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At least 181 records · Page 10Linked to original sources
PubMed1999

A complete human pelvis from the Middle Pleistocene of Spain.

The Middle Pleistocene site of Sima de los Huesos in Sierra de Atapuerca, Spain, has yielded around 2,500 fossils from at least 33 different hominid individuals. These have been dated at more than 200,000 years ago and have been classified as ancestors of Neanderthals. An almost complete human male pelvis (labelled Pelvis 1) has been found, which we associate with two fragmentary femora. Pelvis 1 is robust and very broad with a very long superior pubic ramus, marked iliac flare, and a long femoral neck. This pattern is probably the primitive condition from which modern humans departed. A modern human newborn would pass through the birth canal of Pelvis 1 and this would be even larger in a female individual. We estimate the body mass of this individual at 95 kg or more. Using the cranial capacities of three specimens from Sima de los Huesos, the encephalization quotients are substantially smaller than in Neanderthals and modern humans.

Adult↗
PubMed2000

Sarcomatoid carcinoma of the renal pelvis: a case report.

A case of sarcomatoid carcinoma of the renal pelvis is reported. A 72-year-old male was admitted with a chief complaint of right flank pain. Clinical imaging studies revealed marked dilation of the right renal pelvis caused by a tumor at the pyeloureteric region. Right nephrectomy was performed in June 1999. The 8.4 x 6.5 cm tumor was grossly polypoid in appearance and protruded into the renal pelvis. Histologically, sarcomatoid spindle cells predominated over the carcinomatous component (mainly transitional cell carcinoma, partly associated with squamous cell and adenocarcinoma components). Osteoclast-like CD68-positive multinucleated giant cells were scattered. The sarcomatoid component was immunoreactive for both cytokeratin and vimentin. Sarcomatoid cells negative for cytokeratin were also noted. In both the sarcomatoid and carcinomatous components, nuclear overexpression of p53 oncoprotein was confirmed. The histogenesis of sarcomatoid carcinoma of the renal pelvis is discussed.

Adenocarcinoma↗
PubMed2000

Roles of p53 and MDM2 in tumor proliferation and determination of the prognosis of transitional cell carcinoma of the renal pelvis and ureter.

BACKGROUND: The significance of p53 overexpression for the prognosis of transitional cell carcinoma (TCC) of the renal pelvis and ureter remains controversial. Simultaneous evaluation of p53 and MDM2 may enable better prediction of tumor proliferation and patient prognosis than that obtained with evaluation of p53 alone. METHODS: Immunohistochemical detection of p53 protein, MDM2 protein and Ki-67 antigen as proliferation markers was performed for tissue samples obtained from 74 patients with TCC of the renal pelvis and ureter. The correlations of p53/MDM2 overexpression with conventional pathological features, Ki-67 labelling index (LI) and patient survival were studied. RESULTS: Overexpression of p53 was related to progression of each of the pathological features examined (grade, stage, type of infiltration, vascular invasion and lymphatic invasion) and Ki-67 LI was significantly higher with high p53 expression than with low p53 expression. However, overexpression of MDM2 was related to neither disease progression nor Ki-67 LI. Survival analyses were performed for 66 patients. Univariate analysis showed p53 to be a useful prognostic indicator, but in a multivariate analysis only type of infiltration and Ki-67 LI were independent survival markers, while p53 was not. Overexpression of MDM2 was unrelated to patient survival, and the combination of p53 and MDM2 for survival indication was found not to be useful. CONCLUSIONS: Overexpression of p53 is related to disease progression, increased tumor proliferation and patient survival for TCC of the renal pelvis and ureter, but the independent prognostic value of p53 did not reach statistical significance. Combined analysis of MDM2 with p53 cannot be recommended for examination of the malignant potential of TCC of the renal pelvis and ureter.

Adult↗
PubMed1985

Management of pelvi-ureteric junction obstruction in the first six months of life.

The authors report on clinical experience from 20 infants who were under six months of age, and who had been referred during the last five years for pelvi-ureteric junction obstruction. Any over-eagerness to arrive at an early diagnosis, mostly on the basis of prenatal ultrasonographic suspicion, must be tempered. Pyelocaliceal dilatation in newborn infants may not be related to obstruction, and overtreatment must be avoided by careful preoperative evaluation. Tc-DTPA diuretic computerised renography proved extremely reliable, whereas IVP may be unsatisfactory and misleading. Whenever surgical correction was indicated for a documented pelvi-ureteric junction obstruction, Anderson-Hynes pyeloplasty was performed, except in one case, where severe dysplastic changes in the hydronephrotic kidney necessitated nephrectomy. Splinting of the anastomosis was adopted in newborn with thin ureters. An infant with left pelvi-ureteric obstruction and right multicystic kidney died from renal failure a few days after right nephrectomy and left pyeloureteroplasty. No operative failure was otherwise observed, except for a transient anastomotic obstruction in two cases. Treatment of pelvi-ureteric obstruction in the first 6 months is a serious undertaking and should be restricted to experienced centres with facilities for intensive neonatal care, even for dialysis.

Female↗
PubMed1998

Iodine concentrations in the rat kidney measured by X-ray microanalysis. Comparison of concentrations and viscosities in the proximal tubules and renal pelvis after intravenous injections of contrast media.

PURPOSE: To measure the iodine concentrations in the proximal tubules and renal pelvis after i.v. injections of contrast media (CM) at 1600 mg I/kg b.w., using a micropuncture technique and X-ray microanalysis. MATERIAL AND METHODS: The correlation between the viscosity of each CM and its iodine concentration was evaluated and the viscosity of the fluid in the proximal tubule and renal pelvis was estimated in rats. RESULTS: After iotrolan injection, the iodine concentration in the proximal tubular fluid had increased to values about three times higher than those reached with diatrizoate, iohexol and ioxaglate. Similarly, iotrolan tended to produce a higher iodine concentration in the renal pelvis than did the other CM. The urine viscosity in the renal pelvis was much higher after the iotrolan injection than after the other CM injections. CONCLUSION: High urine viscosity after iotrolan injection can at least partly explain our previous findings of a prolonged increase in tubular hydrostatic pressure and a prolonged decrease in the single nephron glomerular filtration rate after administration of this CM.

Animals↗
PubMedDate not supplied

CT in searching for abscess after abdominal or pelvic surgery in patients with neoplasia: do abdomen and pelvis both need to be scanned?

PURPOSE: This prospective study was undertaken to determine the incremental yield of combined abdominal and pelvic CT in searching for clinically suspected postoperative abscess in oncologic patients. METHOD: One hundred seventeen oncologic patients underwent CT to exclude a clinically suspected abscess within 30 days of abdominal or pelvic surgery during an 8 month period. Scans were evaluated for the presence of ascites, loculated fluid collections, or other possible sources of fever. The clinical course and any intervention in the abdomen or pelvis within 30 days after CT were recorded. RESULTS: After abdominal surgery, 44 of 69 [64%; confidence interval (CI) 51-75%] patients had loculated fluid collections in the abdomen; no patient (0%; CI 0-5%) had a loculated fluid collection present only in the pelvis. After pelvic surgery, 22 of 48 (46%; CI 31-61%) patients had loculated fluid collections in the pelvis; no patient (0%; CI 0-7%) had a loculated collection present only in the abdomen. Loculated collections were present in both the abdomen and the pelvis in 4 of 69 (6%; CI 1.6-14%) patients after abdominal surgery and 3 of 48 (6%; CI 1.3-17%) after pelvic surgery. CONCLUSION: Isolated pelvic abscesses after abdominal surgery and isolated abdominal abscesses after pelvic surgery appear to be very uncommon in oncologic patients. CT initially need be directed only to the region of surgery in this particular patient population.

Abdominal Abscess↗
PubMed2001

Extension of fusions to the pelvis in idiopathic scoliosis.

STUDY DESIGN: Retrospective study of patients after extension of previous scoliosis fusions to the pelvis. OBJECTIVE: To determine whether modern instrumentation and surgical techniques provide for increased fusion rates with fewer complications. SUMMARY OF BACKGROUND DATA: Traditionally, long fusions to the pelvis in adults with idiopathic scoliosis have resulted in high complication rates, including pseudarthrosis. METHODS: The hospital and clinic charts of 41 patients (40 female, 1 male) were reviewed 41 months (range: 24-116) after surgery for extension to the pelvis of previous scoliosis fusions. Thirty-nine of 41 had a combined anteroposterior fusion extension; two had posterior extension only. In 37 of 41 patients, Cotrel-Dubousset (CD) instrumentation was used; in two, Isola (Acromed Corp., Cleveland, OH), in one, TSRH; (Sofamor-Danek, Memphis, TN), and in one, Synergy (Cross Medical Products, Columbus, OH). Parameters analyzed were fusion rate, sagittal and coronal balance, lumbar lordosis, length of fusion extension, and distal fixation method. RESULTS: Complications were seen in 30 of 41 patients. The pseudarthrosis rate was 37% (15/41) and was significantly related to the method of distal posterior fixation. With sacral fixation only, the rate was 53% (8/15), with iliac fixation only 42% (3/7), and with both iliac and sacral fixation 21% (4/19; P < 0.05). This was not correlated with fusion rate, and the length of fusion extension did not affect the pseudarthrosis rate or sagittal balance. CONCLUSION: When fixed to the ilium and sacrum, modern instrumentation appears capable of maintaining sagittal balance with lower rates of pseudarthrosis when previous scoliosis fusions are extended to the pelvis. The complication rate remains significant.

Adult↗
PubMed2002

Effect of derotation osteotomy of the femur on hip and pelvis rotations in hemiplegic and diplegic children.

The purpose of this study was to evaluate hip and pelvis rotations in groups of hemiplegic and diplegic children before and after surgical correction of fixed internal rotation deformity of the hip. Twenty-two children with cerebral palsy (eight diplegia, 14 hemiplegia) having fixed internal rotation deformity at the hip were treated by multilevel surgery which included derotation osteotomy of the femur. Evaluation was done before and at a mean of 3.1 years after surgery using three-dimensional computerized gait analysis. Preoperatively, the patients in the hemiplegia group had a significantly greater compensatory external rotation of the pelvis than those in the diplegic group. Post-operatively there were no significant differences between the two groups. In the hemiplegia group the external rotation of the pelvis was corrected after correction of hip rotation by derotation osteotomy. Patients in the diplegia group showed significant improvements in the hip rotation with no significant change in the pelvis rotation after multilevel surgery.

Adolescent↗
PubMed2006

Sagittal alignment of the spine and pelvis in the presence of L5-s1 isthmic lysis and low-grade spondylolisthesis.

STUDY DESIGN: A radiographic study of 82 patients with L5-S1 spondylolysis or spondylolisthesis of less than 50% displacement of L5 on S1. OBJECTIVE: To measure and describe the sagittal alignment of the spine and pelvis in patients with spondylolysis before the development of a large secondary deformity associated with progression of the spondylolisthesis. SUMMARY OF BACKGROUND DATA: Several publications have addressed the alignment of the spine and pelvis as an important factor in the occurrence, symptomatology, progression, and treatment of spondylolysis and spondylolisthesis. To our knowledge, this is the first report to systematically document the native sagittal alignment of affected patients and compare them to a large control population. MATERIALS AND METHODS: The sagittal alignment in this cohort of 82 patients was compared with a control population of 160 patients without symptoms of back pain or radiographic abnormalities of the spine and pelvis that was the subject of a previous study. RESULTS: Patients with spondylolysis and low-grade spondylolisthesis demonstrate increased pelvic incidence, increased lumbar lordosis, but less segmental extension between L5 and S1 than in a normal population. CONCLUSIONS: These data suggest that differences in the sagittal alignment of the spine and pelvis may influence the biomechanical environment that results in the development of spondylolysis and progressive spondylolisthesis.

Adolescent↗
PubMedDate not supplied

Mucinous cystadenoma with malignant transformation arising in the renal pelvis.

Mucinous cystadenoma with malignant transformation occupying the lower half portion of the right renal pelvis in a 69-year-old Japanese man was recorded. The patient had recent dysuria but no clinical history of pyelonephritis or urolithiasis. Under the clinical diagnosis of unusual renal cyst, the right total nephrectomy was performed. Grossly, the cystic tumor, 5 cm across, formed a monolocular lumen filled with mucins and showed no direct communication with the renal pelvis inside. Microscopically, the epithelial lining was characterized by a single layer of benign mucin producing columnar cells that scattered foci of non-invasive papillary projections with cell stratification and nuclear atypia suggestive of malignancy. Although there was non-specific chronic pyelitis, no pyelitis cystica et glandularis was encountered. Of circa 60 glandular neoplasms arising in the renal pelvis reported previously, adenomas are only five including two mucinous cystadenomas, while the remainder are adenocarcinomas. The histological findings of mucinous cystadenoma in the present case may represent the process of a transition from adenoma to adenocarcinoma. The result suggests the possibility that adenoma-carcinoma sequence may exist among the glandular neoplasma arising in the renal pelvis. The histogenesis was unclarified.

Aged↗
PubMed2007

Digital three-dimensional modelling of the male pelvis and bicycle seats: impact of rider position and seat design on potential penile hypoxia and erectile dysfunction.

OBJECTIVE: To digitally model (three-dimensional, 3D) the course of the pudendal arteries relative to the bony pelvis in the adult male, and to identify sites of compression with different bicycle riding positions as a potential cause of penile hypoxia and erectile dysfunction. SUBJECTS AND METHODS: 3D models were made from computed tomography scans of one adult male pelvis (a healthy volunteer) and three bicycle seats. Models were correlated with lateral radiographs of a seated rider to determine potential vascular compression between the bony pelvis and seats at different angles of rider positioning. RESULTS: Pelvis/seat models suggest that the most likely site of compression of the internal pudendal artery is immediately below the pubic symphysis, especially with the rider leaning forward. For an upright rider, the internal pudendal arteries do not appear to be compressed between the seat and the bony pelvis. Leaning partly forward with arms extended, the seat/symphysis areas were reduced to 73 mm(2) with standard seat and 259 mm(2) with a grooved seat. Leaning fully forward, the seat/symphysis areas decreased (no space with standard seat; 51 mm(2) with a grooved seat) and both the ischial tuberosities and the pubic symphysis might be in contact with the seat. CONCLUSION: A grooved seat allows better preservation of the seat/symphysis space than a standard seat, but the rider's position is more important for preserving the seat-symphysis space (and reducing compression) than is seat design alone. Any factors which influence the seat-symphysis space (including an individual's anatomy, seat design and rider position) can increase the potential for penile hypoxia and erectile dysfunction/perineal numbness.

Adult↗
PubMed1999

Prospective study of outcome in antenatally diagnosed renal pelvis dilatation.

AIMS: To ascertain the outcome associated with antenatal renal pelvis dilatation; to recommend guidelines for postnatal investigation and determine an upper limit of normal for the anterioposterior dimensions of the fetal renal pelvis. METHODS: Infants whose antenatal ultrasound scan showed a fetal renal pelvis of 5 mm or greater were investigated using postnatal renal tract ultrasound and a micturating cystogram. Isotope studies were also performed, where appropriate. RESULTS: Vesicoureteric reflux (VUR), the most common diagnosis, was evident in 23/104 (22%). In 14 infants with VUR the postnatal ultrasound scan was normal. There was no evidence of renal scarring or dysplasia in any of the refluxing kidneys. Other diagnoses were pelviureteric junction obstruction, renal dysplasia, and idiopathic dilatation. Antenatal counselling and parental information facilitated postnatal assessment. CONCLUSIONS: Infants with antenatal renal pelvis measurements of 5 mm or greater should be investigated postnatally, as a significant percentage will have VUR. A normal postnatal ultrasound scan does not preclude the presence of VUR.

Female↗
PubMed1981

Multiple-coupled pacemaker system in renal pelvis of the unicalyceal kidney.

The characteristics of spontaneous contractility in the renal pelvis were examined in the unicalyceal kidney of the rabbit. In vitro isometric studies were done on whole as well as renal pelvic segments dissected longitudinally and radially. The results show that the contractile frequency of isolated segments was highest in the proximal region (4.188 +/- 0.162 min-1) and decreased distally to (2.178 +/- 0.330 min-1). There was no significant frequency gradient in the circumferential direction. A modulation of wave form (waxing and waning phenomena) was observed in both the proximal and middle regions of the pelvis. Based on these results, a simulation of the renal pelvic activity was made by using a chain of coupled linear oscillators. At high values of coupling a pacemaker contraction of the renal pelvis was reproduced by the coupled oscillator model. The modulation of wave form was observed when the coupling of the circumferential direction was weak. These results are discussed in the context of the hierarchically organized multiple-coupled pacemaker system, which characterizes an integrative activity of the unicalyceal renal pelvis.

Animals↗
PubMed1990

Urea recycling from the renal pelvis in sheep: a study with [14C]urea.

To test the hypothesis that urea can be recycled from the renal pelvis, [14C]urea diluted in native urine (1 microCi/ml) was perfused (0.5 ml/min) into one of the pelvises of sheep fed either normal (NP) or low (LP)-protein diets. Blood samples were obtained from the ipsilateral renal vein and from the carotid artery throughout the perfusions. 14C activity determinations in urine and plasma demonstrated a flux of [14C]urea from the pelvis to renal vein blood (40,000 in NP and 130,000 disintegrations/min in LP sheep, P less than 0.01). The corresponding flux of native urea was only 1.5 times higher in NP than in LP sheep (6.8 +/- 1.1 vs. 4.7 +/- 2.9 mumol/min, not significant) despite their 8 times higher urinary concentration of urea. The fraction of filtered urea that was reabsorbed in the pelvis was larger in LP sheep (7.5 +/- 3.7 vs. 1.9 +/- 0.7% in NP sheep, P less than 0.05). A fraction of urea is thus actually recycled from the renal pelvis in sheep, and this pelvic retention is enhanced in LP animals. The importance of this phenomenon in the nitrogen economy is discussed.

Absorption↗
PubMed2005

Urothelial cancer of the renal pelvis in percutaneous nephrolithotomy patients.

INTRODUCTION: The association between staghorn calculus of the kidney long-standing and urothelial tumors of the renal pelvis is well documented. We describe 3 patients with urothelial cancer in a kidney who underwent percutaneous nephrolithotomy (PCNL). PATIENTS AND METHODS: Retrospective analysis of our series of more than 500 PCNLs revealed 3 patients in whom urothelial cancer of the renal pelvis was diagnosed during or following percutaneous stone removal. Preoperative assessment included IVP, renal sonography and renal scan using DTPA in all 3 patients, and CT in 2 patients. Imaging did not raise the suspicion of a neoplastic lesion. RESULTS: All patients had a long history of urolithiasis and urinary infections. No patient was diagnosed preoperatively. One patient was diagnosed postoperatively, when a CT demonstrated a renal lesion. The second patient underwent simple nephrectomy due to a non-functioning kidney, and the tumor was found on pathological analysis. In the third patient, biopsies were taken from a suspicious-looking tissue in the renal pelvis during the PCNL session. All patients had transitional cell carcinoma: 1 associated with sarcomatoid features and 1 with squamous carcinoma. They all died from metastatic disease 2-19 months after the diagnosis of urothelial cancer. CONCLUSIONS: The preoperative diagnosis of urothelial cancer in patients with staghorn stones is difficult due to the existing stone and inflammation. Since the prognosis of urothelial cancer is extremely poor, biopsies of the renal pelvis, obtained directly through the nephroscope during the PCNL session, may be the only key for early diagnosis and treatment. A high index of suspicion should be raised when patients suffering from infected staghorn calculi are encountered, and such intraoperative biopsies should be considered.

Aged↗
PubMed1983

Topographic variations in alpha-adrenergic and cholinergic response in the pig renal pelvis.

The effect of alpha-adrenergic and cholinergic receptor stimulation is quantitatively analyzed in different regions of the pig pyeloureter. Smooth muscle strips from minor calyces, pelvis proper and ureter were investigated. Stimulation with potassium (127 mM) was used as reference. Both phenylephrine and carbachol caused a concentration-dependent increase in basal tone in the pelvis and the minor calyx. The maximum response obtained was significantly smaller in the pelvis than in the minor calyx. As compared to phenylephrine, the response to carbachol was negligible. The ureter showed a different behavior as compared to the minor calyx and pelvis. A constant basal tone could not be obtained and the tissue did not respond to potassium in a reproducible way.

Animals↗
PubMed1988

Analysis of the in vitro pharmacologic response of renal pelvis and detrusor smooth muscle to thiphenamil, oxybutynin and verapamil.

A new computerized methodology was used to acquire and analyze the relative pharmacologic sensitivity of the renal pelvis and urinary bladder of the rabbit to pharmacologic stimulation. Comparison was made of the effects of thiphenamil, verapamil and oxybutynin on the spontaneous contractions of isolated detrusor and renal pelvis. Data collected by computer were evaluated in terms of amplitude, frequency, and tension change to varying concentration of pharmacologic stimulation. Data were analyzed using a frequency/time domain algorithm developed specifically to evaluate the contribution of the oscillatory components of tension associated with smooth muscle tissues. For the renal pelvis the results show 6 X 10(-5) M thiphenamil, 10(-3) M oxybutynin, and 5 X 10(-6) M verapamil resulted in a 50% inhibition of the phasic contractions. Thiphenamil significantly increased the contractile frequency of the renal pelvis. For the bladder 10(-3) M thiphenamil resulted in a 50% inhibition of the phasic contractions, while 3 X 10(-4) M oxybutynin and 3 X 10(-6) M verapamil were needed to achieve the same level of inhibition. Thiphenamil at lower doses (10(-4) M to 5 X 10(-4) M) showed a biphasic effect--an increase of the bladder tissue activity followed by a relaxation phase--that oxybutynin and verapamil failed to produce. The results show that the calcium blocker suppresses the spontaneous activity of the upper and lower urinary tract at lower concentrations than the anticholinergic or thiphenamil.

Animals↗
PubMed1995

The radiation dose to children from X-ray examinations of the pelvis and the urinary tract.

X-ray examinations of the pelvis and the urinary tract are frequent examinations of children, in which a large part of the trunk is irradiated. The irradiated volume contains many of the most radiation sensitive organs and tissues. The absorbed dose to children during the examination was estimated from measurements with a dose-area product meter and thermoluminescent dosemeters (TLDs). Entrance surface dose and the dose-area product results are presented. Conversion factors between the entrance surface dose and the organ dose were derived. The energy imparted, organ dose and effective dose were determined. The entrance surface dose for one single exposure varied between 0.32 mGy and 8.6 mGy for the urinary tract examination and between 0.26 mGy and 2.89 mGy per exposure for the pelvis examination. These variations are mainly influenced by the body size of the patient. The number of images taken during one examination varied. For the urinary tract investigation, the average number of exposures was six, while the corresponding number for the pelvis examination was two. The average effective dose for a typical urinary tract investigation ranged from 0.9 mSv to 8.5 mSv and from 0.3 mSv to 1.4 mSv for the pelvis examination. The radiation dose depends greatly on the body size. The recommendations to present the results in relation to age have been followed; however, the variation of body size even within each specified age range is significant. It is suggested that doses should be quoted in relation to a more critical parameter than age.

Adolescent↗