effects from the embryonic left-right machinery. Defects in this embryonic program controlling vertebral symmetry might lead

  12. Routine needle biopsy during vertebral augmentation procedures. Is it necessary?

    Science.gov (United States)

    Pneumaticos, Spiros G; Chatziioannou, Sofia N; Savvidou, Christiana; Pilichou, Anastasia; Rontogianni, Dimitra; Korres, Dimitrios S

    2010-11-01

    Vertebral augmentation procedures are currently widely performed to treat vertebral compression fractures. The purpose of this study was to determine the frequency of underlying previously unrecognized etiology in a consecutive series of patients undergoing kyphoplasty to treat vertebral compression fractures. A prospective histological evaluation of vertebral body biopsy specimens from presumed osteoporotic vertebral compression fractures were performed in order to identify aforementioned causes. Over a 2-year period, vertebral body biopsies from 154 vertebral levels were performed in 75 patients undergoing kyphoplasty for vertebral compression fractures. All patients received a preoperative workup that included plain radiographs, MRI, whole body bone scan, and laboratory examinations. Bone specimens were obtained from affected vertebral bodies and submitted for histologic evaluation to identify the prevalence of an underlying cause. All specimens demonstrated fragmented bone with variable amounts of unmineralised bone, signs of bone-remodeling and/or fracture-healing. In 11 patients underlying pathology other than osteoporosis was identified (prostate cancer, 1; pancreatic cancer, 1; colon cancer, 1; breast cancer, 2; multiple myeloma, 3; leukemia, 1; and lung cancer, 2). In all but one patient the results of the biopsy confirmed the diagnosis suspected from the preoperative workup. For the last patient, namely the one with pancreatic cancer, the workup did not identify the origin of the primary tumor, although the patient was considered to have a compression fracture secondary to metastatic disease of unknown origin, the vertebral biopsy suggested the presence of adenocarcinoma which eventually was proven to be pancreatic cancer. In augmentation procedures for vertebral compression fractures, bone biopsy should be reserved for the patients where the preoperative evaluation raises the suspicion of a non-osteoporotic etiology.

  13. Simultaneous Occurrence of Malignant Fibrous Histiocytoma of the Ureter and Dioctophyma Renale Infection: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hye Young; Seo, Jung Wook; Lee, Byung Hoon; Lee, Ji Young; Kim, Su Young; Cha, Soon Joo; Kim, Yong Hoon; Hwang, Yoon Joon; Kim, You Sung [Dept. of Radiology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang (Korea, Republic of)

    2013-03-15

    A common soft-tissue tumor, malignant fibrous histiocytoma (MFH) occurs in mainly limbs, retroperitoneal and peritoneal space, and occurrence in kidneys or the ureter is very rare. Dioctophyma renale (D. renale) since first discovered in dog's kidney was found in the kidneys of animals such as mink, coyote and weasel, and human infection has only been reported in only approximately 20 cases worldwide. MFH of the ureter and D. renale infection very rarely occur in humans, and has not been reported in our country. Here, we described the case of an adult man in whom MFH of the ureter simultaneously occurred with D. renale infection. An initial CT scan showed a well-defined, persistent, enhancing polypoid mass-like lesion in the upper ureter. After 10 months, D. renale was excreted in the urine and a follow-up CT scan showed an increase in the size of that lesion and irregular thickening of the ureter wall. The diagnosis of MFH was pathologically verified.

  14. Wrap plication of megaureter around normal-sized ureter for complete duplex system reimplantations.

    Science.gov (United States)

    van den Heijkant, M M C; Dik, P; Klijn, A J; Chrzan, R; Kuijper, C F; de Jong, T P V M

    2013-01-01

    A duplex collecting system is a common congenital renal tract abnormality associated with different clinical problems. We describe our experience with ureteral reimplantations of a complete duplex collecting system where 1 megaureter needing recalibration and 1 normal-sized ureter coexisted. Recalibration of the megaureter was done by wrap plication around the normal-sized ureter. Operative logs and case notes were reviewed of consecutive children with a complete duplex collecting system treated with wrap plication of the megaureter around the normal-sized ureter and reimplantation between 1997 and 2010. Reoperation, vesicoureteral reflux and obstruction rates were assessed. A total of 25 children underwent wrap plication and ureteral reimplantation. Of the cases 19 (76%) were completely successful and 6 (24%) needed reoperation. Three children (12%) had persistent high grade vesicoureteral reflux, 2 (8%) underwent endoscopic correction and 1 (4%) underwent repeat reimplantation of the duplex system. Three children (12%) had postoperative obstruction and 2 (8%) underwent endoscopic incision of the ureteral orifice. In 1 child (4%) a nonfunctioning lower moiety of the kidney developed, which was managed by heminephrectomy. Wrap plication of a megaureter around the normal-sized ureter before reimplantation seems to be a relatively safe method in the surgical management of children with a complete duplex collecting system of the kidney. Sufficient spatulation of the lower pole ureter seems to be crucial. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  15. Vertebral Augmentation Involving Vertebroplasty or Kyphoplasty for Cancer-Related Vertebral Compression Fractures: An Economic Analysis.

    Science.gov (United States)

    2016-01-01

    Untreated vertebral compression fractures can have serious clinical consequences and impose a considerable impact on patients' quality of life and on caregivers. Since non-surgical management of these fractures has limited effectiveness, vertebral augmentation procedures are gaining acceptance in clinical practice for pain control and fracture stabilization. The objective of this analysis was to determine the cost-effectiveness and budgetary impact of kyphoplasty or vertebroplasty compared with non-surgical management for the treatment of vertebral compression fractures in patients with cancer. We performed a systematic review of health economic studies to identify relevant studies that compare the cost-effectiveness of kyphoplasty or vertebroplasty with non-surgical management for the treatment of vertebral compression fractures in adults with cancer. We also performed a primary cost-effectiveness analysis to assess the clinical benefits and costs of kyphoplasty or vertebroplasty compared with non-surgical management in the same population. We developed a Markov model to forecast benefits and harms of treatments, and corresponding quality-adjusted life years and costs. Clinical data and utility data were derived from published sources, while costing data were derived using Ontario administrative sources. We performed sensitivity analyses to examine the robustness of the results. In addition, a 1-year budget impact analysis was performed using data from Ontario administrative sources. Two scenarios were explored: (a) an increase in the total number of vertebral augmentation procedures performed among patients with cancer in Ontario, maintaining the current proportion of kyphoplasty versus vertebroplasty; and (b) no increase in the total number of vertebral augmentation procedures performed among patients with cancer in Ontario but an increase in the proportion of kyphoplasties versus vertebroplasties. The base case considered each of kyphoplasty and vertebroplasty

  16. Vertebral Augmentation Involving Vertebroplasty or Kyphoplasty for Cancer-Related Vertebral Compression Fractures: An Economic Analysis

    Science.gov (United States)

    2016-01-01

    Background Untreated vertebral compression fractures can have serious clinical consequences and impose a considerable impact on patients' quality of life and on caregivers. Since non-surgical management of these fractures has limited effectiveness, vertebral augmentation procedures are gaining acceptance in clinical practice for pain control and fracture stabilization. The objective of this analysis was to determine the cost-effectiveness and budgetary impact of kyphoplasty or vertebroplasty compared with non-surgical management for the treatment of vertebral compression fractures in patients with cancer. Methods We performed a systematic review of health economic studies to identify relevant studies that compare the cost-effectiveness of kyphoplasty or vertebroplasty with non-surgical management for the treatment of vertebral compression fractures in adults with cancer. We also performed a primary cost-effectiveness analysis to assess the clinical benefits and costs of kyphoplasty or vertebroplasty compared with non-surgical management in the same population. We developed a Markov model to forecast benefits and harms of treatments, and corresponding quality-adjusted life years and costs. Clinical data and utility data were derived from published sources, while costing data were derived using Ontario administrative sources. We performed sensitivity analyses to examine the robustness of the results. In addition, a 1-year budget impact analysis was performed using data from Ontario administrative sources. Two scenarios were explored: (a) an increase in the total number of vertebral augmentation procedures performed among patients with cancer in Ontario, maintaining the current proportion of kyphoplasty versus vertebroplasty; and (b) no increase in the total number of vertebral augmentation procedures performed among patients with cancer in Ontario but an increase in the proportion of kyphoplasties versus vertebroplasties. Results The base case considered each of

  17. Causes and prevention of laparoscopic ureter injuries: an analysis of 31 cases during laparoscopic hysterectomy in the Netherlands

    NARCIS (Netherlands)

    Janssen, P.F.; Brölmann, H.A.M.; Huirne, J.A.F.

    2013-01-01

    Background: Ureter injuries are the most dreaded complication in gynecological surgery. Some risk factors for the occurrence of urinary tract injuries are known, but clear guidelines to prevent ureter injuries during laparoscopic hysterectomy (LH) are lacking. The aim of this study was to analyze

  18. A new 2-micrometer continuous wave laser method for management of the distal ureter in retroperitoneal laparoscopic nephroureterectomy.

    Science.gov (United States)

    Guo, Gang; Yang, Yong; Dong, Jun; Zhenhong, Zhou; Zhang, Xu

    2015-04-01

    Retroperitoneal laparoscopic nephroureterectomy (LNU) is a classic technique for the treatment of patients with urothelial cancer of the upper urinary tract. Management of the distal ureter in patients undergoing this procedure remains controversial, however. We evaluated a new method involving cystoscopic sleeve resection of the distal ureter using a 2-μm continuous wave laser before LNU. LNU was performed in 38 patients at our hospital between January 2008 and January 2012. The distal end of the ureter was managed by using a 2-μm continuous wave laser to evaporate and excise the ureteral orifice and bladder cuff. A standard technique was applied to keep the ureter intact. The ureter was dissected to the entrance of the bladder, and the distal ureter was easily detached from the bladder. The distal ureter was excised completely in all cases using this new technique. The average operative time was 2.4 hours, and the average blood loss was 69.4 mL. At 1 year after surgery, the cause-specific survival rate of the patients was 100%, the bladder recurrence-free rate was 89%, and the extravesical recurrence-free rate was 100%. For managing the distal ureter during LNU, the new technique described proved to be a simple, safe, and minimally invasive method.

  19. Obstructed kidney and sepsis secondary to urethral catheter misplacement into the distal ureter

    Science.gov (United States)

    Crawford, Ruairidh Lorn Hunter; Liston, Thomas; Bong, Ai Shiang; Cunnane, Max Joshua

    2015-01-01

    An 86-year-old woman underwent routine catheter replacement in the community. The new catheter failed to drain urine. Attempts to remove the catheter failed, both by the community nurse as well as by the urology team in the hospital. A CT scan confirmed that the catheter balloon was inflated in the distal right ureter. The patient was started on antibiotics and listed for cystoscopy under general anaesthetic. The catheter was visualised entering the right ureter and the balloon punctured using a wire under image intensifier guidance. Once removed, a new catheter was inserted. Very dilated ureteric orifices were noted. Post operatively the patient required HDU support for 48 h due to sepsis and on recovery was discharged home. The key learning point in this case is to always consider catheter misplacement in the ureter if it is not draining well and the patient presents with pain. PMID:25976188

  20. Minimally invasive treatment of iatrogenic complete left ureter obstruction after hysterectomy

    Directory of Open Access Journals (Sweden)

    Yigit Akin

    2012-09-01

    Full Text Available The iatrogenic ureter injuries are rare complications and may have serious consequences. The treatment options depend on situations. Pelvic surgeons, keep in mind that this kinds of complications, is very important for diagnosis and treatment, during the surgery. This report presents a case of a patient with iatrogenic left ureteral injury during hysterectomy. The patient visited emergency department of our hospital with the chief complaints of left lomber pain on the 17th day of hysterectomy. After evaluation in emergency clinic, the patient had an endoscopic treatment for iatrogenic ureter injury. The patient is still in follow-up period. We also review the literature and discuss diagnose, treatment, prognosis of iatrogenic ureter injuries. The treatmentoptions are still developing by technology.

  1. Ureteral Stone in the Distal Blind-ending Branch of a Bifid Ureter.

    Science.gov (United States)

    Niwa, Naoya; Ohigashi, Takashi; Bessho, Hideharu; Arakawa, Takashi

    2017-01-01

    A bifid ureter with a distal blind-ending branch is a rare congenital anomaly. Most patients are asymptomatic; only patients with complications, such as infection, vesicoureteral reflux, or stone formation, present symptoms. We describe the case of a patient with urinary stone located in the distal blind-ending branch of a bifid ureter diagnosed during transurethral lithotripsy. Preoperative noncontrast-enhanced computed tomography did not reveal a stone in the distal blind-ending branch of the bifid ureter, but a rigid ureteroscope did; however, it could not reach the stone. Therefore, the stone was extracted using a basket catheter under a flexible ureteroscope. Copyright © 2016 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2009-01-01

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

  3. Radiotherapy of vertebral hemangiomas

    Energy Technology Data Exchange (ETDEWEB)

    Sakata, Kohichi; Hareyama, Masato; Oouchi, Atushi; Sido, Mitsuo; Nagakura, Hisayasu; Tamakawa, Mituharu; Akiba, Hidenari; Morita, Kazuo [Dept. of Radiology, Sapporo Medical Univ., School of Medicine (Japan)

    1997-12-31

    Between 1975 and 1996, 14 patients (11 females, 3 males) with vertebral hemangioma received treatment with radiotherapy. Thirteen patients had a history of back pain or lumbago and 2 patients had neurological symptoms such as sensory impairment or paraplegia. The standard dose administered was 36 Gy in 18 fractions (five treatments per week). In the 13 patients with pain, this was completely or partially relieved. The condition of a man with hypesthesia of the legs deteriorated and a woman with paraplegia who was treated with decompressive laminectomy followed by radiotherapy recovered completely after irradiation. CT scan before irradiation showed thickened trabeculae as small punctate areas of sclerosis in all patients. At MR imaging before irradiation, T2-weighted MR images showed areas of high intensity in all patients and MR images demonstrated lesion enhancement. However, none of the patients who were treated successfully with radiation demonstrated any changes of the affected vertebra in the conventional radiographic films, CT scan or MR imaging, even 5 years after irradiation. Radiological imaging is indispensable for the diagnosis of vertebral hemangiomas but does not appear to be useful for evaluating the effects of radiotherapy. (orig.).

  4. Retroperitoneoscopic ureteroplasty for retrocaval ureter: report of nine cases and literature review.

    Science.gov (United States)

    Liu, Erpeng; Sun, Xiao; Guo, Hui; Li, Faping; Liu, Shukun; Wang, Kaixuan; Hou, Yuchuan

    2016-08-01

    The aim of this study was to report the experience of retroperitoneal laparoscopic ureteroplasty for nine cases of retrocaval ureter. Six males and three females were referred with a diagnosis of retrocaval ureter. A retroperitoneal laparoscopic approach was taken in all patients, who were diagnosed by intravenous pyelography (IVP), computed tomography urography and retrograde pyelography. After the dilated proximal ureter was mobilized, the ureter was transected just above the retrocaval segment, which was repositioned to the anterior of the vena cava. The retrocaval segment was observed and evaluated to enable a decision as to whether or not to reserve. Then, tension-free, water-tight anastomosis was performed with absorbable sutures using intracorporeal suturing techniques over a double-J stent, which was laparoscopically inserted in an antegrade manner. The stent was removed 4-6 weeks postoperatively. The ureteroplasty was accomplished in all cases. The retrocaval segment of the ureter was reserved with a grossly normal appearance in six cases; the abnormal retrocaval segment was excised in the three other cases. The mean operative duration was 103 min (range 89-110 min) and the mean hospital stay was 7 days (range 6-9 days). No serious complications occurred. Follow-up by ultrasonography and IVP, lasting 6 months to 4 years, revealed considerable improvement in hydronephrosis and upper ureteral dilatation. No ureteral stenosis was found at the anastomotic site. Retroperitoneoscopic ureteroplasty should be recommended as the first line treatment for retrocaval ureter because of its advantages of minimal invasion and shorter hospital stay than open surgery. Skilled laparoscopic anastomosis with a retroperitoneal approach can shorten the operative duration.

  5. Collateral damage to the ureter and Nitinol stone baskets during thulium fiber laser lithotripsy.

    Science.gov (United States)

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

    2015-07-01

    The experimental Thulium fiber laser (TFL) is currently being studied as a potential alternative lithotripter to the clinical gold standard Holmium:YAG laser. Safety studies characterizing undesirable Holmium:YAG laser-induced damage to ureter tissue and stone baskets have been previously reported. Similarly, this study characterizes TFL induced ureter and stone basket damage. A TFL beam with energy of 35 mJ per pulse, pulse duration of 500 µs, and variable pulse rates of 50-500 Hz, was delivered through 100-µm-core optical fibers, to either porcine ureter wall, in vitro, or a standard 1.9-Fr Nitinol stone basket wire. Ureter perforation times were measured and gross, histological, and optical coherence tomography images of the ablation area were acquired. Stone basket damage was graded as a function of pulse rate, number of pulses, and working distance. TFL operation at 150, 300, and 500 Hz produced mean ureter perforation times of 7.9, 3.8, and 1.8 seconds, respectively. Collateral damage widths averaged 510, 370, and 310 µm. Nitinol wire damage decreased with working distance and was non-existent at distances greater than 1.0 mm. In contact mode, 500 pulses delivered at pulse rates ≥300 Hz (≤1.5 seconds) were sufficient to cut Nitinol wires. The TFL, operated in low pulse energy and high pulse rate mode, may provide a greater safety margin than the standard Holmium:YAG laser for lithotripsy, as evidenced by longer TFL ureter perforation times and shorter non-contact working distances for stone basket damage than previously reported with Holmium:YAG laser. © 2015 Wiley Periodicals, Inc.

  6. Retrocaval ureter and contra lateral renal agenesis - a case report and review of literature.

    Science.gov (United States)

    Cardoza, Felix; Shambhulinga, C K; Rajeevan, A T

    2016-01-01

    Associated congenital anomalies are seen in 21% of retrocaval ureter patients; among them, associated contralateral renal agenesis is a very rare entity. We report one such case of right circumcaval ureter with left renal agenesis, diagnosed after febrile UTI. Surgical correction with uretero-ureterostomy was successful. In literature very few such cases are reported and only one case with renal failure was reported. Unilateral renal agenesis cases complicated by associated such anomalies need definitive management and lifelong clinical monitoring to diagnose and prevent chronic kidney disease. Copyright© by the International Brazilian Journal of Urology.

  7. Balloon Dilation of the Ureter: A Contemporary Review of Outcomes and Complications.

    Science.gov (United States)

    Kuntz, Nicholas J; Neisius, Andreas; Tsivian, Matvey; Ghaffar, Momin; Patel, Nishant; Ferrandino, Michael N; Sur, Roger L; Preminger, Glenn M; Lipkin, Michael E

    2015-08-01

    During ureteroscopy ureteral balloon dilation may be necessary to allow for passage of endoscopic instruments or access sheaths. We assessed the efficacy and complications associated with ureteral balloon dilation. We retrospectively reviewed the records at 2 institutions from 2000 to 2012 to identify patients who underwent ureteral balloon dilation during ureteroscopic treatment of upper tract stones. An 18Fr balloon dilator was used in all cases. Patients with documented ureteral stricture, radiation therapy or urothelial cancer were excluded from analysis. Primary outcomes were the stone-free rate, operative complications, balloon dilation failure and the postoperative ureteral stricture rate. Complications were divided into intraoperative and postoperative groups according to the Satava and Clavien-Dindo classifications, respectively. A total of 151 patients fulfilled study criteria. Median followup was 12 months. The stone-free rate was 72% and median time to first postoperative imaging was 2.8 months. Balloon dilation failed in only 8 patients (5%). Eight intraoperative ureteral perforations (5%) were identified, which were managed by a ureteral stent in 7 patients and a percutaneous tube in 1. Endoscopic re-treatment was required in 4 patients with Satava 2b postoperative complications. The postoperative complication rate was 8% (11 cases). A single ureteral stricture was attributable to balloon dilation. In this contemporary review balloon dilation of the ureter before endoscopic treatment of stone disease was associated with a high success rate and few complications. Ureteral balloon dilation may decrease the need for a secondary procedure in patients undergoing ureteroscopy to manage proximal ureteral and intrarenal stones. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  8. Thulium fiber laser lithotripsy in an in vitro ureter model

    Science.gov (United States)

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

    2014-12-01

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

  9. Vertebral contour in spondylolisthesis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, J. S.; Rho, J. C.; Park, J. H.; Choi, H. Y.; Kim, B. K. [Wallace memorial Baptist Hospital, Busan (Korea, Republic of)

    1981-09-15

    The defect in the pars interarticularis of spondylolisthesis may be dependent on contributing factors related to trauma and stress to which the neural arch is subjected, superimposed on a hereditary diasthesis. Posterior wedging of 5th lumber vertebral body in lumbosacral spondylolisthesis together with the degree of slip have been measured. The average wedging in spondylolisthesis is significantly greater than patient without this condition, and forms a characteristic radiological sign. The degree of wedging and slip show a statistically valid correlation. The diagnosis of spondylolisthesis is becoming more prevalent as the complexity of our society result in the increasing use of roentgenography of the lumbar spine. Isolated lateral deviation and rotation of spinous process seen in anteroposterior radiographs of the lumbar spine seems to be associated with pathology in the pars interarticularis.

  10. Compression CT urography: a comparison with IVU in the opacification of the collecting system and ureters.

    Science.gov (United States)

    Heneghan, J P; Kim, D H; Leder, R A; DeLong, D; Nelson, R C

    2001-01-01

    The purpose of this study was to evaluate opacification of the collecting system and ureters using compression computed tomography (CT) urography compared with conventional intravenous urography (IVU). Fifty consecutive patients underwent compression CT urography as part of a dedicated renal CT. A compression belt was applied prior to nephrographic phase imaging. Excretory phase scans were acquired through the kidneys 3 minutes post injection with the compression belt in place. The compression belt was then released, and scans were obtained through the ureters. Three independent readers then scored opacification of the collecting system and ureters on a scale of 0-2 (0 = no opacification, 1 = partial opacification, 2 = full opacification and distension). Fifty consecutive nonmatched IVUs were scored by segment by the same readers. Comparison of the two modalities was made using the Mann-Whitney U test. Interobserver agreement was assessed by the Kappa coefficient. CT demonstrated significantly better opacification (p IVU. The Kappa coefficient was 0.53. Compression CT urography yields equal or better opacification of the collecting system and ureters when compared with IVU, and shows promise for the routine evaluation of the renal excretory system.

  11. Spontaneous perforation of the ureter diagnosed on technetium 99m DTPA excretory urography

    Energy Technology Data Exchange (ETDEWEB)

    Barasch, E.; Kashdan, B.; Rathore, A.

    1988-01-01

    A case of nontraumatic rupture of the ureter secondary to a nonopaque calculus is presented. Because of the inherent high image contrast caused by the leak of technetium 99m-DTPA-labeled urine, the technetium 99m-DTPA excretory urogram is seen as an alternative to the intravenous urogram or contrast-enhanced computed tomography in selected cases of suspected ureteral rupture.

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

    Science.gov (United States)

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

    2012-01-01

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

  13. Extensive cellulitis as the first symptom of ureter lesion after laparoscopic hysterectomy

    NARCIS (Netherlands)

    Ooijen, P. van; Haar, J.F. ter; Pijnenborg, J.M.A.

    2011-01-01

    Laparoscopic hysterectomy as an alternative to abdominal hysterectomy is frequently performed for benign uterine pathology. Although laparoscopic hysterectomy is associated with less pain, quicker recovery, and better short-term quality of life, it is associated with an increased risk of ureter

  14. Partial substitution of the ureter using a double short segments of the ...

    African Journals Online (AJOL)

    The partial substitution of the ureter using a pediculated double short segments of the ileum is a technique used to re-establish ureteral transit and preserve the renal unit, following the resection of extensive ureteral lesions. Standard surgical procedure for an ileoureteroplasty consists of isolating an ileal duct of equal or ...

  15. The management of total avulsion of the ureter from both ends: Our experience and literature review.

    Science.gov (United States)

    Sevinc, Cuneyd; Balaban, Muhsin; Ozkaptan, Orkunt; Yucetas, Ugur; Karadeniz, Tahir

    2016-07-04

    To evaluate the treatment modalities of total ureteral avulsion and to clarify the risk factors of this serious complication. This study retrospectively analyzed the data of 3 patients with complete ureteral avulsion during ureteroscopy. Of the three patients, two had distal ureteral complete avulsion, and one total ureteral avulsion on both ends. Ureteroneocystostomy (UNC) was immediately performed after distal ureteral avulsion cases. Ileal ureter substition was performed on the same session after the total ureteral avulsion in both ends. Two of the patients were under chronic use of corticosteroid treatment due to diagnosis of idiopathic trombocytopenic purpura and myastenia gravis and all patients had unsuccesful shockwave litotripsy (SWL) treatment history with at least 1 month period before surgery. The patient who had ileal ureter substitution was followed at 3-month intervals by ultrasonography and renal function tests and she was uneventful after a 2 year follow-up period. The patients treated with UNC were followed up at 3 month interval by ultrasonography and renal function tests. They had normal renal function 1 year after the operation Complete ureteral avulsion is a rare but severe complication. Treatment modality can vary and ileal ureter can be applied succesfully in the total ureter avulsion in both ends when bladder capacity is not enough for a Boari flap. Failed SWL and/or corticosteroid treatment history of patients seems to increase the risk of the ureteral avulsion.

  16. Anatomy of ureterovesical junction and distal ureter studied by endoluminal ultrasonography in vitro

    NARCIS (Netherlands)

    Roshani, H.; Dabhoiwala, N. F.; Verbeek, F. J.; Kurth, K. H.; Lamers, W. H.

    1999-01-01

    PURPOSE: The emerging technique of endoluminal ultrasonography (ELUS) provides a new modality for endoscopic visualization of the urinary tract which needs to be further evaluated. We studied the normal anatomy of distal ureter and ureterovesical junction using ELUS. MATERIALS AND METHODS: An

  17. Wrap Plication of Megaureter Around Normal-Sized Ureter for Complete Duplex System Reimplantations

    NARCIS (Netherlands)

    van den Heijkant, M. M. C.; Dik, P.; Klijn, A. J.; Chrzan, R.; Kuijper, C. F.; de Jong, T. P. V. M.

    2013-01-01

    Purpose: A duplex collecting system is a common congenital renal tract abnormality associated with different clinical problems. We describe our experience with ureteral reimplantations of a complete duplex collecting system where 1 megaureter needing recalibration and 1 normal-sized ureter

  18. Numerical analysis of the urine flow in a stented ureter with no peristalsis.

    Science.gov (United States)

    Kim, Hyoung-Ho; Choi, Young Ho; Lee, Seung Bae; Baba, Yasutaka; Kim, Kyung-Wuk; Suh, Sang-Ho

    2015-01-01

    A ureteral stenosis or occlusion causes the disturbance of normal urine flow and results in renal failure. Ureteral stents are used to relieve the stagnation of urine in the upper urinary tract. Peristalsis in the ureter, which occurs to help urine flow, becomes to weaken when a stent is inserted and effective peristalsis disappears as time goes on, and a stented ureter seems to be tubular and curved in the human body. Double J stents, which are manufactured by many medical companies and are used widely these days, have different geometries of side holes in the stent shafts. In total, 12 models-six curved models of a stented ureter according to different numbers and positions of side holes and ureteral and stent stenoses and another six straight models for comparison with the curved ones-were made based on the data collected from 19 men. The flow rate and pattern in the stented ureter were evaluated using computational fluid dynamics (CFD). According to the results, curved models reflecting the human anatomy seem to be more desirable in the CFD simulation of urine flow and must be good for evaluating the effect of geometrical variations in stent design on urine flow.

  19. Three-Dimensional Imaging of Ureter with Endoscopic Optical Coherence Tomography

    Science.gov (United States)

    Wang, Hui; Kang, Wei; Zhu, Hui; MacLennan, Gregory; Rollins, Andrew M.

    2010-01-01

    OBJECTIVES To verify the ability to identify the layered structures of ureteral wall and to image a segment of ureter in three dimensions with a high speed endoscopic optical coherence tomography (EOCT). METHODS We imaged a porcine ureter ex vivo using a spectral domain EOCT with an specially designed circumferential scanning fiber catheter. The images were correlated with the histology to identify corresponding structures. Three-dimensional images and en face images at different depths from the luminal surface were reconstructed from the multiple cross-sectional images to visualize the layered structure of a segment of the ureter from different perspectives. RESULTS EOCT images can clearly reveal all layers of the ureteral wall as shown in the histological images. Especially, with the specially designed fiber catheter, the light beam was well centered during the rotation and pull back, which allowed constant acquisition of high fidelity images and unambiguous identification of the smooth muscle layers in all images. With high speed EOCT, a segment of ureter (20 mm) can be imaged in less than 90 seconds at a high resolution. CONCLUSIONS With its ability to visualize all layers of the ureteral wall, EOCT imaging offers the potential to stage urothelial cancers that have infiltrated the muscular wall (stage T2). This information will be complimentary to the diagnostic information obtained through ureteroscopic biopsy and CT urogram. PMID:21256548

  20. [Seminal vesicular cysts associated with renal agenesis, ipsilateral ureter and hemitrigone. Report of a case].

    Science.gov (United States)

    Llopis Mínguez, B; Ferrutxe Frau, J; Moreno Pardo, B; Baixauli Martínez, J M; Moreno Barrachina, E; Rodríguez Hernández, J H

    1979-01-01

    A case is presented of seminal vesicular cyst associated with kidney agenesia, ipsilateral ureter and hemitrigon; this is the 17th case presented in the world literature reviewed. A study is made of all the cases published and the authors recommend deferento-vesiculography as the best means of diagnosis and total excision of the cyst as the most effective treatment.

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

    Directory of Open Access Journals (Sweden)

    Stilianos Giannakopoulos

    2012-01-01

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

  2. Ectopic ureterocele and ectopic ureter in pediatric patients; Ureterocele ectopico y ectopia ureteral en pacientes pediatricos

    Energy Technology Data Exchange (ETDEWEB)

    Lloret, M. T.; Ricart, V.; Muro, M. D.; Perez, D.; Martinez, I.; Brugger, S.; Romero, M. J.; Cortina, H. [hospital General Universitario La Fe. Valencia (Spain)

    2000-07-01

    To describe the radiological findings associated with ectopic ureterocele and ectopic ureter in pediatric patients. To assess the role of ultrasound (US), serial micturating cystourethrography (SM-CU) and intravenous urography (IVU) in the diagnosis of these two entities. The authors performed a retrospective study of 132 patients, 73 with ectopic ureterocele and 59 with ectopic ureter. The imaging studies used were US, SMCU, IVU and methods to determine renal function (diuretic renography and renal scintigraphy). The findings were confirmed during surgery in every case. The most common radiological findings in ectopic ureterocele were renal duplication (86,3%). vesicoureteral reflux (VUR) to the lower half of the kidney (46.6%), dilatation of the lower pole of the kidney (38.4%) and contralateral duplication (30.1%). In boys, the ectopic ureter entered via bladder neck and posterior urethra (73.7%) or into seminal vesicles (15.8%); in girls, it went to vagina (32.5%), bladder neck (30%) or urethra (22.5%). Renal duplication was associated in 64.4%, with VUR to the ectopic ureter in 21% while there was a single renal system in 35.6%, with VUR to the ectopic ureter in 57.1% and contralateral renal agenesis in 19%. Eighteen patients (13.6%) presented a single, dy plastic, nonfunctioning renal system (6 cases of ureterocele and 12 of ectopic ureter). Knowledge of the embryological development of ureteral duplication is essential for the understanding of these two entities and helps to differentiate between them, thus facilitating a sometimes complicated diagnosis. Ectopic ureters and ureteroceles accompanied by a single, dysplastic renal system are associated with a greater incidence of congenital anomalies and a higher rate of complications than the duplicate systems. A prenatal US examination enables early diagnosis. The anatomical information provided by US is, on occasion, more valuable than that resulting from IVU or SMCU, However, IVU is indispensable in girls

  3. Kyphoplasty Increases Vertebral Height, Decreases Both Pain Score and Opiate Requirements While Improving Functional Status

    Science.gov (United States)

    Tolba, Reda; Bolash, Robert B.; Shroll, Joshua; Costandi, Shrif; Dalton, Jarrod E.; Sanghvi, Chirag; Mekhail, Nagy

    2014-01-01

    Vertebral compression fractures can result from advanced osteoporosis, or less commonly from metastatic or traumatic insults to the vertebral column, and result in disabling pain and decreased functional capacity. Various vertebral augmentation options including kyphoplasty aim at preventing the sequelae of pain and immobility that can develop as the result of the vertebral fractures. The mechanism for pain relief following kyphoplasty is not entirely understood, and the restoration of a portion of the lost vertebral height is a subject of debate. We retrospectively reviewed radiographic imaging, pain relief, analgesic intake and functional outcomes in 67 consecutive patients who underwent single- or multilevel kyphoplasty with the primary goal of quantifying the restoration of lost vertebral height. We observed a mean of 45% of the lost vertebral height restored postprocedurally. Secondarily, kyphoplasty was associated with significant decreases in pain scores, daily morphine consumption and improvement in patient-reported functional measures. PMID:24165285

  4. Mitotic chromosome condensation in vertebrates

    Energy Technology Data Exchange (ETDEWEB)

    Vagnarelli, Paola, E-mail: P.Vagnarelli@ed.ac.uk

    2012-07-15

    Work from several laboratories over the past 10-15 years has revealed that, within the interphase nucleus, chromosomes are organized into spatially distinct territories [T. Cremer, C. Cremer, Chromosome territories, nuclear architecture and gene regulation in mammalian cells, Nat. Rev. Genet. 2 (2001) 292-301 and T. Cremer, M. Cremer, S. Dietzel, S. Muller, I. Solovei, S. Fakan, Chromosome territories-a functional nuclear landscape, Curr. Opin. Cell Biol. 18 (2006) 307-316]. The overall compaction level and intranuclear location varies as a function of gene density for both entire chromosomes [J.A. Croft, J.M. Bridger, S. Boyle, P. Perry, P. Teague,W.A. Bickmore, Differences in the localization and morphology of chromosomes in the human nucleus, J. Cell Biol. 145 (1999) 1119-1131] and specific chromosomal regions [N.L. Mahy, P.E. Perry, S. Gilchrist, R.A. Baldock, W.A. Bickmore, Spatial organization of active and inactive genes and noncoding DNA within chromosome territories, J. Cell Biol. 157 (2002) 579-589] (Fig. 1A, A'). In prophase, when cyclin B activity reaches a high threshold, chromosome condensation occurs followed by Nuclear Envelope Breakdown (NEB) [1]. At this point vertebrate chromosomes appear as compact structures harboring an attachment point for the spindle microtubules physically recognizable as a primary constriction where the two sister chromatids are held together. The transition from an unshaped interphase chromosome to the highly structured mitotic chromosome (compare Figs. 1A and B) has fascinated researchers for several decades now; however a definite picture of how this process is achieved and regulated is not yet in our hands and it will require more investigation to comprehend the complete process. From a biochemical point of view a vertebrate mitotic chromosomes is composed of DNA, histone proteins (60%) and non-histone proteins (40%) [6]. I will discuss below what is known to date on the contribution of these two different classes

  5. [CLINICAL EXPERIENCE IN DIAGNOSIS AND MANAGEMENT OF COMPLETE DUPLICATION OF KIDNEY AND URETER IN 106 CHILDREN].

    Science.gov (United States)

    Zeng, Li; Huang, Guizhen; Zhang, Jie; Kang, Lei; Huang, Yidong; Yuan, Miao; Huang, Lugang

    2015-11-01

    To discuss the clinical classification and treatment protocols of complete duplication of kidney and ureter in children. Between March 2000 and February 2015, 106 children with complete duplication of kidney and ureter were treated, and the clinical data were retrospectively analyzed. Of them, there were 11 boys and 95 girls, aged from 1 month to 11 years (mean, 3.5 years); one side was involved in 88 cases and two sides in 18 cases. They were divided into 4 types according to image examinations and clinical presentations: 14 patients who needed no special treatment were classified into the first type, 15 patients who underwent reconstruction into the second type, 74 patients who underwent segment removal of renal dysplasia and subtotal excision of abnormal duplicated ureter into the third type, and 3 patients who underwent removal of the whole affected kidney and subtotal excision of whole ureter into the forth type. The patients were followed up 2 months to 14 years (median, 23 months). There was no deteriorating case in the first type. There was no complication such as leakage of urine, discomfort over the back and loins, ureterocele, reproductive tract infection, or hematuresis in the other types. The results of white blood cell count, renal function, and electrolyte presented no abnormality. One patient in the second type and 6 patients in the third type had ureteral stump syndrome; 1 patient in the second type and 3 patients in the third type had urinary tract infection; and 3 patients in the second type had mild hydronephrosis after operation. It can obtain good clinical outcome to choose individualized treatment according to clinical classification of complete duplication of kidney and ureter, which can reserve effective renal units as much as possible and improves the patients' quality of life.

  6. Age- and region-related changes in the biomechanical properties and composition of the human ureter.

    Science.gov (United States)

    Sokolis, Dimitrios P; Petsepe, Despoina C; Papadodima, Stavroula A; Kourkoulis, Stavros K

    2017-01-25

    The ureter has been largely overlooked heretofore in the study of the biomechanics of soft biological tissues, although there has been significant motivation to use its biomechanical properties as inputs to mathematical models of ureteral function. Herein, we used histological analysis for quantification of collagen contents and thickness/area of ureteral layers, with concomitant geometrical analysis of zero-stress and no-load states, and inflation/extension testing to biomechanically characterize with the Fung-type model the ureters from cadavers. The effects of age and gender on the regional distribution of those properties were examined. Tissue properties did not differ (p>0.05) between the left and right ureter. Regional heterogeneity was established that was profoundly age-related but seldom gender-related, based on the following evidence: 1) In younger subjects, the axial stress-circumferential strain curves of upper ureter were shifted to smaller stresses and model parameter a 2 representing axial stiffness was smallest (pureter was the least stiff region axially; 2) upper ureter underwent axial stiffening with advanced age, evidenced by the increasing (pureter, evidenced by the non-varying (p>0.05) parameters C,a 1 ,a 2 ,anda 4 ; 3) aging raised (pureter to favor a near-uniform regional distribution; 4) wall thickness increased with age, unlike the opening angle and residual strains, reflecting the thickening of outer (muscular) vs. inner (mucosal) layers in aged subjects, with significant differences (p0.05) the opening angle and morphometry of no-load and zero-stress states. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Vertebral Malformations in French Bulldogs

    OpenAIRE

    KURICOVÁ, Mária; LEDECKÝ, Valent; KVETKOVÁ, Jaroslava; LIPTÁK, Tomáš

    2017-01-01

    The aim of this study was to detect vertebral malformations among French Bulldogs admitted between the years 2011 – 2016 due to the high popularity of the breed and the intentions to increase the breed welfare by reducing the occurrence of congenital anomalies. Besides, we aimed to look for gender predisposition, possible vertebral predisposition, occurrence of clinical symptoms and radiographic findings. A total of 73 French Bulldogs met the inclusion criteria (radiographs of the whole spine...

  8. Maturation of ureter-bladder connection in mice is controlled by LAR family receptor protein tyrosine phosphatases.

    NARCIS (Netherlands)

    Uetani, N.; Bertozzi, K.; Chagnon, M.J.; Hendriks, W.J.A.J.; Tremblay, M.L.; Bouchard, M.

    2009-01-01

    Congenital anomalies affecting the ureter-bladder junction are frequent in newborns and are often associated with other developmental defects. However, the molecular and morphological processes underlying these malformations are still poorly defined. In this study, we identified the leukocyte

  9. Intraluminal pressure changes in vivo in the middle and distal pig ureter during propagation of a peristaltic wave

    NARCIS (Netherlands)

    Roshani, H.; Dabhoiwala, N. F.; Dijkhuis, T.; Lamers, W. H.

    2002-01-01

    OBJECTIVES: To establish the characteristics of mechanical activity during ureteral peristalsis and unidirectional bolus transport, pressure changes in the middle and distal (juxtavesical and ureterovesical junction) porcine ureter were quantified in vivo. METHODS: Five female New Yorkshire pigs (50

  10. Y-type partial duplication of a vaginal ectopic ureter with ipsilateral hypoplastic pelvic kidney and bicornuate uterus.

    Science.gov (United States)

    Chen, Shushang; Zhu, Lingfeng; Yang, Shunliang; Tan, Jianming

    2013-06-01

    We present a case of vaginal ectopic ureter with ipsilateral partial duplication of the upper ureter (Y-type ureter), ipsilateral hypoplastic pelvic kidney and bicornuate uterus in a 20-year-old woman who presented with mild urinary incontinence since infancy. Ultrasonography, computed tomography and intravenous pyelography examination showed a left kidney with no evidence of a right kidney. Cystourethroscopy showed absence of the right hemitrigone. Magnetic resonance (MR) urography demonstrated the presence of a bicornuate uterus, an ectopic dysplastic right kidney in the pelvic cavity, and a right ureter that terminates in the vaginae fornix. The patient underwent right nephroureterectomy and urinary continence was restored completely. Although congenital malformations of the urinary tract are frequently associated with genital tract abnormalities, to best our knowledge, this is the first report of the coexistence of all of these anomalies in an individual. Our report also highlights the importance of MR urography in the diagnosis of such rare and complex anomalies.

  11. Causes and prevention of laparoscopic ureter injuries: an analysis of 31 cases during laparoscopic hysterectomy in the Netherlands.

    Science.gov (United States)

    Janssen, Petra F; Brölmann, Hans A M; Huirne, Judith A F

    2013-03-01

    Ureter injuries are the most dreaded complication in gynecological surgery. Some risk factors for the occurrence of urinary tract injuries are known, but clear guidelines to prevent ureter injuries during laparoscopic hysterectomy (LH) are lacking. The aim of this study was to analyze all known ureter injuries that occurred during LH for a benign indication in the Netherlands, in order to identify patient- and surgeon-related risk factors. Ninety-five LH-performing gynecologists were asked to recall all cases of known ureter injuries during LH in their hospital. After identification of ureter injuries, a structured interview was performed with a questionnaire that focused on the identification of predisposing factors which could account for the cause of the injury. Forty-one injuries were detected in 37 patients (4 bilateral ureter injuries) in a 20-year period. The questionnaire could be completed for 31 cases. Predisposing factors were retrospectively assessed and classified into categories: patient-related (i.e., deep infiltrating endometriosis, intraligamentary fibroids) (n = 18), surgeon-related (insufficient experience and/or technique) (n = 16), or both (insufficient experience and difficult case) (n = 8). According to earlier-mentioned recommendations in a Delphi study among experts, in 48.4 % of these ureter injury cases, more than one of the recommended techniques or predisposing conditions were not applied or available. Only one ureter injury was diagnosed during the LH; the mean time to diagnose the injury was 29 days. Incomplete learning curve, insufficient applied technique such as coagulation of the uterine artery without the use of a uterine manipulator, and/or from the contralateral side and/or without previously performed ureterolysis in case of distorted anatomy may be considered as the main predisposing factors.

  12. Reconstructing the ancestral vertebrate brain.

    Science.gov (United States)

    Sugahara, Fumiaki; Murakami, Yasunori; Pascual-Anaya, Juan; Kuratani, Shigeru

    2017-05-01

    Highly complicated morphologies and sophisticated functions of vertebrate brains have been established through evolution. However, the origin and early evolutionary history of the brain remain elusive, owing to lack of information regarding the brain architecture of extant and fossil species of jawless vertebrates (agnathans). Comparative analyses of the brain of less studied cyclostomes (only extant agnathan group, consisting of lampreys and hagfish) with the well-known sister group of jawed vertebrates (gnathostomes) are the only tools we have available to illustrate the ancestral architecture of the vertebrate brain. Previous developmental studies had shown that the lamprey lacked well-established brain compartments that are present in gnathostomes, such as the medial ganglionic eminence and the rhombic lip. The most accepted scenario suggested that cyclostomes had fewer compartments than that of the gnathostome brain and that gnathostomes thus evolved by a stepwise addition of innovations on its developmental sequence. However, recent studies have revealed that these compartments are present in hagfish embryos, indicating that these brain regions have been acquired before the split of cyclostomes and gnathostomes. By comparing two cyclostome lineages and gnathostomes, it has become possible to speculate about a more complex ancestral state of the brain, excluding derived traits in either of the lineages. In this review, we summarize recent studies on the brain development of the lamprey and hagfish. Then, we attempt to reconstruct the possible brain architecture of the last common ancestor of vertebrates. Finally, we discuss how the developmental plan of the vertebrate brain has been modified independently in different vertebrate lineages. © 2017 Japanese Society of Developmental Biologists.

  13. Nephroureterectomy and ureteroneocystostomy in an alpaca with bilateral ectopic ureters diagnosed by computed tomographic excretory urography.

    Science.gov (United States)

    Polf, Holly D; Smith, Shasta; Simpson, Katharine M; Rochat, Mark C

    2015-01-01

    To report diagnosis and treatment of urinary incontinence in a female Huacaya alpaca. Clinical case report. Female intact Huacaya alpaca (n = 1) METHODS: Computed tomographic (CT) excretory urography and vaginourethrography were performed to diagnose the cause of urinary incontinence. Bilateral ectopic ureters and left hydronephrosis and hydroureter were diagnosed. Left nephroureterectomy and right ureteroneocystostomy were performed with subsequent resolution of clinical signs. Pyelonephritis was identified by culture of the resected left kidney. CT excretory urography was helpful in the diagnosis of bilateral ectopic ureters in an alpaca and provided information for surgical planning. Surgical repair by ureteroneocystostomy and unilateral nephroureterectomy was successful in resolving clinical signs. © Copyright 2014 by The American College of Veterinary Surgeons.

  14. A case of ectopic dysplastic kidney and ectopic ureter diagnosed by MRI.

    Science.gov (United States)

    Duong, David T; Shortliffe, Linda Md

    2008-11-01

    A 14-year-old girl with a solitary right kidney had continuous urinary incontinence. Four months previously she had undergone surgical resection of a vaginal septum associated with uterus didelphys, which was causing obstructed menstrual flow. She was toilet trained at the age of 2 years, had a normal voiding pattern, and had no history or family history of incontinence. Pelvic examination, abdominal and pelvic ultrasonography, renal scintigraphy, voiding cystourethrography, abdominal and pelvic MRI, fluoroscopic retrograde vaginography, vaginoscopy, cystourethroscopy after administration of indigo carmine, laparoscopy, and pathologic examination of the excised specimen. Ectopic ureter draining into the vagina associated with a contralateral dysplastic kidney. Laparoscopic nephrectomy of the left renal remnant and ligation of the left distal ureter.

  15. A Rare Case: Gastric Cancer; Involving Primery Thoracal Vertebral Metastases

    Directory of Open Access Journals (Sweden)

    Harun Arslan

    2013-06-01

    Full Text Available Primery bone metastases rarely occur in gastric cancer. Bone metastases indicate that the prognosis is bad. In that article we present a case that is diagnosed as a gastric cancer with primary bone metasteses that caused pathologic thoracal vertebral fracture seenby computer ised tomography.

  16. Third-generation percutaneous vertebral augmentation systems

    OpenAIRE

    Vanni, Daniele; Galzio, Renato; Kazakova, Anna; Pantalone, Andrea; Grillea, Giovanni; Bartolo, Marcello; Salini, Vincenzo; Magliani, Vincenzo

    2016-01-01

    Currently, there is no general consensus about the management of osteoporotic vertebral fractures (OVF). In the past, conservative treatment for at least one month was deemed appropriate for the majority of vertebral fractures. When pain persisted after conservative treatment, it was necessary to consider surgical interventions including: vertebroplasty for vertebral fractures with less than 30% loss of height of the affected vertebral body and kyphoplasty for vertebral fractures with greater...

  17. Perioperative Anuria Resulting in the Diagnosis of Infrasphincteric Ectopic Ureter in an Adult Female

    Directory of Open Access Journals (Sweden)

    Andrea McNab

    2014-05-01

    Full Text Available Ectopic ureter, particularly in females, often presents at a young age as incontinence. Otherwise healthy girls who have continuous urinary wetting during day and night despite adequate toilet training should be held with a high level of suspicion for an extravesical infrasphincteric ectopic ureteral orifice. If such a diagnosis goes undiscovered, frequent reflux or obstruction may cause permanent damage to the renal unit, as in the patient discussed here.

  18. Perioperative Anuria Resulting in the Diagnosis of Infrasphincteric Ectopic Ureter in an Adult Female.

    Science.gov (United States)

    McNab, Andrea; Williams, Christopher

    2014-05-01

    Ectopic ureter, particularly in females, often presents at a young age as incontinence. Otherwise healthy girls who have continuous urinary wetting during day and night despite adequate toilet training should be held with a high level of suspicion for an extravesical infrasphincteric ectopic ureteral orifice. If such a diagnosis goes undiscovered, frequent reflux or obstruction may cause permanent damage to the renal unit, as in the patient discussed here.

  19. Hernie Inguinoscrotale de l'Uretère: Fait Clinique et Revue de la ...

    African Journals Online (AJOL)

    Le bilan biologique avait montré une insuffisance rénale (créatinémie à 137 micromole/l). Une urétéropyélographie rétrograde. (UPR) avec montée de sonde ... en raison de fuites urinaires par la plaie1. On distingue deux types de hernies in- guinoscrotales de l'uretère. • Les hernies parapéritonéales qui com- portent un ...

  20. REIMPLANTAÇÃO DE URETER ECTÓPICO EM CADELA

    OpenAIRE

    Kosachenco,Beatriz Guilhembernard; Godoy,Carmen Lice Buchmann de; Schmitt,Izabela; Pellegrini,Luiz Carlos de; Campello,Rui Afonso Vieira

    1994-01-01

    RESUMO Relata-se um caso de ectopia uretral esquerda em cadela. Descreve-se os sintomas, diagnóstico radiológico e cirúrgico, anastomose vesicouretral com reimplante do ureter no trígono vesical e exame radiográfico pós-operatório através de urografia excretora para avaliação da função renal e ureteral.

  1. REIMPLANTAÇÃO DE URETER ECTÓPICO EM CADELA

    Directory of Open Access Journals (Sweden)

    Beatriz Guilhembernard Kosachenco

    1994-01-01

    Full Text Available RESUMO Relata-se um caso de ectopia uretral esquerda em cadela. Descreve-se os sintomas, diagnóstico radiológico e cirúrgico, anastomose vesicouretral com reimplante do ureter no trígono vesical e exame radiográfico pós-operatório através de urografia excretora para avaliação da função renal e ureteral.

  2. MR urography findings of a duplicated ectopic ureter in an adult man

    Energy Technology Data Exchange (ETDEWEB)

    Engin, G.; Rozanes, I. [Department of Radiology, Istanbul Faculty of Medicine, Istanbul (Turkey); Esen, T. [Department of Urology, Istanbul Faculty of Medicine, Istanbul (Turkey)

    2000-08-01

    In this report we present the imaging findings in an adult male with a duplicated ectopic ureter which inserted into the prostatic urethra. The appearances at excretory urography, US, CT, and MR urography are described together with the potential pitfalls of the imaging techniques. Both US and MR urography accurately image the collecting system from the kidney to the point of distal ureteral insertion, and in our patient, MR urography provided similar information to US. (orig.)

  3. Three-Dimensional Numerical Simulations of Peristaltic Contractions in Obstructed Ureter Flows.

    Science.gov (United States)

    Najafi, Zahra; Gautam, Prashanta; Schwartz, Bradley F; Chandy, Abhilash J; Mahajan, Ajay M

    2016-10-01

    Ureteral peristalsis can be considered as a series of waves on the ureteral wall, which transfers the urine along the ureter toward the bladder. The stones that form in the kidney and migrate to the ureter can create a substantial health problem due to the pain caused by interaction of the ureteral walls and stones during the peristaltic motion. Three-dimensional (3D) computational fluid dynamics (CFD) simulations were carried out using the commercial code ansys fluent to solve for the peristaltic movement of the ureter, with and without stones. The effect of stone size was considered through the investigation of varying obstructions of 5%, 15%, and 35% for fixed spherical stone shape. Also, an understanding of the effect of stone shape was obtained through separate CFD calculations of the peristaltic ureter with three different types of stones, a sphere, a cube, and a star, all at a fixed obstruction percentage of 15%. Velocity vectors, mass flow rates, pressure gradients, and wall shear stresses were analyzed along one bolus of urine during peristalsis of the ureteral wall to study the various effects. It was found that the increase in obstruction increased the backflow, pressure gradients, and wall shear stresses proximal to the stone. On the other hand, with regard to the stone shape study, while the cube-shaped stones resulted in the largest backflow, the star-shaped stone showed highest pressure gradient magnitudes. Interestingly, the change in stone shape did not have a significant effect on the wall shear stress at the obstruction level studied here.

  4. Pediatric Multilocular Cystic Nephroma Extending into the Renal Pelvis and Ureter

    Directory of Open Access Journals (Sweden)

    Hasan Serkan Doğan

    2014-11-01

    Full Text Available Multilocular cystic nephroma (MCN is a rare tumor at the most benign end of the spectrum of the multilocular cystic neplasms of kidney. Nephrectomy is curative for MCN. In this case-report, we present a 16-month-old girl with a 10x15 cm multilocular cystic renal tumor extending into the renal pelvis and proximal ureter on the right side demonstrated on magnetic resonance imaging. Nephrectomy was performed. The pathology was completely consistent with MCN.

  5. Does an extra kidney-ureter-bladder radiograph taken in the upright position during routine intravenous urography provide diagnostic benefit?

    Science.gov (United States)

    Gürel, Kamil; Gürel, Safiye; Kalfaoğlu, Melike; Yilmaz, Ozlem; Metin, Ahmet

    2008-12-01

    The aim of this prospective study was to assess the diagnostic benefit of taking a kidney-ureter-bladder (KUB) radiograph in an upright position during routine intravenous urography (IVU). Between February 2005 and September 2007, 170 consecutive patients were included in the study. A basal IVU exam consisted of pre-contrast supine KUB, post-contrast supine KUB at the 7th and 15th minutes, and supine pelvic radiographs with full bladder and post-voiding. When needed, additional compression and/or oblique radiographs were taken. In this study, for all patients, a post-contrast 15th minute upright KUB radiograph was added to IVU. Two consecutive radiographs taken at the 15th minute postcontrast in supine and upright positions were evaluated by consensus of 2 radiologists. Primary benefits were improved filling and emptying of the collecting system, and secondary benefits were nephroptosis and ascertaining diagnosis of phlebolith. Of 170 patients, 337 kidneys and collecting systems (n = 168 right; n = 169 left) were examined. Improved filling, emptying of the collecting system, nephroptosis, ascertaining diagnosis of phleboliths were detected with the rates of 12.5%, 44.2%, 8.3%, and 3.2%, respectively. Improved filling was significant in the presence of hydronephrosis (P IVU (P < 0.05) on either side. Upright KUB radiographs provide supplementary data about urine flow in terms of improved filling and emptying of the collecting system.

  6. Pregnancy related symptomatic vertebral hemangioma

    Directory of Open Access Journals (Sweden)

    Meena Gupta

    2014-01-01

    Full Text Available Vertebral hemangiomas are benign vascular tumors of the spine that remain asymptomatic in most cases and incidentally encountered on imaging. Rarely, altered hemodynamic and hormonal changes during pregnancy may expand these benign lesions resulting in severe cord compression. The management of symptomatic vertebral hemangioma during pregnancy is controversial as modalities like radiotherapy and embolization are not suitable and surgery during pregnancy has a risk of preterm labor. Few cases of pregnancy related symptomatic vertebral hemangioma with marked epidural component have been reported in the literature. We report a case of 23-year-old primigravida who developed rapidly progressive paraparesis at 28 weeks of gestation and spine magnetic resonance imaging (MRI revealed upper thoracic vertebral hemangioma with extensive extra-osseous extension and spinal cord compression. Laminectomy and surgical decompression of the cord was performed at 32 weeks of the pregnancy. There was significant improvement in muscle power after a week of surgery. Six weeks postoperatively she delivered a full term normal baby with subsequent improvement of neurologic deficit. Repeat MRI of dorsal spine performed at 3 months postoperatively showed reduced posterior and anterior epidural components of vertebral hemangioma.

  7. Response of the renal pelvis and ureter to distension of the contralateral renal pelvis and ureter: identification of the reno-renal pelvic reflex.

    Science.gov (United States)

    Shafik, A

    1998-01-01

    For the study of the relationship of the pelviureteric system of one kidney to that of the contralateral one, bilateral cutaneous ureterostomy was performed in 14 dogs. The renal pelvis (RP) and ureter (U) of one side were distended separately with a balloon filled with saline in increments of 1 and 0.25 ml, respectively, and the pressure response of the contralateral RP and U was recorded. The test was repeated after anesthetization of the RP and U. RP distension with 1 ml of saline effected a pressure rise (P 0.05). RP distension with 2, 3, and 4 ml of saline induced a significant pressure rise in the ipsi- and contralateral RP but not in the ureters. Ureteric distension produced a pressure elevation (P 0.05) or on either of the renal pelves (P > 0.05). Distension of the anesthetized RP or U effected no pressure response in any of the ipsi- or contralateral RPs or Us. In conclusion, distension of the RP with large volumes led to an increase in pressure in the contralateral RP but not in the U. A reflex relationship is postulated to exist between the two renal pelves and to be mediated through a reflex we call the reno-renal pelvic reflex. It seems that this reflex acts to allow either of the kidneys to share an extra load of the other one by increasing the contractile activity of the RP, thus assumedly assisting the regulation of urine flow.

  8. Pancake kidney with a single ureter: a rare incidental observation at autopsy.

    Science.gov (United States)

    Kanchan, Tanuj; Murlimanju, B V; Saralaya, Vasudha V

    2017-01-01

    We report an extremely rare case of a pancake kidney with a single ureter. During the medicolegal autopsy on the body of a traffic accident victim, the kidneys were not located in the abdomen. The anterior surfaces of both kidneys were completely fused in the pelvic cavity, and the kidney was shaped like a pancake. This pancake kidney had accessory renal arteries around it and one renal vein from each kidney. The left renal vein was much smaller in diameter than the right one. There were two major calyces, one each from each kidney. The major calyces joined to form a single renal pelvis from both the kidneys, which continued as a single ureter. The renal pelvis and ureter lay posterior to the pancake kidney. Urologists and pelvic surgeons should be aware of the variant anatomy of the pancake kidney, particularly concerning its vasculature, to prevent unexpected catastrophic bleeding. If the kidneys are not located in the abdominal cavity, the autopsy surgeon must consider the possibility of its presence in the pelvic cavity. This could be especially important during medicolegal investigations into allegations of missing kidneys and unlawful kidney transplantations.

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

    Directory of Open Access Journals (Sweden)

    Vito Leanza

    2014-05-01

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

  10. The biogeography of threatened insular iguanas and opportunities for invasive vertebrate management

    Science.gov (United States)

    Tershy, Bernie R.; Newton, Kelly M.; Spatz, Dena R.; Swinnerton, Kirsty; Iverson, John B.; Fisher, Robert N.; Harlow, Peter S.; Holmes, Nick D.; Croll, Donald A.; Iverson, J.B.; Grant, T. D.; Knapp, C. R.; Pasachnik, S. A.

    2016-01-01

    Iguanas are a particularly threatened group of reptiles, with 61% of species at risk of extinction. Primary threats to iguanas include habitat loss, direct and indirect impacts by invasive vertebrates, overexploitation, and human disturbance. As conspicuous, charismatic vertebrates, iguanas also represent excellent flagships for biodiversity conservation. To assist planning for invasive vertebrate management and thus benefit threatened iguana recovery, we identified all islands with known extant or extirpated populations of Critically Endangered and Endangered insular iguana taxa as recognized by the International Union for Conservation of Nature (IUCN) Red List of Threatened Species. For each island, we determined total area, sovereignty, the presence of invasive alien vertebrates, and human population. For the 23 taxa of threatened insular iguanas we identified 230 populations, of which iguanas were extant on 185 islands and extirpated from 45 islands. Twenty-one iguana taxa (91% of all threatened insular iguana taxa) occurred on at least one island with invasive vertebrates present; 16 taxa had 100% of their population(s) on islands with invasive vertebrates present. Rodents, cats, ungulates, and dogs were the most common invasive vertebrates. We discuss biosecurity, eradication, and control of invasive vertebrates to benefit iguana recovery: (1) on islands already free of invasive vertebrates; (2) on islands with high iguana endemicity; and (3) for species and subspecies with small total populations occurring across multiple small islands. Our analyses provide an important first step toward understanding how invasive vertebrate management can be planned effectively to benefit threatened insular iguanas.

  11. Vertebrate pressure-gradient receivers

    DEFF Research Database (Denmark)

    Christensen-Dalsgaard, Jakob

    2011-01-01

    The eardrums of all terrestrial vertebrates (tetrapods) are connected through Eustachian tubes or interaural canals. In some of the animals, these connections create pressure-gradient directionality, an enhanced directionality by interaction of sound arriving at both sides of the eardrum and stro......The eardrums of all terrestrial vertebrates (tetrapods) are connected through Eustachian tubes or interaural canals. In some of the animals, these connections create pressure-gradient directionality, an enhanced directionality by interaction of sound arriving at both sides of the eardrum....... Recent vertebrates form a continuum from perfect interaural transmission (0 dB in a certain frequency band) and pronounced eardrum directionality (30-40 dB) in the lizards, over somewhat attenuated transmission and limited directionality in birds and frogs, to the strongly attenuated interaural...

  12. [Indications and results of early functional vertebral fracture treatment].

    Science.gov (United States)

    Kempf, L; Plaue, R

    1985-01-01

    Early functional treatment was administered to 213 patients with stable compression fractures of thoracic and lumbar vertebrae between 1975 and 1982. Physiotherapy was carried out according to a uniform schedule. The patients were mobilized after an average of 6 days; hospitalization lasted 2 weeks on an average. Control examinations of 82 of these patients revealed only a slight union of compressed vertebral bodies (on an average, 7% of the initial height), which correlated with the primary compression and the patient's age. Remaining functional restriction of the spine and subjective complaints did not correlate significantly with the extent of vertebral compression.

  13. The application of wrapping ureter by a pedicled gastrocolic omentum flap combined with an artificial external scaffold to prevent stoma stenosis in rabbit after ureterocutaneostomy.

    Science.gov (United States)

    Zhang, Shigeng; Gao, Fei; Xue, Chong; Zhang, Nan; Gao, Feng; Li, Shaojiang; Wen, Jiaming

    2017-02-01

    To evaluate the feasibility and possibility of wrapping ureter by a pedicled gastrocolic omentum flap combined with an artificial ureter external scaffold to prevent stoma stenosis in rabbit after ureterocutaneostomy. Forty male New Zealand rabbits were involved in this study. For application of ureterocutaneostomy, the right ureter was wrapped by a pedicled gastrocolic omentum flap and combined with application of an artificial external scaffold, which served as experimental side. Traditional ureterocutaneostomy was applied in left ureter (control side). All rabbits were killed after 1 month, and the kidney, ureter and abdominal segment ureter were collected to study the morphological and pathological changes by using HE staining, Masson staining, immunohistochemistry staining and microvessel density (MVD) study. HE staining showed that renal medullary tubular dilatation, large number of collagen deposition, renal glomerular and renal tubular atrophy. Glomerular vascular leaves and interstitial fibrosis were detected in the kidney of control side. However, these abnormities in the kidney of experimental side were significantly alleviated compared to control side. The hydronephrosis and ureterectasia in the experimental side were dramatically attenuated compared to control side. Fibrosis in ureter around stoma and stoma stenosis were prevented by wrapping ureter by a pedicled gastrocolic omentum flap combined with an artificial external scaffold. In this study, we have demonstrated that wrapping ureter by a pedicled gastrocolic omentum flap combined with an artificial external scaffold is capable of preventing stoma stenosis in rabbit after ureterocutaneostomy, which provided a new method and theoretical basis for clinical application in the future.

  14. Efeitos da simpaticotomia endoscópica sobre as artérias carótidas e vertebrais na terapêutica cirúrgica da hiperidrose primária Effects of endoscopic sympathicotomy in carotid and vertebral arteries in the surgical treatment of primary hiperhidrosis

    Directory of Open Access Journals (Sweden)

    Jeancarlo F. Cavalcante

    2005-01-01

    Full Text Available OBJETIVOS: Analisar, em pacientes submetidos a simpaticotomia videotoracoscópica para tratamento da Hiperidrose Primária (HP, as conseqüências hemodinâmicas da desnervação vascular das artérias carótidas e vertebrais após a trans-secção cirúrgica da cadeia simpática torácica (simpaticotomia, através da mensuração de parâmetros ultra-sonográficos. MÉTODO: Vinte e quatro pacientes portadores de HP submetidos a quarenta e oito simpaticotomias torácicas endoscópicas foram avaliados através da mensuração da velocidade de pico sistólico (VPS, velocidade de pico diastólico (VPD, índice de pulsatibilidade (IP e índice de resistência (IR nas artérias carótidas comuns, internas e externas, além da artéria vertebral bilateralmente usando o eco-doppler duplex scan. As avaliações foram realizadas antes da intervenção cirúrgica e trinta dias após o procedimento. O teste de Wilcoxon foi usado na análise das diferenças entre as variáveis antes e depois da simpaticotomia. RESULTADOS: A simpaticotomia no nível de T3 foi a trans-secção mais realizada (95,83%, seja isoladamente (25% ou associada a T4 (62,50% ou a T2 (8,33%. Houve aumento significativo no IR e no IP da artéria carótida comum bilateralmente (pPURPOSES: Analyze, in patients with primary hyperhidrosis (PH who was undergone to videothoracoscopic sympathicotomy, the degree of vascular denervation after surgical transection of the thoracic sympathetic chain by measuring ultrasonografic parameters in carotid and vertebral arteries. METHODS: Twenty-four patients with PH underwent forty-eight endoscopic thoracic sympathicotomy and were evaluated by duplex eco-doppler measuring systolic peak velocity (SPV, diastolic peak velocity (DPV, pulsatility index (PI and resistivity index (RI in bilateral common, internal and external carotids, besides bilateral vertebral arteries. The exams were performed before operations and a month later. Wilcoxon test was used to

  15. Absorption of the Wolffian duct and duplicated ureter by the urogenital sinus: morphological study using human fetuses and embryos.

    Science.gov (United States)

    Naito, Michiko; Hinata, Nobuyuki; Rodriguez-Vazquez, Jose Francisco; Murakami, Gen; Aizawa, Shin; Fujisawa, Masato

    2015-07-01

    To describe the embryological origin of the duplicated ureter and to investigate whether the urogenital sinus absorbs not only the Wolffian duct (WD) but also the ureter. During studies using sections of human fetuses (45 specimens), we incidentally found a specific type of ureteric duplication (at ~7 weeks) in which two unilateral ureters joined at the vesico-ureteric junction, apparently representing a morphology arising at an intermediate stage between complete and partial ureteric duplication. The existing literature lacks any photographic representation of early development of the vesico-ureteric junction, and we therefore studied horizontal sections of 10 human embryos (at ~5-6 weeks' gestation) in which the ureter did not join the urogenital sinus (future bladder) but instead joined the WD (future vas deferens). The sinus consistently showed a reversed Y-shape, the arms of which extended posteriorly to receive the WD. When absorption of the duct into the sinus wall reached the distal end of the ureter, the arm-like parts appeared to enlarge posteriorly for further involvement of the duct, with little or no incorporation of the ureter; therefore, the future trigone of the bladder might develop from these arm-like parts of the sinus posterior wall. Consequently, in the case of ureteric duplication included in the present study, it is considered that the ureters would probably have merged with the WD at closely adjacent sites. The present study represents the first photographic illustration of the early development of the human vesico-ureteric junction. © 2014 The Authors BJU International © 2014 BJU International Published by John Wiley & Sons Ltd.

  16. Management of vertebral compression fracture in general practice: BEACH program.

    Directory of Open Access Journals (Sweden)

    Rodrigo Z Megale

    Full Text Available The pain associated with vertebral compression fractures can cause significant loss of function and quality of life for older adults. Despite this, there is little consensus on how best to manage this condition.To describe usual care provided by general practitioners (GPs in Australia for the management of vertebral compression fractures.Data from the Bettering the Evaluation And Care of Health (BEACH program collected between April 2005 and March 2015 was used for this study. Each year, a random sample of approximately 1,000 GPs each recorded information on 100 consecutive encounters. We selected those encounters at which vertebral compression fracture was managed. Analyses of management options were limited to encounters with patients aged 50 years or over.i patient demographics; ii diagnoses/problems managed; iii the management provided for vertebral compression fracture during the encounter. Robust 95% confidence intervals, adjusted for the cluster survey design, were used to assess significant differences between group means.Vertebral compression fractures were managed in 211 (0.022%; 95% CI: 0.018-0.025 of the 977,300 BEACH encounters recorded April 2005- March 2015. That provides a national annual estimate of 26,000 (95% CI: 22,000-29,000 encounters at which vertebral fractures were managed. At encounters with patients aged 50 years or over (those at higher risk of primary osteoporosis, prescription of analgesics was the most common management action, particularly opioids analgesics (47.1 per 100 vertebral fractures; 95% CI: 38.4-55.7. Prescriptions of paracetamol (8.2; 95% CI: 4-12.4 or non-steroidal anti-inflammatory drugs (4.1; 95% CI: 1.1-7.1 were less frequent. Non-pharmacological treatment was provided at a rate of 22.4 per 100 vertebral fractures (95% CI: 14.6-30.1. At least one referral (to hospital, specialist, allied health care or other was given for 12.3 per 100 vertebral fractures (95% CI: 7.8-16.8.The prescription of oral

  17. Robot-assisted reconstructive surgery of the distal ureter: single institution experience in 16 patients.

    Science.gov (United States)

    Musch, Michael; Hohenhorst, Lukas; Pailliart, Anne; Loewen, Heinrich; Davoudi, Yadollah; Kroepfl, Darko

    2013-05-01

    WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Open reconstructive surgery of the lower ureteric segment in adults often requires large incisions, as the basic prerequisite for such complex procedures is wide exposure. Published experience on minimally invasive techniques in this challenging surgical field, e.g. conventional laparoscopy or robot-assisted laparoscopy, still remains limited. We report our experience from one of the largest single institution series on robot-assisted reconstructive surgery of the distal ureter in adults, with a special focus on technical aspects of the different surgical procedures. To describe the feasibility of and operative techniques used during different daVinci® robot-assisted laparoscopic reconstructive procedures of the distal ureter, and to report the short-term outcome of such procedures. Between June 2009 and October 2011, 16 patients underwent robot-assisted operations of the distal ureter because of various underlying pathological conditions. We present a description of each procedure, the incidence of perioperative complications and the results of follow-up examination. The data were collected retrospectively using the patients' records and questionnaires sent to the patients and the referring urologists. The follow-up examinations were done at the discretion of the referring urologists. The surgical indications and operative techniques were as follows: seven distal ureteric resections [DUR] with psoas hitch procedures (+/- Boari flap; four), extravesical reimplantation (two) or end-to-end anastomosis (one) because of benign distal ureteric stricture; four DUR with psoas hitch procedure (+/- Boari flap) and pelvic lymphadenectomy for urothelial carcinoma of the ureter; one DUR with psoas hitch procedure and Boari flap because of unexpected locally recurrent prostate cancer; one extravesical reimplantation because of vesico-ureteric reflux; one bilateral intravesical reimplantation of ectopic ureters (as part

  18. Unusual cause of generalized osteolytic vertebral lesions: a case report

    Directory of Open Access Journals (Sweden)

    Nanda Sudip

    2007-06-01

    Full Text Available Abstract Background Vertebral sarcoidosis is an extremely rare form of osseous sarcoidosis. Although osseous sarcoidosis is almost always an incidental finding of sarcoidosis elsewhere in the body, vertebrae may be the primary disease site. Involvement of vertebrae is usually localized and sclerotic or lytic. Case presentation We describe a case of extensive asymptomatic vertebral involvement by sarcoid with osteolytic lesions. Making the diagnosis requires biopsy and ruling out other commoner causes of osteolytic vertebral lesions. Conclusion We report this case in the hope of expanding the knowledge of osseous sarcoidosis. Our patient was unique in that all involvement was axial with sparing of the peripheral skeleton, near absence of any other organ involvement, diffuse involvement of the whole spine and osteolytic bone lesions.

  19. Dupla meningocele na coluna vertebral

    Directory of Open Access Journals (Sweden)

    Ehrenfried O. Wittig

    1968-03-01

    Full Text Available É relatado caso de dupla meningocele de coluna vertebral, respectivamente nas regiões cervico-torácica e tóraco-lombar, no qual ocorreu hidrocéfalo após pneumoventriculografia. Para a compensação do hidrocéfalo foi feita drenagem ventrículo-peritonial.

  20. Permo-Triassic vertebrate extinctions: A program

    Science.gov (United States)

    Olson, E. C.

    1988-01-01

    Since the time of the Authors' study on this subject, a great deal of new information has become available. Concepts of the nature of extinctions have changed materially. The Authors' conclusion that a catastrophic event was not responsible for the extinction of vertebrates has modified to the extent that hypotheses involving either the impact of a massive extra-terrestrial body or volcanism provide plausible but not currently fully testable hypotheses. Stated changes resulted in a rapid decrease in organic diversity, as the ratio of origins of taxa to extinctions shifted from strongly positive to negative, with momentary equilibrium being reached at about the Permo-Triassic boundary. The proximate causes of the changes in the terrestrial biota appear to lie in two primary factors: (1) strong climatic changes (global mean temperatures, temperature ranges, humidity) and (2) susceptibility of the dominant vertebrates (large dicynodonts) and the glossopteris flora to disruption of the equlibrium of the world ecosystem. The following proximate causes have been proposed: (1) rhythmic fluctuations in solar radiation, (2) tectonic events as Pangea assembled, altering land-ocean relationships, patterns of wind and water circulation and continental physiography, (3) volcanism, and (4) changes subsequent to impacts of one or more massive extra terrestrial objects, bodies or comets. These hypotheses are discussed.

  1. Symptomatic vertebral hemangiomas during pregnancy.

    Science.gov (United States)

    Moles, Alexis; Hamel, Olivier; Perret, Christophe; Bord, Eric; Robert, Roger; Buffenoir, Kevin

    2014-05-01

    Symptomatic vertebral hemangiomas during pregnancy are rare, as only 27 cases have been reported in the literature since 1948. However, symptomatic vertebral hemangiomas can be responsible for spinal cord compression, in which case they constitute a medical emergency, which raises management difficulties in the context of pregnancy. Pregnancy is a known factor responsible for deterioration of these vascular tumors. In this paper, the authors report 2 clinical cases of symptomatic vertebral hemangiomas during pregnancy, including 1 case of spontaneous fracture that has never been previously reported in the literature. The authors then present a brief review of the literature to discuss emergency management of this condition. The first case was a 28-year-old woman at 35 weeks of gestation, who presented with paraparesis. Spinal cord MRI demonstrated a vertebral hemangioma invading the body and posterior arch of T-3 with posterior epidural extension. Laminectomy and vertebroplasty were performed after cesarean section, allowing neurological recovery. The second case involved a 35-year-old woman who presented with spontaneous fracture of T-7 at 36 weeks of gestation, revealing a vertebral hemangioma with no neurological deficit, but it was responsible for pain and local instability. Treatment consisted of postpartum posterior interbody fusion. With a clinical and radiological follow-up of 2 years, no complications and no modification of the hemangiomas were observed. A review of the literature reveals discordant management of these rare cases, which is why the treatment course must be decided by a multidisciplinary team as a function of fetal gestational age and maternal neurological features.

  2. IDENTIFICATION AND THE RELATIONSHIP OF DIFFERENT TYPES OF SPONTANEOUS ACTIVITY IN THE RAT URINARY TRACT: URETER, URINARY BLADDER.

    Science.gov (United States)

    Kazaryan, K V; Simonyan, L G; Chibukhchyan, R G

    2015-04-01

    Simultaneous recording of spontaneous electrical activity was conducted from the ending areas of the ureter (the zone bordered with pyeloureteral anastomosis and bladder, respectively), as well as of the proximal part of the bladder. Normally the activity of the distal ureter zone is a propagating from the perirenal area action potentials with increased amplitude (100 microV). In these conditions from the bladder were recorded action potentials with relatively lower values of amplitude and frequency rhythm (31.9 microV and 17 min(-1), respectively). Isolation of investigating ureter areas from each other and from the bladder leads to the emergence of spike activity in the peribladder area different from that in norm: in the background of oscillating waves arises the action potential. Isolation of the ureter from the bladder also affects the nature of the initial activity. Of all analyzed parameters of activity change (decrease) only the amplitude and the frequency of action potentials reaching respectively 24.5 microV and 14.2 min(-1). The results indicate the presence of different types of autonomous spontaneous activity in the extreme zones of the ureter and bladder. The adjustment of these activity parameters in the areas can be provided by their relationship with each other.

  3. Feasibility of catheter-directed intraluminal irreversible electroporation of porcine ureter and acute outcomes in response to increasing energy delivery.

    Science.gov (United States)

    Srimathveeravalli, Govindarajan; Silk, Mikhail; Wimmer, Thomas; Monette, Sebastien; Kimm, Simon; Maybody, Majid; Solomon, Stephen B; Coleman, Jonathan; Durack, Jeremy C

    2015-07-01

    To evaluate the feasibility of focal intraluminal irreversible electroporation (IRE) in the ureter with a novel electrode catheter and to study the treatment effects in response to increasing pulse strength. Five IRE treatment settings were each evaluated twice for the ablation of normal ureter in 5 Yorkshire pigs (n = 1-4 ablations per animal; total of 10 ablations) with the use of a prototype device under ultrasound and fluoroscopic guidance. Animals received unilateral or bilateral treatment, limited to a maximum of 2 ablations in any 1 ureter. Treatment was delivered with increasing pulse strength (from 1,000 V to 3,000 V in increments of 500 V) while keeping the pulse duration (100 μs) and number of pulses (n = 90) constant. Ureter patency was assessed with antegrade ureteropyelography immediately following treatment. Animals were euthanized within 4 hours after treatment, and treated urinary tract was harvested for histopathologic analysis with hematoxylin and eosin and Masson trichrome stains. IRE was successfully performed in all animals, without evidence of ureteral perforation. Hematoxylin and eosin analysis of IRE treatments demonstrated full-thickness ablation at higher field strengths (mucosa to the adventitia). Masson trichrome stains showed preservation of connective tissue at all field strengths. Intraluminal catheter-directed IRE ablation is feasible and produces full-thickness ablation of normal ureters. There was no evidence of lumen perforation even at the maximum voltages evaluated. Copyright © 2015 SIR. Published by Elsevier Inc. All rights reserved.

  4. [Diagnosis of the functional state of the upper part of double kidney in girls with ureter extravesical ectopy].

    Science.gov (United States)

    Iushko, E I

    2008-01-01

    45 girls with extravesical ureter ectopy of double kidneys were treated outpatiently for 1981-2006. Their age varied from 6 months to 15 years. The anomaly was right-sided in 12 children, left-sided in 27 and bilateral in 6 cases. All the patients underwent surgical cor--rection: upper heminephrureterectomy was performed in 35 cases, nephrectomy--in 5 cases, ureteropyeloanastomosis--in 1 case, ureter-ureter anastomosis in the upper one third--in 3 cases and ureter-neo-cystoanastomosis in 1 child. We propose a new diagnostic method for estimation of functional state of the upper part of the double kidney with extravesical ectopy of its ureter. The method is based on comparison of volumes for 24 hour urine collection in natural urination and urinary incontinence, determination of relative density of urine collected in incontinence. If ectopic volume makes 19% and more of normal micturition volume and density of this urine is more than 1014, function of the upper part is good and organ-sparing surgery is indicated. Good results of 1 to 24 year follow-up were achieved in all the patients.

  5. Percutanous vertebroplasty for vertebral compression fracture in ...

    African Journals Online (AJOL)

    ; a report of two cases. ... Background: Osteoporotic vertebral fractures are common in the geriatric age group. ... Conclusion: Percutanous vertebroplasty offers effective, immediate and sustained pain relief in osteoporotic vertebral fractures.

  6. Segmental up-regulation of transforming growth factor-beta in the pathogenesis of primary megaureter. An immunocytochemical study.

    Science.gov (United States)

    Nicotina, P A; Romeo, C; Arena, F; Romeo, G

    1997-12-01

    To examine the maturational-delay hypothesis of primary megaureter (PM), i.e. that the condition arises by a segmental maturational delay of the ureteric wall that can resolve spontaneously within the first year of life, using comparative immunocytochemistry of ureters resected from infants and from homologous pre-natal ureters. Seventeen distal urinary tracts were obtained from children with PM who were referred for surgery (aged 6 months to 8 years, mean 2.1 years). These were compared with ureteric buds obtained from 11-week-old human and 11- to 38-week-old calf fetuses. The samples were immunostained using a monoclonal antibody specific for transforming growth factor beta (TGF-beta). The histological appearances of the narrowed ureteric segments from patients under 18 months old were like the fetal ureteric buds at 26-38 weeks of gestation. Positive TGF-beta immunoreactions were detected in the longitudinal muscle layer in the ureter from patients 6-12 months old. Such reactions weakened progressively in those patients older than 1 year, becoming negative in all children older than 3 years. The TGF-beta immunolabelling in resected ureters was closely similar to that in fetal ureters from 20 to 26-week old calves. From these results, PM should be ascribed to a segmental developmental delay of the terminal ureter arising at about 20 weeks of gestation, with a possible pathogenetic involvement of autocrine TGF-beta overexpression.

  7. An invertebrate stomach's view on vertebrate ecology

    DEFF Research Database (Denmark)

    Calvignac-Spencer, Sébastien; Leendertz, Fabian H.; Gilbert, Tom

    2013-01-01

    Recent studies suggest that vertebrate genetic material ingested by invertebrates (iDNA) can be used to investigate vertebrate ecology. Given the ubiquity of invertebrates that feed on vertebrates across the globe, iDNA might qualify as a very powerful tool for 21st century population...

  8. Initial experience with the use of an expandable titanium cage as a vertebral body replacement in patients with tumors of the spinal column: a report of 95 patients

    National Research Council Canada - National Science Library

    Viswanathan, Ashwin; Abd-El-Barr, Muhammad M; Doppenberg, Egon; Suki, Dima; Gokaslan, Ziya; Mendel, Ehud; Rao, Ganesh; Rhines, Laurence D

    ...) for reconstruction after vertebral body resection for primary or metastatic spine tumors. We report the functional outcome, assess the durability of reconstruction, and describe complications associated...

  9. Decellularized ureter for tissue-engineered small-caliber vascular graft.

    Science.gov (United States)

    Narita, Yuji; Kagami, Hideaki; Matsunuma, Hiroshi; Murase, Yosuke; Ueda, Minoru; Ueda, Yuichi

    2008-01-01

    Previous attempts to create small-caliber vascular prostheses have been limited. The aim of this study was to generate tissue-engineered small-diameter vascular grafts using decellularized ureters (DUs). Canine ureters were decellularized using one of four different chemical agents [Triton-X 100 (Tx), deoxycholate (DCA), trypsin, or sodium dodecyl sulfate (SDS)] and the histology, residual DNA contents, and immunogenicity of the resulting DUs were compared. The mechanical properties of the DUs were evaluated in terms of water permeability, burst strength, tensile strength, and compliance. Cultured canine endothelial cells (ECs) and myofibroblasts were seeded onto DUs and evaluated histologically. Canine carotid arteries were replaced with the EC-seeded DUs (n = 4). As controls, nonseeded DUs (n = 5) and PTFE prostheses (n = 4) were also used to replace carotid arteries. The degree of decellularization and the maintenance of the matrix were best in the Tx-treated DUs. Tx-treated and DCA-treated DUs had lower remnant DNA contents and immunogenicity than the others. The burst strength of the DUs was more than 500 mmHg and the maximum tensile strength of the DUs was not different to that of native ureters. DU compliance was similar to that of native carotid artery. The cell seeding test resulted in monolayered ECs and multilayered alpha-smooth muscle actin-positive cells on the DUs. The animal implantation model showed that the EC-seeded DUs were patent for at least 6 months after the operation, whereas the nonseeded DUs and PTFE grafts become occluded within a week. These results suggest that tissue-engineered DUs may be a potential alternative conduit for bypass surgery.

  10. Origin of renal myofibroblasts in the model of unilateral ureter obstruction in the rat.

    Science.gov (United States)

    Picard, Nicolas; Baum, Oliver; Vogetseder, Alexander; Kaissling, Brigitte; Le Hir, Michel

    2008-07-01

    Tubulo-interstitial fibrosis is a constant feature of chronic renal failure and it is suspected to contribute importantly to the deterioration of renal function. In the fibrotic kidney there exists, besides normal fibroblasts, a large population of myofibroblasts, which are supposedly responsible for the increased production of intercellular matrix. It has been proposed that myofibroblasts in chronic renal failure originate from the transformation of tubular cells via epithelial-mesenchymal transition (EMT) or from infiltration by bone marrow-derived precursors. Little attention has been paid to the possibility of a transformation of resident fibroblasts into myofibroblasts in renal fibrosis. Therefore we examined the fate of resident fibroblasts in the initial phase of renal fibrosis in the classical model of unilateral ureter obstruction (UUO) in the rat. Rats were perfusion-fixed on days 1, 2, 3 and 4 after ligature of the right ureter. Starting from 1 day of UUO an increasing expression of alpha-smooth muscle actin (alphaSMA) in resident fibroblasts was revealed by immunofluorescence and confirmed by the observation of bundles of microfilaments and webs of intermediate filaments in the electron microscope. Inversely, there was a decreased expression of 5'-nucleotidase (5'NT), a marker of renal cortical fibroblasts. The RER became more voluminous, suggesting an increased synthesis of matrix. Intercellular junctions, a characteristic feature of myofibroblasts, became more frequent. The mitotic activity in fibroblasts was strongly increased. Renal tubules underwent severe regressive changes but the cells retained their epithelial characteristics and there was no sign of EMT. In conclusion, after ureter ligature, resident peritubular fibroblasts proliferated and they showed progressive alterations, suggesting a transformation in myofibroblasts. Thus the resident fibroblasts likely play a central role in fibrosis in that model.

  11. A tertiary experience of ileal-ureter substitution: Contemporary indications and outcomes.

    Science.gov (United States)

    Gomez-Gomez, Enrique; Malde, Sachin; Spilotros, Marco; Shah, P J; J Greenwell, Tamsin; Ockrim, Jeremy L

    2016-06-01

    Complex ureteric stricture disease in contemporary practice is typically related to prior pelvic surgery, radiotherapy, or complicated, repeated retrograde stone surgery, although outcomes in this group have not been well studied. The aim of this study was to report medium-term outcomes with ileal-ureter substitution for complex ureteric stricture disease. All patients who had undergone ureteric reconstructive surgery using small bowel over a 5 year period between 2010 and 2015 were identified from the theatre database and their case notes reviewed. Data were collected on aetiology of ureteric stricture, prior surgery or radiotherapy, baseline renal function and comorbidity. Postoperative complications were recorded using the Clavien-Dindo classification, and overall outcome and need for further intervention were documented. Nine patients underwent ileal-ureter substitution for complex ureteric stricture disease over this period, with four having bilateral ileal interpositions. Median age was 48 years (38-62 years) with a median follow-up of 17 months (1-40 months). Simple untailored ileal segments and refluxing anastomoses were used in all cases. One case of anastomotic leak and restricture required reintervention, but all others had favourable outcomes with no stricture and no requirement for further intervention. Two patients reported recurrent cystitis following surgery but there was no deterioration in renal function in any patient, with no metabolic complications reported. Ileal-ureter substitution surgery is a valuable option for selected patients with complex, difficult-to-treat ureteric defects that cannot be bridged by other methods. Simple onlay techniques do not seem to affect renal or metabolic function. Avoiding the extra complexity of tailored and tunnelled anastomoses may reduce the potential morbidity and reintervention rate in patients with challenging surgical fields.

  12. Transvesical Laparoendoscopic Single-Site Management of Distal Ureter During Laparoscopic Radical Nephroureterectomy.

    Science.gov (United States)

    Nunez Bragayrac, Luciano A; Machuca, Victor; Saenz, Eric; Cabrera, Marino; de Andrade, Robert; Sotelo, Rene J

    2014-09-11

    Abstract Objective: To describe the management of the distal ureter during radical nephroureterectomy with the transvesical laparoendoscopic single-site surgery (T-LESS) approach. Methods: Between January 2010 and October 2013, five patients underwent laparoscopic radical nephroureterectomy for upper urinary tract carcinoma (UTUC) with the T-LESS approach. Patients were placed in the supine position. A 2.5-cm skin incision was made in the line between the pubis and the umbilicus. The bladder was identified and a multiport was inserted into the bladder. The patients were repositioned to a lateral decubitus position; pneumovesicum was established and the ureteral openings were identified. We marked the bladder cuff with electrocautery all the way through to the extravesical fat. The bladder defect was sealed with sutures. After checking for any leak or bleeding, the multiport was removed and the bladder was closed. At this point, we continued with nephrectomy by standard laparoscopy or LESS. A 18F Foley catheter was placed into the bladder. Results: The mean age was 70 years (range 58-81 years), the mean operative time was 198 minutes (range 115-390 minutes), the mean time for the management of the distal ureter was 35 minutes (range 27-45 minutes), the mean estimated blood loss was 234 mL (range 60-850 mL), and the mean hospital stay was 3.8 days (range 2-8 days). In all patients the bladder cuff was free of disease. Conclusion: The transvesical laparoendoscopic single-site approach to the distal ureter for UTUC appears safe and reproducible, with faster closure of the bladder defect and improved cosmesis.

  13. A systematic approach to vertebral hemangioma

    Energy Technology Data Exchange (ETDEWEB)

    Gaudino, Simona; Martucci, Matia; Colantonio, Raffaella; Lozupone, Emilio; Visconti, Emiliano; Leone, Antonio; Colosimo, Cesare [Catholic University, School of Medicine, Department of Radiological Sciences, Rome (Italy)

    2015-01-15

    Vertebral hemangiomas (VHs) are a frequent and often incidental finding on computed tomography (CT) and magnetic resonance (MR) imaging of the spine. When their imaging appearance is ''typical'' (coarsened vertical trabeculae on radiographic and CT images, hyperintensity on T1- and T2-weighted MR images), the radiological diagnosis is straightforward. Nonetheless, VHs might also display an ''atypical'' appearance on MR imaging because of their histological features (amount of fat, vessels, and interstitial edema). Although the majority of VHs are asymptomatic and quiescent lesions, they can exhibit active behaviors, including growing quickly, extending beyond the vertebral body, and invading the paravertebral and/or epidural space with possible compression of the spinal cord and/or nerve roots (''aggressive'' VHs). These ''atypical'' and ''aggressive'' VHs are a radiological challenge since they can mimic primary bony malignancies or metastases. CT plays a central role in the workup of atypical VHs, being the most appropriate imaging modality to highlight the polka-dot appearance that is representative of them. When aggressive VHs are suspected, both CT and MR are needed. MR is the best imaging modality to characterize the epidural and/or soft-tissue component, helping in the differential diagnosis. Angiography is a useful imaging adjunct for evaluating and even treating aggressive VHs. The primary objectives of this review article are to summarize the clinical, pathological, and imaging features of VHs, as well as the treatment options, and to provide a practical guide for the differential diagnosis, focusing on the rationale assessment of the findings from radiography, CT, and MR imaging. (orig.)

  14. The "Left Ureteral Triangle" as an Anatomic Landmark for the Identification of the Left Ureter in Laparoscopic Distal Colectomies.

    Science.gov (United States)

    Tebala, Giovanni D

    2016-10-01

    Ureteral injury is one of the possible complications of distal colectomies. It may be caused by misidentification of the anatomic landmarks during the left lateral dissection, due to factor pertaining to the patient, the disease, and the surgeon. The only way to reduce the risk of this avoidable complication is the perfect knowledge and identification of the anatomy of the left ureter. In this article, we describe an anatomic triangle that can be a valid help in the identification of the ureter in the area where higher is the risk of iatrogenic injury. The left ureteric triangle can be prepared after the dissection of the left Toldt plane, as soon as the dissection reaches the superior mesorectum. Sides of this triangle are (a) superiorly, the dissected mesosigmoid, (b) right side, upper mesorectum and sacral promontorium, and (c) inferiorly, the margin of the incised posterior parietal peritoneum. The left ureter runs within this triangle.

  15. Unilateral congenital giant megaureter with renal dysplasia compressing contralateral ureter and causing bilateral hydronephrosis: a case report and literature review.

    Science.gov (United States)

    Yu, Mingming; Ma, Geng; Ge, Zheng; Lu, Rugang; Deng, Yongji; Guo, Yunfei

    2016-02-09

    Congenital giant megaureter (CGM) is uncommon in the pediatric population. The major clinical presentations are marked protruberances and abdominal cysts. We reported a case of CGM with almost the whole left ureter dilation accompanied with a 1 cm stricture at the entrance of the bladder and renal dysplasia, immediately compressing the contralateral ureter and causing bilateral hydronephrosis for the first time. At one-stage of the operation, a left nephrostomy with a right ureterolysis were performed, and a poor left kidney function was found. Then, the left kidney and ureter were cut off by nephroureterectomy at the second-stage. Eventually, the follow-up showed that the patient recovered well by abdominal ultrasound. Based on the findings of these reported literatures, CGM is rare. The physical and imaging examinations are essential for the diagnosis of CGM, and the appropriate treatment methods should be performed based on patients' specific condition.

  16. Right double inferior vena cava associated with retrocaval ureter: computed tomographic findings in two cases.

    Science.gov (United States)

    Shin, Mack; Lee, Jong Beum; Park, Sung Bin; Park, Hyun Jeong; Kim, Yang Soo

    2014-01-01

    Two cases of right double inferior vena cava (RDIVC) were observed on computed tomography. In one case, the duplicated IVCs were both located to the right of the abdominal aorta and were nearly on the same coronal plane. In the other case, the right IVC showed partial duplication. The right ureter coursed posterior to the lateral IVC, then emerged between the duplicated IVC in both cases. The findings from the two cases presented in this report showed novel anatomical differences, likely attributable to different embryologic processes, as compared to previously reported cases of RDIVC. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Ectopic ureter associated with uterine didelphys and obstructed hemivagina: preoperative diagnosis by MRI

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Zhen J.; Daldrup-Link, Heike; Coakley, Fergus V.; Yeh, Benjamin M. [University of California, San Francisco (United States). Department of Radiology

    2010-03-15

    Uterine didelphys with obstructed hemivagina and ipsilateral renal anomalies is a rare congenital malformation of the female urogenital tract. While the urinary anomalies almost always involve renal agenesis, we report a rare case of a 17-year-old girl with the malformation associated with ectopic ureteral insertion into the obstructed hemivagina, which was diagnosed preoperatively by MR imaging. To the best of our knowledge, preoperative MR imaging diagnosis of the ectopic ureter associated with this syndrome has not been previously reported. Accurate preoperative diagnosis of ectopic ureteral insertion associated with this syndrome is important for surgical planning. (orig.)

  18. Physical rehabilitation in complex therapy of the ureter stones patients in the Truskavets health resort area

    Directory of Open Access Journals (Sweden)

    Shologon R.P.

    2010-05-01

    Full Text Available Efficiency of rehabilitation measures is considered in complex therapy with the use of differentiated methods of medical physical education for patients with stones of ureter. Under a supervision there was 143 patients. 93 patients were made basic group, 50 patients - control. From them 51 (56 % are men and 42 (54% are women. Age of patients made from 20 to 60 years. A sanatorium-resort rehabilitation is recommended with the use of the differentiated methods of medical gymnastics. Application of method improved the indexes of the functional state of buds and overhead urinary ways. Frequency of advancement and output of concrements is also megascopic.

  19. Total ureterectomy and ileal ureteric replacement for TCC ureter in a solitary kidney.

    Science.gov (United States)

    Banerji, John S; George, Arun J P

    2014-11-01

    Traditional treatment of upper tract transitional cell carcinoma (TCC) is nephroureterectomy with a bladder cuff. This is in keeping with the nature of the disease, in that TCC is a panurothelial disease. However, there are a few rare occasions when this would mean making a subject anephric, as in a TCC in a solitary kidney or bilateral synchronous/metachronous disease. We present a case of a patient with a dysplastic, poorly functioning left kidney and with a TCC of the ureter on the right side.

  20. Zygotic Genome Activation in Vertebrates.

    Science.gov (United States)

    Jukam, David; Shariati, S Ali M; Skotheim, Jan M

    2017-08-21

    The first major developmental transition in vertebrate embryos is the maternal-to-zygotic transition (MZT) when maternal mRNAs are degraded and zygotic transcription begins. During the MZT, the embryo takes charge of gene expression to control cell differentiation and further development. This spectacular organismal transition requires nuclear reprogramming and the initiation of RNAPII at thousands of promoters. Zygotic genome activation (ZGA) is mechanistically coordinated with other embryonic events, including changes in the cell cycle, chromatin state, and nuclear-to-cytoplasmic component ratios. Here, we review progress in understanding vertebrate ZGA dynamics in frogs, fish, mice, and humans to explore differences and emphasize common features. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2014-01-01

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

  2. Single-incision multiport laparoendoscopic technique to repair retrocaval ureter using the Santosh PGI ureteric tacking fixation technique.

    Science.gov (United States)

    Kumar, Santosh; Shankaregowda, Sriharsha Ajjoor; Devana, Sudheer Kumar; Jain, Siddharth; Singh, Shrawan Kumar

    2014-11-01

    A retrocaval ureter is a rare congenital anomaly associated with upper urinary tract obstruction. It can cause varying degrees of ureteral obstruction, and surgical intervention is often necessary. Here, we present a case of a retrocaval ureter repaired with the single-incision multiport laparoendoscopic technique. We used a new fixation technique, Santosh PGI (Postgraduate Institute) ureteric tacking fixation technique, on both ureteric ends for easy ureteroureteric anastomosis. A 45-year-old man presented with right loin pain. CT urography showed a retrocaval ureter. Because the patient was symptomatic, he underwent retrocaval ureter repair by the single-incision multiport laparoendoscopic technique. A double-J stent was placed in the right ureter with the patient in the lithotomy position. Then, the patient was placed in a modified flank position. After pneumoperitoneum was created, a 2.5-cm incision was made in the umbilicus, and three conventional laparoscopic ports were inserted. The narrow retrocaval segment of ureter was resected, and both spatulated ureteric ends were fixed using the Santosh PGI ureteric tacking fixation technique, and ureteroureteral anastamosis was done. The duration of the procedure was 105 min. The patient was discharged from the hospital on postoperative day 3. Follow-up intravenous pyelography at 3 months showed normal drainage. The single-incision multiport laparoendoscopic technique is feasible and cost effective, has good cosmesis, and has minimal morbidity when performed by an expert laparoscopic surgeon. The Santosh PGI ureteric tacking fixation technique enabled us to suture easily and rapidly within the limited range of motion allowed by conventional laparoscopic instruments in SILS. © 2014 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.

  3. [Extracorporeal piezoelectric lithotripsy in the treatment of calculi of the ureter. Apropos of a series of 143 cases].

    Science.gov (United States)

    Amiel, J; Touabi, K; Peyrottes, A; Toubol, J

    1990-01-01

    The results obtained in 143 cases or ureteral stones treated by EDAP LT-01 were analysed concerning stone location, ureteral manipulation, and treatment position. The ureter was divided into six segments: ureteropelvic junction (UPJ), proximal ureter higher than the lower pole of the kidney (PU1), proximal ureter between the lower pole and the iliac crest (PU2), mid-ureter between the iliac crest and the lower end of the sacroiliac joint (MU), distal ureter between the lower end of the sacroiliac joint and the ischial spine (DU1), and the distal ureter below the ischial spine to the meatus (DU2). The overall fragmentation rate (FR) was 72%, as detailed below: (table; see text) Anesthesia or iv sedation was never used for EPL. 28% of the patients underwent retrograde ureteral manipulation (29/103). For PU1, the FR was twice as high after retrograde manipulation (push back/in situ = 5/8). For UPJ, the supine position was most common. For PU1 and PU2, it was often better to have the patient lie on his side. For DU1 and DU2, a prone position was necessary. For all stones in DU1, the bladder had to be well filled and the FR was higher in DU2 than in DU1. DU2 stones appeared to adhere to the bladder wall or were intravesical (stone in the meatus). The stone-free rate for successfully manipulated ureteral calculi (3 month follow-up) is 93% (27/29). The stone-free rate for in situ stones at 3 months is 94% (70/74). Extracorporeal piezoelectric lithotripsy combined with stone manipulation is highly efficient in the management of UPJ, PU1 and DU2 stones.(ABSTRACT TRUNCATED AT 250 WORDS)

  4. Vertebral development and amphibian evolution.

    Science.gov (United States)

    Carroll, R L; Kuntz, A; Albright, K

    1999-01-01

    Amphibians provide an unparalleled opportunity to integrate studies of development and evolution through the investigation of the fossil record of larval stages. The pattern of vertebral development in modern frogs strongly resembles that of Paleozoic labyrinthodonts in the great delay in the ossification of the vertebrae, with the centra forming much later than the neural arches. Slow ossification of the trunk vertebrae in frogs and the absence of ossification in the tail facilitate the rapid loss of the tail during metamorphosis, and may reflect retention of the pattern in their specific Paleozoic ancestors. Salamanders and caecilians ossify their centra at a much earlier stage than frogs, which resembles the condition in Paleozoic lepospondyls. The clearly distinct patterns and rates of vertebral development may indicate phylogenetic separation between the ultimate ancestors of frogs and those of salamanders and caecilians within the early radiation of ancestral tetrapods. This divergence may date from the Lower Carboniferous. Comparison with the molecular regulation of vertebral development described in modern mammals and birds suggests that the rapid chondrification of the centra in salamanders relative to that of frogs may result from the earlier migration of sclerotomal cells expressing Pax1 to the area surrounding the notochord.

  5. Assembly of primary cilia

    DEFF Research Database (Denmark)

    Pedersen, Lotte B; Veland, Iben R; Schrøder, Jacob M

    2008-01-01

    Primary cilia are microtubule-based, hair-like sensory organelles present on the surface of most growth-arrested cells in our body. Recent research has demonstrated a crucial role for primary cilia in regulating vertebrate developmental pathways and tissue homeostasis, and defects in genes involved...

  6. A rare complication: misdirection of an indwelling urethral catheter into the ureter.

    Science.gov (United States)

    Ishikawa, Tsutomu; Araki, Motoo; Hirata, Takeshi; Watanabe, Masami; Ebara, Shin; Watanabe, Toyohiko; Nasu, Yasutomo; Kumon, Hiromi

    2014-01-01

    We report 3 patients with the rare complication of an indwelling urethral catheter misdirected into the ureter. This is the largest series to date. Patients were referred to us for a variety of reasons following exchange of their chronic indwelling urinary catheters. CT in all cases demonstrated the urinary catheters residing in the left ureter. The ages of the patients were 37, 67 and 81 years old. All patients suffered from neurogenic bladder. Two patients were female, one was male, and 2 of the 3 had a sensory disorder inhibiting their pain response. The catheters were replaced with open-end Foley catheters. Extensive follow-up CT scans were obtained in one case, demonstrating improvement of hydronephrosis and no evidence of ureteral stenosis. Cystoscopy in this patient demonstrated normally positioned and functioning ureteral orifices. Although the placement of an indwelling urethral catheter is a comparatively safe procedure, one must keep in mind that this complication can occur, particularly in female patients with neurogenic bladder. CT without contrast is a noninvasive, definitive diagnostic tool.

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

    Science.gov (United States)

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

    2013-01-01

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

  8. Angiotensin Receptor Blocker Losartan Inhibits Spontaneous Motility of Isolated Human Ureter.

    Science.gov (United States)

    Jankovic, Slobodan M; Stojadinovic, Dobrivoje; Stojadinovic, Miroslav; Jankovic, Snezana V; Djuric, Janko M; Stojic, Isidora; Kostic, Marina

    2016-12-01

    Ureteral motility is essential for elimination of intraluminal stones, and it may be adversely affected by cardiovascular drugs that a patient is taking chronically. The aim of our study was to test whether ACE inhibitors and an angiotensin receptor blocker may influence spontaneous contractions of isolated human ureter. Both phasic and tonic contractions of the isolated ureteral segments taken from 10 patients were measured as changes of the longitudinal tension or pressure recordings. Captopril, enalapril and losartan were separately added to the organ baths cumulatively. While enalapril (2.7 × 10 -7 -3.9 × 10 -4  M) and captopril (6.1 × 10 -7 -2.7 × 10 -3  M) did not affect either spontaneous activity or tone of isolated ureteral segments, losartan (2.9 × 10 -7 -4.2 × 10 -4  M) caused concentration-dependent inhibition of spontaneous contractions of the segments (50 % effective concentration (EC 50 ) = 13.46 ± 1.80 × 10 -6  M; F = 10.72, r = 0.79, p ureter.

  9. Sall1-dependent signals affect Wnt signaling and ureter tip fate to initiate kidney development

    Science.gov (United States)

    Kiefer, Susan M.; Robbins, Lynn; Stumpff, Kelly M.; Lin, Congxing; Ma, Liang; Rauchman, Michael

    2010-01-01

    Development of the metanephric kidney depends on precise control of branching of the ureteric bud. Branching events represent terminal bifurcations that are thought to depend on unique patterns of gene expression in the tip compared with the stalk and are influenced by mesenchymal signals. The metanephric mesenchyme-derived signals that control gene expression at the ureteric bud tip are not well understood. In mouse Sall1 mutants, the ureteric bud grows out and invades the metanephric mesenchyme, but it fails to initiate branching despite tip-specific expression of Ret and Wnt11. The stalk-specific marker Wnt9b and the β-catenin downstream target Axin2 are ectopically expressed in the mutant ureteric bud tips, suggesting that upregulated canonical Wnt signaling disrupts ureter branching in this mutant. In support of this hypothesis, ureter arrest is rescued by lowering β-catenin levels in the Sall1 mutant and is phenocopied by ectopic expression of a stabilized β-catenin in the ureteric bud. Furthermore, transgenic overexpression of Wnt9b in the ureteric bud causes reduced branching in multiple founder lines. These studies indicate that Sall1-dependent signals from the metanephric mesenchyme are required to modulate ureteric bud tip Wnt patterning in order to initiate branching. PMID:20702564

  10. Non-refluxing ileal ureter replacement using intussuscepted nipple valve--an experimental study in dogs.

    Science.gov (United States)

    Tsukamoto, T

    1996-04-01

    Although the vast accumulation of data from the continent urinary reservoir clearly proves that intussusception of the ileum is a reliable procedure for preventing urine reflux, few reports have appeared on the application of this technique to ileal replacement of the ureter. In an effort to determine if the nipple valve created by the intussuscepted ileum can prevent urine reflux in the ileal ureter, an experimental study was done using five dogs. I performed ureteral replacement using a newly developed procedure to secure the nipple valve in place. All dogs were followed for 6 months and evaluated by blood urea nitrogen (BUN), creatinine (Cr), serum electrolyte, urine culture, intravenous urogram (IVU), cystogram, and urodynamic studies. No significant differences were notable between the preoperative and 6-month postoperative values of BUN, Cr, and serum electrolytes in all dogs. Only one of the dogs, which showed extussusception of the nipple valve, demonstrated the reflux. IVUs and Whitaker flow studies did not confirm any urinary outflow obstruction. Furthermore, during the pressure studies, the nipple valve prevented transmission of the increased intravesical pressure to the upper urinary tract. I believe that the intussuscepted ileum can be secured by our procedure and can prevent reflux even though it is incorporated into the urinary system itself.

  11. The Accordion Sign in the Transplant Ureter: Ramifications During Balloon Dilation of Strictures

    Energy Technology Data Exchange (ETDEWEB)

    Kriegshauser, J. Scott, E-mail: skriegshauser@mayo.edu; Naidu, Sailen G. [Mayo Clinic Hospital, Department of Radiology (United States); Chang, Yu-Hui H. [Mayo Clinic, Department of Biostatistics (United States); Huettl, Eric A. [Mayo Clinic Hospital, Department of Radiology (United States)

    2015-04-15

    PurposeThis study was designed to demonstrate the accordion sign within the transplant ureter and evaluate its ramifications during balloon dilation of strictures.MethodsA retrospective electronic chart and imaging review included demographic characteristics, procedure reports, and complications of 28 renal transplant patients having ureteral strictures treated with percutaneous balloon dilation reported in our transplant nephrology database during an 8-year period. The accordion sign was deemed present or absent on the basis of an imaging review and was defined as present when a tortuous ureter became kinked and irregular when foreshortened after placement of a wire or a catheter. Procedure-related urine leaks were categorized as occurring at the stricture if within 2 cm; otherwise, they were considered away from the stricture.ResultsThe accordion sign was associated with a significantly greater occurrence of leaks away from the stricture (P = 0.001) but not at the stricture (P = 0.34).ConclusionsThe accordion sign is an important consideration when performing balloon dilation procedures on transplant ureteral strictures, given the increased risk of leak away from the stricture. Its presence should prompt additional care during wire and catheter manipulations.

  12. MRI for the detection of ureteral opening and ipsilateral kidney in children with single ectopic ureter

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Myung Joon; Lim, Joon Seok; Yoon, Choon Sik; Han, Sang Won [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-06-01

    To assess the usefulness of MRI in the detection of a single ectopic ureteral opening and the location and dysplastic change of ipsilateral kidney. Nine patients (mean age; 4.8 years, M:F=3:6) in whom a single ectopic ureter was suspected clinically and sonographically underwent conventional radiologic studies (IVP, VCUG, 99mTc-DM-SA scan, as well as US) and MRI. We evaluated images of the point of the ectopic ureteral opening and the location and dysplastic or hydronephrotic change of the ipsilateral kidney, and compared those findings with the endoscopic, surgical, and pathological findings. Eight patients had a unilateral single ectopic ureter and one had bilateral lesions. Seven normally positioned kidneys in six patients showed dysplastic (n=3) or hydronephrotic (n=4) change. In two patients an ectopic dysplastic kidney was located in the pelvis and one had ipsilateral renal agenesis. Conventional radiologic studies failed to reveal two ectopic dysplastic kidneys, one renal agenesis, and eight ectopic ureteral openings. In all patients, MRI clearly demonstrated the location of the kidney and ectopic ureteral opening, and dysplastic or hydronephrotic change of the kidney, and in one patient, uterine duplication. Except in two patients whose ectopic ureteral opening was not found on endoscopy, MRI findings were concordant with endoscopic and surgical findings. MRI was useful for the detection of a single ectopic ureteral opening and for demonstrating the location and dysplastic change of ipsilateral kidney.

  13. Complete Transperitoneal Laparoscopic Nephroureterectomy in Circumcaval Ureter with Upper Tract TCC: Initial Case Report.

    Science.gov (United States)

    Chhabra, Jaspreet Singh; Mishra, Shashikant; Sudharsan, S B; Ganpule, Arvind P; Sabnis, Ravindra B; Desai, Mahesh R

    2015-01-01

    Transitional-cell carcinoma (TCC) of the upper tract in a case of circumcaval ureter (CCU) is a rare entity. Laparoscopic transperitoneal nephroureterectomy in such case represents a unique challenge in the era of minimally invasive surgery. We report a case of complete transperitoneal laparoscopic nephroureterectomy with bladder cuff excision done for TCC in a case of CCU. This case report describes the first point of technique of the procedure done for this rare entity. A 38-year-old male patient underwent the procedure for high-grade TCC of right lower calix. The essential tenets of the procedure included performance of the technique in a manner contrary to the conventional nephroureterectomy. The case report describes the procedure in the following steps: management of lower ureter and bladder cuff followed upper tract procedure after transposition of bladder cuff posterior to inferior vena cava. The procedure was accomplished utilizing four ports and a 6 cm Pfannenstiel incision with operative time of 220 minutes and blood loss of 50 mL.

  14. Formation of the sleep-regulating mechanisms in vertebrates.

    Science.gov (United States)

    Khomutetskaya, O E; Shilling, N V; Karmanova, I G

    1979-04-01

    The paper presents new data concerning the mechanisms of regulation of sleep-like states in vertebrates. Somato-vegetative and behavioral correlates of primary sleep (fish, amphibians), intermediate sleep (reptiles), slow-wave and paradoxical sleep (birds) are described. The evolutionary more ancient hypothalamo-cortical and young thalamo-cortical levels of regulation of different forms of sleep are examined. Problems of existence of functional analogues of homoiotherms' sleep are discussed.

  15. Laparoscopic selective clipping of upper moiety vasculature and ureter without partial nephrectomy: A novel technique for pediatric urinary incontinence due to ectopic ureter associated with poor functioning upper renal moiety.

    Science.gov (United States)

    Hosseini Sharifi, S H; Nabavizadeh, B; Mozafarpour, S; Kajbafzadeh, A-M

    2017-04-01

    The aim of this study was to present a novel laparoscopic technique for persistent urinary incontinence in pediatrics due to ectopic ureter associated with poor functioning upper renal moiety. This technique consisted of laparoscopic clipping of the upper moiety artery and vein. The ectopic ureter was also clipped afterwards without upper pole partial nephrectomy. The patient was a seven-year-old girl with persistent urinary incontinence and confirmation of duplex kidney with poor functioning upper moiety in pre-operative investigations. The upper moiety ureter was ectopically drained to the vaginal cavity. She was immediately dry after surgery and discharged on the second postoperative day. During the follow-up period of 14 months, she was continent and symptom-free. Hydronephrosis was not visualized in follow-up ultrasonography. This laparoscopic upper renal moiety vascular and ureteral clipping without partial nephrectomy could serve as a promising, safe and simple alternative in the treatment of patients with ectopic ureter associated with poor functioning renal moiety. Also, ipsilateral normal functioning moiety would not be associated with potential morbidity in this technique. Copyright © 2017 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  16. Osteomielitis vertebral piógena Pyogenic vertebral osteomyelitis

    Directory of Open Access Journals (Sweden)

    Pedro P. Perrotti

    2009-10-01

    Full Text Available La osteomielitis vertebral piógena (OVP es una localización poco frecuente (2-7% Se confirma con el aislamiento de un microorganismo de una vértebra, disco intervertebral, absceso epidural o paravertebral. Se describe una serie de casos por la infrecuente presentación de esta enfermedad, que puede ser consulta inicial en los servicios de clínica médica y por su sintomatología inespecífica que supone una dificultad diagnóstica. Tanto la columna lumbar como la dorsal fueron los sitios más afectados. El dolor dorsolumbar y la paraparesia fueron los síntomas más frecuentes de presentación. En ocho pacientes se aislaron Staphylococcus aureus, en uno Escherichia coli y en el restante Haemophylus sp. Se observó leucocitosis sólo en tres pacientes, y en dos velocidad de sedimentación globular mayor de 100 mm/h. Los diez pacientes presentaron imágenes características de osteomielitis vertebral piógena en la resonancia nuclear magnética. Dentro de las complicaciones, los abscesos paravertebrales y epidurales fueron los más frecuentes (en cinco enfermos. Además, un paciente presentó empiema pleural. De los diez pacientes de esta serie, siete recibieron inicialmente tratamiento médico empírico y luego específico para el germen aislado. En los restantes el tratamiento fue guiado de acuerdo al antibiograma. A dos enfermos fue necesario realizarles laminectomía descompresiva por compromiso de partes blandas y a otros dos estabilización quirúrgica por inestabilidad espinal, observándose buena evolución en todos los casos. Esta serie demuestra que, ante un paciente con dolor dorsolumbar y síntomas neurológicos se deberá tener en cuenta esta entidad para evitar un retraso en el tratamiento.Pyogenic osteomyelitis seldom affects the spine (2-7%. It is diagnosed by the isolation of a bacterial agent in the vertebral body, the intervertebral disks or from paravertebral or epidural abscesses. We report a retrospective study of ten

  17. Prise en charge de l'urete`re rétrocave au Togo: A propos de 3 ...

    African Journals Online (AJOL)

    L'uretère retrocave est une malformation rare. Par ces 3 cas, les auteurs rappellent que cette affection est retrouvée plus souvent chez l'adulte jeune. La manifestation clinique habituelle étant la douleur lombaire due à l'obstruction du haut appareil urinaire, les formes asymptomatiques aussi peuvent être rencontrées.

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

    Science.gov (United States)

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

    2015-01-01

    This study provides information about baseline mechanical properties of the entire muscle and the molecular contractile mechanism in human ureter smooth muscle and proposed to investigate if changes in mechanical motor performance in different regions of isolated human ureter are attributable to differences in myosin crossbridge interactions. Classic mechanical, contraction and energetic parameters derived from the tension-velocity relationship were studied in ureteral smooth muscle strips oriented longitudinally and circularly from abdominal and pelvic human ureter parts. By applying of Huxley's mathematical model we calculated the total working crossbridge number per mm(2) (Ψ), elementary force per single crossbridge (Π0), duration of maximum rate constant of crossbridge attachment 1/f1 and detachment 1/g2 and peak mechanical efficiency (Eff.max). Abdominal longitudinal smooth muscle strips exhibited significantly higher maximum isometric tension and faster maximum unloaded shortening velocity compared to pelvic ones. Contractile differences were associated with significantly higher crossbridge number per mm(2). Abdominal longitudinal muscle strips showed a lower duration of maximum rate constant of crossbridge attachment and detachment and higher peak mechanical efficiency than pelvic ones. Such data suggest that the abdominal human ureter showed better mechanical motor performance mainly related to a higher crossbridge number and crossbridge kinetics differences. Such results were more evident in the longitudinal rather than in the circular layer.

  19. Polyuria due to vasopressin V2 receptor antagonism is not associated with increased ureter diameter in ADPKD patients

    NARCIS (Netherlands)

    Casteleijn, Niek F.; Messchendorp, A. Lianne; Bae, Kyong T.; Higashihara, Eiji; Kappert, Peter; Torres, Vicente; Meijer, Esther; Leliveld, Anna M.

    Tolvaptan, a vasopressin V2 receptor antagonist, has been shown to reduce the rates of growth in total kidney volume (TKV) and renal function loss in ADPKD patients, but also leads to polyuria because of its aquaretic effect. Prolonged polyuria can result in ureter dilatation with consequently renal

  20. The first report of 3 forgotten encrusted double J stents in the same ureter: An endourology nightmare!

    Directory of Open Access Journals (Sweden)

    Ahmed Adam

    2017-09-01

    Conclusion: The first report of 3 encrusted stents within the same ureter is presented. The prevention of JJ stent encrustation is crucial via adequate and appropriate patient counselling. In most patients with forgotten encrusted stents who qualify for endoscopic management, a multi-modality approach is required.

  1. Renal dysplasia with single system ectopic ureter: Diagnosis using magnetic resonance urography and management with laparoscopic nephroureterectomy in pediatric age

    Directory of Open Access Journals (Sweden)

    Milind Joshi

    2009-01-01

    Conclusion : Single system ectopic ureter associated with congenital renal dysplasia is exceedingly rare. MRU is definitely the better investigation for the diagnosis of this condition as compared to the conventional radiological investigations. Laparoscopic nephroureterectomy is a very good procedure for the management of these cases.

  2. CIRSE Guidelines on Percutaneous Vertebral Augmentation

    Energy Technology Data Exchange (ETDEWEB)

    Tsoumakidou, Georgia, E-mail: gtsoumakidou@yahoo.com; Too, Chow Wei, E-mail: spyder55@gmail.com; Koch, Guillaume, E-mail: guillaume.koch@gmail.com; Caudrelier, Jean, E-mail: jean.caudrelier@chru-strasbourg.fr; Cazzato, Roberto Luigi, E-mail: gigicazzato@hotmail.it; Garnon, Julien, E-mail: juliengarnon@gmail.com; Gangi, Afshin, E-mail: gangi@unistra.fr [Strasbourg University Hospital, Interventional Radiology Department (France)

    2017-03-15

    Vertebral compression fracture (VCF) is an important cause of severe debilitating back pain, adversely affecting quality of life, physical function, psychosocial performance, mental health and survival. Different vertebral augmentation procedures (VAPs) are used in order to consolidate the VCFs, relief pain,and whenever posible achieve vertebral body height restoration. In the present review we give the indications, contraindications, safety profile and outcomes of the existing percutaneous VAPs.

  3. Evolutionary Specialization of Tactile Perception in Vertebrates

    Science.gov (United States)

    Schneider, Eve R.

    2016-01-01

    Evolution has endowed vertebrates with the remarkable tactile ability to explore the world through the perception of physical force. Yet the sense of touch remains one of the least well understood senses at the cellular and molecular level. Vertebrates specializing in tactile perception can highlight general principles of mechanotransduction. Here, we review cellular and molecular adaptations that underlie the sense of touch in typical and acutely mechanosensitive vertebrates. PMID:27053733

  4. Evolutionary Specialization of Tactile Perception in Vertebrates

    OpenAIRE

    Schneider, Eve R.; Gracheva, Elena O.; Bagriantsev, Slav N.

    2016-01-01

    Evolution has endowed vertebrates with the remarkable tactile ability to explore the world through the perception of physical force. Yet the sense of touch remains one of the least well understood senses at the cellular and molecular level. Vertebrates specializing in tactile perception can highlight general principles of mechanotransduction. Here, we review cellular and molecular adaptations that underlie the sense of touch in typical and acutely mechanosensitive vertebrates.

  5. Vertebral wedging characteristic changes in scoliotic spines.

    Science.gov (United States)

    Parent, Stefan; Labelle, Hubert; Skalli, Wafa; de Guise, Jacques

    2004-10-15

    A morphometric analysis of vertebral wedging in vertebrae from scoliotic specimens. To quantify the vertebral body changes in 30 anatomic specimens affected by a scoliotic deformity. Only a few studies have evaluated the exact changes occurring at the level of the vertebral body in scoliotic spines. Most are observational studies of rare scoliotic specimens presenting major curvatures. The orientation of vertebral wedging is important for the planning of corrective surgery, performing vertebral osteotomy, and the evaluation of possible growth modulation. Thirty scoliotic specimens with curves presenting various degrees of severity were studied using a three-dimensional digitizing protocol developed to create a precise three-dimensional reconstruction of the vertebrae. Every scoliotic specimen was then matched with a normal specimen, and comparisons were made on the vertebral body parameters both for thoracic and lumbar vertebrae. Analysis of variance and t test calculations were performed to identify significant differences with P = 0.05. A total of 471 vertebrae from scoliotic spines and 510 vertebrae from normal specimens were measured. Vertebral wedging increased progressively towards the apex of the curve and was maximal at the apex. Vertebral wedging was more prominent in the frontal plane, and there was minimal wedging in the sagittal plane. Vertebral heights were significantly different at T3 and T4 for the upper adjacent curve and at T6-T8 for a typical right thoracic curve, with smaller heights located on the concavity of the curve. No changes were observed on the convexity of the curve. Vertebral wedging is an essential component of the scoliotic deformity. The present study provides critical information for corrective surgery and vertebral osteotomy, as vertebral wedging occurs primarily in the frontal plane. Accurate knowledge of this deformity should also provide new insight into corrective surgical strategies aiming at growth modulation and more

  6. Ghrelin receptors in non-mammalian vertebrates

    Directory of Open Access Journals (Sweden)

    Hiroyuki eKaiya

    2013-07-01

    Full Text Available The growth hormone secretagogue-receptor (GHS-R was discovered in humans and pigs in 1996. The endogenous ligand, ghrelin, was discovered three years later, in 1999, and our understanding of the physiological significance of the ghrelin system in vertebrates has grown steadily since then. Although the ghrelin system in non-mammalian vertebrates is a subject of great interest, protein sequence data for the receptor in non-mammalian vertebrates has been limited until recently, and related biological information has not been well organized. In this review, we summarize current information related to the ghrelin receptor in non-mammalian vertebrates.

  7. Radiotherapy for vertebral metastases. Analysis of symptoms and clinical effects by MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Sugiyama, Akira [Shizuoka Saiseikai General Hospital (Japan)

    1994-12-01

    Fifty patients with 63 symptomatic vertebral metastasis (18 sites: pain only, 28 sites: radiculopathy with pain, 17 sites: myelopathy) were treated by radiotherapy. Primary lesions were located in the lung (9 cases), breast (9), colorectal area (9), prostate (7) and so on. We correlated the radiologic findings, symptoms and clinical effects with metastatic features which were classified into 4 types by MR imaging: non-deformity, expanding, vertebral collapse, and destructive mass. Each type of metastasis was accompanied with or without epidural tumor. Osteolytic metastases were apt to create features of deformity (expanding type: 18 vertebrae, vertebral collapse type: 17, destructive mass type: 9). The features of osteoblastic metastases were no deformity (18 vertebrae) and expanding type (2). The symptom of pain only occurred most frequently in the lumbosacral spine. The vertebral body deformity of symptomatic sites was relatively slight (non-deformity type: 6 sites, expanding type: 6, vertebral collapse type: 6), and epidural tumors were seen at only 2 sites. The effect of radiotherapy was excellent (complete pain relief: 64.7%, partial pain relief: 29.4%). Radiculopathy occurred most frequently in the lumber spine. Vertebral body deformity was noted in most symptomatic sites (expanding type: 9 sites, vertebral collapse type: 10, destructive mass type: 2). Complete relief was obtained in 6 sites (22.2%), partial relief in 18 (63.0%). Myelopathy occurred most often in the thoracic spine, followed by the lumbar spine. The vertebral body deformity was severe (expanding: 3 cases, vertebral collapse type: 3, destructive mass type: 6). Epidural tumors were also present in all but one case. Six of 13 patients treated with radiation alone improved. These 6 patients had non-deformity or expanding types with epidural tumor. No improvement was seen in the vertebral collapse type with epidural tumor or destructive mass type. (author).

  8. RADIONUCLIDE MEASURING OF THE TRANSIT OF URINE IN URETERS IN CHILDREN WITH OBSTRUCTIVE UROPATHIES

    Directory of Open Access Journals (Sweden)

    A.G. Burkin

    2011-01-01

    Full Text Available Through the use of radionuclide method for the rate measuring of the urine passing by the ureter, it became possible to assess the outcome of the surgical correction of the vesicoureteral segment obstructive uropathy, based on the nature of urodynamics in the operated organ and urinary tract. This method allows to determine the degree of the urodynamics in the urinary tract violations, the tactics of further treatment and objectively evaluate the outcome of the surgery performed, based on mathematical calculation of the activity of the radiopharmaceutical, eliminating the assessment subjectivity. Key words: radionuclide methods of investigation, obstructive uropathies, megaureter, vesico-ureteral reflux. (Pediatric Pharmacology. — 2011; 8 (5: 118–121.

  9. Routine needle biopsy during vertebral augmentation procedures. Is it necessary?

    OpenAIRE

    Pneumaticos, Spiros G; Sofia N. Chatziioannou; Savvidou, Christiana; Pilichou, Anastasia; Rontogianni, Dimitra; Korres, Dimitrios S

    2010-01-01

    Vertebral augmentation procedures are currently widely performed to treat vertebral compression fractures. The purpose of this study was to determine the frequency of underlying previously unrecognized etiology in a consecutive series of patients undergoing kyphoplasty to treat vertebral compression fractures. A prospective histological evaluation of vertebral body biopsy specimens from presumed osteoporotic vertebral compression fractures were performed in order to identify aforementioned ca...

  10. High-altitude adaptations in vertebrate hemoglobins

    DEFF Research Database (Denmark)

    Weber, Roy E.

    2007-01-01

    Vertebrates at high altitude are subjected to hypoxic conditions that challenge aerobic metabolism. O2 transport from the respiratory surfaces to tissues requires matching between the O2 loading and unloading tensions and theO2-affinity of blood, which is an integrated function of hemoglobin......, birds and ectothermic vertebrates at high altitude....

  11. The MHC molecules of nonmammalian vertebrates

    DEFF Research Database (Denmark)

    Kaufman, J; Skjoedt, K; Salomonsen, J

    1990-01-01

    to develop. There is no molecular evidence yet to decide whether vertebrate immune systems (and particularly the MHC molecules) are evolutionarily related to invertebrate allorecognition systems, and the functional evidence can be interpreted either way. Even among the vertebrates, there is great...

  12. [Spondylosis: diseases of the vertebral column].

    Science.gov (United States)

    Pérez, Amador Schüller

    2008-01-01

    Frequent and transcendent diseases for the difficulties of his diagnosis and treatment. The components of the vertebral column, vertebral bodies, discs and unvertebral joints, spondylosis ligaments must be considered to be a functional Unit. The Patology of each one of their parts concerns or reverberates in others.

  13. BK Channels in the Vertebrate Inner Ear

    NARCIS (Netherlands)

    Pyott, S. J.; Duncan, R. K.; Contet, C

    2016-01-01

    The perception of complex acoustic stimuli begins with the deconstruction of sound into its frequency components. This spectral processing occurs first and foremost in the inner ear. In vertebrates, two very different strategies of frequency analysis have evolved. In nonmammalian vertebrates, the

  14. Vertebral architecture in the earliest stem tetrapods.

    Science.gov (United States)

    Pierce, Stephanie E; Ahlberg, Per E; Hutchinson, John R; Molnar, Julia L; Sanchez, Sophie; Tafforeau, Paul; Clack, Jennifer A

    2013-02-14

    The construction of the vertebral column has been used as a key anatomical character in defining and diagnosing early tetrapod groups. Rhachitomous vertebrae--in which there is a dorsally placed neural arch and spine, an anteroventrally placed intercentrum and paired, posterodorsally placed pleurocentra--have long been considered the ancestral morphology for tetrapods. Nonetheless, very little is known about vertebral anatomy in the earliest stem tetrapods, because most specimens remain trapped in surrounding matrix, obscuring important anatomical features. Here we describe the three-dimensional vertebral architecture of the Late Devonian stem tetrapod Ichthyostega using propagation phase-contrast X-ray synchrotron microtomography. Our scans reveal a diverse array of new morphological, and associated developmental and functional, characteristics, including a possible posterior-to-anterior vertebral ossification sequence and the first evolutionary appearance of ossified sternal elements. One of the most intriguing features relates to the positional relationships between the vertebral elements, with the pleurocentra being unexpectedly sutured or fused to the intercentra that directly succeed them, indicating a 'reverse' rhachitomous design. Comparison of Ichthyostega with two other stem tetrapods, Acanthostega and Pederpes, shows that reverse rhachitomous vertebrae may be the ancestral condition for limbed vertebrates. This study fundamentally revises our current understanding of vertebral column evolution in the earliest tetrapods and raises questions about the presumed vertebral architecture of tetrapodomorph fish and later, more crownward, tetrapods.

  15. Multiple vertebral fluid-fluid levels

    Energy Technology Data Exchange (ETDEWEB)

    Bladt, O.; Demaerel, P.; Catry, F.; Breuseghem, I. Van [University Hospitals Gasthuisberg, Department of Radiology, Leuven (Belgium); Ballaux, F. [University Hospitals Gasthuisberg, Department of Pathology, Leuven (Belgium); Samson, I. [University Hospitals Gasthuisberg, Department of Orthopedic Surgery, Leuven (Belgium)

    2004-11-01

    We present a case of multiple vertebral metastases, with multiple fluid-fluid levels, from a moderately to poorly differentiated carcinoma of unknown origin. We suggest that fluid-fluid levels in multiple vertebral lesions are highly suggestive of bone metastases. (orig.)

  16. Lamprey: a model for vertebrate evolutionary research

    Science.gov (United States)

    XU, Yang; ZHU, Si-Wei; LI, Qing-Wei

    2016-01-01

    Lampreys belong to the superclass Cyclostomata and represent the most ancient group of vertebrates. Existing for over 360 million years, they are known as living fossils due to their many evolutionally conserved features. They are not only a keystone species for studying the origin and evolution of vertebrates, but also one of the best models for researching vertebrate embryonic development and organ differentiation. From the perspective of genetic information, the lamprey genome remains primitive compared with that of other higher vertebrates, and possesses abundant functional genes. Through scientific and technological progress, scientists have conducted in-depth studies on the nervous, endocrine, and immune systems of lampreys. Such research has significance for understanding and revealing the origin and evolution of vertebrates, and could contribute to a greater understanding of human diseases and treatments. This review presents the current progress and significance of lamprey research. PMID:27686784

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

    Directory of Open Access Journals (Sweden)

    Kent Newsom

    2014-01-01

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

  18. Intraoperative Management of an Incidentally Identified Ectopic Ureter Inserting Into the Prostate of a Patient Undergoing Radical Prostatectomy for Prostate Cancer

    Science.gov (United States)

    Singhal, Udit; Dauw, Casey A.; Li, Amy Y.; Miller, David C.; Wolf, J. Stuart; Morgan, Todd M.

    2015-01-01

    Abstract Congenital variations in urinary tract anatomy present unique surgical challenges when they present without prior knowledge. Ectopic ureters occur as a rare anatomic variation of the urinary tract and are often associated with duplicated renal collecting systems. While the condition is uncommon, even more atypical is its discovery and subsequent diagnosis during surgical intervention for treatment of localized prostate cancer. We describe the intraoperative management of a unique case of bilateral ectopic ureters, with a right-sided ureter inserting into the prostate of a 54-year-old male undergoing robotic-assisted radical prostatectomy. While unknown at the time of surgery, this right-sided ureter was associated with a nonfunctioning right upper renal moiety of a duplex renal collecting system. This aberration was discovered intraoperatively and confirmed with imaging, and a robotic-assisted radical prostatectomy with right distal ureterectomy was performed. PMID:26266359

  19. Tumor-like Accumulation of Uromodulin (Tamm-Horsfall Glycoprotein) in the Ureter. A Case Report of a Possible Diagnostic Pitfall.

    Science.gov (United States)

    Ivančič, Andreja Klevišas; Volavšek, Metka

    2015-10-01

    Uromodulin, also known as Tamm-Horsfall glycoprotein (THG), is the most abundantly produced protein appearing in normal urine. Under normal conditions it has several functions, the most important being the provision of a water-tight boundary to the end path of filtration and the prevention of urinary tract infections. Under certain conditions THG is accumulated in urinary tract organs and the deposition is most often clinically silent. We report a case of 78-year-old man with clinically evident hydronephrosis and stenosis of the right ureter. Clinically, a neoplasm was suspected. Histological examination of ureter tissue revealed abundant deposits of THG in the ureter wall without any inflammatory reaction. In cases with deposition of eosinophilic material in the urinary tract organs, accumulation of THG should be considered in the differential diagnosis. To our knowledge this is the first report of tumor-like accumulation of THG in the ureter.

  20. Primary Small Cell Carcinoma of the Upper Urinary Tract

    Directory of Open Access Journals (Sweden)

    Victor Ka-Siong Kho

    2010-03-01

    Full Text Available We report a case of primary extrapulmonary small cell carcinoma of the distal ureter, with a synchronous small cell carcinoma of the ipsilateral renal pelvis. These tumors, rarely reported in the urinary tract, are locally aggressive and have a poor prognosis. A 77-year-old male bedridden patient presented with fever and chills with left side-flank pain for 3 days. Following a diagnosis of ureteral urothelial carcinoma, hand-assisted laparoscopic nephroureterectomy with bladder cuff excision was carried out. Adjuvant chemotherapy was given after pathologic report of primary small cell carcinoma of the distal ureter and a synchronous small cell carcinoma of the ipsilateral renal pelvis. After 3 cycles of combination chemotherapy, the patient died 4 months postoperatively due to sepsis.

  1. The effect of extracorporeal shock wave lithotripsy on distribution of interstitial cells of Cajal in rabbit renal pelvis and proximal ureter.

    Science.gov (United States)

    Boybeyi, Özlem; Fedakar Şenyücel, Mine; Ayva, Ebru Şebnem; Soyer, Tutku; Aslan, Mustafa Kemal; Başar, Mehmet Murad; Çakmak, Ahmet Murat

    2015-01-01

    An experimental study was performed to evaluate the effect of extracorporeal shock wave lithotripsy (ESWL) on the distribution of interstitial cells of Cajal (ICC) in rabbit renal pelvis and proximal ureter. Six New Zealand rabbits were included. Right kidneys were exposed to a total of 3000 shock waves (14 kV) by using an electrohydraulic-type ESWL device. Right sides were allocated as the ESWL group (EG, n = 6) and left sides as the control group (CG, n = 6). Tissues were harvested on day 7. Tissues were examined histopathologically for the presence of edema, inflammation, congestion, hemorrhage, fibrosis, and vascularization. Mast cell tryptase and CD 117 (c-kit) staining was performed for ICC distribution. Although increased tissue edema in renal pelvises and increased inflammation in ureters were observed in EG, no statistical difference was detected between groups (P > 0.05). In CG, positive CD117 staining was detected in 2 renal pelvises and ureters. None of the EG samples showed CD117 staining and no statistical difference was detected between groups (P > 0.05). Rabbit does not appear to be a good model for investigating ICCs. ESWL may cause histopathological alterations in the renal pelvis and ureter. Since it has not been statistically proven, reduced contractility of the ureter after ESWL may not be attributed to altered distribution of ICCs in the renal pelvis and ureter.

  2. Surgical treatment of the stricture of the lower third of ureter after radiation therapy of pelvic organs

    Directory of Open Access Journals (Sweden)

    N. V. Polyakov

    2016-01-01

    Full Text Available Postradiation obstructive changes of distal parts of the ureter most commonly occur after radiation therapy for cervical cancer, endometrial cancer, bladder cancer. Pathogenesis of postradiation lesions of the ureteral wall are explained by destructive effects of radiation on the basal membranes of the capillary cell, causing an occlusion, thrombosis, and neovascularization, which in turn leads to proliferation of fibroblasts and stromal fibrosis. Possible complications include hematuria, urinary tract infections, vesicoureteral reflux, stent migration, stent encrustation. By the way, presence of the stent is often associated with pain and discomfort in patients. Aim of this work is to improve the results of treatment of strictures of the lower ureter following radiotherapy, by evaluating effectiveness of extravesical uretherocystoanastomosis and Boari procedure. 

  3. Value of kidney-ureter-bladder radiography in the erect position in addition to standard intravenous urography examination.

    Science.gov (United States)

    Saeed, R; Al-Saeed, O; Athyal, R; Yadav, C

    2010-01-01

    To determine if additional kidney-ureter-bladder radiography in the erect position can improve the diagnostic yield of standard intravenous urography (IVU) examination. This prospective study was conducted from March to July 2007 on 108 consecutive patients (65 males and 43 females, age ranging from 20 to 50 years) who were referred to the Department of Radiology, Al-Amiri Hospital, Kuwait, for IVU examinations. After 15 min, a film was done in the erect position in addition to the routine IVU protocol. Additional information was demonstrated in the erect radiograph as follows: detecting nephroptosis in 18 (17%) patients, improved visualization of the ureters in 58 (54%) patients, and differentiation between phleboliths and ureteric stone was possible in 12 (11%) patients. Our study demonstrated significant additional findings in the erect position (at 15 min) compared to the supine position. Copyright 2009 S. Karger AG, Basel.

  4. Robotic partial nephrectomy for duplex kidney with ectopic ureter draining in the vagina in an adult patient with urinary incontinence.

    Science.gov (United States)

    Mahmood, Humza; Hadjipavlou, Marios; Das, Raj; Anderson, Chris

    2017-02-06

    A duplex kidney system with an ectopic ureter draining into the vagina is a congenital malformation that typically presents as refractory urinary incontinence. Diagnosis is often difficult to establish and delayed due to a low incidence. We present the case of a patient aged 26 years with a life-long history of persistent urinary incontinence. Initial presentation was at childhood; however, the diagnosis went undetermined for 22 years. CT urography revealed a duplex kidney with an atrophic upper pole associated with an ectopic ureter that drained into the vaginal vault. This is the first description of such a case being managed successfully via a robot-assisted partial nephrectomy approach. Ectopic ureteral duplication should be considered in the differential diagnosis for young women with refractory urinary incontinence. Robotic partial nephrectomy is a safe and effective technique to manage such cases. 2017 BMJ Publishing Group Ltd.

  5. Organizational heterogeneity of vertebrate genomes.

    Directory of Open Access Journals (Sweden)

    Svetlana Frenkel

    Full Text Available Genomes of higher eukaryotes are mosaics of segments with various structural, functional, and evolutionary properties. The availability of whole-genome sequences allows the investigation of their structure as "texts" using different statistical and computational methods. One such method, referred to as Compositional Spectra (CS analysis, is based on scoring the occurrences of fixed-length oligonucleotides (k-mers in the target DNA sequence. CS analysis allows generating species- or region-specific characteristics of the genome, regardless of their length and the presence of coding DNA. In this study, we consider the heterogeneity of vertebrate genomes as a joint effect of regional variation in sequence organization superimposed on the differences in nucleotide composition. We estimated compositional and organizational heterogeneity of genome and chromosome sequences separately and found that both heterogeneity types vary widely among genomes as well as among chromosomes in all investigated taxonomic groups. The high correspondence of heterogeneity scores obtained on three genome fractions, coding, repetitive, and the remaining part of the noncoding DNA (the genome dark matter--GDM allows the assumption that CS-heterogeneity may have functional relevance to genome regulation. Of special interest for such interpretation is the fact that natural GDM sequences display the highest deviation from the corresponding reshuffled sequences.

  6. Melatonin Receptor Genes in Vertebrates

    Directory of Open Access Journals (Sweden)

    Hua Dong Yin

    2013-05-01

    Full Text Available Melatonin receptors are members of the G protein-coupled receptor (GPCR family. Three genes for melatonin receptors have been cloned. The MT1 (or Mel1a or MTNR1A and MT2 (or Mel1b or MTNR1B receptor subtypes are present in humans and other mammals, while an additional melatonin receptor subtype, Mel1c (or MTNR1C, has been identified in fish, amphibians and birds. Another melatonin related orphan receptor, GPR50, which does not bind melatonin, is found exclusively in mammals. The hormone melatonin is secreted primarily by the pineal gland, with highest levels occurring during the dark period of a circadian cycle. This hormone acts systemically in numerous organs. In the brain, it is involved in the regulation of various neural and endocrine processes, and it readjusts the circadian pacemaker, the suprachiasmatic nucleus. This article reviews recent studies of gene organization, expression, evolution and mutations of melatonin receptor genes of vertebrates. Gene polymorphisms reveal that numerous mutations are associated with diseases and disorders. The phylogenetic analysis of receptor genes indicates that GPR50 is an outgroup to all other melatonin receptor sequences. GPR50 may have separated from a melatonin receptor ancestor before the split between MTNR1C and the MTNR1A/B ancestor.

  7. Molecular Synapomorphies Resolve Evolutionary Relationships of Extant Jawed Vertebrates

    National Research Council Canada - National Science Library

    Byrappa Venkatesh; Mark V. Erdmann; Sydney Brenner

    2001-01-01

    .... We identified 13 derived shared molecular markers (synapomorphies) that define clades in the vertebrate lineage and used them to resolve the phylogenetic relationships of extant jawed vertebrates...

  8. Prise en charge de l'uretère rétrocave au Togo: A propos de 3 ...

    African Journals Online (AJOL)

    K. Tengue

    L'uretère rétrocave est une malformation congénitale dont le dia- gnostic repose sur l'uro-scanner. Bien que le traitement chirurgical ouvert classique ait des résultats satisfaisants, la chirurgie laparo- scopique offre de nombreux avantages dont une approche moins invasive et de bons résultats fonctionnels. Conflits D' ...

  9. Intraoperative near infrared fluorescence guided identification of the ureters using low dose methylene blue: a first in human experience.

    Science.gov (United States)

    Verbeek, Floris P R; van der Vorst, Joost R; Schaafsma, Boudewijn E; Swijnenburg, Rutger-Jan; Gaarenstroom, Katja N; Elzevier, Henk W; van de Velde, Cornelis J H; Frangioni, John V; Vahrmeijer, Alexander L

    2013-08-01

    Near infrared fluorescence imaging is a promising technique that offers real-time visual information during surgery. In this study we report the first clinical results to our knowledge of ureteral imaging using near infrared fluorescence after a simple peripheral infusion of methylene blue. Furthermore, we assessed the optimal timing and dose of methylene blue. A total of 12 patients who underwent lower abdominal surgery were included in this prospective feasibility study. Near infrared fluorescence imaging was performed using the Mini-FLARE™ imaging system. To determine optimal timing and dose, methylene blue was injected intravenously at doses of 0.25, 0.5 or 1 mg/kg after exposure of the ureters. Imaging was performed for up to 60 minutes after injection. In all patients both ureters could be clearly visualized within 10 minutes after infusion of methylene blue. The signal lasted at least up to 60 minutes after injection. The mean signal-to-background ratio of the ureter was 2.27 ± 1.22 (4), 2.61 ± 1.88 (4) and 3.58 ± 3.36 (4) for the 0.25, 0.5 and 1 mg/kg groups, respectively. A mixed model analysis was used to compare signal-to-background ratios among dose groups and times, and to assess the relationship between dose and time. A significant difference among time points (p methylene blue for the identification of the ureters during lower abdominal surgery. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  10. Pulmonary Embolism with Vertebral Augmentation Procedures

    Directory of Open Access Journals (Sweden)

    Swetha Bopparaju

    2013-01-01

    Full Text Available With the prevalence of an aging American population on the rise, osteoporotic vertebral fractures are becoming a common occurrence, resulting in an increase in vertebral augmentation procedures and associated complications such as cement leakage, vertebral compressions, and pulmonary embolism. We describe a patient who presented with respiratory distress three years following kyphoplasty of the lumbar vertebra. Computed tomography (CT angiogram of the chest confirmed the presence of polymethylmethacrylate (PMMA cement in the lung fields and pulmonary vessels. We conducted a systematic review of the published literature identifying effective management strategies for the treatment of vertebroplasty-associated pulmonary embolism.

  11. Epidemiology of acute vertebral osteomyelitis in Denmark

    DEFF Research Database (Denmark)

    Krogsgaard, M R; Wagn, P; Bengtsson, J

    1998-01-01

    We studied the epidemiology of acute, non-tuberculous, hematogenous vertebral osteomyelitis in Denmark during 1978-1982. 137 patients fulfilled the criteria for acute vertebral osteomyelitis. The incidence was 5/mill/year. There were no cases in the age group 20-29 years. The highest incidence......-1993, the relative number of reported patients with vertebral osteomyelitis had increased in the age group 20-49 years, compared to 1978-1982, but the incidence was highest in the group aged 60-79 years....

  12. The vertebral biomechanic previous and after kyphoplasty.

    Science.gov (United States)

    Pesce, V; Piazzolla, Andrea; Moretti, L; Carlucci, S; Parato, C; Maxy, P; Moretti, B

    2013-10-01

    The biomechanical understanding of increasing anterior column load with progressing kyphosis leading to subsequent vertebral compression fracture (VCF) established the basic rationale for kyphoplasty. The lumbar spine can support an effort of 500 kg in the axis of the vertebral body, and a bending moment of 20 Nm in flexion. Consequently, if this effort is forward deviated of only 10 cm, the acceptable effort will be reduced to 20 kg so it is important to restore the vertebral anterior wall after a VCF: the authors describe the biomechanical modifications in the spine after kyphoplasty.

  13. Catheter-based intraluminal optical coherence tomography (OCT) of the ureter: ex-vivo correlation with histology in porcine specimens

    Energy Technology Data Exchange (ETDEWEB)

    Mueller-Lisse, Ulrike L.; Stief, Christian G. [University of Munich, Department of Urology, Munich (Germany); Meissner, Oliver A.; Bauer, Margit; Eibel, Roger; Reiser, Maximilian F.; Mueller-Lisse, Ullrich G. [University of Munich, Department of Radiology, Munich (Germany); Babaryka, Gregor [University of Munich, Department Pathology, Munich (Germany)

    2006-10-15

    Intraluminal optical coherence tomography (OCT) applies coherent light to provide cross-sectional images with a spatial resolution of 10-25 {mu}m. We compared OCT and matching whole-mount histology microscopy sections of porcine upper ureters ex vivo for visualization and delineation of different tissue layers of the ureteral wall. Porcine ureters (six specimens, 24 quadrants) were flushed with normal saline solution prior to insertion of the OCT catheter (diameter, 0.014 inch, OCT wavelength, 1,300{+-}20 nm). Cross-sectional OCT images were obtained in marked locations before specimens were fixed in 4% formalin, cut at marked locations, whole-mounted, and stained with hematoxilin and eosin. Visualization and delineation of different tissue layers of the ureteral wall by OCT was compared with matching histology by two independent observers (O1,O2). OCT distinguished tissue layers of the ureteral wall in all quadrants. In OCT images, O1/O2 delineated urothelium and lamina propria in 23/24 quadrants, lamina propria and muscle layer in 19/16 quadrants, inner and outer muscle layer in 13/0 quadrants, and urothelial cell layers in 13/2 quadrants, respectively. Intraluminal OCT provides histology-like images of the ureter in porcine specimens ex vivo and reliably distinguishes between urothelium and deeper tissue layers of the ureteral wall. (orig.)

  14. Tour of a labyrinth: exploring the vertebrate nose.

    Science.gov (United States)

    Van Valkenburgh, Blaire; Smith, Timothy D; Craven, Brent A

    2014-11-01

    This special issue of The Anatomical Record is the outcome of a symposium entitled "Inside the Vertebrate Nose: Evolution, Structure and Function." The skeletal framework of the nasal cavity is a complicated structure that often houses sinuses and comprises an internal skeleton of bone or cartilage that can vary greatly in architecture among species. The nose serves multiple functions, including olfaction and respiratory air-conditioning, and its morphology is constrained by evolution, development, and conflicting demands on cranial space, such as enlarged orbits. The nasal cavity of vertebrates has received much more attention in the last decade due to the emergence of nondestructive methods that allow improved visualization of the internal anatomy of the skull, such as high-resolution x-ray computed tomography and magnetic resonance imaging. The 17 articles included here represent a broad range of investigators, from paleontologists to engineers, who approach the nose from different perspectives. Key topics include the evolution and development of the nose, its comparative anatomy and function, and airflow through the nasal cavity of individual species. In addition, this special issue includes review articles on anatomical reduction of the olfactory apparatus in both cetaceans and primates (the vomeronasal system), as well as the molecular biology of olfaction in vertebrates. Together these articles provide an expansive summary of our current understanding of vertebrate nasal anatomy and function. In this introduction, we provide background information and an overview of each of the three primary topics, and place each article within the context of previous research and the major challenges that lie ahead. © 2014 Wiley Periodicals, Inc.

  15. Characterization of the 5-hydroxytryptamine receptors mediating contraction in the pig isolated intravesical ureter

    Science.gov (United States)

    Hernández, Medardo; Barahona, María Victoria; Simonsen, Ulf; Recio, Paz; Rivera, Luis; Martínez, Ana Cristina; García-Sacristán, Albino; Orensanz, Luis M; Prieto, Dolores

    2003-01-01

    This study was designed to investigate the effect of 5-hydroxytryptamine (5-HT) and to characterize the 5-HT receptors involved in 5-HT responses in the pig intravesical ureter. 5-HT (0.01–10 μM) concentration-dependently increased the tone of intravesical ureteral strips, whereas the increases in phasic contractions were concentration-independent. The 5-HT2 receptor agonist α-methyl 5-HT, mimicked the effect on tone whereas weak or no response was obtained with 5-CT, 8-OH-DPAT, m-chlorophenylbiguanide and RS 67333, 5-HT1, 5-HT1A, 5-HT3 and 5-HT4 receptor agonists, respectively. 5-HT did not induce relaxation of U46619-contracted ureteral preparations. Pargyline (100 μM), a monoaminooxidase A/B activity inhibitor, produced leftward displacements of the concentration-response curves for 5-HT. 5-HT-induced tone was reduced by the 5-HT2 and 5-HT2A receptor antagonists ritanserine (0.1 μM) and spiperone (0.2 μM), respectively. However, 5-HT contraction was not antagonized by cyanopindolol (2 μM), SDZ–SER 082 (1 μM), Y-25130 (1 μM) and GR 113808 (0.1 μM), which are respectively, 5-HT1A/1B, 5-HT2B/2C, 5-HT3, and 5-HT4 selective receptor antagonists. Removal of the urothelium did not modify 5-HT-induced contractions. Blockade of neuronal voltage-activated sodium channels, α-adrenergic receptors and adrenergic neurotransmission with tetrodotoxin (1 μM), phentolamine (0.3 μM) and guanethidine (10 μM), respectively, reduced the contractions to 5-HT. However, physostigmine (1 μM), atropine (0.1 μM) and suramin (30 μM), inhibitors of cholinesterase activity, muscarinic- and purinergic P2-receptors, respectively, failed to modify the contractions to 5-HT. These results suggest that 5-HT increases the tone of the pig intravesical ureter through 5-HT2A receptors located at the smooth muscle. Part of the 5-HT contraction is indirectly mediated via noradrenaline release from sympathetic nerves. PMID:12522083

  16. Delayed vertebral diagnosed L4 pincer vertebral fracture, L2-L3 ruptured vertebral lumbar disc hernia, L5 vertebral wedge fracture - Case report

    Directory of Open Access Journals (Sweden)

    Balasa D

    2016-08-01

    Full Text Available An association between delayed ruptured lumbar disc hernia, L5 vertebral wedge fracture and posttraumaticL4 pincer vertebral fracture (A2.3-AO clasification at different levels is a very rare entity. We present the case of a 55 years old male who falled down from a bicycle. 2 months later because of intense and permanent vertebral lumbar and radicular L2 and L3 pain (Visual Scal Autologus of Pain7-8/10 the patient came to the hospital. He was diagnosed with pincer vertebral L4 fracture (A2.3-AO clasification and L2-L3 right ruptured lumbar disc hernia in lateral reces. The patient was operated (L2-L3 right fenestration, and resection of lumbar disc hernia, bilateral stabilisation, L3-L4-L5 with titan screws and postero-lateral bone graft L4 bilateral harvested from iliac crest.

  17. Vertebral Fractures After Discontinuation of Denosumab

    DEFF Research Database (Denmark)

    Cummings, Steven R; Ferrari, Serge; Eastell, Richard

    2018-01-01

    Denosumab reduces bone resorption and vertebral and nonvertebral fracture risk. Denosumab discontinuation increases bone turnover markers 3 months after a scheduled dose is omitted, reaching above-baseline levels by 6 months, and decreases bone mineral density (BMD) to baseline levels by 12 months....... We analyzed the risk of new or worsening vertebral fractures, especially multiple vertebral fractures, in participants who discontinued denosumab during the FREEDOM study or its Extension. Participants received ≥2 doses of denosumab or placebo Q6M, discontinued treatment, and stayed in the study ≥7...... months after the last dose. Of 1001 participants who discontinued denosumab during FREEDOM or Extension, the vertebral fracture rate increased from 1.2 per 100 participant-years during the on-treatment period to 7.1, similar to participants who received and then discontinued placebo (n = 470; 8.5 per 100...

  18. Interconnections between the Ears in Nonmammalian Vertebrates

    DEFF Research Database (Denmark)

    Feng, Albert S.; Christensen-Dalsgaard, J.

    2010-01-01

    Many of the nonmammalian vertebrates (anurans, lizards, crocodiles, and some bird species) have large, continuous air spaces connecting the middle ears and acoustically coupling the eardrums. Acoustical coupling leads to strongly enhanced directionality of the ear at frequencies where diffraction...

  19. Innate immunity in vertebrates: an overview.

    Science.gov (United States)

    Riera Romo, Mario; Pérez-Martínez, Dayana; Castillo Ferrer, Camila

    2016-06-01

    Innate immunity is a semi-specific and widely distributed form of immunity, which represents the first line of defence against pathogens. This type of immunity is critical to maintain homeostasis and prevent microbe invasion, eliminating a great variety of pathogens and contributing with the activation of the adaptive immune response. The components of innate immunity include physical and chemical barriers, humoral and cell-mediated components, which are present in all jawed vertebrates. The understanding of innate defence mechanisms in non-mammalian vertebrates is the key to comprehend the general picture of vertebrate innate immunity and its evolutionary history. This is also essential for the identification of new molecules with applications in immunopharmacology and immunotherapy. In this review, we describe and discuss the main elements of vertebrate innate immunity, presenting core findings in this field and identifying areas that need further investigation. © 2016 John Wiley & Sons Ltd.

  20. Recombination drives vertebrate genome contraction.

    Science.gov (United States)

    Nam, Kiwoong; Ellegren, Hans

    2012-01-01

    Selective and/or neutral processes may govern variation in DNA content and, ultimately, genome size. The observation in several organisms of a negative correlation between recombination rate and intron size could be compatible with a neutral model in which recombination is mutagenic for length changes. We used whole-genome data on small insertions and deletions within transposable elements from chicken and zebra finch to demonstrate clear links between recombination rate and a number of attributes of reduced DNA content. Recombination rate was negatively correlated with the length of introns, transposable elements, and intergenic spacer and with the rate of short insertions. Importantly, it was positively correlated with gene density, the rate of short deletions, the deletion bias, and the net change in sequence length. All these observations point at a pattern of more condensed genome structure in regions of high recombination. Based on the observed rates of small insertions and deletions and assuming that these rates are representative for the whole genome, we estimate that the genome of the most recent common ancestor of birds and lizards has lost nearly 20% of its DNA content up until the present. Expansion of transposable elements can counteract the effect of deletions in an equilibrium mutation model; however, since the activity of transposable elements has been low in the avian lineage, the deletion bias is likely to have had a significant effect on genome size evolution in dinosaurs and birds, contributing to the maintenance of a small genome. We also demonstrate that most of the observed correlations between recombination rate and genome contraction parameters are seen in the human genome, including for segregating indel polymorphisms. Our data are compatible with a neutral model in which recombination drives vertebrate genome size evolution and gives no direct support for a role of natural selection in this process.

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

    Science.gov (United States)

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

    2009-04-01

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

  2. In quest of Great Lakes ice age vertebrates

    National Research Council Canada - National Science Library

    Holman, J. Alan

    2001-01-01

    ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 The Pleistocene in the Great Lakes Region . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Where to Find Vertebrate Fossils...

  3. Evolution of circadian organization in vertebrates

    Directory of Open Access Journals (Sweden)

    M. Menaker

    1997-03-01

    Full Text Available Circadian organization means the way in which the entire circadian system above the cellular level is put together physically and the principles and rules that determine the interactions among its component parts which produce overt rhythms of physiology and behavior. Understanding this organization and its evolution is of practical importance as well as of basic interest. The first major problem that we face is the difficulty of making sense of the apparently great diversity that we observe in circadian organization of diverse vertebrates. Some of this diversity falls neatly into place along phylogenetic lines leading to firm generalizations: i in all vertebrates there is a "circadian axis" consisting of the retinas, the pineal gland and the suprachiasmatic nucleus (SCN, ii in many non-mammalian vertebrates of all classes (but not in any mammals the pineal gland is both a photoreceptor and a circadian oscillator, and iii in all non-mammalian vertebrates (but not in any mammals there are extraretinal (and extrapineal circadian photoreceptors. An interesting explanation of some of these facts, especially the differences between mammals and other vertebrates, can be constructed on the assumption that early in their evolution mammals passed through a "nocturnal bottleneck". On the other hand, a good deal of the diversity among the circadian systems of vertebrates does not fall neatly into place along phylogenetic lines. In the present review we will consider how we might better understand such "phylogenetically incoherent" diversity and what sorts of new information may help to further our understanding of the evolution of circadian organization in vertebrates

  4. Red flags to screen for vertebral fracture in patients presenting with low-back pain

    NARCIS (Netherlands)

    Williams, Christopher M.; Henschke, Nicholas; Maher, Christopher G.; van Tulder, Maurits W; Koes, Bart W; Macaskill, Petra; Irwig, Les; Henschke, N.

    2013-01-01

    BACKGROUND: Low-back pain (LBP) is a common condition seen in primary care. A principal aim during a clinical examination is to identify patients with a higher likelihood of underlying serious pathology, such as vertebral fracture, who may require additional investigation and specific treatment. All

  5. Potential underdiagnosis of osteoporosis in repeated vertebral augmentation for new vertebral compression fractures

    Directory of Open Access Journals (Sweden)

    İlhan B

    2015-09-01

    Full Text Available Birkan İlhan, Fatih Tufan, Gülistan Bahat, Mehmet Akif KaranDivision of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Istanbul, TurkeyWe read with great interest the article by Liang et al “Repeated vertebral augmentation for new vertebral compression fractures of postvertebral augmentation patients: a nationwide cohort study”.1\tIn their study, the authors investigated the factors possibly associated with new vertebral compression fractures in patients who previously had vertebral augmentation procedures. They reported that osteoporosis (OP was not observed as a risk factor for repeat vertebral augmentation. Among multiple chronic diseases, hypertension (HT was reported as one factor associated with new vertebral fractures. Among the medications used to treat or prevent OP, they reported calcium/vitamin D, bisphosphonates, and calcitonin were associated with not having repeat vertebral augmentation. However, steroids, paracetamol, and nonsteroidal anti-inflammatory drugs were associated with having repeat vertebral augmentation. We would like to comment on their article.View original paper by Kurimato and colleagues.

  6. Evaluation of the distribution of Paclitaxel by immunohistochemistry and nuclear magnetic resonance spectroscopy after the application of a drug-eluting balloon in the porcine ureter.

    Science.gov (United States)

    Liourdi, Despoina; Kallidonis, Panagiotis; Kyriazis, Iason; Tsamandas, Athanasios; Karnabatidis, Dimitrios; Kitrou, Panagiotis; Spyroulias, Georgios A; Kostopoulou, Ourania N; Marousis, Kostas; Kalpaxis, Dimitrios L; Goumenos, Dimitrios S; Liatsikos, Evangelos

    2015-05-01

    The urothelium represents "the tightest and most impermeable barrier in the body." We investigated the distribution of paclitaxel (PTX) in the ureteral wall after the inflation of a paclitaxel-eluting balloon (PEB) in an attempt to elucidate the possibility of clinical application of PEBs in the ureter. Nine domestic pigs were used. Nine PEBs and nine conventional percutaneous angioplasty balloons (CB) were inflated in the right and left ureter of each animal, respectively. The ureter treated by CB was the control for the contralateral ureter. Specimens were removed: Immediately after inflation (group A), after 12 hours (group B), and after 24 hours (group C). Two samples were obtained from each ureter of groups A, B and C. One sample was investigated by nuclear magnetic resonance spectroscopy (NMR), the other by histology and immunohistochemistry (IHC) using a specific for PTX polyclonal antibody. Reduced inflammation was observed in the group B and C samples in comparison with their controls. PTX was distributed mostly in the urothelium and submucosal layer in group A (IHC). The agent was present in the urothelial, submucosal, and muscle layer in groups B and C. The concentration of PTX (NMR) has been reduced in group C compared with the tissue extracts of group B. The distribution of PTX includes the urothelial, submucosal, and smooth muscle layers. Inflammation was reduced in the case of drug-eluting balloons.

  7. Symptomatic vertebral hemangioma: Treatment with radiotherapy

    Directory of Open Access Journals (Sweden)

    Aich Ranen

    2010-01-01

    Full Text Available Background: Vertebrae are the second commonest site among skeletal locations affected by hemangioma, but only about one per cent becomes symptomatic throughout the life. Though surgery, intra vertebral injection of various sclerosing agents have been tried in treating this benign process, no general consensus regarding management has been reached. Radiotherapy is emerging as a low cost, simple, non-invasive but very effective modality of treatment of symptomatic vertebral hemangioma. Aim: This study aims to find out the role of external beam radiotherapy in alleviating the symptoms of symptomatic vertebral hemangiomas without compromising the quality of life. Materials and Methods: Seven consecutive patients with symptomatic vertebral hemangioma were treated with a fixed dose of external beam radiotherapy; and muscle power was assessed before, after treatment and during follow-up. Results: All patients showed improvement of muscle power, which increased with the passage of time. Pain relief with improvement of quality of life was obtained in all the patients. Conclusion: Effect of radiotherapy on vertebral hemangioma is dose-dependent and the dose limiting factor is the spinal cord tolerance. In the present era of IMRT, greater dose can be delivered to the parts of vertebra affected by the hemangioma without compromising the spinal cord tolerance and expected to give better results.

  8. Bone creep can cause progressive vertebral deformity.

    Science.gov (United States)

    Pollintine, Phillip; Luo, Jin; Offa-Jones, Ben; Dolan, Patricia; Adams, Michael A

    2009-09-01

    Vertebral deformities in elderly people are conventionally termed "fractures", but their onset is often insidious, suggesting that time-dependent (creep) processes may also be involved. Creep has been studied in small samples of bone, but nothing is known about creep deformity of whole vertebrae, or how it might be influenced by bone mineral density (BMD). We hypothesise that sustained compressive loading can cause progressive and measurable creep deformity in elderly human vertebrae. 27 thoracolumbar "motion segments" (two vertebrae and the intervening disc and ligaments) were dissected from 20 human cadavers aged 42-91 yrs. A constant compressive force of approximately 1.0 kN was applied to each specimen for either 0.5 h or 2 h, while the anterior, middle and posterior heights of each of the 54 vertebral bodies were measured at 1 Hz using a MacReflex 2D optical tracking system. This located 6 reflective markers attached to the lateral cortex of each vertebral body, with resolution better than 10 microm. Experiments were at laboratory temperature, and polythene film was used to minimise water loss. Volumetric BMD was calculated for each vertebral body, using DXA to measure mineral content, and water immersion for volume. In the 0.5 h tests, creep deformation in the anterior, middle and posterior vertebral cortex averaged 4331, 1629 and 614 micro-strains respectively, where 10,000 micro-strains represents 1% loss in height. Anterior creep strains exceeded posterior (Pspecimens with average BMDfracture.

  9. Vertebral Column Resection for Rigid Spinal Deformity.

    Science.gov (United States)

    Saifi, Comron; Laratta, Joseph L; Petridis, Petros; Shillingford, Jamal N; Lehman, Ronald A; Lenke, Lawrence G

    2017-05-01

    Broad narrative review. To review the evolution, operative technique, outcomes, and complications associated with posterior vertebral column resection. A literature review of posterior vertebral column resection was performed. The authors' surgical technique is outlined in detail. The authors' experience and the literature regarding vertebral column resection are discussed at length. Treatment of severe, rigid coronal and/or sagittal malalignment with posterior vertebral column resection results in approximately 50-70% correction depending on the type of deformity. Surgical site infection rates range from 2.9% to 9.7%. Transient and permanent neurologic injury rates range from 0% to 13.8% and 0% to 6.3%, respectively. Although there are significant variations in EBL throughout the literature, it can be minimized by utilizing tranexamic acid intraoperatively. The ability to correct a rigid deformity in the spine relies on osteotomies. Each osteotomy is associated with a particular magnitude of correction at a single level. Posterior vertebral column resection is the most powerful posterior osteotomy method providing a successful correction of fixed complex deformities. Despite meticulous surgical technique and precision, this robust osteotomy technique can be associated with significant morbidity even in the most experienced hands.

  10. Diagnostic accuracy of neonatal kidney ultrasound in children having antenatal hydronephrosis without ureter and bladder abnormalities.

    Science.gov (United States)

    Rianthavorn, Pornpimol; Limwattana, Sorawan

    2015-10-01

    To determine the diagnostic accuracy of anteroposterior renal pelvic diameter (APD) measurement and the society for fetal urology (SFU) grading in neonatal ultrasonography (USG) for detecting uropathy in newborns having antenatal isolated hydronephrosis (IH), characterized by hydronephrosis without ureter and bladder abnormalities, and to study time to resolution and factors predicting resolution of insignificant hydronephrosis. Ninety-six healthy newborns (129 kidneys) with IH, who underwent USG at age 7-30 days and voiding cystourethrography (VCUG) in conjunction with diuretic renography (DR) if APD > 10 mm or SFU grade 3-4 in neonatal USG, and at least a 12-month follow-up were divided into significant and insignificant hydronephrosis using the combined data of sequential USG, VCUG, and DR as the reference standard. Areas under the receiver operating characteristic plots (95 % CI) were 0.86 (0.79-0.94) versus 0.81 (0.73-0.89); p = 0.08, and 87.6 versus 79.8 % of cases were correctly classified, for APD ≥ 16 mm versus SFU grade 4, respectively. Ureteropelvic junction obstruction (UPJO) was the most common uropathy diagnosed. Of 85 kidneys with insignificant hydronephrosis, 57 underwent spontaneous resolution. The resolution rates were 24, 40, and 68 % at age 6, 12, and 24 months, respectively. APD was the only independent factor predicting resolution with the hazard ratio of 0.83 (95 % CI 0.74-0.92; p = 0.001). In IH, neonatal USG was a useful diagnostic tool to detect uropathy, mainly UPJO. Further investigation should be recommended when APD ≥ 16 mm or SFU grade 4.

  11. Overexpression of Heme Oxygenase-1 Prevents Renal Interstitial Inflammation and Fibrosis Induced by Unilateral Ureter Obstruction.

    Directory of Open Access Journals (Sweden)

    Xiao Chen

    Full Text Available Renal fibrosis plays an important role in the onset and progression of chronic kidney diseases. Many studies have demonstrated that heme oxygenase-1 (HO-1 is involved in diverse biological processes as a cytoprotective molecule, including anti-inflammatory, anti-oxidant, anti-apoptotic, antiproliferative, and immunomodulatory effects. However, the mechanisms of HO-1 prevention in renal interstitial fibrosis remain unknown. In this study, HO-1 transgenic (TG mice were employed to investigate the effect of HO-1 on renal fibrosis using a unilateral ureter obstruction (UUO model and to explore the potential mechanisms. We found that HO-1 was adaptively upregulated in kidneys of both TG and wild type (WT mice after UUO. The levels of HO-1 mRNA and protein were increased in TG mice compared with WT mice under normal conditions. HO-1 expression was further enhanced after UUO and remained high during the entire experimental process. Renal interstitial fibrosis in the TG group was significantly attenuated compared with that in the WT group after UUO. Moreover, overexpression of HO-1 inhibited the loss of peritubular capillaries. In addition, UUO-induced activation and proliferation of myofibroblasts were suppressed by HO-1 overexpression. Furthermore, HO-1 restrained tubulointerstitial infiltration of macrophages and regulated the secretion of inflammatory cytokines in UUO mice. We also found that high expression of HO-1 inhibited reactivation of Wnt/β-catenin signaling, which could play a crucial role in attenuating renal fibrosis. In conclusion, these data suggest that HO-1 prevents renal tubulointerstitial fibrosis possibly by regulating the inflammatory response and Wnt/β-catenin signaling. This study provides evidence that augmentation of HO-1 levels may be a therapeutic strategy against renal interstitial fibrosis.

  12. Alleviation of kidney damage induced by unilateral ureter obstruction in rats by Rhodiola rosea.

    Science.gov (United States)

    Uyeturk, Ugur; Terzi, E Hakan; Kemahli, Eray; Gucuk, Adnan; Tosun, Mehmet; Çetinkaya, Ayhan

    2013-10-01

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

  13. The origin of the vertebrate skeleton

    Science.gov (United States)

    Pivar, Stuart

    2011-01-01

    The anatomy of the human and other vertebrates has been well described since the days of Leonardo da Vinci and Vesalius. The causative origin of the configuration of the bones and of their shapes and forms has been addressed over the ensuing centuries by such outstanding investigators as Goethe, Von Baer, Gegenbauer, Wilhelm His and D'Arcy Thompson, who sought to apply mechanical principles to morphogenesis. However, no coherent causative model of morphogenesis has ever been presented. This paper presents a causative model for the origin of the vertebrate skeleton, based on the premise that the body is a mosaic enlargement of self-organized patterns engrained in the membrane of the egg cell. Drawings illustrate the proposed hypothetical origin of membrane patterning and the changes in the hydrostatic equilibrium of the cytoplasm that cause topographical deformations resulting in the vertebrate body form.

  14. Mitochondrial genome organization and vertebrate phylogenetics

    Directory of Open Access Journals (Sweden)

    Pereira Sérgio Luiz

    2000-01-01

    Full Text Available With the advent of DNA sequencing techniques the organization of the vertebrate mitochondrial genome shows variation between higher taxonomic levels. The most conserved gene order is found in placental mammals, turtles, fishes, some lizards and Xenopus. Birds, other species of lizards, crocodilians, marsupial mammals, snakes, tuatara, lamprey, and some other amphibians and one species of fish have gene orders that are less conserved. The most probable mechanism for new gene rearrangements seems to be tandem duplication and multiple deletion events, always associated with tRNA sequences. Some new rearrangements seem to be typical of monophyletic groups and the use of data from these groups may be useful for answering phylogenetic questions involving vertebrate higher taxonomic levels. Other features such as the secondary structure of tRNA, and the start and stop codons of protein-coding genes may also be useful in comparisons of vertebrate mitochondrial genomes.

  15. THE EFFECT OF HYPOXIA ON ELECTRICAL AND CONTRACTILE PROPERTIES OF SMOOTH MUSCLES OF THE GUINEA PIG URETER

    Directory of Open Access Journals (Sweden)

    I. V. Kovalev

    2016-01-01

    Full Text Available Aim. The effect of hypoxia on the electrical and contractile activities of smooth muscles cells (SMCs of the guinea pig ureter was studied by the method of the double sucrose bridge.Materials and methods. This method allows registering simultaneously parameters of the action potential (AP and the contraction of SMCs, caused by an electrical stimulus.Results. It was found that lowering the oxygen content in the perfusion solution for 10 min resulted to an increase of electrical and contractile activity of ureteral SMCs. Addition of tetraethylammonium chloride (TEA, 5 mM – nonselective blocker of potassium membrane conductance – in hypoxic conditions causing an additional increase in the amplitude of the AP, duration of the AP plateau and the contractile responses of smooth muscles. Thus, the hypoxia decreased the potassium membrane conductance of ureteral SMCs. Inhibition of the effect of the α1 -adrenergic receptors agonist phenylephrine (PE, 10 mM on the electrical and contractile properties of SMCs in hypoxic condition indicate the involvement of the protein kinase C-dependent signaling system in effects of hypoxia. Pretreatment of ureteral smooth muscles with bumetanide (100 mM – selective inhibitor of Na+,K+,2Cl- - cotransporter (NKCC – caused a decrease of the activating effect of hypoxia on the SMCs of guinea pig ureter.Conclusion.Thus, the impact of hypoxia on the regulation of electrical activity and contractions of smooth muscles of guinea pig ureter may be due to changes in ion permeability of membranes SMCs and operation of ion-transporting systems. 

  16. COMPARISON OF TRANSVERSE COMPUTED TOMOGRAPHIC EXCRETORY UROGRAPHY IMAGES AND MAXIMUM INTENSITY PROJECTION IMAGES FOR DIAGNOSING ECTOPIC URETERS IN DOGS.

    Science.gov (United States)

    Secrest, Scott; Bugbee, Andrew; Waller, Kenneth; Jiménez, David A

    2017-03-01

    Computed tomographic maximum intensity projection (MIP) images have been shown to improve reader confidence in their diagnoses and to improve detection of vascular structures and pulmonary nodules. The objectives of this method comparison study were to compare transverse source computed tomographic excretory urography (CTEU) images to two, five, and 10 slab thick MIP images for diagnosing canine ectopic ureters, compare reader confidence, and evaluate interobserver agreement. Two board-certified veterinary radiologists and a board-certified small animal internist blindly reviewed transverse source CTEU and two, five, and 10 slab thick MIP images of 24 dogs enrolled in the study. Inclusion criteria included a diagnostic CTEU and either cystoscopic or surgical confirmation of the presence or absence of ureteral ectopia. Eleven dogs were confirmed to have 17 ectopic ureters at surgery and/or cystoscopically. There was no significant difference in reader diagnoses between viewing methods or between viewing methods and the surgical/cystoscopic findings (P < 0.001). Reader confidence was significantly greater on two (P = 0.0080) and five (P = 0.0009) slab thick MIP images with significant interobserver agreement between readers for all viewing methods (P values ranging between 0.0363 and <0.001). In addition, the diagnostic accuracy of MIP images was similar to or better than transverse source CTEU images, when assessed by a radiologist. The study results suggest that CTEU is a reliable imaging technique for diagnosing canine ectopic ureters among specialists of varied experience. In addition, thin slice reconstructed MIP images improve reader confidence and potentially diagnostic accuracy, and thus their use should be considered, especially in more challenging cases. © 2016 American College of Veterinary Radiology.

  17. Pre- and post-junctional bradykinin B2 receptors regulate smooth muscle tension to the pig intravesical ureter.

    Science.gov (United States)

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

    2016-01-01

    Neuronal and non-neuronal bradykinin (BK) receptors regulate the contractility of the bladder urine outflow region. The current study investigates the role of BK receptors in the regulation of the smooth muscle contractility of the pig intravesical ureter. Western blot and immunohistochemistry were used to show the expression of BK B1 and B2 receptors and myographs for isometric force recordings. B2 receptor expression was consistently detected in the intravesical ureter urothelium and smooth muscle layer, B1 expression was not detected where a strong B2 immunoreactivity was observed within nerve fibers among smooth muscle bundles. On ureteral strips basal tone, BK induced concentration-dependent contractions, were potently reduced by extracellular Ca(2+) removal and by B2 receptor and voltage-gated Ca(2+) (VOC) channel blockade. BK contraction did not change as a consequence of urothelium mechanical removal or cyclooxygenase and Rho-associated protein kinase inhibition. On 9,11-dideoxy-9a,11a-methanoepoxy prostaglandin F2α (U46619)-precontracted samples, under non-adrenergic non-cholinergic (NANC) and nitric oxide (NO)-independent NANC conditions, electrical field stimulation-elicited frequency-dependent relaxations which were reduced by B2 receptor blockade. Kallidin, a B1 receptor agonist, failed to increase preparation basal tension or to induce relaxation on U46619-induced tone. The present results suggest that BK produces contraction of pig intravesical ureter via smooth muscle B2 receptors coupled to extracellular Ca(2+) entry mainly via VOC (L-type) channels. Facilitatory neuronal B2 receptors modulating NO-dependent or independent NANC inhibitory neurotransmission are also demonstrated. © 2014 Wiley Periodicals, Inc.

  18. Effect of 18β-glycyrrhetinic acid on electromechanical coupling in the guinea-pig renal pelvis and ureter

    Science.gov (United States)

    Santicioli, Paolo; Maggi, Carlo Alberto

    2000-01-01

    We have tested the effect of the gap junction inhibitor, 18β-glycyrrhetinic acid (18βGA) on electromechanical coupling in the guinea-pig renal pelvis and ureter by the sucrose gap technique. In the ureter 18βGA (3–30 μM) produced a concentration-dependent inhibition of the spike component of the action potential (AP) and reduced contraction evoked by electrical stimulation. Neurokinin A (NKA) produced a slow depolarization with superimposed APs and phasic contractions of the ureter. 18βGA (30 μM) markedly inhibited the depolarization and APs evoked by NKA. However the contractile response was more sustained in the presence than in the absence of 18βGA. At 100 μM, 18βGA inhibited the mechanical responses to NKA. KCl (80 mM) produced APs and phasic contractions followed by sustained depolarization and tonic contraction. At 30 μM 18βGA markedly inhibited the KCl-evoked APs and phasic contractions without affecting the sustained responses. At 100 μM 18βGA inhibited the tonic contraction to KCl. In the renal pelvis 18βGA (30 μM) inhibited the amplitude of pacemaker potentials and accompanying contractions and induced the appearance of low-amplitude APs not associated with contraction. We conclude that, up to 30 μM, the action of 18βGA is consistent with an inhibition of cell-to-cell electrical coupling via gap junctions. The single-unit character of smooth muscles in the guinea-pig upper urinary tract is partly converted to a multi-unit pattern. At high concentrations 18βGA possesses non specific effects which limit its usefulness as a tool for studying the role of gap junctions in smooth muscles. PMID:10694216

  19. Slipped vertebral epiphysis (report of 2 cases

    Directory of Open Access Journals (Sweden)

    Majid Reza Farrokhi

    2009-02-01

    Full Text Available

    • Avulsion or fracture of posterior ring apophysis of lumbar vertebra is an uncommon cause of radicular low back pain in pediatric age group, adolescents and athletes. This lesion is one of differential diagnosis of disc herniation. We reported two teenage boys with sever low back pain and sciatica during soccer play that ultimately treated with diagnosis of lipped vertebral apophysis.
    • KEY WORDS: Ring Apophysis, vertebral fracture, sciatica, low back pain, disc herniation.

  20. Cervical vertebral fusion with anterior meningocele.

    Science.gov (United States)

    Gallagher, Mathew J; Chavredakis, Emmanuel; Carter, David; Bhojak, Manesh; Jenkinson, Michael D; Clark, Simon R

    2015-04-01

    We present the first described case of cervical vertebral fusion associated with anterior meningocele and syringomyelia. A 45-year-old woman presented with minor trauma, and plain cervical spine radiographs highlighted a congenital deformity of the cervical vertebral bodies. She had a normal neurological examination; however, further imaging revealed a meningocele and syringomyelia. This case highlights the importance of thorough imaging investigation when presented with a congenital deformity in order to detect and prevent development of degenerative spinal cord pathologies. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  1. Nocardia brasiliensis vertebral osteomyelitis and epidural abscess.

    Science.gov (United States)

    Johnson, Philip; Ammar, Hussam

    2013-04-11

    Nocardia species exist in the environment as a saprophyte; it is found worldwide in soil and decaying plant matter. They often infect patients with underlying immune compromise, pulmonary disease or history of trauma or surgery. The diagnosis of nocardiosis can be easily missed as it mimics many other granulomatous and neoplastic disease. We report a 69-year-old man who presented with chronic back pain and paraparesis. He was found to have Nocardial brasiliensis vertebral osteomyelitis and epidural abscess. Laminectomy and epidural wash out was performed but with no neurological recovery. This is the second reported case of N brasiliensis vertebral osteomyelitis in the literature.

  2. Efficacy Quotient Tindakan ESWL Piezolith Richard Wolf 3000 pada Penderita Batu Ureter di RSUPN Dr. Cipto Mangunkusumo, 2008–2011

    Directory of Open Access Journals (Sweden)

    Vinny Verdini

    2017-01-01

    Full Text Available Extracorporeal shockwave lithotripsy (ESWL saat ini telah menjadi metode yang paling umum dalam tatalaksana aktif batu ureter. Sejak Maret 2008, RSCM telah menggunakan mesin ESWL piezolith 3000 richard wolf dan belum diketahui nilai efficacy quotient (EQ. Penelitian ini bertujuan untuk menentukan nilai EQ dari tindakan ESWL menggunakan mesin piezolith richard wolf 3000 pada batu ureter dan hubungan angka bebas batu dengan lokasi batu, jumlah batu, beban batu, opasitas batu, obstruksi, dan fungsi ginjal. Studi cross sectional ini dilakukan pada bulan Januari 2008-Desember 2011 dan data dianalisis dengan statistik multivariat. Terdapat 113 (95 % dari 119 pasien yang dinyatakan bebas batu setelah tindakan ESWL pertama. Didapatkan nilai EQ 0,89. Hanya ukuran batu yang mempengaruhi angka bebas batu dalam penelitian ini (p<0,05. Disimpulkan bahwa prosedur ESWL menggunakan mesin richard wolf piezolith 3000 memiliki nilai EQ dan angka bebas batu yang lebih baik daripada mesin-mesin sebelumnya dan mesin lain yang sejenis. Faktor yang mempengaruhi keberhasilan adalah ukuran batu ureter yang ditatalaksana.Kata Kunci: batu ureter, ESWL, efficacy quotient, angka bebas batu. Efficacy Quotient of ESWL Piezolith Richard Wolf 3000 Machine in Patientswith Ureteral Stones in Dr. Cipto MangunkusumoNational Hospital 2008 - 2011AbstractExtracorporeal shockwave lithotripsy (ESWL is the most common method of ureteral stone management. Since 2008, RSCM has ben using ESWL piezolith 3000 richard wolf and efficacy quotient (EQ value have not yet studied. The study aims was to determine the efficacy quotient (EQ of ESWL using piezolith richard wolf 3000 machine for ureteral stone by analyzing free-stone rate with location of stones, number of stones, stone burden, stone opacity, obstruction and kidney function. This cross sectional study was carried out in January 2008-December 2011, with multivariate analytical study. Ninety five percent (n=113 of 119 patients were

  3. Prise en charge de l’uretère rétrocave au Togo: A propos de 3 observations

    Directory of Open Access Journals (Sweden)

    K. Tengue

    2016-12-01

    Full Text Available L’uretère retrocave est une malformation rare. Par ces 3 cas, les auteurs rappellent que cette affection est retrouvée plus souvent chez l’adulte jeune. La manifestation clinique habituelle étant la douleur lombaire due à l’obstruction du haut appareil urinaire, les formes asymptomatiques aussi peuvent être rencontrées. Le diagnostic reposant sur l’uroscanner son traitement au Togo et dans la plupart des pays africains demeure la chirurgie ouverte qui donne autant de bons résultats que la laparoscopie.

  4. Partial substitution of the ureter using a double short segments of the ileum following the Monti procedure.

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2014-06-15

    The absence of Discs-large 1 (DLG1), the mouse ortholog of the Drosophila discs-large tumor suppressor, results in congenital hydronephrosis characterized by urinary tract abnormalities, reduced ureteric bud branching, and delayed disconnection of the ureter from the common nephric duct (CND). To define the specific cellular requirements for Dlg1 expression during urogenital development, we used a floxed Dlg1 allele and Pax2-Cre, Pax3-Cre, Six2-Cre, and HoxB7-Cre transgenes to generate cell type-restricted Dlg1 mutants. In addition, we used Ret(GFP) knockin and retinoic acid response element-lacZ transgenic mice to determine the effects of Dlg1 mutation on the respective morphogenetic signaling pathways. Mutation of Dlg1 in urothelium and collecting ducts (via HoxB7-Cre or Pax2-Cre) and in nephron precursors (via Pax2-Cre and Six2-Cre) resulted in no apparent abnormalities in ureteric bud branching or in distal ureter maturation, and no hydronephrosis. Mutation in nephrons, ureteric smooth muscle, and mesenchyme surrounding the lower urinary tract (via the Pax3-Cre transgene) resulted in congenital hydronephrosis accompanied by reduced branching, abnormal distal ureter maturation and insertion, and smooth muscle orientation defects, phenotypes very similar to those in Dlg1 null mice. Dlg1 null mice showed reduced Ret expression and apoptosis during ureter maturation and evidence of reduced retinoic acid signaling in the kidney. Taken together, these results suggest that Dlg1 expression in ureter and CND-associated mesenchymal cells is essential for ensuring distal ureter maturation by facilitating retinoic acid signaling, Ret expression, and apoptosis of the urothelium. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Both cell-autonomous mechanisms and hormones contribute to sexual development in vertebrates and insects.

    Science.gov (United States)

    Bear, Ashley; Monteiro, Antónia

    2013-08-01

    The differentiation of male and female characteristics in vertebrates and insects has long been thought to proceed via different mechanisms. Traditionally, vertebrate sexual development was thought to occur in two phases: a primary and a secondary phase, the primary phase involving the differentiation of the gonads, and the secondary phase involving the differentiation of other sexual traits via the influence of sex hormones secreted by the gonads. In contrast, insect sexual development was thought to depend exclusively on cell-autonomous expression of sex-specific genes. Recently, however, new evidence indicates that both vertebrates and insects rely on sex hormones as well as cell-autonomous mechanisms to develop sexual traits. Collectively, these new data challenge the traditional vertebrate definitions of primary and secondary sexual development, call for a redefinition of these terms, and indicate the need for research aimed at explaining the relative dependence on cell-autonomous versus hormonally guided sexual development in animals. © 2013 The Authors. BioEssays published by WILEY Periodicals, Inc.

  7. A blind-ending ureter with infection due to vesicoureteric reflux with associated renal agenesis: A rare cause of pain abdomen

    Directory of Open Access Journals (Sweden)

    Vinita Rathi

    2011-01-01

    Full Text Available We report a 12-year-old male child with an unusual cause of abdominal pain, i.e. a blind-ending ureter with vesicoureteral reflux. The pain improved with antibiotic therapy, implying infection as the cause of pain. This entity is difficult to diagnose clinically, thereby affecting management. Usually, a blind-ending ureter is not filled on intravenous urography (IVU and the diagnosis is confirmed by retrograde pyelography, which is an invasive procedure. We illustrate the contribution of IVU and computerized tomographic cystography, which has not been reported earlier, in the evaluation of such cases.

  8. [Management of High-Risk Prostate Cancer and Left Ectopic Ureter Inserting into Seminal Vesicle with Ipsilateral Hypoplastic Kidney of a Young Patient : A Case Report].

    Science.gov (United States)

    Matsumoto, Teppei; Koie, Takuya; Soma, Osamu; Kusaka, Ayumu; Hosogoe, Shogo; Hamano, Itsuto; Imai, Atsushi; Hatakeyama, Shingo; Yoneyama, Takahiro; Hashimoto, Yasuhiro; Ohyama, Chikara

    2016-06-01

    A 44-year-old male patient visited our hospital with a chief complaint of macroscopic hematuria. Prostate biopsies were performed due to prostate specific antigen (PSA) 11.6 ng/ml, and he was diagnosed with Gleason score 5+4 prostate cancer. Computed tomography showed a left hypoplastic kidney. T2- weighted magnetic resonance imaging showed the left ureter stump with ectopic insertion into the dilated left seminal vesicle. He was diagnosed with high-risk prostate cancer and left ectopic ureter inserting into the seminal vesicle with ipsilateral hypoplastic kidney. Laparoscopic left nephroureterectomy and open radical prostatectomy were performed.

  9. Investigation of Buckling Phenomenon Induced by Growth of Vertebral Bodies Using a Mechanical Spine Model

    Science.gov (United States)

    Sasaoka, Ryu; Azegami, Hideyuki; Murachi, Shunji; Kitoh, Junzoh; Ishida, Yoshito; Kawakami, Noriaki; Makino, Mitsunori; Matsuyama, Yukihiro

    A hypothesis that idiopathic scoliosis is a buckling phenomenon of the fourth or sixth mode, which is the second or third lateral bending mode, induced by the growth of vertebral bodies was presented in a previous paper by the authors using numerical simulations with a finite-element model of the spine. This paper presents experimental proof of the buckling phenomenon using mechanical spine models constructed with the geometrical data of the finite-element model used in a previous work. Using three spine mechanical models with different materials at intervertebral joints, the change in the natural vibration eigenvalue of the second lateral bending mode with the growth of vertebral bodies was measured by experimental modal analysis. From the result, it was observed that natural vibration eigenvalue decreased with the growth of vertebral bodies. Since the increase in primary factor inducing the buckling phenomenon decreases natural vibration eigenvalue, the obtained result confirms the buckling hypothesis.

  10. The shape of the human lumbar vertebral canal A forma do canal vertebral lombar humano

    Directory of Open Access Journals (Sweden)

    Edmundo Zarzur

    1996-09-01

    Full Text Available Literature on the anatomy of the human vertebral column characterizes the shape of the lumbar vertebral canal as triangular. The purpose of the present study was to determine the precise shape of the lumbar vertebral canal. Ten lumbar vertebral columns of adult male cadavers were dissected. Two transverse sections were performed in the third lumbar vertebra. One section was performed at the level of the lower border of the ligamenta flava, and the other section was performed at the level of the pedicles. The shape of the lumbar vertebral canal at the level of the pedicles tends to be oval or circular, whereas the shape of the lumbar vertebral canal at the level of the lower border of the ligamenta flava is triangular. Thus, the shape of the human lumbar vertebral canal is not exclusively triangular, as reported in the literature. It is related to the level of the transversal section performed on the lumbar vertebra. This finding should be taken into consideration among factors involved in the spread of solutions introduced into the epidural space.A literatura sobre a anatomia da coluna vertebral descreve como sendo triangular o formato do canal vertebral na região lombar. O objetivo deste estudo é determinar a real forma do canal da coluna vertebral lombar.Dez colunas vertebrais de cadáveres de homens adultos foram dissecadas. Dois cortes transversais foram executados na terceira vértebra lombar. Um corte foi feito no nível das bordas inferiores de dois ligamentos amarelos vizinhos e o outro corte foi transversal, no nível dos pedículos. A forma do canal vertebral variou: no nível dos pedículos ela tende a ser oval ou circular e junto às bordas inferiores dos ligamentos amarelos passa a ser triangular. Portanto, a forma do canal vertebral lombar não é somente triangular; ela depende do nível em que se faz o corte transversal da vértebra. Estes achados devem ser levados em consideração entre os fatores envolvidos na difusão das

  11. Development of an equation for calculating vertebral shear failure tolerance without destructive mechanical testing using iterative linear regression.

    Science.gov (United States)

    Howarth, Samuel J; Giangregorio, Lora M; Callaghan, Jack P

    2013-08-01

    Equations used to determine vertebral failure tolerances without the need for destructive testing are useful for scaling applied sub-maximal forces during in vitro repetitive loading studies. However, existing equations that use vertebral bone density and morphology for calculating compressive failure tolerance are unsuitable for calculating vertebral shear failure tolerance since the primary site of failure is the pars interarticularis and not the vertebral body. Therefore, this investigation developed new equations for non-destructively determining vertebral shear failure tolerance from morphological and/or bone density measures. Shear failure was induced in 40 porcine cervical vertebral joints (20 C3-C4 and 20 C5-C6) by applying a constant posterior displacement to the caudal vertebra at 0.15 mm/s. Prior to destructive testing, morphology and bone density of the posterior elements were made with digital calipers, X-rays, and peripheral quantitative computed tomography. Iterative linear regression identified mathematical relationships between shear failure tolerance, and morphological and bone density measurements. Along with vertebral level, pars interarticularis length and lamina height from the cranial vertebra, and inferior facet height from the caudal vertebra collectively explained 61.8% of shear failure tolerance variance. Accuracy for this relationship, estimated using the same group of specimens, was 211.9 N or 9.8% of the measured shear failure tolerance. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  12. les hemangiomes vertebraux agressifs vertebral hemangiomas

    African Journals Online (AJOL)

    Background 1. Vertebral hemangiomas are benign tumeurs and are raré< ly symptomatic Aggressive forms represent less than. 1% of all cases Medical imaging allows both diagnosis ... '+ tro'ubles sphinctêriens. Irritation pyramidale '. Laminectomie - échec [saignement important) embolieationcomplêtée par une résection.

  13. Impacts of underwater noise on marine vertebrates

    NARCIS (Netherlands)

    Liebschner, Alexander; Seibel, Henrike; Teilmann, Jonas; Wittekind, Dietrich; Parmentier, Eric; Dähne, Michael; Dietz, Rune; Driver, Jörg; Elk, van Cornelis; Everaarts, Eligius; Findeisen, Henning; Kristensen, Jacob; Lehnert, Kristina; Lucke, Klaus; Merck, Thomas; Müller, Sabine; Pawliczka, Iwona; Ronnenberg, Katrin; Rosenberger, Tanja; Ruser, Andreas; Tougaard, Jakob; Schuster, Max; Sundermeyer, Janne; Sveegaard, Signe; Siebert, Ursula

    2016-01-01

    The project conducts application-oriented research on impacts of underwater noise on marine vertebrates in the North and Baltic Seas. In distinct subprojects, the hearing sensitivity of harbor porpoises and gray seals as well as the acoustic tolerance limit of harbor porpoises to impulsive noise

  14. Separation of vertebral epiphyses in bovine carcases.

    Science.gov (United States)

    Cooke, M

    1987-01-01

    Separation of vertebral epiphyses in the thoracolumbar region is a cause of rejection of beef carcases for Intervention storage. Incidence is highest in younger cattle and the problem is associated with certain types of hide puller and dressing technique. Three dressing methods are evaluated and tensile strenght of bone specimens is measured. Copyright © 1987. Published by Elsevier Ltd.

  15. Extensive thoracolumbosacral vertebral osteomyelitis after Lemierre syndrome

    NARCIS (Netherlands)

    Kempen, D. H R; van Dijk, M.; Hoepelman, A. I M|info:eu-repo/dai/nl/074382160; Oner, F. C.|info:eu-repo/dai/nl/188615326; Verlaan, J. J.|info:eu-repo/dai/nl/269057285

    2015-01-01

    Purpose: To present a unique case of multilevel vertebral osteomyelitis after Lemierre syndrome. Methods: A previously healthy 27-year-old man presented in the Emergency Department in septic shock because of Lemierre syndrome for which he was subsequently treated with intravenous benzylpenicillin

  16. Diagnosis and Management of Vertebral Compression Fractures.

    Science.gov (United States)

    McCarthy, Jason; Davis, Amy

    2016-07-01

    Vertebral compression fractures (VCFs) are the most common complication of osteoporosis, affecting more than 700,000 Americans annually. Fracture risk increases with age, with four in 10 white women older than 50 years experiencing a hip, spine, or vertebral fracture in their lifetime. VCFs can lead to chronic pain, disfigurement, height loss, impaired activities of daily living, increased risk of pressure sores, pneumonia, and psychological distress. Patients with an acute VCF may report abrupt onset of back pain with position changes, coughing, sneezing, or lifting. Physical examination findings are often normal, but can demonstrate kyphosis and midline spine tenderness. More than two-thirds of patients are asymptomatic and diagnosed incidentally on plain radiography. Acute VCFs may be treated with analgesics such as acetaminophen, nonsteroidal anti-inflammatory drugs, narcotics, and calcitonin. Physicians must be mindful of medication adverse effects in older patients. Other conservative therapeutic options include limited bed rest, bracing, physical therapy, nerve root blocks, and epidural injections. Percutaneous vertebral augmentation, including vertebroplasty and kyphoplasty, is controversial, but can be considered in patients with inadequate pain relief with nonsurgical care or when persistent pain substantially affects quality of life. Family physicians can help prevent vertebral fractures through management of risk factors and the treatment of osteoporosis.

  17. VerSeDa: vertebrate secretome database

    Science.gov (United States)

    Cortazar, Ana R.; Oguiza, José A.

    2017-01-01

    Based on the current tools, de novo secretome (full set of proteins secreted by an organism) prediction is a time consuming bioinformatic task that requires a multifactorial analysis in order to obtain reliable in silico predictions. Hence, to accelerate this process and offer researchers a reliable repository where secretome information can be obtained for vertebrates and model organisms, we have developed VerSeDa (Vertebrate Secretome Database). This freely available database stores information about proteins that are predicted to be secreted through the classical and non-classical mechanisms, for the wide range of vertebrate species deposited at the NCBI, UCSC and ENSEMBL sites. To our knowledge, VerSeDa is the only state-of-the-art database designed to store secretome data from multiple vertebrate genomes, thus, saving an important amount of time spent in the prediction of protein features that can be retrieved from this repository directly. Database URL: VerSeDa is freely available at http://genomics.cicbiogune.es/VerSeDa/index.php PMID:28365718

  18. Progressive non-infectious anterior vertebral fusion

    Energy Technology Data Exchange (ETDEWEB)

    Smith, J.R.G.; Martin, I.R.; Shaw, D.G.; Robinson, R.O.

    1986-11-01

    Four cases of progressive non-infectious anterior vertebral fusion are described. Three cases remain relatively asymptomatic, but one has developed spinal cord compression secondary to an acute angled kyphosis. The clinical, radiological, and pathological features are reviewed and some comparisons with the spinal changes in thalidomide embryopathy are made.

  19. Neogene vertebrates from the Gargano Peninsula, Italy

    NARCIS (Netherlands)

    Freudenthal, M.

    1971-01-01

    Fissure-fillings in Mesozoic limestones in the Gargano Peninsula yield rich collections of fossil vertebrates, which are characterized by gigantism and aberrant morphology. Their age is considered to be Vallesian or Turolian. The special features of the fauna are probably due to isolation on an

  20. Biomechanical aspects of bone microstructure in vertebrates ...

    Indian Academy of Sciences (India)

    2009-10-29

    Oct 29, 2009 ... Bone is an important tissue in paleontological studies as it is a commonly preserved element in most fossil vertebrates, and can often allow its ... of the size of the bone's building blocks (such as osteon or trabecular thickness) to meet the metabolic demand concomitant to minimal expenditure of energy.

  1. Biomechanical aspects of bone microstructure in vertebrates ...

    Indian Academy of Sciences (India)

    Prakash

    2009-10-29

    Oct 29, 2009 ... Biomechanical aspects of bone microstructure in vertebrates: potential approach to palaeontological investigations. S MISHRA. School of Engineering Systems and Institute of Health and Biomedical Innovation, Queensland University of Technology,. Brisbane 4000, Australia. (Email, sk.mishra@qut.edu.au).

  2. Pleistocene vertebrates of the Yukon Territory

    Science.gov (United States)

    Harington, C. R.

    2011-08-01

    Unglaciated parts of the Yukon constitute one of the most important areas in North America for yielding Pleistocene vertebrate fossils. Nearly 30 vertebrate faunal localities are reviewed spanning a period of about 1.6 Ma (million years ago) to the close of the Pleistocene some 10 000 BP (radiocarbon years before present, taken as 1950). The vertebrate fossils represent at least 8 species of fishes, 1 amphibian, 41 species of birds and 83 species of mammals. Dominant among the large mammals are: steppe bison ( Bison priscus), horse ( Equus sp.), woolly mammoth ( Mammuthus primigenius), and caribou ( Rangifer tarandus) - signature species of the Mammoth Steppe fauna ( Fig. 1), which was widespread from the British Isles, through northern Europe, and Siberia to Alaska, Yukon and adjacent Northwest Territories. The Yukon faunas extend from Herschel Island in the north to Revenue Creek in the south and from the Alaskan border in the west to Ketza River in the east. The Yukon holds evidence of the earliest-known people in North America. Artifacts made from bison, mammoth and caribou bones from Bluefish Caves, Old Crow Basin and Dawson City areas show that people had a substantial knowledge of making and using bone tools at least by 25 000 BP, and possibly as early as 40 000 BP. A suggested chronological sequence of Yukon Pleistocene vertebrates ( Table 1) facilitates comparison of selected faunas and indicates the known duration of various taxa.

  3. Core Needle Percutaneous Transpedicular Vertebral Body Biopsy: A Study of 128 Cases.

    Science.gov (United States)

    Kamei, Yoichi; Nishida, Jun; Mimata, Yoshikuni; Shiraishi, Hideo; Ehara, Shigeru; Satoh, Takashi; Shimamura, Tadashi

    2015-08-01

    We report an accurate technique for percutaneous transpedicular core needle biopsy of vertebral body lesions, and evaluate its effectiveness for histologic diagnosis retrospectively. The purpose of this study is to evaluate the effectiveness and accuracy of this method retrospectively. Better knowledge of vertebral pedicle morphometry has led to the development of transpedicular fixation techniques in spinal surgery. After experience with these techniques, we have been performing percutaneous transpedicular vertebral body core needle biopsies (transpedicular biopsy) for histologic diagnosis since 1993. A total of 128 patients who had undergone transpedicular biopsy for T1-L5 vertebral body lesions were evaluated. The biopsies were carried out under local anesthesia, except in children, for whom general anesthesia was used. Biopsy specimens were obtained by passing 8 or 11 G needle biopsy instruments percutaneously through the pedicle into the site of the lesion under C-arm fluoroscopy guidance. Histologic analyses were performed, and the accuracy and effectiveness of this technique were evaluated. The pathologic evaluations were definitive in 120 patients (93.8%) and not diagnostic in 8. The accuracy of the results differed among the diagnostic categories. Diagnostic accuracy was 78.6% for primary neoplasms and 97.0% for metastatic neoplasms. There was a significant difference in the diagnostic criteria and spinal segment. True positive rate was higher in the thoracic spine (92.2%) than that of lumbar spine (76.6%). Transpedicular biopsy is a useful procedure for evaluation of thoracic and lumbar vertebral body lesions.

  4. [Vertebral destruction with sever pain in the SAPHO syndrome].

    Science.gov (United States)

    Hagemann, D; Pfaffenbach, B; Schmid, G; Adamek, R J

    1999-02-05

    A 57-year-old man had for the past 18 months complained of recurrent, recently worsening, belt-like backache radiating ventrally. On admission a skin rash consisting of blister and pustules was noted on the palms of both hands. He had pain on pressure over the right upper abdomen, an enlarged prostate and definite pain on percussing the vertebral column with restricted movement of the thoracic vertebral column, but no other physical signs. Radiology revealed clearly increased sclerosis of several thoracic vertebrae with osteolytic destruction and a paravertebral soft tissue tumor. Search for a primary tumor was unsuccessful. Bone scintigraphy demonstrated nuclide enrichment of the thoracic vertebrae and of the sternoclavicular joints without increase in the LeukoScan. These findings indicated the diagnosis of SAPHO syndrome (synovitis-acne-pustulosis-hyperostosis-osteomyelitis). Rapid subjective and objective improvement followed the administration of clindamycin and ibuprofen. In case of bone pain of uncertain aetiology, especially when associated with skin rash, the rare SAPHO syndrome should be considered in the differential diagnosis, avoiding lengthy diagnostic steps and allowing early treatment.

  5. Surgical management of extramural ectopic ureter by modified colposuspension following ureteroneocystostomy in a young female Siberian Husky dog

    Directory of Open Access Journals (Sweden)

    In Seong Jeong

    2017-09-01

    Full Text Available Objective: Postoperative complication of extramural ectopic ureters (EEUs with persistent urinary incontinence (UI is common in Siberian Huskies. This case report was aimed at reporting the successful correction procedure of EEU in Siberian Huskies by surgical procedure. Materials and methods: A three-month-old and weighing 7.9 kg Siberian Husky dog was presented with history of an acute dermatitis around the genitals, swelling of the genitals and dribbling urination. Abdominal radiographs, ultrasonography, and 3D computed tomography scanning revealed presence of the ectopic ureter with urinary incontinence. Ureteroneocystostomy was applied as the first choice of corrective procedure in this case, and clinical sings were corrected apparently after surgery. Unfortunately, UI with cystitis was developed two months postoperatively. To correct the condition, surgical procedure of colposuspension with ovarianhystectomy and cystopexy was opted. Results: Post-operative progression showed good prognosis and the dog recovered fully. Follow up checkup of the patient after 4 months postoperative and follow up phone call 27 months later did not reveal any abnormalities. Conclusion: This case report recommends surgical procedure of modified colposuspension following ureteroneocystostomy to correct EEUs and its postoperative complication. [J Adv Vet Anim Res 2017; 4(3.000: 301-306

  6. Endometrioid Adenocarcinoma in the Native Ureter of a Renal Transplant Patient: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Kelly A. Healy

    2010-01-01

    Full Text Available Endometriosis is characterized by endometrial-like tissue outside the uterus, primarily on the pelvic peritoneum, ovaries, and rectovaginal septum, and, in rare cases, within the urinary tract (1–3%. Although endometriosis is a benign condition, malignant transformation of endometriosis is a well-described phenomenon. Malignancies arising in endometriosis are uncommon at extragonadal pelvic sites. A case of endometrioid adenocarcinoma in the native ureter of a postmenopausal renal transplant patient presented with painless gross hematuria and hydroureteronephrosis. The patient had a history of total abdominal hysterectomy and bilateral salpingo-oophrectomy 14 years prior for menorrhagia and had since been on unopposed estrogen replacement therapy. Workup revealed a filling defect in the native left mid-ureter secondary to a large 2.5-cm ureteral tumor. Endoscopic biopsies of the native left ureteral mass showed endometrioid adenocarcinoma, grade II-III. The patient ultimately underwent an open native left nephroureterectomy and temporary diverting colostomy. Final pathology confirmed endometrioid adenocarcinoma, grade II-III, arising in a background of endometriosis with negative perirectal lymph nodes. This case of ureteral endometrioid adenocarcinoma highlights the importance of obtaining a careful history and maintaining a high index of suspicion for malignant degeneration, especially in the context of hyperestrogenism.

  7. The CW domain, a structural module shared amongst vertebrates, vertebrate-infecting parasites and higher plants.

    Science.gov (United States)

    Perry, Jason; Zhao, Yunde

    2003-11-01

    A previously undetected domain, named CW for its conserved cysteine and tryptophan residues, appears to be a four-cysteine zinc-finger motif found exclusively in vertebrates, vertebrate-infecting parasites and higher plants. Of the twelve distinct nuclear protein families that comprise the CW domain-containing superfamily, only the microrchida (MORC) family has begun to be characterized. However, several families contain other domains suggesting a relationship between the CW domain and either chromatin methylation status or early embryonic development.

  8. Vertebral body stenting: a new method for vertebral augmentation versus kyphoplasty.

    Science.gov (United States)

    Rotter, Robert; Martin, Heiner; Fuerderer, Sebastian; Gabl, Michael; Roeder, Christoph; Heini, Paul; Mittlmeier, Thomas

    2010-06-01

    Vertebroplasty and kyphoplasty are well-established minimally invasive treatment options for compression fractures of osteoporotic vertebral bodies. Possible procedural disadvantages, however, include incomplete fracture reduction or a significant loss of reduction after balloon tamp deflation, prior to cement injection. A new procedure called "vertebral body stenting" (VBS) was tested in vitro and compared to kyphoplasty. VBS uses a specially designed catheter-mounted stent which can be implanted and expanded inside the vertebral body. As much as 24 fresh frozen human cadaveric vertebral bodies (T11-L5) were utilized. After creating typical compression fractures, the vertebral bodies were reduced by kyphoplasty (n = 12) or by VBS (n = 12) and then stabilized with PMMA bone cement. Each step of the procedure was performed under fluoroscopic control and analysed quantitatively. Finally, static and dynamic biomechanical tests were performed. A complete initial reduction of the fractured vertebral body height was achieved by both systems. There was a significant loss of reduction after balloon deflation in kyphoplasty compared to VBS, and a significant total height gain by VBS (mean +/- SD in %, p VBS: 3.7 +/- 3.8], and total anterior height gain [kyphoplasty: 8.0 +/- 9.4; VBS: 13.3 +/- 7.6]). Biomechanical tests showed no significant stiffness and failure load differences between systems. VBS is an innovative technique which allows for the possibly complete reduction of vertebral compression fractures and helps maintain the restored height by means of a stent. The height loss after balloon deflation is significantly decreased by using VBS compared to kyphoplasty, thus offering a new promising option for vertebral augmentation.

  9. Vertebral body stenting: a new method for vertebral augmentation versus kyphoplasty

    OpenAIRE

    Rotter, Robert; Martin, Heiner; Fuerderer, Sebastian; Gabl, Michael; Roeder, Christoph; Heini, Paul; Mittlmeier, Thomas

    2010-01-01

    Vertebroplasty and kyphoplasty are well-established minimally invasive treatment options for compression fractures of osteoporotic vertebral bodies. Possible procedural disadvantages, however, include incomplete fracture reduction or a significant loss of reduction after balloon tamp deflation, prior to cement injection. A new procedure called ?vertebral body stenting? (VBS) was tested in?vitro and compared to kyphoplasty. VBS uses a specially designed catheter-mounted stent which can be impl...

  10. Varied overstrain injuries of the vertebral column conditioned by evolution

    Energy Technology Data Exchange (ETDEWEB)

    Kohlbach, W.

    1983-08-01

    During physiological growth of the juvenile vertebral column, various stages of stability occur which are characterized by the condition of the marginal rim of the vertebral bodies. If the vertebral juvenile column is overstrained, these variations in stability results in a variety of damage to vertebral bodies and vertebral disks. One of these lesions corresponds to Scheuermann's disease (osteochondrosis of vertebral epiphyses in juveniles). Damage of the vertebral column due to overstrain can occur only if the overstrain is applied in upright position. Since Man alone can damage his vertebral column in upright position (as a result of his evolutionary development), Scheuermann's thesis is confirmed that Scheuermann's disease is confined to Man. Spondylolysis/spondylolisthesis is also a damage caused by overstrain. Here, too, the damage can occur only if the load is exercised in upright position, with the exception of a slanted positioning of the intervertebral components.

  11. Evolution of the vertebrate claudin gene family: insights from a basal vertebrate, the sea lamprey.

    Science.gov (United States)

    Mukendi, Christian; Dean, Nicholas; Lala, Rushil; Smith, Jeramiah; Bronner, Marianne E; Nikitina, Natalya V

    2016-01-01

    Claudins are major constituents of tight junctions, contributing both to their intercellular sealing and selective permeability properties. While claudins and claudin-like molecules are present in some invertebrates, the association of claudins with tight junctions has been conclusively documented only in vertebrates. Here we report the sequencing, phylogenetic analysis and comprehensive spatiotemporal expression analysis of the entire claudin gene family in the basal extant vertebrate, the sea lamprey. Our results demonstrate that clear orthologues to about half of all mammalian claudins are present in the lamprey, suggesting that at least one round of whole genome duplication contributed to the diversification of this gene family. Expression analysis revealed that claudins are expressed in discrete and specific domains, many of which represent vertebrate-specific innovations, such as in cranial ectodermal placodes and the neural crest; whereas others represent structures characteristic of chordates, e.g. pronephros, notochord, somites, endostyle and pharyngeal arches. By comparing the embryonic expression of claudins in the lamprey to that of other vertebrates, we found that ancestral expression patterns were often preserved in higher vertebrates. Morpholino mediated loss of Cldn3b demonstrated a functional role for this protein in placode and pharyngeal arch morphogenesis. Taken together, our data provide novel insights into the origins and evolution of the claudin gene family and the significance of claudin proteins in the evolution of vertebrates.

  12. Vertebrate richness and biogeography in the Big Thicket of Texas

    Science.gov (United States)

    Michael H MacRoberts; Barbara R. MacRoberts; D. Craig Rudolph

    2010-01-01

    The Big Thicket of Texas has been described as rich in species and a “crossroads:” a place where organisms from many different regions meet. We examine the species richness and regional affiliations of Big Thicket vertebrates. We found that the Big Thicket is neither exceptionally rich in vertebrates nor is it a crossroads for vertebrates. Its vertebrate fauna is...

  13. The incidence of secondary vertebral fracture of vertebral augmentation techniques versus conservative treatment for painful osteoporotic vertebral fractures: a systematic review and meta-analysis.

    Science.gov (United States)

    Song, Dawei; Meng, Bin; Gan, Minfeng; Niu, Junjie; Li, Shiyan; Chen, Hao; Yuan, Chenxi; Yang, Huilin

    2015-08-01

    Percutaneous vertebroplasty (PVP) and balloon kyphoplasty (BKP) are minimally invasive and effective vertebral augmentation techniques for managing osteoporotic vertebral compression fractures (OVCFs). Recent meta-analyses have compared the incidence of secondary vertebral fractures between patients treated with vertebral augmentation techniques or conservative treatment; however, the inclusions were not thorough and rigorous enough, and the effects of each technique on the incidence of secondary vertebral fractures remain unclear. To perform an updated systematic review and meta-analysis of the studies with more rigorous inclusion criteria on the effects of vertebral augmentation techniques and conservative treatment for OVCF on the incidence of secondary vertebral fractures. PubMed, MEDLINE, EMBASE, SpringerLink, Web of Science, and the Cochrane Library database were searched for relevant original articles comparing the incidence of secondary vertebral fractures between vertebral augmentation techniques and conservative treatment for patients with OVCFs. Randomized controlled trials (RCTs) and prospective non-randomized controlled trials (NRCTs) were identified. The methodological qualities of the studies were evaluated, relevant data were extracted and recorded, and an appropriate meta-analysis was conducted. A total of 13 articles were included. The pooled results from included studies showed no statistically significant differences in the incidence of secondary vertebral fractures between patients treated with vertebral augmentation techniques and conservative treatment. Subgroup analysis comparing different study designs, durations of symptoms, follow-up times, races of patients, and techniques were conducted, and no significant differences in the incidence of secondary fractures were identified (P > 0.05). No obvious publication bias was detected by either Begg's test (P = 0.360 > 0.05) or Egger's test (P = 0.373 > 0.05). Despite current thinking in the

  14. Factors for vertebral artery injury accompanied by cervical trauma

    Energy Technology Data Exchange (ETDEWEB)

    Murata, Masaaki; Shingu, Hikosuke; Kimura, Isao; Nasu, Yoshiro; Shiotani, Akihide [San-in Rosai Hospital, Yonago, Tottori (Japan). Spine and Low Back Pain Center

    2001-09-01

    Injury of the vertebral artery with cerebellar and brain stem infarction is a complication of cervical vertebral trauma. However, the pathogenesis and etiological factors remain to be clarified. In this study, we investigated patients with cervical vertebral and cord injury. This study included 51 patients with cervical vertebral and cord injury who were treated in our department. In these patients, plain X-ray, CT, MRI, and MRA findings were examined. The incidence of vertebral arterial injury was 33.3% (17 of 51 patients with cervical vertebral trauma). In 11 of the 17 patients, dislocation fracture was noted, comprising a markedly high percentage (64.7%). Particularly, vertebral arterial injury was commonly observed in patients with a large dislocation distance and severe paralysis. Cerebellar and brain stem infarction related to vertebral arterial injury was observed in 5 of the 17 patients (29.4%). No infarction developed in patients 50 years old or younger. Infarction was detected in relatively elderly patients. Vertebral arterial injury and cerebellar/brain stem infarction related to cervical vertebral trauma were frequently observed in patients with high energy injury. However, these disorders commonly occurred in elderly patients. Therefore, age-related factors such as arteriosclerosis may also be closely involved. In the acute stage, the state of the vertebral artery should be evaluated by MRA and MRI. Among patients with vertebral arterial injury, caution is needed during follow-up those with risk factors such as high energy injury and advanced age. (author)

  15. Closure of the vertebral canal in human embryos and fetuses

    NARCIS (Netherlands)

    Mekonen, Hayelom K.; Hikspoors, Jill P. J. M.; Mommen, Greet; Kruepunga, Nutmethee; Köhler, S. Eleonore; Lamers, Wouter H.

    2017-01-01

    The vertebral column is the paradigm of the metameric architecture of the vertebrate body. Because the number of somites is a convenient parameter to stage early human embryos, we explored whether the closure of the vertebral canal could be used similarly for staging embryos between 7 and 10weeks of

  16. Lumbar Vertebral Canal Diameters in Adult Ugandan Skeletons ...

    African Journals Online (AJOL)

    Background: Normal values of lumbar vertebral canal diameters are useful in facilitating diagnosis of lumbar vertebral canal stenosis. Various studies have established variation on values between different populations, gender, age, and ethnic groups. Objectives: To determine the lumbar vertebral canal diameters in adult ...

  17. Cilia Control Vascular Mural Cell Recruitment in Vertebrates

    Directory of Open Access Journals (Sweden)

    Xiaowen Chen

    2017-01-01

    Full Text Available Vascular mural cells (vMCs are essential components of the vertebrate vascular system, controlling blood vessel maturation and homeostasis. Discrete molecular mechanisms have been associated with vMC development and differentiation. The function of hemodynamic forces in controlling vMC recruitment is unclear. Using transgenic lines marking developing vMCs in zebrafish embryos, we find that vMCs are recruited by arterial-fated vessels and that the process is flow dependent. We take advantage of tissue-specific CRISPR gene targeting to demonstrate that hemodynamic-dependent Notch activation and the ensuing arterial genetic program is driven by endothelial primary cilia. We also identify zebrafish foxc1b as a cilia-dependent Notch-specific target that is required within endothelial cells to drive vMC recruitment. In summary, we have identified a hemodynamic-dependent mechanism in the developing vasculature that controls vMC recruitment.

  18. Anatomia do sulco da artéria vertebral Vertebral artery groove anatomy

    Directory of Open Access Journals (Sweden)

    Max Franco de Carvalho

    2009-01-01

    Full Text Available INTRODUÇÃO: Diversas técnicas cirúrgicas têm sido realizadas na região craniocervical devido a diversas patologias. Durante o acesso cirúrgico a essa região existe um risco potencial de lesão iatrogênica da artéria vertebral, relacionado ao acesso lateral amplo e à avaliação inadequada da anatomia local. Variações no trajeto da artéria vertebral ocasionam maior risco de lesão vascular. O estudo pré-operatório por imagem da anatomia da artéria vertebral e do seu sulco tem sido realizado para aumentar a segurança cirúrgica. OBJETIVO: Estudar a morfometria da artéria vertebral no atlas através da tomografia computadorizada do sulco da artéria vertebral (SAV em 30 atlas isolados de cadáveres. MATERIAIS E MÉTODOS: O SAV e suas relações com a linha média foram avaliados através de oito medidas lineares e duas angulares, bilateralmente. A média, valor máximo e mínimo, e desvio padrão foram calculados para cada parâmetro. RESULTADOS: O SAV apresentou uma maior largura e maior espessura do lado esquerdo (pINTRODUCTION: Several surgical techniques have been carried through in the skull-cervical region due to various pathologies. During the surgical access to this region, a potential risk of iatrogenic injury of the vertebral artery exists, related to extended lateral access and the inadequate evaluation of the local anatomy. Variations in the groove of the vertebral artery lead to a greater risk of vascular injury during surgery. Preoperative image study of the vertebral artery anatomy and its groove has been realized to enhance surgical safety. OBJECTIVE: to study the morphometry of atlas vertebral artery on computed tomography scan images of the vertebral artery groove (VAG in 30 dry atlas. METHODS: VAG and its relationship with the midline were evaluated through eight linear and two angular measures, bilaterally. The average, maximum and minimum values, and standard deviation were calculated for each parameter

  19. Ectopic insertion of a duplicated ureter into prostatic urethra: Demonstration by 3D multi-detector computed tomography urography.

    Science.gov (United States)

    Deng, Jun; Lu, Xiongbing; Liu, Ying

    2016-10-06

    Ectopic insertion of the ureter in the genitourinary tract is a rare congenital disorder, usually associated with ureteral duplication. Identification of the insertion open is critical for ureteric re-implantation. However, the challenge in the diagnosis of ectopic insertion of the ureter usually is to identify its insertion, particularly when the affected ureter is not dilated. Multi-detector computed tomography (MDCT) urography with nonionic iodinated contrast media delineates the ureteric course in the normal functioning kidney in the excretory phase [1]. This report presented a young male patient with ectopic insertion of a duplicated ureter diagnosed by MDCT urography. Three-dimensional (3D) analysis technology, such as volume rendering (with a color display improving the visualization of complex anatomy and 3D relationships) and maximum intensity projection (similar in principle to projection angiography), is useful for the illustration of urinary tract anatomy [1]. Rotated volume rendering reconstruction images and continual thinner maximum intensity projection reformatted images can be viewed as videos, which provides detail delineation of the ectopic ureteral insertion and its associated ureteral duplication.In this study, we reported MDCT urography and 3D analysis technology as an appropriate diagnostic method for the ectopic ureteral insertion and its associated complications.

  20. Single Large Bladder Stone in a Young Male Adult with Primary Hyperparathyroidism

    Directory of Open Access Journals (Sweden)

    Omar Halalsheh

    2017-07-01

    Full Text Available Bladder stones are caused when minerals are built up in the bladder, especially if the bladder is incompletely emptied. These stones will pass while they are small. Otherwise, they get stuck to the bladder wall or ureter. If this happens, they gradually gather more mineral crystals, becoming larger over time. Primary hyperparathyroidism is usually caused by a tumor within the parathyroid gland, and elevated calcium levels can cause digestive symptoms, psychiatric abnormalities, bone disease and multiple kidney stones.

  1. The Sarmatian vertebrates from Draxeni (Moldavian Platform

    Directory of Open Access Journals (Sweden)

    Vlad Codrea

    2007-10-01

    Full Text Available Middle Miocene (Sarmatian vertebrates had been unearthed at Draxeni (Vaslui district. The site is located in the northern area of the Moldavian Platform. There, the sand belonging to Şcheia Formation (Bessarabian is mined in a restricted open pit. This sand is related to a littoral environment (shoreface and foreshore. Some of its levels are rich in mollusc debris. Vertebrate remains, carried into the Bessarabian brackish basin are present too, but in smaller amounts. Mastodon, rhinoceros, hipparionine, tortoise remains had been collected there over several years. All teeth and bones are isolated and bear the marks of intensive rolling by waves and currents. This assemblage is typical for the top of Bessarabian in Moldavia, i.e. soon after the first hipparionine invasion in this part of the Europe. This assemblage can be related to the base of MN 9 unit.

  2. Photoreceptor cell fate specification in vertebrates

    Science.gov (United States)

    Brzezinski, Joseph A.; Reh, Thomas A.

    2015-01-01

    Photoreceptors – the light-sensitive cells in the vertebrate retina – have been extremely well-characterized with regards to their biochemistry, cell biology and physiology. They therefore provide an excellent model for exploring the factors and mechanisms that drive neural progenitors into a differentiated cell fate in the nervous system. As a result, great progress in understanding the transcriptional network that controls photoreceptor specification and differentiation has been made over the last 20 years. This progress has also enabled the production of photoreceptors from pluripotent stem cells, thereby aiding the development of regenerative medical approaches to eye disease. In this Review, we outline the signaling and transcription factors that drive vertebrate photoreceptor development and discuss how these function together in gene regulatory networks to control photoreceptor cell fate specification. PMID:26443631

  3. Functions of Antimicrobial Peptides in Vertebrates.

    Science.gov (United States)

    Avila, Eva Edilia

    2017-01-01

    The aim of this review is to examine the multiple activities of antimicrobial peptides (AMPs) in vertebrates. The largest AMP families are the cathelicidins and defensins, but several peptides derived from bigger proteins have also been reported. Cathelicidins are characterized by a conserved Nterminal pro-region and a variable region that encodes the C-terminal mature peptide. The β-defensins comprise a large family of AMPs that have diversified their functions, apparently without losing their antimicrobial activity. Cathelicidins and β-defensins are present in all vertebrates studied so far; α- defensins are present in mammals, while θ-defensins are only present in some non-human primates. The AMPs are regulated by posttranslational modifications that mainly include proteolysis, amidation, ADP-ribosylation, glycosylation and phosphorylation. In addition to their antimicrobial effects, AMPs show activity against viral particles and interfere in different steps of virus replication. Moreover, AMPs may both promote and inhibit cancer growth: several vertebrate AMPs kill cancer cells, and some tumors grow in an environment wherein the expression of β-defensins is reduced; however, human cathelicidin and some β-defensins are overexpressed in several types of cancer and are correlated with tumor growth. AMPs are part of the complex network of cells and molecules that forms the vertebrate innate defense system and they induce adaptive responses. In addition, they participate in sperm maturation and male reproduction. AMPs are multifunctional peptides that participate in immune responses, wound healing, angiogenesis, toxin neutralization, iron metabolism, male reproduction, among other functions. However, AMPs may also contribute to excessive inflammation and tumorigenesis. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  4. Delayed coupling theory of vertebrate segmentation

    OpenAIRE

    Morelli, Luis G.; Ares, Saúl; Herrgen, Leah; Schröter, Christian; Jülicher, Frank; Andrew C. Oates

    2008-01-01

    Rhythmic and sequential subdivision of the elongating vertebrate embryonic body axis into morphological somites is controlled by an oscillating multicellular genetic network termed the segmentation clock. This clock operates in the presomitic mesoderm (PSM), generating dynamic stripe patterns of oscillatory gene-expression across the field of PSM cells. How these spatial patterns, the clock’s collective period, and the underlying cellular-level interactions are related is not understood. A th...

  5. Vertebral artery dissection associated with sildenafil abuse.

    Science.gov (United States)

    Dersch, Rick; Anastasopoulos, Constantin; Hader, Claudia; Stich, Oliver

    2013-05-01

    We present a 49-year-old male who suffered a cerebellar infarction due to a vertebral artery dissection. The patient had taken sildenafil daily for at least 2 years for sexual enhancement. There was no sexual intercourse or traumatic event prior to symptom onset. Sildenafil intake has been associated with aortic dissection and, in the light of this report, we suggest that chronic sildenafil intake could be a risk factor for arterial dissection. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Vertebral involvement in SAPHO syndrome: MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Nachtigal, A.; Cardinal, E.; Bureau, N.J. [Dept. of Radiology, Univ. de Montreal, QC (Canada); Sainte-Marie, L.G. [Dept. of Internal Medicine, Univ. de Montreal, QC (Canada); Milette, F. [Department of Pathology, Univ. de Montreal, QC (Canada)

    1999-03-01

    We report on the MRI findings in the vertebrae and surrounding soft tissues in two patients with the SAPHO syndrome (Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis). The MRI findings include abnormal bone marrow signal, either focal or diffuse, of the vertebral bodies and posterior elements; hyperintense paravertebral soft tissue swelling and abnormal signal of the intervertebral discs. These changes are consistent with discitis and osteitis. (orig.) With 6 figs., 17 refs.

  7. Transmission of ranavirus between ectothermic vertebrate hosts.

    Science.gov (United States)

    Brenes, Roberto; Gray, Matthew J; Waltzek, Thomas B; Wilkes, Rebecca P; Miller, Debra L

    2014-01-01

    Transmission is an essential process that contributes to the survival of pathogens. Ranaviruses are known to infect different classes of lower vertebrates including amphibians, fishes and reptiles. Differences in the likelihood of infection among ectothermic vertebrate hosts could explain the successful yearlong persistence of ranaviruses in aquatic environments. The goal of this study was to determine if transmission of a Frog Virus 3 (FV3)-like ranavirus was possible among three species from different ectothermic vertebrate classes: Cope's gray treefrog (Hyla chrysoscelis) larvae, mosquito fish (Gambusia affinis), and red-eared slider (Trachemys scripta elegans). We housed individuals previously exposed to the FV3-like ranavirus with naïve (unexposed) individuals in containers divided by plastic mesh screen to permit water flow between subjects. Our results showed that infected gray treefrog larvae were capable of transmitting ranavirus to naïve larval conspecifics and turtles (60% and 30% infection, respectively), but not to fish. Also, infected turtles and fish transmitted ranavirus to 50% and 10% of the naïve gray treefrog larvae, respectively. Nearly all infected amphibians experienced mortality, whereas infected turtles and fish did not die. Our results demonstrate that ranavirus can be transmitted through water among ectothermic vertebrate classes, which has not been reported previously. Moreover, fish and reptiles might serve as reservoirs for ranavirus given their ability to live with subclinical infections. Subclinical infections of ranavirus in fish and aquatic turtles could contribute to the pathogen's persistence, especially when highly susceptible hosts like amphibians are absent as a result of seasonal fluctuations in relative abundance.

  8. The timing of Timezyme diversification in vertebrates.

    Directory of Open Access Journals (Sweden)

    Damien Cazaméa-Catalan

    Full Text Available All biological functions in vertebrates are synchronized with daily and seasonal changes in the environment by the time keeping hormone melatonin. Its nocturnal surge is primarily due to the rhythmic activity of the arylalkylamine N-acetyl transferase AANAT, which thus became the focus of many investigations regarding its evolution and function. Various vertebrate isoforms have been reported from cartilaginous fish to mammals but their origin has not been clearly established. Using phylogeny and synteny, we took advantage of the increasing number of available genomes in order to test whether the various rounds of vertebrate whole genome duplications were responsible for the diversification of AANAT. We highlight a gene secondary loss of the AANAT2 in the Sarcopterygii, revealing for the first time that the AAANAT1/2 duplication occurred before the divergence between Actinopterygii (bony fish and Sarcopterygii (tetrapods, lobe-finned fish, and lungfish. We hypothesize the teleost-specific whole genome duplication (WDG generated the appearance of the AANAT1a/1b and the AANAT2/2'paralogs, the 2' isoform being rapidly lost in the teleost common ancestor (ray-finned fish. We also demonstrate the secondary loss of the AANAT1a in a Paracantopterygii (Atlantic cod and of the 1b in some Ostariophysi (zebrafish and cave fish. Salmonids present an even more diverse set of AANATs that may be due to their specific WGD followed by secondary losses. We propose that vertebrate AANAT diversity resulted from 3 rounds of WGD followed by previously uncharacterized secondary losses. Extant isoforms show subfunctionalized localizations, enzyme activities and affinities that have increased with time since their emergence.

  9. Modular evolution of the Cetacean vertebral column.

    Science.gov (United States)

    Buchholtz, Emily A

    2007-01-01

    Modular theory predicts that hierarchical developmental processes generate hierarchical phenotypic units that are capable of independent modification. The vertebral column is an overtly modular structure, and its rapid phenotypic transformation in cetacean evolution provides a case study for modularity. Terrestrial mammals have five morphologically discrete vertebral series that are now known to be coincident with Hox gene expression patterns. Here, I present the hypothesis that in living Carnivora and Artiodactyla, and by inference in the terrestrial ancestors of whales, the series are themselves components of larger precaudal and caudal modular units. Column morphology in a series of fossil and living whales is used to predict the type and sequence of developmental changes responsible for modification of that ancestral pattern. Developmental innovations inferred include independent meristic additions to the precaudal column in basal archaeocetes and basilosaurids, stepwise homeotic reduction of the sacral series in protocetids, and dissociation of the caudal series into anterior tail and fluke subunits in basilosaurids. The most dramatic change was the novel association of lumbar and anterior caudal vertebrae in a module that crosses the precaudal/caudal boundary. This large unit is defined by shared patterns of vertebral morphology, count, and size in all living whales (Neoceti).

  10. Fungal osteomyelitis with vertebral re-ossification.

    Science.gov (United States)

    O Guinn, Devon J; Serletis, Demitre; Kazemi, Noojan

    2016-01-01

    We present a rare case of thoracic vertebral osteomyelitis secondary to pulmonary Blastomyces dermatitides. A 27-year-old male presented with three months of chest pains and non-productive cough. Examination revealed diminished breath sounds on the right. CT/MR imaging confirmed a right-sided pre-/paravertebral soft tissue mass and destructive lytic lesions from T2 to T6. CT-guided needle biopsy confirmed granulomatous pulmonary Blastomycosis. Conservative management with antifungal therapy was initiated. Neurosurgical review confirmed no clinical or profound radiographic instability, and the patient was stabilized with TLSO bracing. Serial imaging 3 months later revealed near-resolution of the thoracic soft tissue mass, with vertebral re-ossification from T2 to T6. Fungal osteomyelitis presents a rare entity in the spectrum of spinal infections. In such cases, lytic spinal lesions are classically seen in association with a large paraspinous mass. Fungal infections of the spinal column may be treated conservatively, with surgical intervention reserved for progressive cases manifesting with neurological compromise and/or spinal column instability. Here, we found unexpected evidence for vertebral re-ossification across the affected thoracic levels (T2-6) in response to IV antibiotic therapy and conservative bracing, nearly 3 months later. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  11. Epidemiologia do traumatismo da coluna vertebral

    Directory of Open Access Journals (Sweden)

    Marcelo Ferraz de Campos

    Full Text Available OBJETIVO: Avaliação epidemiológica retrospectiva de 100 casos de traumatismo da coluna vertebral. MÉTODO: Estudo transversal de dados colhidos por levantamento de prontuário, segundo protocolo de decodificação local. RESULTADOS: Predomínio etário de 20 a 40 anos em 64% dos casos; sexo masculino em 86%; segmento toracolombar mais comumente atingido 64% e 36% para o segmento cervical; principais causas foram às quedas em 40%, seguidas de acidentes automobilísticos em 25% e quedas da laje 23%. A prevalência dos ferimentos por arma de fogo foi de 7%, mergulho em águas rasas 3% e agressões 2%. Houve análise complementar com cruzamentos entre idade, sexo, causa e segmento da coluna vertebral acometido, observando que o segmento cervical teve grande predomínio nas mulheres em relação aos homens em 85,7% X 14,3%. CONCLUSÃO: O traumatismo da coluna vertebral ocorreu predominantemente em homens entre 20 e 40 anos e o segmento cervical foi o mais acometido nas mulheres em relação aos homens na proporção de 6:1.

  12. Nestedness of ectoparasite-vertebrate host networks.

    Directory of Open Access Journals (Sweden)

    Sean P Graham

    2009-11-01

    Full Text Available Determining the structure of ectoparasite-host networks will enable disease ecologists to better understand and predict the spread of vector-borne diseases. If these networks have consistent properties, then studying the structure of well-understood networks could lead to extrapolation of these properties to others, including those that support emerging pathogens. Borrowing a quantitative measure of network structure from studies of mutualistic relationships between plants and their pollinators, we analyzed 29 ectoparasite-vertebrate host networks--including three derived from molecular bloodmeal analysis of mosquito feeding patterns--using measures of nestedness to identify non-random interactions among species. We found significant nestedness in ectoparasite-vertebrate host lists for habitats ranging from tropical rainforests to polar environments. These networks showed non-random patterns of nesting, and did not differ significantly from published estimates of nestedness from mutualistic networks. Mutualistic and antagonistic networks appear to be organized similarly, with generalized ectoparasites interacting with hosts that attract many ectoparasites and more specialized ectoparasites usually interacting with these same "generalized" hosts. This finding has implications for understanding the network dynamics of vector-born pathogens. We suggest that nestedness (rather than random ectoparasite-host associations can allow rapid transfer of pathogens throughout a network, and expand upon such concepts as the dilution effect, bridge vectors, and host switching in the context of nested ectoparasite-vertebrate host networks.

  13. Evolution of sound localisation in land vertebrates.

    Science.gov (United States)

    Köppl, Christine

    2009-08-11

    The story of the evolution of hearing in land vertebrates is fascinating but complex. The water-to-land transition changed the physical environment in which hearing happens so dramatically that both the peripheral receptor structures and the central auditory circuits underwent a revolution, leading to the sensitive hearing of higher-frequency airborne sound. This (r)evolution took a very long time indeed. Most of it happened after the early divergence of the major clades of land vertebrates. Hearing, at least hearing as we commonly understand it today, is the youngest of the major senses and much of its evolutionary history is not shared between amphibians, lepidosauromorphs (lizards and snakes), archosauromorphs (birds and crocodilians) and mammals. There was no linear evolution of complexity from 'lower' to 'higher' vertebrates. We are only just beginning to appreciate the implications of this for central auditory processing. There is no consensus, yet, on the evolution of sound localisation. The multitude of physical cues involved in sound localisation means that different selective pressures interact and need to be considered. The use and neural processing of interaural time differences is just one example. It has taught us that long-standing assumptions, such as the homology of the mammalian medial superior olive and the avian nucleus laminaris, need to be questioned and that important insights may arise from unexpected directions, such as the paleontology of middle-ear ossicles. There is still much to discover.

  14. Vertebral osteomyelitis in adults: an update.

    Science.gov (United States)

    Nickerson, Emma K; Sinha, Rohitashwa

    2016-03-01

    The incidence of vertebral osteomyelitis is increasing, attributed to an ageing population with inherent co-morbidities and improved case ascertainment. References were retrieved from the PubMed database using the terms 'vertebral osteomyelitis' and 'spondylodiscitis' between January 1, 2009 and April 30, 2014 published in English as checked in May 2014 (>1000 abstracts checked). Blood cultures and whole spine imaging with magnetic resonance imaging are essential investigations. Thorough debridement is the mainstay of surgical management, although placing metalwork in active infection is becoming increasingly common. The extent of pursuing spinal biopsies to determine aetiology, antimicrobial choices and duration, monitoring the response to treatment, and surgical techniques and timing all vary widely in clinical practice with heterogeneous studies limiting comparisons. Surgery, rather than conservative approaches, is being proposed as the default management choice, because it can, in carefully selected patients, offer faster reduction in pain scores and improved quality of life. Further studies are needed to define the most effective technique for spinal biopsies to maximize determining aetiology. High-quality trials are required to provide an evidence base for both the medical and surgical management of vertebral osteomyelitis, including challenging medical management as the default option. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. Phylotranscriptomic consolidation of the jawed vertebrate timetree.

    Science.gov (United States)

    Irisarri, Iker; Baurain, Denis; Brinkmann, Henner; Delsuc, Frédéric; Sire, Jean-Yves; Kupfer, Alexander; Petersen, Jörn; Jarek, Michael; Meyer, Axel; Vences, Miguel; Philippe, Hervé

    2017-09-01

    Phylogenomics is extremely powerful but introduces new challenges as no agreement exists on "standards" for data selection, curation and tree inference. We use jawed vertebrates (Gnathostomata) as model to address these issues. Despite considerable efforts in resolving their evolutionary history and macroevolution, few studies have included a full phylogenetic diversity of gnathostomes and some relationships remain controversial. We tested a novel bioinformatic pipeline to assemble large and accurate phylogenomic datasets from RNA sequencing and find this phylotranscriptomic approach successful and highly cost-effective. Increased sequencing effort up to ca. 10Gbp allows recovering more genes, but shallower sequencing (1.5Gbp) is sufficient to obtain thousands of full-length orthologous transcripts. We reconstruct a robust and strongly supported timetree of jawed vertebrates using 7,189 nuclear genes from 100 taxa, including 23 new transcriptomes from previously unsampled key species. Gene jackknifing of genomic data corroborates the robustness of our tree and allows calculating genome-wide divergence times by overcoming gene sampling bias. Mitochondrial genomes prove insufficient to resolve the deepest relationships because of limited signal and among-lineage rate heterogeneity. Our analyses emphasize the importance of large curated nuclear datasets to increase the accuracy of phylogenomics and provide a reference framework for the evolutionary history of jawed vertebrates.

  16. Flapping wing aerodynamics: from insects to vertebrates.

    Science.gov (United States)

    Chin, Diana D; Lentink, David

    2016-04-01

    More than a million insects and approximately 11,000 vertebrates utilize flapping wings to fly. However, flapping flight has only been studied in a few of these species, so many challenges remain in understanding this form of locomotion. Five key aerodynamic mechanisms have been identified for insect flight. Among these is the leading edge vortex, which is a convergent solution to avoid stall for insects, bats and birds. The roles of the other mechanisms - added mass, clap and fling, rotational circulation and wing-wake interactions - have not yet been thoroughly studied in the context of vertebrate flight. Further challenges to understanding bat and bird flight are posed by the complex, dynamic wing morphologies of these species and the more turbulent airflow generated by their wings compared with that observed during insect flight. Nevertheless, three dimensionless numbers that combine key flow, morphological and kinematic parameters - the Reynolds number, Rossby number and advance ratio - govern flapping wing aerodynamics for both insects and vertebrates. These numbers can thus be used to organize an integrative framework for studying and comparing animal flapping flight. Here, we provide a roadmap for developing such a framework, highlighting the aerodynamic mechanisms that remain to be quantified and compared across species. Ultimately, incorporating complex flight maneuvers, environmental effects and developmental stages into this framework will also be essential to advancing our understanding of the biomechanics, movement ecology and evolution of animal flight. © 2016. Published by The Company of Biologists Ltd.

  17. Incontinence due to an infrasphincteric ectopic ureter: why the delay in diagnosis and what the radiologist can do about it

    Energy Technology Data Exchange (ETDEWEB)

    Carrico, C.; Lebowitz, R.L. [Children`s Hospital Medical Center, Boston, MA (United States). Dept. of Radiology

    1998-12-01

    Purpose. To determine (1) the reasons for the frequently long delay in the diagnosis of an infrasphincteric ectopic ureter in girls, and (2) what role the radiologist can play in decreasing the delay. Materials and methods. Twelve girls were referred to our hospital from June 1994 until April 1997 for evaluation of constant urinary dribbling and/or vaginal discharge. Available imaging studies, radiology reports, and clinic notes were reviewed. Results. Mean age at the time of diagnosis was 6 years 7 months (range 2 years 10 months to 11 years 11 months). Mean delay until diagnosis after presentation was 2 years 5 months. Excluding the one girl whose ectopic ureter was diagnosed while she was still in diapers, mean age at the time of the first parental ``complaint`` was 4 years 9 months. The significance of the classic history of constant urinary dribbling was not recognized by physicians in 7 girls for 4 months to 7 years 10 months after presentation. Physical exam was not meticulously performed, as the ectopic orifice was visible in 8 of 12 girls. Imaging studies were ineffectively utilized: no imaging was done (for 2 years in 2 girls), inappropriate studies were done (ultrasound and voiding cystourethrography) and were misleading, studies were called normal when they were not (ultrasound and excretory urography), or perinatal imaging led to the incorrect assumption of a congenitally absent kidney in one girl and a multicystic dysplastic kidney in another. Excretory urography (EU) was diagnostic in all 10 girls with a duplex kidney, and computed tomography (CT) was supportive in 2 with a dysplastic kidney. CT was an adjunct in 3 girls; a Tc-99m-dimercaptosuccinic acid (DMSA) scan was needed in 2. Conclusion. The classic history of constant urinary dribbling in a successfully toilet-trained girl should immediately lead to an imaging search for the portion of kidney (or entire kidney) drained by an infrasphincteric ectopic ureter. EU should usually be the first

  18. Normal Porcine Ureter Retains Lumen Wall Integrity but Not Patency Following Catheter-Directed Irreversible Electroporation: Imaging and Histologic Assessment over 28 Days.

    Science.gov (United States)

    Srimathveeravalli, Govindarajan; Cornelis, Francois; Wimmer, Thomas; Monette, Sebastien; Kimm, Simon Y; Maybody, Majid; Solomon, Stephen B; Coleman, Jonathan A; Durack, Jeremy C

    2017-06-01

    To evaluate the effect of catheter-directed irreversible electroporation (IRE) on the integrity, patency, and function of the normal porcine ureter. A catheter-mounted electrode was used to perform fluoroscopy-guided IRE in 8 healthy pigs. Two unilateral ablations (90 pulses at 2,000 V, 100 μs) were performed in each animal in the proximal and distal ureter. Serum creatinine measurements and contrast-enhanced computed tomography imaging were performed at 1, 7, 14, 21, and 28 days after IRE, and findings were compared with baseline values by Student t test. Two animals each were euthanized at 1, 7, 14, and 28 days after IRE for histologic assessment of treatment effects. Quantitative histologic analysis of regeneration and healing of the ureteral wall was graded on a five-point scale. IRE was successfully performed in all animals. Preservation of ureteral wall integrity was confirmed by the leakage-free passage of contrast medium in the treated ureter of all animals through the observation period. Ureteral strictures and associated renal pelvicaliceal dilation were observed in all animals by study days 7 (P = .005) and 14 (P = .007) and did not resolve by day 28. Urothelial recovery was observed in tissue samples from day 7, with progressive replacement of the tunica muscularis with granulation tissue. Despite extensive scarring of the tunica muscularis, full recovery of the urothelium was observed by day 28. The normal porcine ureter retains lumen wall integrity and function following catheter-directed IRE. Scarring of the tunica muscularis in the treated ureter results in stricture formation and reduction of lumen patency. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

  19. Endoscopic Spatulation of the Intramural Ureter: A Technique to Prevent Stenosis of the Ureterovesical Junction in Patients Undergoing Resection of the Ureteral Orifice.

    Science.gov (United States)

    Creta, Massimiliano; Mirone, Vincenzo; Di Meo, Sergio; Buonopane, Roberto; Fusco, Ferdinando; Imperatore, Vittorio

    2016-08-01

    Wide resection of the ureteral orifice (UO) may result in scarring and stenosis of the ureterovesical junction (UVJ). We aimed to describe a technique of endoscopic spatulation of the intramural ureter in patients undergoing resection of the UO at the time of transurethral resection of bladder tumor (TURBT) and compare the surgical and oncological outcomes of this procedure with those of patients undergoing conventional UO resection. The clinical records of patients who underwent TURBT at a single institution were retrospectively analyzed. Patients who underwent conventional UO resection or UO resection followed by endoscopic spatulation of the intramural ureter were included in the analysis. The two groups were compared in terms of intra- and postoperative outcomes. A total of 227 patients were included in the final comparative analyses. Of them, 104 underwent conventional UO resection and 123 underwent UO resection followed by endoscopic spatulation of the intramural ureter. The two groups were comparable for demographic and clinical features. There were not statistically significant differences in terms of mean operative times. The incidence of transient postoperative hydronephrosis as well as UVJ scarring and stenosis was significantly lower in patients undergoing endoscopic spatulation of the intramural ureter. The two groups were similar in terms of incidence of vesicoureteral reflux (VUR) and upper urinary tract cancer recurrence. Endoscopic spatulation of the intramural ureter after UO resection is a safe and quick procedure that significantly reduces the incidence of transient early postoperative hydronephrosis and late UVJ stricture if compared with UO resection alone. This procedure is quick to perform, safe, and does not increase the risk of VUR.

  20. Surgical management of the distal ureter during radical nephroureterectomy is an independent predictor of oncological outcomes: results of a current series and a review of the literature.

    Science.gov (United States)

    Krabbe, Laura-Maria; Westerman, Mary E; Bagrodia, Aditya; Gayed, Bishoy A; Khalil, Dina; Kapur, Payal; Shariat, Shahrokh F; Raj, Ganesh V; Sagalowsky, Arthur I; Cadeddu, Jeffrey A; Lotan, Yair; Margulis, Vitaly

    2014-01-01

    To evaluate the effect of distal ureter management on oncological outcomes in patients with radical nephroureterectomy (RNU) for upper tract urothelial carcinoma. Retrospective review of patient records and operative reports was conducted on 122 patients who underwent RNU. Data were compared between 2 groups using substratification by distal ureter management (transvesical bladder cuff [TVBC]) vs. no TVBC). Mean patient age was 69.0 years and 63.1% were male. Median follow-up was 32.0 months. Most patients (n = 76, 62.3%) received a TVBC and 46 (37.7%) patients received no TVBC during RNU. There were no significant differences in clinicopathological variables between both groups except for a higher rate of lymphadenectomy during surgery in the TVBC group (38.2% vs. 15.2%). On multivariate analysis, intravesical recurrence (IVR) was not affected by distal ureter management but was affected by tumor multifocality (hazard ratio [HR] = 2.2; 95% confidence interval [CI], 1.2-4.0; P = 0.013). However, non-IVR-free survival (non-IVR FS) and cancer-specific survival (CSS) were independently influenced by T stage (HR = 4.9; 95% CI, 1.5-16.3; P = 0.010 for non-IVR FS and HR = 6.3; 95% CI, 1.7-23.1; P = 0.005 for CSS) and management of the distal ureter (HR = 3.2; 95% CI, 1.3-7.6; P = 0.010 for non-IVR FS and HR = 3.4; 95% CI, 1.3-8.8; P = 0.010 for CSS). In our study, surgical management of the distal ureter without excision of a TVBC resulted in significantly worse non-IVR FS and CSS but had no influence on IVR. This is hypothesis generating and supports further prospective study as to standardization of BC resection during RNU. © 2013 Published by Elsevier Inc.

  1. Angioplasty and stenting of symptomatic and asymptomatic vertebral artery stenosis: to treat or not to treat.

    Science.gov (United States)

    Parkhutik, V; Lago, A; Tembl, J I; Aparici, F; Vazquez, V; Mainar, E

    2010-02-01

    Comprehensive indications for treatment of symptomatic vertebral stenosis remain unavailable. Even less is known about endovascular treatment of asymptomatic cases. We treated symptomatic and asymptomatic vertebral ostium stenosis with angioplasty and stenting and investigated the long term outcome. Consecutive patients with two different indications were included. Group 1 (G1) had symptomatic >50% stenosis. Group 2 (G2) had asymptomatic >50% stenosis and severe lesions of anterior circulation and were expected to benefit from additional cerebral blood supply. Twenty nine vertebral origin stenoses in 28 patients (75% men, mean age 64 +/- 9 years) were treated. There were 16 G1 and 13 G2 cases. Technical success rate was 100%. Immediate neurological complications rate was 3.4% (one G1 patient with vertebral TIA due to release of emboli). Two further strokes were seen during follow up (32 +/- 24 months): vertebrobasilar stroke in a G2 patient with permeable stent in V1 segment, new ipsilateral V3 occlusion and high-risk cardioembolic source, and carotid stroke in a G1 patient who had had ipsilateral carotid stenting. There were no deaths of any cause. Asymptomatic restenosis was observed in one out of 19 patients from both groups who underwent a follow up angiography. Angioplasty and stenting appears to be technically feasible and safe in asymptomatic and symptomatic vertebral stenosis. More studies are needed in order to clarify its role in primary and secondary prevention of vertebrobasilar stroke. High risk anterior circulation lesions should be taken into account as a possible indication in patients with asymptomatic vertebral stenosis.

  2. A nomenclature for vertebral fossae in sauropods and other saurischian dinosaurs.

    Directory of Open Access Journals (Sweden)

    Jeffrey A Wilson

    Full Text Available BACKGROUND: The axial skeleton of extinct saurischian dinosaurs (i.e., theropods, sauropodomorphs, like living birds, was pneumatized by epithelial outpocketings of the respiratory system. Pneumatic signatures in the vertebral column of fossil saurischians include complex branching chambers within the bone (internal pneumaticity and large chambers visible externally that are bounded by neural arch laminae (external pneumaticity. Although general aspects of internal pneumaticity are synapomorphic for saurischian subgroups, the individual internal pneumatic spaces cannot be homologized across species or even along the vertebral column, due to their variability and absence of topographical landmarks. External pneumatic structures, in contrast, are defined by ready topological landmarks (vertebral laminae, but no consistent nomenclatural system exists. This deficiency has fostered confusion and limited their use as character data in phylogenetic analysis. METHODOLOGY/PRINCIPAL FINDINGS: We present a simple system for naming external neural arch fossae that parallels the one developed for the vertebral laminae that bound them. The nomenclatural system identifies fossae by pointing to reference landmarks (e.g., neural spine, centrum, costal articulations, zygapophyses. We standardize the naming process by creating tripartite names from "primary landmarks," which form the zygodiapophyseal table, "secondary landmarks," which orient with respect to that table, and "tertiary landmarks," which further delineate a given fossa. CONCLUSIONS/SIGNIFICANCE: The proposed nomenclatural system for lamina-bounded fossae adds clarity to descriptions of complex vertebrae and allows these structures to be sourced as character data for phylogenetic analyses. These anatomical terms denote potentially homologous pneumatic structures within Saurischia, but they could be applied to any vertebrate with vertebral laminae that enclose spaces, regardless of their developmental

  3. Globally threatened vertebrates on islands with invasive species.

    Science.gov (United States)

    Spatz, Dena R; Zilliacus, Kelly M; Holmes, Nick D; Butchart, Stuart H M; Genovesi, Piero; Ceballos, Gerardo; Tershy, Bernie R; Croll, Donald A

    2017-10-01

    Global biodiversity loss is disproportionately rapid on islands, where invasive species are a major driver of extinctions. To inform conservation planning aimed at preventing extinctions, we identify the distribution and biogeographic patterns of highly threatened terrestrial vertebrates (classified by the International Union for Conservation of Nature) and invasive vertebrates on ~465,000 islands worldwide by conducting a comprehensive literature review and interviews with more than 500 experts. We found that 1189 highly threatened vertebrate species (319 amphibians, 282 reptiles, 296 birds, and 292 mammals) breed on 1288 islands. These taxa represent only 5% of Earth's terrestrial vertebrates and 41% of all highly threatened terrestrial vertebrates, which occur in invasive vertebrates was available for 1030 islands (80% of islands with highly threatened vertebrates). Invasive vertebrates were absent from 24% of these islands, where biosecurity to prevent invasions is a critical management tool. On the 76% of islands where invasive vertebrates were present, management could benefit 39% of Earth's highly threatened vertebrates. Invasive mammals occurred in 97% of these islands, with Rattus sp. as the most common invasive vertebrate (78%; 609 islands). Our results provide an important baseline for identifying islands for invasive species eradication and other island conservation actions that reduce biodiversity loss.

  4. Percutaneous vertebral augmentation for painful osteolytic vertebral metastasis: a case report

    Directory of Open Access Journals (Sweden)

    Anselmetti GC

    2012-03-01

    Full Text Available Giovanni C Anselmetti1, Sean M Tutton2, Francis R Facchini3, Larry E Miller4,5, Jon E Block51Institute for Cancer Research and Treatment, Turin, Italy; 2Medical College of Wisconsin in Milwaukee, Froedtert Memorial Lutheran Hospital, Milwaukee, WI, USA; 3Interventional Radiology, Interventional Oncology, VIR Chicago, Hinsdale, IL, USA; 4Miller Scientific Consulting, Inc, Arden, NC, USA; 5The Jon Block Group, San Francisco, CA, USAIntroduction: Vertebral metastases are associated with significant pain, disability, and morbidity. Open surgery for fracture stabilization is often inappropriate in this population due to a poor risk-benefit profile, particularly if life expectancy is short. Percutaneous vertebroplasty and kyphoplasty are appealing adjunctive procedures in patients with malignancy for alleviation of intractable pain. However, these patients have higher risk of serious complications, notably cement extravasation. Described in this report is a case of a painful osteolytic vertebral metastasis that was successfully treated by a novel percutaneous vertebral augmentation system.Case presentation: A 42-year-old Caucasian female presented with a history of metastatic lung cancer unresponsive to radiation and chemotherapy with symptoms inadequately controlled by opiates over the previous 6 months. Magnetic resonance imaging and spiral computed tomography with two-dimensional reconstruction showed an osteolytic vertebral metastasis with complete involvement of the T10 vertebral body, extending to the cortical vertebral wall anteriorly and posteriorly. The patient was treated with percutaneous vertebral augmentation (Kiva® VCF Treatment System, Benvenue Medical, Inc, Santa Clara, CA utilizing a novel coil-shaped polyetheretherketone implant designed to minimize the risk of cement extravasation. After the minimally invasive procedure, bone cement distribution within the vertebral body was ideal, with no observed cement extravasation. No

  5. Evolution of vertebrate GnRH receptors from the perspective of a basal vertebrate

    Directory of Open Access Journals (Sweden)

    Stacia A Sower

    2012-11-01

    Full Text Available This minireview provides the current status on gonadotropin-releasing hormone receptors (GnRH-R in vertebrates, from the perspective of a basal vertebrate, the sea lamprey, and provides an evolutionary scheme based on the recent advance of whole genome sequencing. In addition, we provide a perspective on the functional divergence and evolution of the receptors. In this review we use the phylogenetic classification of vertebrate GnRH receptors that groups them into three clusters: type I (mammalian and non-mammalian, type II, and type III GnRH receptors. New findings show that the sea lamprey has two type III-like GnRH receptors and an ancestral type GnRH receptor that is more closely related to the type II-like receptors. These two novel GnRH receptors along with lGnRH-R-1 share similar structural features and amino acid motifs common to other known gnathostome type II/III receptors. Recent data analyses of the lamprey genome provide strong evidence that 2 whole rounds of genome duplication (2R occurred prior to the gnathostome-agnathan split. Based on our current knowledge, it is proposed that lGnRH-R-1 evolved from an ancestor of the type II receptor following a vertebrate-shared genome duplication and that the two type III receptors resulted from a duplication within lamprey of a gene derived from a lineage shared by many vertebrates.

  6. Primary mediastinal tuberculous abscess: Demonstration with MR

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, R.K.; Jena, A.; Prakash, R.; Sharma, B.K.; Talukdar, B.; Pant, K.

    1989-06-01

    An unusual case of primary mediastinal tuberculous abscess is presented in whom the diagnosis was obtained on magnetic resonance (MR) and ultrasound (US) guided aspiration cytology. Mycobacterium tuberculosis was isolated from direct smear as well as from culture of the 'pus'. Normal spine signal with MR and normal bone scintigraphy excluded any vertebral focus of infection. MR was helpful in defining the extent and characterising the abscess besides excluding a vertebral focus of infection.

  7. Balloon Kyphoplasty for Managing Intractable Pain in Pediatric Pathologic Vertebral Fractures.

    Science.gov (United States)

    Hoashi, Jane S; Thomas, Stefanie M; Goodwin, Ryan C; Gurd, David P; Hanna, Rabi; Kuivila, Thomas E

    2017-06-01

    Vertebral compression fractures are a common result of osteoporosis and osteopenia secondary to steroid use and chemotherapy treatment. Balloon kyphoplasty is a treatment option with good to excellent results well described in adults. Although a few recent studies have been published regarding the use of kyphoplasty in children, no formal indication exists for the pediatric population. The purpose of this study is to describe the outcomes of 3 chronically ill children with intractable pain from vertebral compression fractures, managed with kyphoplasty. We retrospectively reviewed 3 pediatric patients who underwent balloon kyphoplasty for vertebral compression fractures secondary to chronic illness. Patient variables included age, sex, primary diagnosis and treatments, levels of vertebral fracture, and time elapsed from initial therapy to fracture. A numeric rating scale of 0 to 10 was used for patient-reported pain, before and after kyphoplasty. Preoperative and postoperative analgesic use and physical function were also described. Surgical variables included levels of kyphoplasty, operative time, and procedure-related complications. The primary diagnoses were relapsed rhabdomyosarcoma, abdominal desmoplastic small round cell tumor, and IPEX-like (immune dysregulation, polyendrocrinopathy, enteropathy, X-linked) syndrome. All 3 patients were males, aged 12, 12, and 13, respectively, at the time of kyphoplasty. Pain scores were 8 to 9 preoperatively in 2 patients, severely affecting their physical function including independent walking. Excruciating back pain was a contributing factor to the respiratory distress of the third patient, who required elective intubation. All of the patients reported significant pain relief (range, 0 to 2) and improved physical function with kyphoplasty. The third patient was successfully extubated 1 week postoperatively and eventually returned to baseline activity. There were no complications related to kyphoplasty. Balloon kyphoplasty

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

    Science.gov (United States)

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

    2013-01-01

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

  9. Inadvertent placement of a urinary catheter into the ureter: A report of 3 cases and review of the literature

    Directory of Open Access Journals (Sweden)

    Rui Luo

    2017-10-01

    Full Text Available We describe three cases of inadvertent placement of the urinary catheter into the ureter. An 85-year-old gentleman on long-term indwelling catheter (IDC for neurogenic bladder presented with fever and right flank pain. CT of abdomen and pelvis demonstrated the tip of the IDC to be located within the right vesicoureteric junction with acute right hydronephrosis and acute pyelonephritis. A 74-year-old woman, on long-term IDC for neurogenic bladder was found to have hydronephrosis on ultrasound imaging. Contrast-enhanced CT intravenous pyelography done subsequently showed the IDC was in the right distal ureter. A 47-year-old lady, on IDC for urinary retention and voiding dysfunction likely secondary to schizophrenia and anti-psychotic medications, presented with raised creatinine. A non-enhanced CT of her abdomen and pelvis was done and showed that the tip of the urethral IDC was located up to the left vesicoureteric junction. In all patients, the hydronephrosis resolved after changing the catheter and they were well on discharge. We also review the literature to identify the incidence, outcomes and possible risk factors. To our knowledge, only 20 cases have been reported thus far in the English literature. Although serious complications can occur, the incidence is very low. One risk factor that has been identified is long-term catheterization in patients with neurogenic bladder. We do not recommend routine imaging after catheterization in this group of patients. However, we should still be mindful of the possibility of this occurrence and evaluate and treat as necessary when clinical suspicion arises.

  10. Standards of the Polish Ultrasound Society – update. Ultrasound examination of the kidneys, ureters and urinary bladder

    Directory of Open Access Journals (Sweden)

    Janusz F. Tyloch

    2013-09-01

    Full Text Available The paper presents the principles of performing proper ultrasound examinations of the urinary tract. The following are discussed: preparation of patients, type of optimal apparatus, technique of examination and conditions which its description should fulfill. Urinary track examination in adults and in children constitutes an integral part of each abdominal examination. Such examinations should be performed with fasting patients or several hours after the last meal, with filled urinary bladder. Apparatus: Ultrasound examinations in children and infants are performed using transducers with the frequency of 5.0–9.0 MHz and in adults – with the frequency of 2.0–6.0 MHz. Doppler options are desirable since they improve diagnostic capacity of sonography in terms of differentiation between renal focal lesions. Scanning technique: Renal examinations are performed with the patients in the supine position. The right kidney is examined in the right hypochondriac region using the liver as the ultrasound “window.” The left kidney is examined in the left hypochondriac region, preferably in the posterior axillary line. Ultrasound examinations of the upper segment of the ureters are performed after renal examination when the pelvicalyceal system is dilated. A condition necessary for a proper examination of the perivesical portion of the ureter is full urinary bladder. The scans of the urinary bladder are performed in transverse, longitudinal and oblique planes when the bladder is filled. Description of the examination: The description should include patient’s personal details, details of the referring unit, of the unit in which the examination is performed, examining physician’s details, type of ultrasound apparatus and transducers as well as the description proper.

  11. Clinical and neuroimaging features vertebral radiculopathy in the combination with vertebral hemangiomas

    Directory of Open Access Journals (Sweden)

    Che-honatskaya M.L.

    2012-06-01

    Full Text Available

    Aim of the study: to study the clinical and neuroimaging features of radiculopathy vertebral hemangiomas in conjunction with the vertebrae. Materials and methods. A total of 56 patients with radiculopathy vertebral hemangiomas combined with the vertebrae. Results. The patients in addition to pain, and focal neurological symptoms were observed violation of urination, and chronic venous insuffciency of lower extremities. MRI identifed three types of vertebral hem-angiomas, depending on the structural characteristics. Conclusion. The aim of the study is realized.Most hemangiomas are asymptomatic yourself. Pain and neurological symptoms caused by musculo-tonic component, the presence of disc herniation, changes in the intervertebral joints, ligaments violation. Type III meets the criteria for hemangiomas and requires aggressive surgical treatment.

  12. Repeated vertebral augmentation for new vertebral compression fractures of postvertebral augmentation patients: a nationwide cohort study

    Directory of Open Access Journals (Sweden)

    Liang CL

    2015-03-01

    Full Text Available Cheng-Loong Liang,1 Hao-Kwan Wang,1 Fei-Kai Syu,2 Kuo-Wei Wang,1 Kang Lu,1 Po-Chou Liliang1 1Department of Neurosurgery, E-Da Hospital, I-Shou University, Kaohsiung City, Taiwan; 2Department of Pharmacy, China Medical University Hospital, Taichung City, Taiwan Purpose: Postvertebral augmentation vertebral compression fractures are common; repeated vertebral augmentation is usually performed for prompt pain relief. This study aimed to evaluate the incidence and risk factors of repeat vertebral augmentation.Methods: We performed a retrospective, nationwide, population-based longitudinal observation study, using the National Health Insurance Research Database (NHIRD of Taiwan. All patients who received vertebral augmentation for vertebral compression fractures were evaluated. The collected data included patient characteristics (demographics, comorbidities, and medication exposure and repeat vertebral augmentation. Kaplan–Meier and stratified Cox proportional hazard regressions were performed for analyses.Results: The overall incidence of repeat vertebral augmentation was 11.3% during the follow-up until 2010. Patients with the following characteristics were at greater risk for repeat vertebral augmentation: female sex (AOR=1.24; 95% confidence interval [CI]: 1.10–2.36, advanced age (AOR=1.60; 95% CI: 1.32–2.08, diabetes mellitus (AOR=4.31; 95% CI: 4.05–5.88, cerebrovascular disease (AOR=4.09; 95% CI: 3.44–5.76, dementia (AOR=1.97; 95% CI: 1.69–2.33, blindness or low vision (AOR=3.72; 95% CI: 2.32–3.95, hypertension (AOR=2.58; 95% CI: 2.35–3.47, and hyperlipidemia (AOR=2.09; 95% CI: 1.67–2.22. Patients taking calcium/ vitamin D (AOR=2.98; 95% CI: 1.83–3.93, bisphosphonates (AOR=2.11; 95% CI: 1.26–2.61, or calcitonin (AOR=4.59; 95% CI: 3.40–5.77 were less likely to undergo repeat vertebral augmentation; however, those taking steroids (AOR=7.28; 95% CI: 6.32–8.08, acetaminophen (AOR=3.54; 95% CI: 2.75–4.83, or nonsteroidal

  13. Alternative approaches for vertebrate ecotoxicity tests in the ...

    Science.gov (United States)

    The need for alternative approaches to the use of vertebrate animals for hazard assessing chemicals and pollutants has become of increasing importance. It is now the first consideration when initiating a vertebrate ecotoxicity test, to ensure that unnecessary use of vertebrate organisms is minimised wherever possible. For some regulatory purposes, the use of vertebrate organisms for environmental risk assessments (ERA) has even been banned, and in other situations the numbers of organisms tested has been dramatically reduced, or the severity of the procedure refined. However, there is still a long way to go to achieve replacement of vertebrate organisms to generate environmental hazard data. The development of animal alternatives is not just based on ethical considerations but also to reduce the cost of performing vertebrate ecotoxicity tests and in some cases to provide better information aimed at improving ERAs. The present focus paper provides an overview of the considerable advances that have been made towards alternative approaches for ecotoxicity assessments over the last few decades. The need for alternative approaches to the use of vertebrate animals for hazard assessing chemicals and pollutants has become of increasing importance. It is now the first consideration when initiating a vertebrate ecotoxicity test, to ensure that unnecessary use of vertebrate organisms is minimised wherever possible. For some regulatory purposes, the use of vertebrate organi

  14. Juxta-vertebral lesions in granulomatosis with polyangiitis.

    Science.gov (United States)

    Ramirez, Giuseppe A; Della-Torre, Emanuel; Campochiaro, Corrado; Bozzolo, Enrica; Berti, Alvise; Praderio, Luisa; Dagna, Lorenzo; Sabbadini, Maria Grazia

    2016-12-01

    To describe the clinical, pathological, serological, and radiological characteristics of juxta-vertebral masses occurring in patients with granulomatosis with polyangiitis (GPA). We analyzed the clinical records of patients with juxta-vertebral lesions from our GPA study cohort and reviewed the English literature for other cases of GPA with juxta-vertebral localization. Out of 74 patients in our GPA study cohort, six (8%) had juxta-vertebral lesions. We found 10 cases of juxta-vertebral GPA described in the English literature. Overall, juxta-vertebral lesions were detected at GPA onset in 11/16 (69%) patients, and preferentially occurred on the right side of the spine (12/15 patients, 80%). Fifteen patients (94%) with juxta-vertebral lesions had systemic GPA. Juxta-vertebral lesions were associated with back pain at GPA onset in 8/16 (50%) patients. In all of them juxta-vertebral lesions resolved or improved after treatment. Preference for the right-anterior side of the spine, increased 18 FDG uptake on PET scan, low or absent invasiveness of the surrounding tissues, and occurrence in the context of systemic disease were the main features of juxta-vertebral GPA. Symptomatic lesions showed a better response to immunosuppressive therapies. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Assisted techniques for vertebral cementoplasty: Why should we do it?

    Energy Technology Data Exchange (ETDEWEB)

    Muto, M., E-mail: mutomar@tiscali.it [Department of Diagnostic Imaging, Section of Neuroradiology—“A. Cardarelli” Hospital, Naples (Italy); Marcia, S. [Section of Radiology—Santissima Trinità Hospital, Cagliari (Italy); Guarnieri, G. [Department of Diagnostic Imaging, Section of Neuroradiology—“A. Cardarelli” Hospital, Naples (Italy); Pereira, V. [Unit of Interventional Neuroradiology–HUG, Geneva (Switzerland)

    2015-05-15

    Assisted techniques (AT) for vertebral cementoplasty include multiple mini-invasive percutaneous systems in which vertebral augmentation is obtained through mechanical devices with the aim to reach the best vertebral height restoration. As an evolution of the vertebroplasty, the rationale of the AT-treatment is to combine the analgesic and stability effect of cement injection with the restoration of a physiological height for the collapsed vertebral body. Reduction of the vertebral body kyphotic deformity, considering the target of normal spine biomechanics, could improve all systemic potential complications evident in patient with vertebral compression fracture (VCF). Main indications for AT are related to fractures in fragile vertebral osseous matrix and non-osteoporotic vertebral lesions due to spine metastasis or trauma. Many companies developed different systems for AT having the same target but different working cannula, different vertebral height restoration system and costs. Aim of this review is to discuss about vertebral cementoplasty procedures and techniques, considering patient inclusion and exclusion criteria as well as all related minor and/or major interventional complications.

  16. Influence of physical activity on vertebral strength during late adolescence.

    Science.gov (United States)

    Junno, Juho-Antti; Paananen, Markus; Karppinen, Jaro; Tammelin, Tuija; Niinimäki, Jaakko; Lammentausta, Eveliina; Niskanen, Markku; Nieminen, Miika T; Järvelin, Marjo-Riitta; Takatalo, Jani; Tervonen, Osmo; Tuukkanen, Juha

    2013-02-01

    Reduced vertebral strength is a clear risk factor for vertebral fractures. Men and women with vertebral fractures often have reduced vertebral size and bone mineral density (BMD). Vertebral strength is controlled by both genetic and developmental factors. Malnutrition and low levels of physical activity are commonly considered to result in reduced bone size during growth. Several studies have also demonstrated the general relationship between BMD and physical activity in the appendicular skeleton. In this study, we wanted to clarify the role of physical activity on vertebral bodies. Vertebral dimensions appear to generally be less pliant than long bones when lifetime changes occur. We wanted to explore the association between physical activity during late adolescence and vertebral strength parameters such as cross-sectional size and BMD. The association between physical activity and vertebral strength was explored by measuring vertebral strength parameters and defining the level of physical activity during adolescence. The study population consisted of 6,928 males and females who, at 15 to 16 and 19 years of age, responded to a mailed questionnaire inquiring about their physical activity. A total of 558 individuals at the mean age of 21 years underwent magnetic resonance imaging (MRI) scans. We measured the dimensions of the fourth lumbar vertebra from the MRI scans of the Northern Finland Birth Cohort 1986 and performed T2* relaxation time mapping, reflective of BMD. Vertebral strength was based on these two parameters. We analyzed the association of physical activity on vertebral strength using the analysis of variance. We observed no association between the level of physical activity during late adolescence and vertebral strength at 21 years. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Autophagy in the Vertebrate Inner Ear

    Directory of Open Access Journals (Sweden)

    Marta Magariños

    2017-05-01

    Full Text Available Autophagy is a conserved catabolic process that results in the lysosomal degradation of cell components. During development, autophagy is associated with tissue and organ remodeling, and under physiological conditions it is tightly regulated as it plays a housekeeping role in removing misfolded proteins and damaged organelles. The vertebrate inner ear is a complex sensory organ responsible for the perception of sound and for balance. Cell survival, death and proliferation, as well as cell fate specification and differentiation, are processes that are strictly coordinated during the development of the inner ear in order to generate the more than a dozen specialized cell types that constitute this structure. Here, we review the existing evidence that implicates autophagy in the generation of the vertebrate inner ear. At early stages of chicken otic development, inhibiting autophagy impairs neurogenesis and causes aberrant otocyst morphogenesis. Autophagy provides energy for the clearing of dying cells and it favors neuronal differentiation. Moreover, autophagy is required for proper vestibular development in the mouse inner ear. The autophagy-related genes Becn1, Atg4g, Atg5, and Atg9, are expressed in the inner ear from late developmental stages to adulthood, and Atg4b mutants show impaired vestibular behavior associated to defects in otoconial biogenesis that are also common to Atg5 mutants. Autophagic flux appears to be age-regulated, augmenting from perinatal stages to young adulthood in mice. This up-regulation is concomitant with the functional maturation of the hearing receptor. Hence, autophagy can be considered an intracellular pathway fundamental for in vertebrate inner ear development and maturation.

  18. Autophagy in the Vertebrate Inner Ear.

    Science.gov (United States)

    Magariños, Marta; Pulido, Sara; Aburto, María R; de Iriarte Rodríguez, Rocío; Varela-Nieto, Isabel

    2017-01-01

    Autophagy is a conserved catabolic process that results in the lysosomal degradation of cell components. During development, autophagy is associated with tissue and organ remodeling, and under physiological conditions it is tightly regulated as it plays a housekeeping role in removing misfolded proteins and damaged organelles. The vertebrate inner ear is a complex sensory organ responsible for the perception of sound and for balance. Cell survival, death and proliferation, as well as cell fate specification and differentiation, are processes that are strictly coordinated during the development of the inner ear in order to generate the more than a dozen specialized cell types that constitute this structure. Here, we review the existing evidence that implicates autophagy in the generation of the vertebrate inner ear. At early stages of chicken otic development, inhibiting autophagy impairs neurogenesis and causes aberrant otocyst morphogenesis. Autophagy provides energy for the clearing of dying cells and it favors neuronal differentiation. Moreover, autophagy is required for proper vestibular development in the mouse inner ear. The autophagy-related genes Becn1, Atg4g, Atg5, and Atg9, are expressed in the inner ear from late developmental stages to adulthood, and Atg4b mutants show impaired vestibular behavior associated to defects in otoconial biogenesis that are also common to Atg5 mutants. Autophagic flux appears to be age-regulated, augmenting from perinatal stages to young adulthood in mice. This up-regulation is concomitant with the functional maturation of the hearing receptor. Hence, autophagy can be considered an intracellular pathway fundamental for in vertebrate inner ear development and maturation.

  19. Molecular mechanisms of taste transduction in vertebrates.

    Science.gov (United States)

    Ishimaru, Yoshiro

    2009-01-01

    Among the five senses, taste and olfaction play crucial roles in the detection of chemical substances in the environment and are referred to as chemical senses. In the past decade, much progress has been made in studies on molecular mechanisms of the gustatory system by methods such as those based on molecular and cellular biology, genetics, and bioinformatics. This review covers recent studies on taste receptors, intracellular signaling transduction in taste receptor cells, and taste coding at the periphery in vertebrates from fish to mammals.

  20. Resection of the Intramural Portion of the Distal Ureter during Transurethral Resection of Bladder Tumors: Predictive Factors for Secondary Stenosis and Development of Upper Urinary Tract Recurrence.

    Science.gov (United States)

    Rodriguez Faba, Oscar; Gaya, J M; Breda, Alberto; Juarez Del Dago, Pablo; Pisano, Francesca; Salas, Daniel; Palou, Juan

    2016-07-01

    We analyzed the incidence of and predictive factors for ureteral stenosis and recurrent upper urinary tract urothelial carcinoma after resection of tumors located in the intramural portion of the distal ureter. We retrospectively analyzed the records of 2,317 patients who underwent transurethral resection of bladder tumor for nonmuscle invasive bladder cancer, including 112 (4.83%) with tumors involving the intramural portion of the distal ureter. Multivariate Cox regression analysis was done to determine predictive factors for ureteral stenosis and recurrent urinary tract urothelial carcinoma. At a mean followup of 56 months 17 patients (15.2%) presented with recurrent upper urinary tract urothelial carcinoma and ureteral stenosis had developed in 13 (11.6%). On univariate analysis previous recurrences were associated with both events. On multivariate analysis tumor size 1.5 cm or greater (HR 4.521, p = 0.023) and T1 tumor stage (HR 8.525, p = 0.005) were independent predictive factors for stenosis. Stage T1 in the bladder (HR 7.253, p = 0.001) and carcinoma in situ in the intramural portion of the distal ureter (HR 6.850, p = 0.005) increased the risk of recurrent upper urinary tract urothelial carcinoma. The main study limitation was the lack of information on vesicoureteral reflux due to the retrospective design. Involvement of the intramural portion of the distal ureter is uncommon. In patients with nonmuscle invasive bladder cancer and involvement of the intramural portion of the distal ureter a stage T1 tumor and a tumor size 1.5 cm or greater are independent predictive factors for distal ureteral stenosis. Moreover, stage T1 and carcinoma in situ in the intramural portion of the distal ureter significantly increase the risk of recurrent upper urinary tract urothelial carcinoma. The urinary tract should be more closely followed in this patient subgroup. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc

  1. Endplates Changes Related to Age and Vertebral Segment

    Directory of Open Access Journals (Sweden)

    Carlos Fernando P. S. Herrero

    2014-01-01

    Full Text Available Endplate separations are defined as the presence of a space between the hyaline cartilage and the cortical bone of the adjacent vertebral body. This study evaluates endplate separations from the vertebral body and intervertebral discs and verifies if endplate separation is related to age and the spinal level. Groups were formed based on age (20–40 and 41–85 years old and the vertebral segment (T7-T8 and L4-L5 segments. Histological analysis included assessment of the length of the vertebral endplates, the number and dimensions of the separations, and orientation of the collagen fibers, in the mid-sagittal slice. Two indexes were created: the separation index (number of separations/vertebral length and separation extension index (sum of all separations/vertebral length. The results of the study demonstrated a direct relationship between the density of separations in the endplate and two variables: age and spinal level.

  2. Evolution of vertebrate interferon inducible transmembrane proteins

    Directory of Open Access Journals (Sweden)

    Hickford Danielle

    2012-04-01

    Full Text Available Abstract Background Interferon inducible transmembrane proteins (IFITMs have diverse roles, including the control of cell proliferation, promotion of homotypic cell adhesion, protection against viral infection, promotion of bone matrix maturation and mineralisation, and mediating germ cell development. Most IFITMs have been well characterised in human and mouse but little published data exists for other animals. This study characterised IFITMs in two distantly related marsupial species, the Australian tammar wallaby and the South American grey short-tailed opossum, and analysed the phylogeny of the IFITM family in vertebrates. Results Five IFITM paralogues were identified in both the tammar and opossum. As in eutherians, most marsupial IFITM genes exist within a cluster, contain two exons and encode proteins with two transmembrane domains. Only two IFITM genes, IFITM5 and IFITM10, have orthologues in both marsupials and eutherians. IFITM5 arose in bony fish and IFITM10 in tetrapods. The bone-specific expression of IFITM5 appears to be restricted to therian mammals, suggesting that its specialised role in bone production is a recent adaptation specific to mammals. IFITM10 is the most highly conserved IFITM, sharing at least 85% amino acid identity between birds, reptiles and mammals and suggesting an important role for this presently uncharacterised protein. Conclusions Like eutherians, marsupials also have multiple IFITM genes that exist in a gene cluster. The differing expression patterns for many of the paralogues, together with poor sequence conservation between species, suggests that IFITM genes have acquired many different roles during vertebrate evolution.

  3. Vertebroplasty and Kyphoplasty in Vertebral Osteoporotic Fractures.

    Science.gov (United States)

    Aparisi, Francisco

    2016-09-01

    Vertebroplasty and kyphoplasty are minimally invasive treatments and indispensable tools in the treatment of osteoporotic compression fractures. This method of treatment is performed using fluoroscopy or a scanner control an access via the pedicle or the posterolateral angle of the vertebral body. Vertebroplasty requires a smaller caliber needle than kyphoplasty, so it is technically easier. Vertebroplasty uses high-pressure injection, whereas in kyphoplasty the injection is held at low pressure, which together with the effect of compression on the bone that the balloon produces reduces the risk and rate of cement leakage. Vertebroplasty is effective in managing osteoporotic compression vertebral fractures, with improvement in pain and quality of life in the immediate postoperative period and over the medium term.Both techniques have a very low complication rate. There is no consensus on whether the emergence of new fractures in the cases treated by vertebroplasty and kyphoplasty are related to mechanical variations that were introduced or is a complication related to the age and evolution of the patient's osteoporosis. Even with this risk of new fractures, the improvement in quality of life obtained after vertebroplasty and kyphoplasty treatment is worthwhile. The benefits outweigh the risks. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  4. Identifying Synonymous Regulatory Elements in Vertebrate Genomes

    Energy Technology Data Exchange (ETDEWEB)

    Ovcharenko, I; Nobrega, M A

    2005-02-07

    Synonymous gene regulation, defined as driving shared temporal and/or spatial expression of groups of genes, is likely predicated on genomic elements that contain similar modules of certain transcription factor binding sites (TFBS). We have developed a method to scan vertebrate genomes for evolutionary conserved modules of TFBS in a predefined configuration, and created a tool, named SynoR that identify synonymous regulatory elements (SREs) in vertebrate genomes. SynoR performs de novo identification of SREs utilizing known patterns of TFBS in active regulatory elements (REs) as seeds for genome scans. Layers of multiple-species conservation allow the use of differential phylogenetic sequence conservation filters in the search of SREs and the results are displayed as to provide an extensive annotation of genes containing detected REs. Gene Ontology categories are utilized to further functionally classify the identified genes, and integrated GNF Expression Atlas 2 data allow the cataloging of tissue-specificities of the predicted SREs. We illustrate how this new tool can be used to establish a linkage between human diseases and noncoding genomic content. SynoR is publicly available at http://synor.dcode.org.

  5. Tandemly Arrayed Genes in Vertebrate Genomes

    Directory of Open Access Journals (Sweden)

    Deng Pan

    2008-01-01

    Full Text Available Tandemly arrayed genes (TAGs are duplicated genes that are linked as neighbors on a chromosome, many of which have important physiological and biochemical functions. Here we performed a survey of these genes in 11 available vertebrate genomes. TAGs account for an average of about 14% of all genes in these vertebrate genomes, and about 25% of all duplications. The majority of TAGs (72–94% have parallel transcription orientation (i.e., they are encoded on the same strand in contrast to the genome, which has about 50% of its genes in parallel transcription orientation. The majority of tandem arrays have only two members. In all species, the proportion of genes that belong to TAGs tends to be higher in large gene families than in small ones; together with our recent finding that tandem duplication played a more important role than retroposition in large families, this fact suggests that among all types of duplication mechanisms, tandem duplication is the predominant mechanism of duplication, especially in large families. Finally, several species have a higher proportion of large tandem arrays that are species-specific than random expectation.

  6. A membrane-bound vertebrate globin.

    Directory of Open Access Journals (Sweden)

    Miriam Blank

    Full Text Available The family of vertebrate globins includes hemoglobin, myoglobin, and other O(2-binding proteins of yet unclear functions. Among these, globin X is restricted to fish and amphibians. Zebrafish (Danio rerio globin X is expressed at low levels in neurons of the central nervous system and appears to be associated with the sensory system. The protein harbors a unique N-terminal extension with putative N-myristoylation and S-palmitoylation sites, suggesting membrane-association. Intracellular localization and transport of globin X was studied in 3T3 cells employing green fluorescence protein fusion constructs. Both myristoylation and palmitoylation sites are required for correct targeting and membrane localization of globin X. To the best of our knowledge, this is the first time that a vertebrate globin has been identified as component of the cell membrane. Globin X has a hexacoordinate binding scheme and displays cooperative O(2 binding with a variable affinity (P(50∼1.3-12.5 torr, depending on buffer conditions. A respiratory function of globin X is unlikely, but analogous to some prokaryotic membrane-globins it may either protect the lipids in cell membrane from oxidation or may act as a redox-sensing or signaling protein.

  7. The vertebrate heart: an evolutionary perspective.

    Science.gov (United States)

    Stephenson, Andrea; Adams, Justin W; Vaccarezza, Mauro

    2017-09-14

    Convergence is the tendency of independent species to evolve similarly when subjected to the same environmental conditions. The primitive blueprint for the circulatory system emerged around 700-600 Mya and exhibits diverse physiological adaptations across the radiations of vertebrates (Subphylum Vertebrata, Phylum Chordata). It has evolved from the early chordate circulatory system with a single layered tube in the tunicate (Subphylum Urchordata) or an amphioxus (Subphylum Cephalochordata), to a vertebrate circulatory system with a two-chambered heart made up of one atrium and one ventricle in gnathostome fish (Infraphylum Gnathostomata), to a system with a three-chambered heart made up of two atria which maybe partially divided or completely separated in amphibian tetrapods (Class Amphibia). Subsequent tetrapods, including crocodiles and alligators (Order Crocodylia, Subclass Crocodylomorpha, Class Reptilia), birds (Subclass Aves, Class Reptilia) and mammals (Class Mammalia) evolved a four-chambered heart. The structure and function of the circulatory system of each individual holds a vital role which benefits each species specifically. The special characteristics of the four-chamber mammalian heart are highlighted by the peculiar structure of the myocardial muscle. © 2017 Anatomical Society.

  8. "Ostrich sign" indicates bilateral vertebral artery dissection.

    Science.gov (United States)

    Rose, David Z; Husain, M Rizwan

    2012-11-01

    Vertebral artery dissections (VADs) comprise about 2% of ischemic strokes and can be associated with trauma, chiropractic manipulation, motor vehicle collisions, whiplash, amusement park rides, golfing, and other motion-induced injuries to the neck. We present a case of bilateral extracranial VAD as a complication of conducting an orchestra. To our knowledge, this has not been documented in the literature. Conceivably, vigorous neck twisting in an inexperienced, amateur conductor may place excessive rotational forces upon mobile portions of the verterbral arteries, tear the intima, deposit subintimal blood that extends longitudinally, and cause neck pain and/or posterior fossa ischemic symptoms. Magnetic resonance angiography examinations of axially oriented slices of bilateral VADs resemble the face of an ostrich. This observation is similar to the "puppy sign," in which bilateral internal carotid artery dissections resemble the face of a dog. Craniocervical dissections of either the carotid or vertebral arteries have the potential to form an aneurysm, cause artery-to-artery embolism, or completely occlude the parent artery, resulting in an ischemic stroke. Because bilateral VADs in axial magnetic resonance angiographic sections stand out like the eyes of an ostrich, and because the fast identification of VADs is so critical, we eponymize this image the "ostrich sign." Copyright © 2012 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  9. The characters of Palaeozoic jawed vertebrates.

    Science.gov (United States)

    Brazeau, Martin D; Friedman, Matt

    2014-04-01

    Newly discovered fossils from the Silurian and Devonian periods are beginning to challenge embedded perceptions about the origin and early diversification of jawed vertebrates (gnathostomes). Nevertheless, an explicit cladistic framework for the relationships of these fossils relative to the principal crown lineages of the jawed vertebrates (osteichthyans: bony fishes and tetrapods; chondrichthyans: sharks, batoids, and chimaeras) remains elusive. We critically review the systematics and character distributions of early gnathostomes and provide a clearly stated hierarchy of synapomorphies covering the jaw-bearing stem gnathostomes and osteichthyan and chondrichthyan stem groups. We show that character lists, designed to support the monophyly of putative groups, tend to overstate their strength and lack cladistic corroboration. By contrast, synapomorphic hierarchies are more open to refutation and must explicitly confront conflicting evidence. Our proposed synapomorphy scheme is used to evaluate the status of the problematic fossil groups Acanthodii and Placodermi, and suggest profitable avenues for future research. We interpret placoderms as a paraphyletic array of stem-group gnathostomes, and suggest what we regard as two equally plausible placements of acanthodians: exclusively on the chondrichthyan stem, or distributed on both the chondrichthyan and osteichthyan stems.

  10. Appearance of Myelin proteins during vertebrate evolution.

    Science.gov (United States)

    Waehneldt, T V; Matthieu, J M; Jeserich, G

    1986-01-01

    Myelin, defined as an arrangement of spirally fused unit membranes, is an acquisition of vertebrates and first appeared during evolution in Gnathostomata. In all species studied PNS and CNS myelins contain the myelin-associated glycoprotein (MAG) and the myelin basic protein (MBP). Throughout phylogeny PNS myelin is characterized by the major P(0) glycoprotein which is called IP in fishes. The PNS myelin proteins did not evolve further except for the addition of P(2) protein from reptiles onward. In Elasmobranchii and Chondrostei, PNS and CNS myelin proteins are similar. CNS myelin of actinopterygian fishes possesses a 36,000 Da protein (36K) in addition to P(0)-like IP glycoproteins. In tetrapod CNS myelin, P(0) is replaced by the proteolipid protein (PLP) and the Wolfgram protein (WP). Of particular interest in a transitional phylogenetic sense are the lungfish Protopterus, carrying glycosylated PLP (g-PLP) but no P(0), 36K or WP, and the bichir Polypterus, showing simultaneous presence of P(0), 36K and PLP. These results indicate that myelin proteins could be valuable molecular markers in establishing vertebrate phylogenetic relationships and in reconstructing the fish-tetrapod transition.

  11. Vertebral Compression Fractures after Lumbar Instrumentation.

    Science.gov (United States)

    Granville, Michelle; Berti, Aldo; Jacobson, Robert E

    2017-09-29

    Lumbar spinal stenosis (LSS) is primarily found in an older population. This is a similar demographic group that develops both osteoporosis and vertebral compression fractures (VCF). This report reviewed a series of patients treated for VCF that had previous lumbar surgery for symptomatic spinal stenosis. Patients that only underwent laminectomy or fusion without instrumentation had a similar distribution of VCF as the non-surgical population in the mid-thoracic, or lower thoracic and upper lumbar spine. However, in the patients that had previous short-segment spinal instrumentation, fractures were found to be located more commonly in the mid-lumbar spine or sacrum adjacent to or within one or two spinal segments of the spinal instrumentation. Adjacent-level fractures that occur due to vertebral osteoporosis after long spinal segment instrumentation has been discussed in the literature. The purpose of this report is to highlight the previously unreported finding of frequent lumbar and sacral osteoporotic fractures in post-lumbar instrumentation surgery patients. Important additional factors found were lack of preventative medical treatment for osteoporosis, and secondary effects related to inactivity, especially during the first year after surgery.

  12. Evolution of Adaptive Immune Recognition in Jawless Vertebrates

    OpenAIRE

    Saha, Nil Ratan; Smith, Jeramiah; Amemiya, Chris T.

    2010-01-01

    All extant vertebrates possess an adaptive immune system wherein diverse immune receptors are created and deployed in specialized blood cell lineages. Recent advances in DNA sequencing and developmental resources for basal vertebrates have facilitated numerous comparative analyses that have shed new light on the molecular and cellular bases of immune defense and the mechanisms of immune receptor diversification in the “jawless” vertebrates. With data from these key species in hand, it is beco...

  13. Distal vertebral artery reconstruction when managing vertebrobasilar insufficiency

    OpenAIRE

    D. M. Galaktionov; A. V. Dubovoy; K. S. Ovsyannikov

    2017-01-01

    This article presents a literature review devoted to the reconstruction of the distal vertebral artery and a clinical case of successful surgical treatment of a patient suffering from vertebrobasilar insufficiency caused by occlusion of the vertebral artery in a proximal segment. The external carotid artery-distal vertebral artery bypass was performed by using the radial artery.Received 27 February 2017. Revised 25 July 2017. Accepted 3 August 2017.Funding: The study did not have sponsorship....

  14. Independent regulation of vertebral number and vertebral identity by microRNA-196 paralogs.

    Science.gov (United States)

    Wong, Siew Fen Lisa; Agarwal, Vikram; Mansfield, Jennifer H; Denans, Nicolas; Schwartz, Matthew G; Prosser, Haydn M; Pourquié, Olivier; Bartel, David P; Tabin, Clifford J; McGlinn, Edwina

    2015-09-01

    The Hox genes play a central role in patterning the embryonic anterior-to-posterior axis. An important function of Hox activity in vertebrates is the specification of different vertebral morphologies, with an additional role in axis elongation emerging. The miR-196 family of microRNAs (miRNAs) are predicted to extensively target Hox 3' UTRs, although the full extent to which miR-196 regulates Hox expression dynamics and influences mammalian development remains to be elucidated. Here we used an extensive allelic series of mouse knockouts to show that the miR-196 family of miRNAs is essential both for properly patterning vertebral identity at different axial levels and for modulating the total number of vertebrae. All three miR-196 paralogs, 196a1, 196a2, and 196b, act redundantly to pattern the midthoracic region, whereas 196a2 and 196b have an additive role in controlling the number of rib-bearing vertebra and positioning of the sacrum. Independent of this, 196a1, 196a2, and 196b act redundantly to constrain total vertebral number. Loss of miR-196 leads to a collective up-regulation of numerous trunk Hox target genes with a concomitant delay in activation of caudal Hox genes, which are proposed to signal the end of axis extension. Additionally, we identified altered molecular signatures associated with the Wnt, Fgf, and Notch/segmentation pathways and demonstrate that miR-196 has the potential to regulate Wnt activity by multiple mechanisms. By feeding into, and thereby integrating, multiple genetic networks controlling vertebral number and identity, miR-196 is a critical player defining axial formulae.

  15. Reintroduction of locally extinct vertebrates impacts arid soil fungal communities.

    Science.gov (United States)

    Clarke, Laurence J; Weyrich, Laura S; Cooper, Alan

    2015-06-01

    Introduced species have contributed to extinction of native vertebrates in many parts of the world. Changes to vertebrate assemblages are also likely to alter microbial communities through coextinction of some taxa and the introduction of others. Many attempts to restore degraded habitats involve removal of exotic vertebrates (livestock and feral animals) and reintroduction of locally extinct species, but the impact of such reintroductions on microbial communities is largely unknown. We used high-throughput DNA sequencing of the fungal internal transcribed spacer I (ITS1) region to examine whether replacing exotic vertebrates with reintroduced native vertebrates led to changes in soil fungal communities at a reserve in arid central Australia. Soil fungal diversity was significantly different between dune and swale (interdune) habitats. Fungal communities also differed significantly between sites with exotic or reintroduced native vertebrates after controlling for the effect of habitat. Several fungal operational taxonomic units (OTUs) found exclusively inside the reserve were present in scats from reintroduced native vertebrates, providing a direct link between the vertebrate assemblage and soil microbial communities. Our results show that changes to vertebrate assemblages through local extinctions and the invasion of exotic species can alter soil fungal communities. If local extinction of one or several species results in the coextinction of microbial taxa, the full complement of ecological interactions may never be restored. © 2015 John Wiley & Sons Ltd.

  16. Osteoporotic vertebral fracture simulating a spinal tumor: a case report

    Directory of Open Access Journals (Sweden)

    Moscote-Salazar Luis Rafael

    2015-06-01

    Full Text Available Vertebral fractures are a frequent entity, mainly in the thoracolumbar and lumbar spine. In some circumstances the differential diagnosis of vertebral injuries can confuse the physician, since the difference between an osteoporotic vertebral fracture and a fracture secondary to a tumor is not clear. We report the case of a patient with osteoporotic vertebral fracture simulating a spinal tumor, handled by our department of neurosurgery as illustrative experience to guide the approach in those cases, in which the definitive diagnosis is crucial for therapeutic decision making

  17. Presence of the earliest vertebrate hard tissue in conodonts.

    Science.gov (United States)

    Sansom, I J; Smith, M P; Armstrong, H A; Smith, M M

    1992-05-29

    From histological investigations into the microstructure of conodont elements, a number of tissue types characteristic of the phosphatic skeleton of vertebrates have been identified. These include cellular bone, two forms of hypermineralized enamel homologs, and globular calcified cartilage. The presence of cellular bone in conodont elements provides unequivocal evidence for their vertebrate affinities. Furthermore, the identification of vertebrate hard tissues in the oral elements of conodonts extends the earliest occurrence of vertebrate hard tissues back by around 40 million years, from the Middle Ordovician (475 million years ago) to the Late Cambrian (515 million years ago).

  18. Pelviureteral inhibitory reflex and ureteropelvic excitatory reflex: role of the two reflexes in regulation of urine flow from the renal pelvis to the ureter.

    Science.gov (United States)

    Shafik, A

    1997-01-01

    The mechanism by which the ureteropelvic junction (UPJ) regulates the passage of urine from the renal pelvis to the ureter, and prevents urinary backflow from the the ureter to the renal pelvis, is not completely understood. The current communication studies this mechanism in 18 dogs. With the dogs under anesthesia, nephrostomy was done through which two catheters (one pressure and one balloon-tipped) were introduced into the UPJ and the renal pelvis, respectively. Renal pelvis distension with a balloon filled with 1 ml of saline effected a rise of renal pelvic pressure from a mean basal pressure of 4.8 +/- 1.2 cm H2O to 6.9 +/- 2.3 cm H2O (P pelvic balloon (P > 0.05). Renal pelvic distension with 2, 3, and 4 ml caused a significant rise of renal pelvic pressure to 8.4 +/- 2.7 (P elevation of ureteric and UPJ pressure which was not significantly different from that observed with distension with 0.5 ml (P > 0.05). In contrast, the UPJ showed no significant pressure change upon distension of the locally anesthetized renal pelvis or ureter, respectively. Likewise, the locally anesthetized UPJ exhibited no significant pressure response to renal pelvic or ureteric distension. The study demonstrates that urine might have to accumulate in the renal pelvis up to a certain volume and pressure so as to effect UPJ opening, which occurs at its maximum irrespective of the distending volume. UPJ opening upon renal pelvic distension postulates a reflex relationship which we call "pelviureteral inhibitory reflex." This reflex is believed to regulate the passage of urine from the renal pelvis to the ureter. Ureteric distension closes the UPJ; we call this reflex action the "ureteropelvic excitatory reflex" as it seems to prevent reflux of urine through the UPJ and thus protects the kidney. The concept that the UPJ acts as a physiologic sphincter is put forward.

  19. A Novel and Simple Modification for Management of Distal Ureter During Laparoscopic Nephroureterectomy Without Patient Repositioning: A Bulldog Clamp Technique and Description of Modified Port Placement.

    Science.gov (United States)

    Liu, Pei; Fang, Dong; Xiong, Gengyan; Yang, Kaiwei; Zhang, Lei; Yao, Lin; Zhang, Cuijian; Li, Xuesong; He, Zhisong; Zhou, Liqun

    2016-02-01

    To describe a novel and pure laparoscopic approach using a custom-made bulldog clamp with modified port placement for management of distal ureter during laparoscopic nephroureterectomy. Between October 2013 and December 2014, 31 patients found to have upper tract urothelial carcinoma were treated using this technique. After finishing a standard laparoscopic transperitoneal nephrectomy in a 45° to 60° recumbent position, an additional 12-mm trocar was inserted at the lower abdomen to allow the surgeon to continue dissecting the ureter caudally toward the bladder wall without repositioning the patient. The intramural ureter was separated from the surrounding detrusor muscle and down to the bladder mucosa, until a tent-shaped bladder cuff and intramural ureter could be formed by retraction in the superior and lateral directions. Then, a custom-made laparoscopic bulldog clamp was placed at the bottom of the tent-shaped structure to prevent urine spillage, and the bladder was closed by two-layer running closure using a barbed suture. All surgeries were completed uneventfully. The mean operative time and estimated blood loss were 146.6 minutes and 47.3 mL, respectively. The median duration of the postoperative hospital stay was 6 days. No complications were noted. There were no positive margins in any specimen. No patients experienced stone formation or local or bladder recurrence during the 10.5-month follow-up period. Our novel technique fully replicates the open excision technique and conforms to the strictest oncologic principles while avoiding patient repositioning and the use of staplers (EndoGIA or Hemolock) to prevent stone formation.

  20. A SHH-FOXF1-BMP4 signaling axis regulating growth and differentiation of epithelial and mesenchymal tissues in ureter development.

    Science.gov (United States)

    Bohnenpoll, Tobias; Wittern, Anna B; Mamo, Tamrat M; Weiss, Anna-Carina; Rudat, Carsten; Kleppa, Marc-Jens; Schuster-Gossler, Karin; Wojahn, Irina; Lüdtke, Timo H-W; Trowe, Mark-Oliver; Kispert, Andreas

    2017-08-01

    The differentiated cell types of the epithelial and mesenchymal tissue compartments of the mature ureter of the mouse arise in a precise temporal and spatial sequence from uncommitted precursor cells of the distal ureteric bud epithelium and its surrounding mesenchyme. Previous genetic efforts identified a member of the Hedgehog (HH) family of secreted proteins, Sonic hedgehog (SHH) as a crucial epithelial signal for growth and differentiation of the ureteric mesenchyme. Here, we used conditional loss- and gain-of-function experiments of the unique HH signal transducer Smoothened (SMO) to further characterize the cellular functions and unravel the effector genes of HH signaling in ureter development. We showed that HH signaling is not only required for proliferation and SMC differentiation of cells of the inner mesenchymal region but also for survival of cells of the outer mesenchymal region, and for epithelial proliferation and differentiation. We identified the Forkhead transcription factor gene Foxf1 as a target of HH signaling in the ureteric mesenchyme. Expression of a repressor version of FOXF1 in this tissue completely recapitulated the mesenchymal and epithelial proliferation and differentiation defects associated with loss of HH signaling while re-expression of a wildtype version of FOXF1 in the inner mesenchymal layer restored these cellular programs when HH signaling was inhibited. We further showed that expression of Bmp4 in the ureteric mesenchyme depends on HH signaling and Foxf1, and that exogenous BMP4 rescued cell proliferation and epithelial differentiation in ureters with abrogated HH signaling or FOXF1 function. We conclude that SHH uses a FOXF1-BMP4 module to coordinate the cellular programs for ureter elongation and differentiation, and suggest that deregulation of this signaling axis occurs in human congenital anomalies of the kidney and urinary tract (CAKUT).

  1. A SHH-FOXF1-BMP4 signaling axis regulating growth and differentiation of epithelial and mesenchymal tissues in ureter development.

    Directory of Open Access Journals (Sweden)

    Tobias Bohnenpoll

    2017-08-01

    Full Text Available The differentiated cell types of the epithelial and mesenchymal tissue compartments of the mature ureter of the mouse arise in a precise temporal and spatial sequence from uncommitted precursor cells of the distal ureteric bud epithelium and its surrounding mesenchyme. Previous genetic efforts identified a member of the Hedgehog (HH family of secreted proteins, Sonic hedgehog (SHH as a crucial epithelial signal for growth and differentiation of the ureteric mesenchyme. Here, we used conditional loss- and gain-of-function experiments of the unique HH signal transducer Smoothened (SMO to further characterize the cellular functions and unravel the effector genes of HH signaling in ureter development. We showed that HH signaling is not only required for proliferation and SMC differentiation of cells of the inner mesenchymal region but also for survival of cells of the outer mesenchymal region, and for epithelial proliferation and differentiation. We identified the Forkhead transcription factor gene Foxf1 as a target of HH signaling in the ureteric mesenchyme. Expression of a repressor version of FOXF1 in this tissue completely recapitulated the mesenchymal and epithelial proliferation and differentiation defects associated with loss of HH signaling while re-expression of a wildtype version of FOXF1 in the inner mesenchymal layer restored these cellular programs when HH signaling was inhibited. We further showed that expression of Bmp4 in the ureteric mesenchyme depends on HH signaling and Foxf1, and that exogenous BMP4 rescued cell proliferation and epithelial differentiation in ureters with abrogated HH signaling or FOXF1 function. We conclude that SHH uses a FOXF1-BMP4 module to coordinate the cellular programs for ureter elongation and differentiation, and suggest that deregulation of this signaling axis occurs in human congenital anomalies of the kidney and urinary tract (CAKUT.

  2. Careful Dissection of the Distal Ureter Is Highly Important in Nerve-sparing Radical Pelvic Surgery: A 3D Reconstruction and Immunohistochemical Characterization of the Vesical Plexus.

    Science.gov (United States)

    Kraima, Anne C; Derks, Marloes; Smit, Noeska N; van de Velde, Cornelis J H; Kenter, Gemma G; DeRuiter, Marco C

    2016-06-01

    Radical hysterectomy with pelvic lymphadenectomy (RHL) is the preferred treatment for early-stage cervical cancer. Although oncological outcome is good with regard to recurrence and survival rates, it is well known that RHL might result in postoperative bladder impairments due to autonomic nerve disruption. The pelvic autonomic network has been extensively studied, but the anatomy of nerve fibers branching off the inferior hypogastric plexus to innervate the bladder is less known. Besides, the pathogenesis of bladder dysfunction after RHL is multifactorial but remains unclear. We studied the 3-dimensional anatomy and neuroanatomical composition of the vesical plexus and describe implications for RHL. Six female adult cadaveric pelvises were macroscopically dissected. Additionally, a series of 10 female fetal pelvises (embryonic age, 10-22 weeks) was studied. Paraffin-embedded blocks were transversely sliced in 8-μm sections. (Immuno) histological analysis was performed with hematoxylin and eosin, azan, and antibodies against S-100 (Schwann cells), tyrosine hydroxylase (postganglionic sympathetic fibers), and vasoactive intestinal peptide (postganglionic parasympathetic fibers). The results were 3-dimensionally visualized. The vesical plexus formed a group of nerve fibers branching off the ventral part of the inferior hypogastric plexus to innervate the bladder. In all adult and fetal specimens, the vesical plexus was closely related to the distal ureter and located in both the superficial and deep layers of the vesicouterine ligament. Efferent nerve fibers belonging to the vesical plexus predominantly expressed tyrosine hydroxylase and little vasoactive intestinal peptide. The vesical plexus is located in both layers of the vesicouterine ligament and has a very close relationship with the distal ureter. Complete mobilization of the ureter in RHL might cause bladder dysfunction due to sympathetic and parasympathetic denervation. Hence, the distal ureter should be

  3. The vagaries of proper imaging in diagnosing single-system ectopic ureter in children with continuous incontinence and outcomes of simple nephrectomy.

    Science.gov (United States)

    Lee, Yong Seung; Im, Young Jae; Kim, Sang Woon; Kim, Myung-Joon; Lee, Mi-Jung; Lim, Neddy Lee; Han, Sang Won

    2016-03-01

    To investigate the proper diagnostic modalities and failure cases of treatment in patients with single-system ectopic ureter (SSEU) who underwent nephrectomy for incontinence. SSEU combined with dysplastic kidney is a rare cause of female incontinence. We retrospectively analyzed 45 pediatric SSEU patients that underwent simple nephrectomy at our institution during 1996-2013 for incontinence. We reviewed imaging studies to detect dysplastic kidney and ectopic ureter insertion, postoperative results, and urodynamic findings for remaining incontinence after nephrectomy. Median operative age was 59.3months. Both ultrasonography and magnetic resonance imaging (MRI) showed 50.0% dysplastic kidney detection rates respectively. Dimercaptosuccinic acid (DMSA) scanning and computerized tomography (CT) showed equal detection rates of 95.5%. Ectopic ureter insertion sites were determined by ultrasonography, CT, and MRI in 17.5%, 13.6%, and 33.3% of patients, respectively. Renal vascular structures were identified in 3/22 patients (13.6%) with CT. Post-nephrectomy, incontinence disappeared in 41 patients (91.1%), but remained in 4 patients (8.9%); urodynamics suggested bladder neck incompetence in these patients. DMSA is a highly sensitive diagnostic modality for detecting dysplastic kidney in SSEU patients with more than 95% detection rates. Once detected by DMSA, additional CT or MRI studies do not provide further information about ectopic ureter insertion or renal vascular structure. Although nephrectomy is successful in nearly 90% of SSEU patients with dysplastic kidneys, postoperative incontinence occasionally remains and requires additional treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Dystopic dysplastic kidney with ectopic ureter: improved localization by fusion of MR urography and {sup 99m}Tc-DMSA SPECT datasets

    Energy Technology Data Exchange (ETDEWEB)

    Kreissl, Michael C.; Lorenz, Reinhard [University Clinic Wuerzburg, Clinic and Polyclinic of Nuclear Medicine, Wuerzburg (Germany); Ohnheiser, Gerd [University Clinic Wuerzburg, Zentrum Operative Medizin, Clinic and Polyclinic of Urology, Wuerzburg (Germany); Darge, Kassa [University Clinic Wuerzburg, Department of Paediatric Radiology, Institute of Radiodiagnosis, Wuerzburg (Germany)

    2008-02-15

    We report a 12-year-old girl with a long history of constant urinary dribbling and apparently only a left kidney. Using a multimodality approach involving the fusion of MR urography and {sup 99m}Tc-dimercaptosuccinic acid (DMSA) SPECT datasets, it was finally possible to exactly localize the very small dystopic, dysplastic right kidney and its ectopic ureter draining into the vagina. (orig.)

  5. X-ray morphology of the eburnated vertebral body - diagnostic and differential diagnostic problems

    Energy Technology Data Exchange (ETDEWEB)

    Krug, B.; Lorenz, R.; Steinbrich, W.

    1988-08-01

    1. Numerous diseases may become manifest as eburnated vertebral bodies, and hence the X-ray morphological sign of eburnation is an unspecific one. Isolated characteristics such as the involvement of one or several vertebrae, an intact vertebral space, a broadening of the paravertebral accompanying shadow, and the remaining radiological skeletal status enable narrowing down the differential diagnosis, although anamnesis and clinical findings will supply the main pointers. 2. In primary tumorous eburnations radiotherapy or chemotherapy will render an X-ray morphological assessment of therapeutic success impossible. 3. In primary diagnosis of an eburnated vertebral body it is possible to apply sonography. CT and MR as diagnostic tools step by step to narrow down the differential diagnosis by detecting or excluding pathological abdominal processes such as liver or lymphatic node metastases, paravertebral or intraspinal soft-part dense space-occupying growths or bone infiltration, but it will only rarely be possible to classify the phenomenon properly as being caused by a well-defined process, even if CT and MR are employed.

  6. Oncologic Outcomes of Kidney Sparing Surgery versus Radical Nephroureterectomy for the Elective Treatment of Clinically Organ Confined Upper Tract Urothelial Carcinoma of the Distal Ureter.

    Science.gov (United States)

    Seisen, Thomas; Nison, Laurent; Remzi, Mezut; Klatte, Tobias; Mathieu, Romain; Lucca, Ilaria; Bozzini, Grégory; Capitanio, Umberto; Novara, Giacomo; Cussenot, Olivier; Compérat, Eva; Renard-Penna, Raphaële; Peyronnet, Benoit; Merseburger, Axel S; Fritsche, Hans-Martin; Hora, Milan; Shariat, Shahrokh F; Colin, Pierre; Rouprêt, Morgan

    2016-05-01

    We compared the oncologic outcomes of radical nephroureterectomy, distal ureterectomy and endoscopic surgery for elective treatment of clinically organ confined upper tract urothelial carcinoma of the distal ureter. From a multi-institutional collaborative database we identified 304 patients with unifocal, clinically organ confined urothelial carcinoma of the distal ureter and bilateral functional kidneys. Rates of overall, cancer specific, local recurrence-free and intravesical recurrence-free survival according to surgery type were compared using Kaplan-Meier statistics. Univariable and multivariable Cox regression analyses were performed to assess the adjusted outcomes of radical nephroureterectomy, distal ureterectomy and endoscopic surgery. Overall 128 (42.1%), 134 (44.1%) and 42 patients (13.8%) were treated with radical nephroureterectomy, distal ureterectomy and endoscopic surgery, respectively. Although rates of overall, cancer specific and intravesical recurrence-free survival were equivalent among the 3 surgical procedures, 5-year local recurrence-free survival was lower for endoscopic surgery (35.7%) than for nephroureterectomy (95.0%, p ureter. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  7. Radiotherapy may improve overall survival of patients with T3/T4 transitional cell carcinoma of the renal pelvis or ureter and delay bladder tumour relapse

    Science.gov (United States)

    2011-01-01

    Background Since transitional cell carcinoma (TCC) of the upper urinary tract is a relatively uncommon malignancy, the role of adjuvant radiotherapy is unknown. Methods We treated 133 patients with TCC of the renal pelvis or ureter at our institution between 1998 and 2008. The 67 patients who received external beam radiotherapy (EBRT) following surgery were assigned to the radiation group (RT). The clinical target volume included the renal fossa, the course of the ureter to the entire bladder, and the paracaval and para-aortic lymph nodes, which were at risk of harbouring metastatic disease in 53 patients. The tumour bed or residual tumour was targeted in 14 patients. The median radiation dose administered was 50 Gy. The 66 patients who received intravesical chemotherapy were assigned to the non-radiation group (non-RT). Results The overall survival rates for the RT and non-RT groups were not significantly different (p = 0.198). However, there was a significant difference between the survival rates for these groups based on patients with T3/T4 stage cancer. A significant difference was observed in the bladder tumour relapse rate between the irradiated and non-irradiated bladder groups (p = 0.004). Multivariate analysis indicated that improved overall survival was associated with age grade 3) hematologic symptoms also occurred. Conclusion EBRT may improve overall survival for patients with T3/T4 cancer of the renal pelvis or ureter and delay bladder tumour recurrence in all patients. PMID:21756352

  8. Current and emerging treatment strategies for vertebral compression fractures

    Directory of Open Access Journals (Sweden)

    Hacein-Bey L

    2012-05-01

    Full Text Available Lotfi Hacein-BeyRadiological Associates of Sacramento Medical Group Inc, Sacramento, CA, USABackground: Vertebral compression fractures are most commonly related to osteoporosis or cancer, both of which are on the rise throughout the world. Once a vertebra is fractured, gradual deterioration of quality of life due to crippling pain and spinal instability usually follows. Although a number of traditional management options have been available to promote pain relief and to allow for increased activities, such as bed rest, bracing, pain medications, and light exercise programs, these have limited effectiveness in the majority of patients. Over 20 years ago, percutaneous vertebroplasty, which is a minimally invasive procedure consisting of the injection of polymethylmethacrylate directly into the fractured vertebra, emerged as an effective treatment. Various vertebral augmentation procedures were subsequently designed, all of which aim at eliminating pain, limiting or reversing vertebral collapse, and providing stability to the affected segment of the spine.Objective: This article discusses clinical aspects of vertebral compression fractures, current indications and contraindications and summarizes technical aspects of vertebroplasty, kyphoplasty, lordoplasty, and device-implanting vertebral augmentation procedures. Treatment effectiveness, which is significant despite recent criticism of vertebroplasty and other vertebral augmentation procedures, is also discussed. As economic pressures on health care systems are increasing in all countries, it is expected that the appropriateness, clinical effectiveness, and cost-effectiveness of vertebral augmentation procedures will be increasingly established by outcome analyses.Conclusion: It is important that physicians are familiar with vertebroplasty and other procedures designed to treat vertebral fractures in patients with advanced osteoporosis or cancer. These fractures, which are common and often

  9. Outcome following treatment of vertebral tumors in 20 dogs (1986-1995).

    Science.gov (United States)

    Dernell, W S; Van Vechten, B J; Straw, R C; LaRue, S M; Powers, B E; Withrow, S J

    2000-01-01

    Twenty dogs with histopathologically confirmed primary (n=15) or metastatic (n=5) osteosarcoma (n=14) or fibrosarcoma (n=6) of the vertebral column were treated with surgery (n=4), radiation therapy and chemotherapy (n=6), surgery and chemotherapy (n=2), or surgery, radiation, and chemotherapy (n=8). All dogs died due to their disease; 15 died due to local failure, and five died due to nonvertebral metastasis. Overall median survival time was 135 days, with a range of 15 to 600 days. Of the factors evaluated, only postoperative neurological status had a significant influence on outcome by multivariate analysis. This study supports the overall guarded prognosis for dogs with vertebral neoplasia. Better combinations of surgery, chemotherapy, and radiation therapy remain to be defined for this difficult subset of animal cancer.

  10. Characteristic features of bone tissue regeneration in the vertebral bodies in the experiment with osteograft

    Science.gov (United States)

    Zaydman, A. M.; Predein, Yu. A.; Korel, A. V.; Shchelkunova, E. I.; Strokova, E. I.; Lastevskiy, A. D.; Rerikh, V. V.; Fomichev, N. G.; Falameeva, O. V.; Shevchenko, A. I.; Shevtcov, V. I.

    2017-09-01

    In the practice of orthopedic and trauma surgeons, there is a need to close bone tissue defects after removal of tumors or traumatic and dystrophic lesions. Currently, as cellular technologies are being developed, stem embryonic and pluripotent cells are widely introduced into practical medicine. The unpredictability of the spectrum of cell differentiations, up to oncogenesis, raised the question of creating biological structures committed toward osteogenic direction, capable of regenerating organo-specific graft at the optimal time. Such osteograft was created at the Novosibirsk Institute of Traumatology and Orthopaedics (patent RU 2574942). Its osteogenic orientation was confirmed by the morphological and immunohistochemical methods, and by the expression of bone genes. The regeneration potential of the osteograft was studied in the vertebral bodies of the mini piglet model. The study revealed that the regeneration of the vertebral body defect and the integration of the osteograft with the bed of the recipient proceeds according to the type of primary angiogenic osteogenesis within 30 days.

  11. Motor primitives in vertebrates and invertebrates.

    Science.gov (United States)

    Flash, Tamar; Hochner, Binyamin

    2005-12-01

    In recent years different lines of evidence have led to the idea that motor actions and movements in both vertebrates and invertebrates are composed of elementary building blocks. The entire motor repertoire can be spanned by applying a well-defined set of operations and transformations to these primitives and by combining them in many different ways according to well-defined syntactic rules. Motor and movement primitives and modules might exist at the neural, dynamic and kinematic levels with complicated mapping among the elementary building blocks subserving these different levels of representation. Hence, while considerable progress has been made in recent years in unravelling the nature of these primitives, new experimental, computational and conceptual approaches are needed to further advance our understanding of motor compositionality.

  12. Ischemic stroke: carotid and vertebral artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Vilela, P.; Goulao, A. [Hospital Garcia de Orta, Servico de Neurorradiologia, Almada (Portugal)

    2005-03-01

    Ischemic strokes may have distinct aetiologies, including several different intrinsic arterial pathological disorders. The diagnosis and understanding of these arterial diseases is critical for the correct management of stroke as different treatment approaches are undertaken according to the aetiology. Atherosclerosis is by far the most common arterial disease among adults, and other pathological processes include arterial dissection, small vessel disease, inflammatory and non-inflammatory vasculopathy and vasomotor disorders. In children, there are several vasculopathies responsible for vaso-occlusive disease such as sickle-cell anemia, acute regressive angiopathy and Moya-Moya disease, neurofibromatosis, dissections, vasculitis associated with intracranial and systemic infections. An overview of the major carotid and vertebral pathological diseases responsible for ischemic stroke in adults and children, highlighting the accuracy of the different imaging modalities for its diagnosis and the imaging appearance of these diseases, is given. (orig.)

  13. High-throughput hyperdimensional vertebrate phenotyping.

    Science.gov (United States)

    Pardo-Martin, Carlos; Allalou, Amin; Medina, Jaime; Eimon, Peter M; Wählby, Carolina; Fatih Yanik, Mehmet

    2013-01-01

    Most gene mutations and biologically active molecules cause complex responses in animals that cannot be predicted by cell culture models. Yet animal studies remain too slow and their analyses are often limited to only a few readouts. Here we demonstrate high-throughput optical projection tomography with micrometre resolution and hyperdimensional screening of entire vertebrates in tens of seconds using a simple fluidic system. Hundreds of independent morphological features and complex phenotypes are automatically captured in three dimensions with unprecedented speed and detail in semitransparent zebrafish larvae. By clustering quantitative phenotypic signatures, we can detect and classify even subtle alterations in many biological processes simultaneously. We term our approach hyperdimensional in vivo phenotyping. To illustrate the power of hyperdimensional in vivo phenotyping, we have analysed the effects of several classes of teratogens on cartilage formation using 200 independent morphological measurements, and identified similarities and differences that correlate well with their known mechanisms of actions in mammals.

  14. Giant cell tumor of dorsal vertebral body

    Directory of Open Access Journals (Sweden)

    Rakesh Redhu

    2012-01-01

    Full Text Available A 30-year-old female patient presented with complaints of backache, weakness in both lower limbs and bladder/bowel dysfunction. Imaging showed an osteolytic lesion at tenth dorsal (D10 vertebra with anterior compression on the spinal cord. Complete intralesional tumor excision with reconstruction was carried out using the anterolateral extrapleural approach. Histopathological examination was suggestive of giant cell tumor (GCT. Because of complete intralesional tumor excision and fear of post-radiation osteonecrosis of bone used for delayed bony union, a conservative approach was used, and radiation therapy was not given. After one year of follow-up patient is doing well without any recurrence of the tumor and is ambulant with support. GCT of dorsal vertebral body is an uncommon entity and total en bloc excision is difficult. Therefore, the treatment strategy is not well-defined. We discuss in brief about incidence, presentation and various treatment modalities available for spinal GCT.

  15. ORIGINAL ARTICLE The pattern and prevalence of vertebral artery ...

    African Journals Online (AJOL)

    ORIGINAL ARTICLE. 52 SAJR June 2013 Vol. 17 No. 2. Vertebral artery injuries are rare, with an incidence of 0.1 - 1.0%, if all patients admitted with blunt head trauma are considered.[1] It is not unusual for vertebral artery injury to occur when there are fractures through the transverse foraminae of the first to the sixth ...

  16. Vertebrate pests of cassava in Africa and their control | Cudjoe ...

    African Journals Online (AJOL)

    Much attention bas been given to almost all agents that cause losses to crops with the possible exception of vertebrate pests of which comparatively little is known in relation to farming activities. Due to the paucity of information on vertebrate pests there is very little or no indication of what damage is caused by which pest, ...

  17. Evolutionarily conserved elements in vertebrate, insect, worm, and yeast genomes

    DEFF Research Database (Denmark)

    Siepel, Adam; Bejerano, Gill; Pedersen, Jakob Skou

    2005-01-01

    We have conducted a comprehensive search for conserved elements in vertebrate genomes, using genome-wide multiple alignments of five vertebrate species (human, mouse, rat, chicken, and Fugu rubripes). Parallel searches have been performed with multiple alignments of four insect species (three spe...... for RNA secondary structure....

  18. Checklist of vertebrate animals of the Cascade Head Experimental Forest.

    Science.gov (United States)

    Chris Maser; Jerry F. Franklin

    1974-01-01

    Three months, April and August 1971 and August 1972, were spent studying the vertebrate fauna of Cascade Head Experimental Forest. The resulting annotated checklist includes 9 amphibians, 2 reptiles, 35 birds, and 40 mammals. A standardized animal habitat classification is presented in an effort to correlate the vertebrates in some meaningful way to their environment...

  19. PICTORIAL ESSAY Is anomalous origin of the left vertebral artery ...

    African Journals Online (AJOL)

    The incidence of anomalous origin of the left vertebral artery from the aortic arch ranges between 1% and 5.8%.1,2 This anomaly has important implications for thoracic surgery and interventional procedures. The left vertebral artery may originate from: • the left common carotid artery. • the root of the left subclavian artery ...

  20. Sexual dimorphism in cervical vertebral canal measurements of ...

    African Journals Online (AJOL)

    Sexual dimorphism in cervical vertebral canal measurements of human foetuses. ... Anatomy Journal of Africa ... Cervical parts of vertebral canal in 30 normal human foetuses was exposed in coronal plane and were divided in groups 1 and 2 which correspond with 2nd and 3rd trimester of pregnancy respectively. Groups 1 ...

  1. Closed cervical spine trauma associated with bilateral vertebral artery injuries

    NARCIS (Netherlands)

    Kloen, P.; Patterson, J. D.; Wintman, B. I.; Ozuna, R. M.; Brick, G. W.

    1999-01-01

    Bilateral vertebral artery injuries in closed cervical spine injuries are uncommon, but early recognition and treatment are important to prevent neurological deterioration. A case of bilateral vertebral injuries in a 35-year-old motor vehicle accident victim is presented, and the current literature

  2. Can vertebral density changes be explained by intervertebral disc degeneration?

    NARCIS (Netherlands)

    Homminga, J.J.; Aquarius, R.J.; Bulsink, V.E.; Jansen, C.T.; Verdonschot, N.J.

    2012-01-01

    One of the major problems facing the elderly spine is the occurrence of vertebral fractures due to low bone mass. Although typically attributed to osteoporosis, disc degeneration has also been suggested to play a role in vertebral fractures. Existing bone adaptation theories and simulations may

  3. Closed cervical spine trauma associated with bilateral vertebral artery injuries.

    Science.gov (United States)

    Kloen, P; Patterson, J D; Wintman, B I; Ozuna, R M; Brick, G W

    1999-01-01

    Bilateral vertebral artery injuries in closed cervical spine injuries are uncommon, but early recognition and treatment are important to prevent neurological deterioration. A case of bilateral vertebral injuries in a 35-year-old motor vehicle accident victim is presented, and the current literature is reviewed.

  4. Vertebrate Osmoregulation: A Student Laboratory Exercise Using Teleost Fish

    Science.gov (United States)

    Boily P.; Rees, B. B.; Williamson, L. A. C.

    2007-01-01

    Here, we describe a laboratory experiment as part of an upper-level vertebrate physiology course for biology majors to investigate the physiological response of vertebrates to osmoregulatory challenges. The experiment involves measuring plasma osmolality and Na[superscript +] -K[superscript +] -ATPase activity in gill tissue of teleost fish…

  5. Origin and evolution of retinoid isomerization machinery in vertebrate visual cycle: hint from jawless vertebrates.

    Directory of Open Access Journals (Sweden)

    Eugenia Poliakov

    Full Text Available In order to maintain visual sensitivity at all light levels, the vertebrate eye possesses a mechanism to regenerate the visual pigment chromophore 11-cis retinal in the dark enzymatically, unlike in all other taxa, which rely on photoisomerization. This mechanism is termed the visual cycle and is localized to the retinal pigment epithelium (RPE, a support layer of the neural retina. Speculation has long revolved around whether more primitive chordates, such as tunicates and cephalochordates, anticipated this feature. The two key enzymes of the visual cycle are RPE65, the visual cycle all-trans retinyl ester isomerohydrolase, and lecithin:retinol acyltransferase (LRAT, which generates RPE65's substrate. We hypothesized that the origin of the vertebrate visual cycle is directly connected to an ancestral carotenoid oxygenase acquiring a new retinyl ester isomerohydrolase function. Our phylogenetic analyses of the RPE65/BCMO and N1pC/P60 (LRAT superfamilies show that neither RPE65 nor LRAT orthologs occur in tunicates (Ciona or cephalochordates (Branchiostoma, but occur in Petromyzon marinus (Sea Lamprey, a jawless vertebrate. The closest homologs to RPE65 in Ciona and Branchiostoma lacked predicted functionally diverged residues found in all authentic RPE65s, but lamprey RPE65 contained all of them. We cloned RPE65 and LRATb cDNAs from lamprey RPE and demonstrated appropriate enzymatic activities. We show that Ciona ß-carotene monooxygenase a (BCMOa (previously annotated as an RPE65 has carotenoid oxygenase cleavage activity but not RPE65 activity. We verified the presence of RPE65 in lamprey RPE by immunofluorescence microscopy, immunoblot and mass spectrometry. On the basis of these data we conclude that the crucial transition from the typical carotenoid double bond cleavage functionality (BCMO to the isomerohydrolase functionality (RPE65, coupled with the origin of LRAT, occurred subsequent to divergence of the more primitive chordates

  6. Prevalence of silent vertebral fractures detected by vertebral fracture assessment in young Portuguese men with hyperthyroidism.

    Science.gov (United States)

    Barbosa, Ana Paula; Rui Mascarenhas, Mário; Silva, Carlos Francisco; Távora, Isabel; Bicho, Manuel; do Carmo, Isabel; de Oliveira, António Gouveia

    2015-02-01

    Hyperthyroidism is a risk factor for reduced bone mineral density (BMD) and osteoporotic fractures. Vertebral fracture assessment (VFA) by dual-energy X-ray absorptiometry (DXA) is a radiological method of visualization of the spine, which enables patient comfort and reduced radiation exposure. This study was carried out to evaluate BMD and the prevalence of silent vertebral fractures in young men with hyperthyroidism. We conducted a cross-sectional study in a group of Portuguese men aged up to 50 years and matched in hyperthyroidism (n=24) and control (n=24) groups. A group of 48 Portuguese men aged up to 50 years was divided and matched in hyperthyroidism (n=24) and control (n=24) groups. BMD (g/cm(2)) at L1-L4, hip, radius 33%, and whole body as well as the total body masses (kg) were studied by DXA. VFA was used to detect fractures and those were classified by Genant's semiquantitative method. No patient had previously been treated for hyperthyroidism, osteoporosis, or low bone mass. Adequate statistical tests were used. The mean age, height, and total fat mass were similar in both groups (P≥0.05). The total lean body mass and the mean BMD at lumbar spine, hip, and whole body were significantly decreased in the hyperthyroidism group. In this group, there was also a trend for an increased prevalence of reduced BMD/osteoporosis and osteoporotic vertebral fractures. The results obtained using VFA technology (confirmed by X-ray) suggest that the BMD changes in young men with nontreated hyperthyroidism may lead to the development of osteoporosis and vertebral fractures. This supports the pertinence of using VFA in the routine of osteoporosis assessment to detect silent fractures precociously and consider early treatment. © 2015 European Society of Endocrinology.

  7. Globally threatened vertebrates on islands with invasive species

    Science.gov (United States)

    Spatz, Dena R.; Zilliacus, Kelly M.; Holmes, Nick D.; Butchart, Stuart H. M.; Genovesi, Piero; Ceballos, Gerardo; Tershy, Bernie R.; Croll, Donald A.

    2017-01-01

    Global biodiversity loss is disproportionately rapid on islands, where invasive species are a major driver of extinctions. To inform conservation planning aimed at preventing extinctions, we identify the distribution and biogeographic patterns of highly threatened terrestrial vertebrates (classified by the International Union for Conservation of Nature) and invasive vertebrates on ~465,000 islands worldwide by conducting a comprehensive literature review and interviews with more than 500 experts. We found that 1189 highly threatened vertebrate species (319 amphibians, 282 reptiles, 296 birds, and 292 mammals) breed on 1288 islands. These taxa represent only 5% of Earth’s terrestrial vertebrates and 41% of all highly threatened terrestrial vertebrates, which occur in species eradication and other island conservation actions that reduce biodiversity loss. PMID:29075662

  8. Non-contiguous multifocal vertebral osteomyelitis caused by Serratia marcescens.

    Science.gov (United States)

    Lau, Jen Xin; Li, Jordan Yuanzhi; Yong, Tuck Yean

    2015-03-01

    Serratia marcescens is a common nosocomial infection but a rare cause of osteomyelitis and more so of vertebral osteomyelitis. Vertebral osteomyelitis caused by this organism has been reported in few studies. We report a case of S. marcescens vertebral discitis and osteomyelitis affecting multiple non-contiguous vertebras. Although Staphylococcus aureus is the most common cause of vertebral osteomyelitis, rare causes, such as S. marcescens, need to be considered, especially when risk factors such as intravenous heroin use, post-spinal surgery and immunosuppression are present. Therefore, blood culture and where necessary biopsy of the infected region should be undertaken to establish the causative organism and determine appropriate antibiotic susceptibility. Prompt diagnosis of S. marcescens vertebral osteomyelitis followed by the appropriate treatment can achieve successful outcomes.

  9. Novel technique of laparoscopic extravesical ureteric reimplantation in primary obstructive megaureter.

    Science.gov (United States)

    Khan, Altaf; Rahiman, Mujeebu; Verma, Ashish; Bhargava, Rahul

    2017-01-01

    This study aims to demonstrate a novel laparoscopic technique of tapering megaureter without disrupting the blood supply and disconnecting the ureter. Eight cases of primary obstructive megaureter in the age group of 14-22 years underwent laparoscopic extravesical ureteric reimplantation between August 2011 and July 2015 using our novel technique. Five patients had obstruction on left side and three on right side. Follow-up ultrasonography at 1 month and 3 months, voiding cystourethrogram (VCUG) at 3 months and intravenous urogram (IVU) at 6 months was obtained to assess the development of reflux and to look for adequate drainage of the obstructive ureter. Average age of the patients at the time of surgery was 18.5 years. Mean operating time was 95 min. Mean blood loss of 20 ml. VCUG done after 3 months showed no reflux in all cases. IVU done after six months showed no obstruction and complete drainage of dye. Our technique of tapering obstructed megaureter over a preplaced ureteral dilator is time saving and also helps in preserving blood supply to lower ureter. As a result, ureteric anastomotic stricture rate is very low. It is easily reproducible in the open as well as by robotic.

  10. Comparison of different morphological parameters with duration of obstruction created experimentally in unilateral upper ureters: An animal model

    Directory of Open Access Journals (Sweden)

    Shasanka Shekhar Panda

    2014-01-01

    Full Text Available Background: The objective of the following study is to determine and to compare the different morphological parameters with duration of obstruction created experimentally in unilateral upper ureters of rats. Materials and Methods: Unilateral upper ureteric obstruction was created in 60 adult Wistar rats that were reversed after predetermined intervals. Rats were sacrificed and ipsilateral kidneys were subjected for analysis of morphological parameters such as renal height, cranio-caudal diameter, antero-posterior diameter, lateral diameter, volume of the pelvis and average cortical thickness: Renal height. Results: Renal height and cranio-caudal diameter of renal pelvis after ipsilateral upper ureteric obstruction started rising as early as 7 days of creating obstruction and were affected earlier than antero-posterior and lateral diameter and also were reversed earlier than other parameters after reversal of obstruction. Renal cortical thickness and volume of the pelvis were affected after prolonged obstruction (> 3 weeks and were the late parameters to be reversed after reversal of obstruction. Conclusions: Cranio-caudal diameter and renal height were the early morphological parameters to be affected and reversed after reversal of obstruction in experimentally created ipsilateral upper ureteric obstruction.

  11. Multi-modality imaging of the leaking ureter: why does detection of traumatic and iatrogenic ureteral injuries remain a challenge?

    Science.gov (United States)

    Alabousi, Abdullah; Patlas, Michael N; Menias, Christine O; Dreizin, David; Bhalla, Sanjeev; Hon, Man; O'Brien, Andres; Katz, Douglas S

    2017-08-01

    Ureteral injuries are uncommon in trauma patients, accounting for fewer than 1% of all injuries to the urinary tract. These uncommon, yet problematic, injuries can often be overlooked in the standard search pattern on abdominal and pelvic multi-detector CT (MDCT) images, as radiologists focus on more immediate life-threatening injuries. However, early diagnosis and management are vital to reduce potential morbidity. If there is a high clinical index of suspicion for ureteral injuries with penetrating or blunt trauma, or if there is suspected iatrogenic ureteral injury, delayed-phase/urographic-phase MDCT images are essential for confirming the diagnosis. Moreover, making the distinction between partial and complete ureteral transection is critical, as it will guide management. The aim of this pictorial review is to overview the key imaging findings in blunt and penetrating traumatic and iatrogenic injuries of the ureter, as well as to discuss the advantages and disadvantages of different imaging modalities for accurately and rapidly establishing or excluding the diagnosis of ureteral injuries, with an emphasis on MDCT. The potential causes of missed ureteral injuries will also be discussed.

  12. Embolization of a hypoplastic kidney with a vaginal ectopic ureter in a case of pseudo-incontinence.

    Science.gov (United States)

    Solinas, Andrea; De Giorgi, Franco; Frongia, Mauro

    2004-09-01

    Ureteral ectopy into the vagina is a cause of pseudo-incontinence. When the corresponding kidney has a good function, the treatment of choice is the ureter reimplantation, otherwise the alternative is partial or total nephrectomy. To report a case of 18-year-old girl presented with urinary leakage occurring between normal voids that at 11-year-old was found to have, at cistoscopy and vaginoscopy, an left ureteral ectopy into the vagina with a non demonstrable corresponding kidney at conventional intravenous urography, dimercaptosuccinic acid scintigraphy and ultrasonography. Moreover the right kidney was found enlarged but normally located. Her parents refused the explorative laparotomy to localize and to remove the left kidney. We completed the examination with computed tomography that revealed a small hypoplastic and ectopic left kidney located at L4 level. Because the contribution of the hypoplastic kidney to the total renal function was insignificant, we decided to eliminate it. A selective embolization of the left renal artery was performed using polyvinyl alcohol foam. The pseudo-incontinence stopped immediately after The patient was discharged home in II postoperative day and has been free from any leakage for 3 years. Serum creatinine levels and blood pressure returned to their normal values.

  13. Neurorehabilitation in stroke produced by vertebral artery dissection: case presentation

    Directory of Open Access Journals (Sweden)

    Stanescu Ioana

    2018-02-01

    Full Text Available Arterial dissections are a common cause of stroke in the young (mean age 44 to 46 years. Primary lesion is a tear of the arterial intima, which promotes platelet aggregation, thrombus formation, which further produced vessel stenosis / occlusion, distal embolism or vessel wall rupture. Vertebral artery (VA dissection appear most commonly in extracranial segments V2 and V3, and could be spontaneous (with underlying predispositions or triggered by various traumatisms. Clinicaly, VA dissection produces an ischemic stroke or transient ischemic attack , preceded by local symptoms such as neck pain or headache. The diagnosis is confirmed by neurovascular imaging. Treatment of symptomatic VA dissections respect indications of treatment in ischemic strokes. Prognosis is mostly favorable in extracranial dissections. We present the case of a left VA dissection in V2 segment, produced by physical effort (swimming, which causes 2 ischemic lesions, one in the territory of the left posterior cerebral artery and the other in the territory of the left posterolateral chorroidal artery. Patient’s treatment included antiplatelet agents, statines, and an adapted physical rehabilitation program. At three months he showed significant clinical improvement with regain of autonomy and partial recanalisation at angio-MRI of the V2 segment of the dissected artery.

  14. Vertebral artery anomaly and injury in spinal surgery.

    Science.gov (United States)

    Molinari, Robert; Bessette, Matthew; Raich, Annie L; Dettori, Joseph R; Molinari, Christine

    2014-04-01

    Systematic review. The purpose of this review is to further define the published literature with respect to vertebral artery (VA) anomaly and injury in patients with degenerative cervical spinal conditions. In adult patients with cervical spine or degenerative cervical spine disorders receiving cervical spine surgery, what is the incidence of VA injury, and among resulting VA injuries, which treatments result in a successful outcome and what percent are successfully repaired? A systematic review of pertinent articles published up to April 2013. Studies involving traumatic onset, fracture, infection, deformity or congenital abnormality, instability, inflammatory spinal diseases, or neoplasms were excluded. Two independent reviewers assessed the level of evidence quality using the Grades of Recommendation Assessment, Development and Evaluation criteria; disagreements were resolved by consensus. From a total of 72 possible citations, the following met our inclusion criteria and formed the basis for this report. Incidence of VA injuries ranged from 0.20 to 1.96%. None of the studies reported using preoperative imaging to identify anomalous or tortuous VA. Primary repair and ligation were the most effective in treating VA injuries. The incidence of VA injuries in degenerative cervical spinal surgery might be as high as 1.96% and is likely underreported. Direct surgical repair is the most effective treatment option. The most important preventative technique for VA injuries is preoperative magnetic resonance imaging or computed tomography angiographic imaging to detect VA anomalies. The overall strength of evidence for the conclusions is low.

  15. Vertebral Adaptations to Large Body Size in Theropod Dinosaurs.

    Science.gov (United States)

    Wilson, John P; Woodruff, D Cary; Gardner, Jacob D; Flora, Holley M; Horner, John R; Organ, Chris L

    2016-01-01

    Rugose projections on the anterior and posterior aspects of vertebral neural spines appear throughout Amniota and result from the mineralization of the supraspinous and interspinous ligaments via metaplasia, the process of permanent tissue-type transformation. In mammals, this metaplasia is generally pathological or stress induced, but is a normal part of development in some clades of birds. Such structures, though phylogenetically sporadic, appear throughout the fossil record of non-avian theropod dinosaurs, yet their physiological and adaptive significance has remained unexamined. Here we show novel histologic and phylogenetic evidence that neural spine projections were a physiological response to biomechanical stress in large-bodied theropod species. Metaplastic projections also appear to vary between immature and mature individuals of the same species, with immature animals either lacking them or exhibiting smaller projections, supporting the hypothesis that these structures develop through ontogeny as a result of increasing bending stress subjected to the spinal column. Metaplastic mineralization of spinal ligaments would likely affect the flexibility of the spinal column, increasing passive support for body weight. A stiff spinal column would also provide biomechanical support for the primary hip flexors and, therefore, may have played a role in locomotor efficiency and mobility in large-bodied species. This new association of interspinal ligament metaplasia in Theropoda with large body size contributes additional insight to our understanding of the diverse biomechanical coping mechanisms developed throughout Dinosauria, and stresses the significance of phylogenetic methods when testing for biological trends, evolutionary or not.

  16. Hyperkyphosis predicts mortality independent of vertebral osteoporosis in older women.

    Science.gov (United States)

    Kado, Deborah M; Lui, Li-Yung; Ensrud, Kristine E; Fink, Howard A; Karlamangla, Arun S; Cummings, Steven R

    2009-05-19

    Excessive kyphosis may be associated with earlier mortality, but previous studies have not controlled for clinically silent vertebral fractures, which are a known mortality risk factor. To determine whether hyperkyphosis predicts increased mortality independent of vertebral fractures. Prospective cohort study. Four clinical centers in Baltimore County, Maryland; Portland, Oregon; Minneapolis, Minnesota; and the Monongahela Valley, Pennsylvania. 610 women, age 67 to 93 years, from a cohort of 9704 women recruited from community-based listings between 1986 and 1988. Kyphosis was measured by using a flexicurve. Prevalent radiographic vertebral fractures at baseline were defined by morphometry, and mortality was assessed during an average follow-up of 13.5 years. In age-adjusted models, each SD increase in kyphosis carried a 1.14-fold increased risk for death (95% CI, 1.02 to 1.27; P = 0.023). After adjustment for age and other predictors of mortality, including such osteoporosis-related factors as low bone density, moderate and severe prevalent vertebral fractures, and number of prevalent vertebral fractures, women with greater kyphosis were at increased risk for earlier death (relative hazard per SD increase, 1.15 [CI, 1.01 to 1.30]; P = 0.029). On stratification by prevalent vertebral fracture status, only women with prevalent fractures were at increased mortality risk from hyperkyphosis, independent of age, self-reported health, smoking, spine bone mineral density, number of vertebral fractures, and severe vertebral fractures (relative hazard per SD increase, 1.58 [CI, 1.06 to 2.35]; P = 0.024). The study population included only white women. In older women with vertebral fractures, hyperkyphosis predicts an increased risk for death, independent of underlying spinal osteoporosis and the extent and severity of vertebral fractures. National Institute of Arthritis and Musculoskeletal and Skin Diseases and National Institute on Aging.

  17. Primary pelvic hydatic cyst mimicking ovarian carcinoma

    Directory of Open Access Journals (Sweden)

    Faruk Abike

    2011-05-01

    Full Text Available Hydatic cyst is an illness that appears in consequence of the cystic form of small strap-shaped worm Echinococcus granulosis. Frequently, cysts exist in the lungs and liver. Peritoneal involvement is rare, and generally occurs as a result of second inoculation from rupture of a liver-located hydatic cyst. Primary ovarian hydatic cyst is very rare. A 56-year-old female patient was admitted to Emergency Service with the complaint of stomachache and swollen abdomen. From ultrasonographic examination, a right ovarian 52 × 45-mm heterogeneous semi-solid cystic mass and right hydronephrosis were detected. As a result of the tomographic examination, the right ovarian growth was judged to be a 60 × 45-mm lobule contoured, septal, heterogeneously cystic mass (ovarian carcinoma. Depending on these indicators and with the diagnosis of ovarian carcinoma, laparotomy was planned. During the observation, a mass that compressed on the right ureter and dilatation in the right ureter were determined. The mass was approximately 6 cm long and smoothly contoured, including widespread adhesions, and also obliteration of the pouch of Douglas. The mass was excised and total abdominal hysterectomy and bilateral salpingo-oopherectomy performed. After a pathological examination, hydatid cyst was diagnosed. Although pointing at the issue of the distinctive diagnosis of pelvic and peritoneal mass, it should be realized that the existence of primary peritoneal and pelvic involvement of the hydatic cyst is generally a result of the second inoculation, and is also more common in regions in which Echinococcus granulosa is endemic and livestock production is prevalent.

  18. The Lamprey: A jawless vertebrate model system for examining origin of the neural crest and other vertebrate traits

    Science.gov (United States)

    Green, Stephen A.; Bronner, Marianne E.

    2014-01-01

    Summary Lampreys are a group of jawless fishes that serve as an important point of comparison for studies of vertebrate evolution. Lampreys and hagfishes are agnathan fishes, the cyclostomes, which sit at a crucial phylogenetic position as the only living sister group of the jawed vertebrates. Comparisons between cyclostomes and jawed vertebrates can help identify shared derived (i.e. synapomorphic) traits that might have been inherited from ancestral early vertebrates, if unlikely to have arisen convergently by chance. One example of a uniquely vertebrate trait is the neural crest, an embryonic tissue that produces many cell types crucial to vertebrate features, such as the craniofacial skeleton, pigmentation of the skin, and much of the peripheral nervous system (Gans and Northcutt, 1983). Invertebrate chordates arguably lack unambiguous neural crest homologs, yet have cells with some similarities, making comparisons with lampreys and jawed vertebrates essential for inferring characteristics of development in early vertebrates, and how they may have evolved from nonvertebrate chordates. Here we review recent research on cyclostome neural crest development, including research on lamprey gene regulatory networks and differentiated neural crest fates. PMID:24560767

  19. ANOMALOUS PREVERTEBRAL COURSE OF THE LEFT VERTEBRAL ARTERY. Recorrido prevertebral anómalo de la arteria vertebral izquierda

    Directory of Open Access Journals (Sweden)

    Prakash B Billakanti

    2016-03-01

    Full Text Available La arteria vertebral es una de las arterias que irriga el cerebro. El conocimiento de la anatomía normal y las variantes de la arteria vertebral adquiere importancia en la práctica clínica y la radiología vascular. El origen anómalo de la arteria vertebral del arco de la aorta o cualquiera de las arterias del cuello ha sido reportado por muchos autores. En este informe se presenta una variación del curso prevertebral de la arteria vertebral izquierda. La arteria vertebral tenía su origen habitual en la arteria subclavia con un largo curso prevertebral y entraba en el foramen transversarium de la vértebra CII. El origen y recorrido de la arteria vertebral en el lado derecho fue normal. Clínicamente es importante conocer el origen y curso del segmento prevertebral de la arteria vertebral y las posibles variaciones. El presente informe debería ser de interés para el médico vascular con respecto a las variaciones en el cuello y región torácica, y puede dar idea para dilucidar el mecanismo de desarrollo de la angiogénesis. Vertebral artery is one of the arteries supplying the brain. Knowledge of the normal and variant anatomy of the vertebral artery assumes importance in clinical practice and vascular radiology. Anomalous origins of the vertebral artery from the arch of the aorta or any one of the arteries of the neck have been reported by several authors. In this report a variation of the prevertebral course of the left vertebral artery is being presented. The Vertebral artery had usual origin from the subclavian artery and had a longer prevertebral course to enter the foramen transversarium of the CII vertebra. The origin and course of the vertebral artery on the right side was normal. It is clinically important to know the origin and course of the prevertebral segment of the vertebral artery and possible variations. The present report should be of interest for clinicians with regard to vascular variations in the neck and thoracic

  20. [The Efficacy of Percutaneous Transluminal Angioplasty and Stenting for Traumatic Vertebral Artery Dissection due to Cervical Vertebral Fracture].

    Science.gov (United States)

    Kawaguchi, Misato; Nii, Kouhei; Sakamoto, Kimiya; Kawahara, Kanae; Inoue, Ritsurou; Hiraoka, Fumihiro; Morinaga, Yusuke; Mitsutake, Takafumi; Hanada, Hayatsura; Tsutsumi, Masanori

    2018-02-01

    A 73-year-old man was admitted at another hospital after a traffic accident. The diagnosis was cervical vertebral fracture. Despite conservative treatment, 5 days later he manifested dysarthria due to cerebellar infarction and was transferred to our hospital. Imaging studies revealed right vertebral arterial dissection at the level of the axial fracture. We performed percutaneous transluminal angioplasty with stenting to address his subacute vertebral artery dissection prior to treating the cervical vertebral fracture using external fixation. His clinical course was good;ischemia did not recur after stenting and his dysarthria disappeared upon rehabilitation. Cerebral angiograms obtained 6 months later revealed no significant in-stent restenosis. While medical management tends to be the first-line treatment of traumatic vertebral artery dissection, percutaneous transluminal angioplasty with stenting is necessary before treating other traumatic lesions to prevent neurologic events.