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At least 217 records · Page 12Linked to original sources
PubMed1986

[A case of primary ureteral carcinoma in the duplicated renal pelvis and ureter diagnosed by transurethral uretero-renoscopy].

We present a case of primary ureteral carcinoma in the duplicated renal pelvis and ureter diagnosed by transurethral uretero-renoscopy. The case was of a 78-year-old man with the complaint of sudden asymptomatic macrohematuria. An excretory urogram strongly suggested the presence of duplication of the right collecting system, and cystoscopy revealed a gross hematuria from the right ureteral orifice. A retrograde ureteropyelogram revealed incomplete duplication of the right renal pelvis and ureter fused at about the ureter crossing over the iliac vessels, and a polyp-like filling defect in the lower segment of duplicated ureter at about 4 cm from the fusion of the ureters. Transurethral uretero-renoscopy was employed to investigate the filling defect, and a papillary tumor extended into the lower segment of duplicated ureter was revealed. Tumor was resected by a rigid operating instrument under transurethral uretero-renoscopy. The pathological diagnosis was grade I-transitional cell carcinoma of the ureter, so that right total nephroureterectomy with partial cystectomy was carried out subsequently. Surgical specimen after right total nephroureterectomy with partial cystectomy showed no other tumor in the pelvis or ureter macroscopically, and histopathological studies of surgical specimens were no evidence of malignancy. We believe that transurethral uretero-renoscopy significantly increases the diagnostic accuracy in determining the nature of upper urinary tract lesions, and this procedure is indispensable in the diagnosis of ureteral tumors. The present case was the 7th case of primary ureteral carcinoma in the duplicated renal pelvis and ureter in the Japanese literature.

Aged↗
PubMedDate not supplied

Duplication of the renal pelvis and ureter: associated anomalies and pathological conditions.

Thirty-one patients with anomalous and/or pathological conditions in the duplication of the renal pelvis and ureter were studied in order to analyze the urographic findings. A segmental defect evident in the visualization was caused by the abscess of one of the poles in the kidney. In patients with hypoplasia of one of the poles, the other normal pelvis extended to the neighboring segment, and consequently showed the same pattern as a simple pelvis and ureter on urography. The renal hypoplasia was apt to be combined with simple or ectopic ureterocele and ectopic ureteral opening. In patients with non-visualization of two pelves, hydronephrosis or renal hypoplasia was proved by other radiological modalities including computed tomography. Incidence of vesicoureteral reflux was more frequent in the ureter of the lower pelvis. Reflux was also found between the two ureters of the bifid ureter. It was concluded that these urographical findings correlated closely with pathological conditions.

Abnormalities, Multiple↗
PubMed1995

[Description of a case of squamous cell carcinoma of the renal pelvis].

A case of squamous cell carcinoma of renal pelvis is reported. A 73-year-old Caucasian male complained of macrohematuria. The echography and Computer Tomography scan of the abdomen and pelvis revealed a large tumor mass in the right kidney associated with lymphadenopathy. A nephrectomy of the right kidney and lymphadenectomy were performed. The isotologic examination revealed a squamous carcinoma of the renal pelvis involving the renal parenchyma and extending to the perirenal fat. The regional lymph nodes were also involved. Neoplastic invasion of inferior vena cava was found. Squamous carcinoma in situ and squamous metaplasia were noted in the urothelium adjacent to the tumor. Three months later an echography revealed a local recurrence of the disease. The patient underwent adjuvant chemotherapy. The aggressive course of the disease is in agreement with the poor prognosis of squamous carcinomas of the renal pelvis as previously reported in the literature.

Aged↗
PubMed1993

Adenocarcinoma of renal pelvis.

Adenocarcinoma accounts for a small percentage of neoplasms arising within the renal pelvis. We describe a mucinous adenocarcinoma of the renal pelvis that occurred in a 57-year-old woman. Investigation of the recent literature reveals an additional 12 cases of adenocarcinoma of the renal pelvis reported since 1980. These 13 cases are summarized in detail, for a total of 59 cases of adenocarcinoma of the renal pelvis documented in the English-language literature. These tumors can be subdivided into three major histologic types: tubulovillous, mucinous, and papillary non-intestinal. The tubulovillous and mucinous tumors are morphologically similar to intestinal tumors accounting for 71.5% and 21.5% of cases, respectively. They are believed to arise in foci of intestinal metaplasia. Only three cases (7%) were of the nonintestinal, nonmucinous, papillary subtype. These rare tumors are notable for their morphologic similarity to Bellini or collecting duct carcinoma, but a specific morphologic precursor has not been identified. Of the three subtypes, tumors of tubulovillous morphology confer the worst prognosis with 70% of patients dying within 5 years. Thirty-three percent of mucinous tumors and none of the papillary nonintestinal tumors were fatal.

Adenocarcinoma↗
PubMed1995

[Schematic sections of the female pelvis].

The anatomic complexity of the female pelvis is pointed out. The diagrammatic frontal and lateral sections through the female pelvis presented in this article are based on results of anatomic studies of cadavers of adults and fetuses and on pelvic ultrasonography and magnetic resonance imaging findings. The horizontal floor of the pelvis, the perineum, and the pelvic cavity are visible on both sections. Newly identified structures are the urogenital fossa, the pubosacral perineal cord, and the urethro-clitorido-vulvar erectile body. Special attention is devoted to the description of the ischiorectal fossa and its extensions and of the uro-genito-rectal mesentery. A study of the functional anatomy of the female pelvis would be feasible.

Adult↗
PubMed1996

[Primary adenocarcinoma of renal pelvis and ureter associated with incomplete ureteral duplication: a case report].

We report a rare case of primary adenocarcinoma of the renal pelvis and ureter in an incomplete duplicated ureter. A 69-year-old male with macroscopic hematuria consulted our hospital. Retrograde pyelography revealed left incomplete duplicated ureter and a filling defect in the lower pole of the ureter. Transurethral ureteroscopy was employed to investigate the filling defect, and a papillary tumor was detected extending into the lower segment of the incomplete duplicated ureter. From these findings, the patient was diagnosed with tumor of renal pelvis and ureter, and left total nephroureterectomy was performed. Pathological diagnosis was adenocarcinoma of the renal pelvis and ureter, INF beta, pT2, pR0, pL0, PV0, PN0. No evidence of either tumor recurrence or metastasis was found on the 3-month postoperative follow up. This case is thought to be the first report of primary adenocarcinoma of the renal pelvis in an incomplete duplicated ureter.

Adenocarcinoma↗
PubMed1977

[Experiences with lavage cytology from renal pelvis and ureter (author's transl)].

In 41 cases of roentgenologic filling defects in renal pelvis and ureter, which could not be determined exactly preoperatively, we could confirm the diagnostic value of cytology from washings of renal pelvis and ureter (lavage cytology), especially in preoperative diagnosis of carcinoma of renal pelvis and ureter. Ten of fourteen tumors (71%) were detected by this method. The diagnostic reliability increased with tumor-stage and was more accurate than the normal exfoliative urinary cytology. In five cases of hypernephromas invading the renal pelvis lavage cytology was not successful and we had obtained only false negative results. In roentgenologic filling defects that were not tumor-induced especially uric acid stones, inflammatory processes, blood clots and renal cysts, we had no false positive results. Our findings are discussed together with the literature.

Humans↗
PubMed1998

[Surgical treatment of kidney pelvis spontaneous rupture].

OBJECTIVE: To describe a case of spontaneous rupture of the renal pelvis that required treatment by open surgery due to its size. METHODS/RESULTS: We describe a case of spontaneous rupture of considerable size in the renal pelvis arising from a calculus in the pelvic ureter. A significant urinary extravasation was produced which became infected. Percutaneous drainage was performed. Repair of the reptured renal pelvis and stone removal were achieved by open surgery. CONCLUSIONS: Open surgery may occasionally be required to repair a spontaneous rupture of the renal pelvis due to the size of the lesion, the importance of the urinary extravasation or other related factors that warrant this approach.

Aged↗
PubMed2001

Soft tissue sarcomas involving the pelvis.

BACKGROUND AND OBJECTIVES: Soft tissue sarcomas (STS) of the true pelvis are rare tumors and there is little information in the literature related to pelvic STS. The purposes of this review were to understand the anatomic extension of these tumors to better plan surgical treatment and to determine the outcome of these patients. METHODS: Eighteen consecutive patients presenting between 1987 and 1995 with soft tissue sarcomas involving the true pelvis were retrospectively reviewed at minimum follow-up of 18 months. Cross-sectional imaging was reviewed for each patient to determine the anatomical location of the lesions. RESULTS: The tumors were confined to the true pelvis in 4 patients, extended to the retroperitoneum in three cases, and extended to the thigh in 11 patients. Adjuvant radiation was administered to all but 2 patients who had received radiation to the region in the past and all patients underwent surgical resection (local resection in 13 patients and hindquarter amputation in 5 patients). Surgical resection had a high rate of morbidity and complications including positive resection margins in nine individuals. Of the 18 patients, 11 died at a mean time of 15.5 (2-58) months from surgery, 4 were alive with evidence of disease at a mean time of 44.3 (18-68) months, and 3 were alive with no evidence of disease at a mean time of 57 (43-71) months. CONCLUSIONS: Soft tissue sarcoma of the pelvis is fortunately a rare disease with a high risk of local and systemic disease progression despite treatment with irradiation and surgical resection.

Adult↗
PubMed2004

Movements of the pelvis and lumbar spine during walking in people with acute low back pain.

BACKGROUND AND PURPOSE: Little is known about how acute low back pain affects pelvic and lumbar movements during walking. The aim of the present study was to determine if measurement of the amplitude of the angular movements of the pelvis and lumbar spine during walking is useful in the evaluation of people with acute low back pain. METHOD: The study used a repeated-measures and correlational design; 11 individuals with low back pain (tested in the acute phase and six weeks later when symptoms had resolved) and matched control subjects were tested during treadmill walking. A video-analysis system was used to measure the amplitudes of movements of the pelvis and lumbar spine during walking. Pain level was measured with a visual analogue scale (VAS). RESULTS: During walking, movements of the pelvis (axial rotation) and lumbar spine (lateral flexion) were reduced in people with acute back pain compared with the resolved condition, but were not different from a group without a history of back pain. The amplitudes of the frontal plane movements of the pelvis and lumbar spine were negatively correlated with the intensity of pain (r(s) = -0.74). CONCLUSIONS: Measurement of pelvic and lumbar movements during walking is unlikely to have useful clinical applications for individuals, or when discriminating between impaired and unimpaired people, but may be applied to groups for hypothesis testing in evaluating change in back pain over time. An hypothesized model to explain the observed movements has been proposed.

Acute Disease↗
PubMed2003

[Integration of modern technologies in therapy of sarcomas of the pelvis. Computer-assisted hemipelvectomy and implantation of a "custom-made" Bonit gentamycin coated partial pelvic prosthesis].

The resection of primary malignancies in the pelvis is technically demanding as organs and structures are to be preserved and reconstruction of the defect as well as the postoperative function and rehabilitation are dependent on an optimal prosthesis. We present two patients with a sarcoma of the pelvis where for the first time a structured concept of technology integration led to a press-fit implantation of a hemipelvic prosthesis. This concept includes the design and production of a "custom-made" prosthesis as a hemipelvic substitute and the coating of this prosthesis with Bonit, a second-generation calcium phosphate, and gentamycin in watery solution. The tumor resection was done with computer-assisted surgery based on computed tomographies (CT) of the pelvis model done by rapid prototyping rather than on the CT of the patients' pelvis. With this procedure the presurgically simulated resection could be executed precisely with complete resection of the tumors and an accuracy which allowed an exact implantation of the prosthesis. The course was uneventful with primary healing and no sign of an infection or loosening after 6 months.

Bone Neoplasms↗
PubMed1999

Improved automatic separation of renal parenchyma and pelvis in dynamic renal scintigraphy using fuzzy regions of interest.

The aim of the study was to examine the physiological relevance of factors produced by a modified procedure for factor analysis of dynamic renal studies. Factor analysis has been applied locally to subsets of dynamic renal data which were well defined in both space and time domains. Optimised factor images resulting from different subsets were used as fuzzy regions of interest (ROIs) for the extraction of time-activity curves corresponding to renal parenchyma, renal pelvis, vascular and spatially homogeneous background. The original procedure employed the factor images of renal parenchyma and pelvis resulting from an analysis of the interval between the peaks of parenchymal and pelvic curves. In an attempt to improve the separation of renal parenchyma and pelvis, new fuzzy ROIs were used. They correspond to the factor image of renal uptake obtained from the analysis of the early phase of the study, and to the factor image of the renal pelvis obtained from the outflow phase. The curves generated with the new fuzzy ROIs were compared with those of the original procedure and tested for the presence of known artefacts inconsistent with the expected physiological behaviour. Unlike with the original procedure, no such artefacts were found. The most striking difference was that the pelvic factor curves did not start from zero time of the study but exhibited a physiologically correct initial horizontal zero segment the length of which correlated closely with the minimum parenchymal transit time (r=0.79, n=46, P<0.001). The new method permits easy and reliable application of factor analysis to dynamic renal studies. Problems which remain to be solved are user-independent identification of the optimum factors and suboptimal performance of the method under extreme conditions. Our results provide additional evidence that factor analysis can extract physiologically relevant information quantitatively from dynamic scintigraphic data.

Algorithms↗
PubMed2003

Significance of CA 125 serum level in discrimination between benign and malignant masses in the pelvis.

AIM: Our aim was to confirm that preoperative CA 125 serum level can be useful for discrimination between benign and malignant masses in the pelvis. METHODS: Preoperative CA 125 serum level was analyzed retrospectively in 121 patients who had surgery because of a malignant ovarian tumor and in 91 patients with benign masses in the pelvis. The cutoff serum level CA 125 between benign and malignant masses in the pelvis was 35 and 65 IU/ml. RESULTS: Of those patients with a malignant ovarian tumor, 65.3% had menopause whereas only 31.5% of those with a benign tumor did so. The average age of the patients with a malignant tumor was 54.2 years and of those with a benign tumor 46.8 years. The preoperative CA 125 serum level was higher than 35 IU/ml in 80.2% and higher than 65 IU/ml in 72.7% of all analyzed patients with a malignant tumor, whereas it was 23.9% and 9.8% respectively in patients with a benign mass. In early stage ovarian cancer disease (borderline stage, I/II) the preoperative CA 125 serum level was higher than 35 IU/ml in 67.8% and in 52.5% higher than 65 IU/ml. In advanced stages (III/IV), it was higher than 35 and 65 IU/ml in 96.1%. After therapy the CA 125 serum level dropped below 35 IU/ml in 70.8% and after three chemotherapy courses in 78.1%. A CA 125 level less than 35 IU/ml was achieved by therapy in 84.2% patients with an early stage disease (I/II) and in 62.1% in advanced stages (III/IV). The calculated sensitivity was 80.2% and negative 74.5% (CA 125 higher than 35 IU/ml) and 72.7%, 90.2%, 90.7%, 71.6% respectively (CA 125 higher than 65 IU/ml). CONCLUSION: . Preoperative determination of CA 125 is a very useful method to discriminate between benign and malignant masses in the pelvis.

Biomarkers, Tumor↗
PubMed1988

Permanent chondrification in the pelvis and occurrence of hernias in mice treated neonatally with tamoxifen.

Male and female C57BL/Tw mice were given 5 daily subcutaneous injections of 100 micrograms tamoxifen (Tx), starting on the day of birth (Tx mice). In untreated fetal mice on day 18 of gestation, the greater part of the pubic and ischial bones were cartilaginous. At more than 30 days of age, however, untreated mice showed completely calcified pelvic bone, whereas in age-matched Tx mice the greater part of the junctional regions in the pelvis remained cartilaginous. Treatment with Tx starting within 5 days of age caused bladder hernia with or without cecum hernia. The pubic ligament in Tx mice at ages of 30-540 days was markedly expanded as compared with that in age-matched controls. The permanent chondrification in the pelvis was found in all mice given Tx starting within 10 days of age. By contrast, neonatal treatments of mice with other antiestrogens, clomiphene and nafoxidine (100 micrograms/day), induced neither permanent chondrification in the pelvis nor expansion of the pubic ligament nor hernia. These findings suggest that Tx has a specific effect on the symphysis pubis and some junctional regions of the developing pelvis in mice when given neonatally.

Animals↗
PubMed2000

Postural sway of the affected and nonaffected pelvis and leg in stance of hemiparetic patients.

OBJECTIVES: To study potential differences between sway of the paretic and of the nonparetic pelvis and leg in standing hemiparetic patients by comparing measurements of corresponding bilateral waist and leg sites, and by comparing the results to those of healthy control subjects. DESIGN AND SETTING: Anterior-posterior and mediolateral sway of 15 hemiparetic patients and 13 healthy control subjects was measured with the eyes open and closed during quiet stance. Data were collected via an ultrasonic-based system that continuously monitored the position of four transducers mounted bilaterally on the anterior aspect of the pelvis and on each tibial tuberosity. Sway of each transducer marker was calculated by the standard deviation around its mean position and by its mean speed. Descriptive statistics, analysis of variance, and cross-correlation analysis were used for comparing hemiparetic patients with healthy subjects, as well as for determining the effects of body level, body side, and vision on postural sway. RESULTS: For all four measurement sites and in both the anterior-posterior and mediolateral axes, the hemiparetic patients had larger sways than the control subjects. Patients' sway on the paretic side was larger than on the nonparetic side, whereas no side differences were detected in the control subjects. For both groups, waist sway was larger than legs' sway. Cross-correlation values between sway of the ipsilateral waist and leg on each body side, as well as between the two legs, were substantially lower in the patients than in healthy subjects. CONCLUSIONS: Postural sway of standing hemiparetic patients is characterized by an asymmetrical profile that is expressed both in larger sway values of the paretic than of the nonparetic side, and in low temporal synchronization between sway of the legs and of the pelvis as well as between the two legs. Impairment in the ability to stabilize the distal segments of the lower extremity on the paretic side, rather than in stabilization of the pelvis, appears to underlie the enhanced postural sway of hemiparetic patients during stance.

Aged↗
PubMed2001

Evaluation of the bony pelvis in classic bladder exstrophy by using 3D-CT: further insights.

OBJECTIVES: To provide a complete look at the bony pelvis in children with classic bladder exstrophy: dimensions, orientation, and relationships. METHODS: Three-dimensional computed tomography was used in 6 boys and 1 girl, 5 of whom underwent primary closure and 2 who underwent reclosure at 4 and 8 months. These exstrophy pelves (intrapelvic angles and osseous dimensions) were compared with 26 age and sex-matched controls. RESULTS: The iliac wing angle was 11.4 degrees larger in the classic bladder exstrophy cases. The sacroiliac joint angle was 9.9 degrees more externally rotated in the exstrophy cases. The pelvis was rotated 14.7 degrees in the superoinferior plane in the exstrophy cases. The mean pubic diastasis was 4.2 cm (0.6 cm in controls). The inter-triradiate distance in the patients with classic bladder exstrophy averaged 6.0 cm (4.2 cm in controls). CONCLUSIONS: These new findings provide a better understanding of the bony pelvis, especially its posterior portion, in patients with classic bladder exstrophy. The results of this study revealed the orientation of the sacroiliac joints to be more externally oriented than previously thought and the pelvis to be rotated inferiorly, a previously unknown observation. Both of these factors will be important in the planning of newer osteotomies and pelvic reconstruction.

Adult↗
PubMed2003

Breast cancer metastatic to abdomen and pelvis: role of surgical resection.

OBJECTIVE: The purpose of this study was to describe the characteristics and outcome of women with metastatic breast cancer to the abdomen and pelvis, and to assess the role of surgical resection of abdominal and pelvic metastasis in this disease. METHODS: We retrospectively reviewed the medical records of 59 women with documented metastatic breast cancer to the abdomen or pelvis who had exploratory surgery by the Gynecology Service between 1986 and 2001. RESULTS: Exploratory surgery was performed a median of 5 years (range, 0-25 years) after initial diagnosis of breast cancer. Median survival from diagnosis of abdominal disease was 23 months, and 5-year survival was 24%. Survival was 36 months for optimally debulked patients (<2 cm of residual disease) and 20 months for suboptimally debulked patients (P = 0.07). Patients diagnosed 5 or more years after initial breast cancer diagnosis had a median survival of 36 months versus 17 months if diagnosed earlier (P < 0.01). On multivariate analysis the time to recurrence of breast cancer in the abdomen and optimal debulking were both significant variables. Hazard ratio for dying of disease if recurring before 5 years was 2.7 (CI 1.45-5.03) [P < 0.01]. Hazard ratio for dying of disease if suboptimal debulking was achieved was 2.14 (CI 1.13-4.02) [P = 0.02]. CONCLUSIONS: The disease pattern of metastatic breast carcinoma to the abdomen and pelvis does not appear to effect survival. Survival in patients where optimal debulking is achieved and in those recurring late is improved. Surgical resection of metachronous metastatic breast cancer to the abdomen and pelvis may be an important component of the management of this disease and should be considered in candidate patients.

Abdominal Neoplasms↗
PubMed2002

Comparison of angular lumbar spine and pelvis kinematics during treadmill and overground locomotion.

OBJECTIVE: To determine the differences between angular oscillation curves of the lumbar spine and pelvis during walkway and treadmill ambulation. DESIGN: An in vivo observation of walking in overground and treadmill conditions. BACKGROUND: Angular movements of the lumbar spine and pelvis have been obtained during overground and treadmill walking. No data are available to indicate whether lumbar spine treadmill findings may be compared or generalized to overground readings. METHODS: Nine male subjects walked at their natural cadence along an 8 m walkway positioned over a motorized treadmill. During each of 20 walking trials, kinematic data of one full gait cycle were collected in the middle segment of the walkway. Following the overground readings the walkway was removed and treadmill recordings were taken at the subjects' preferred walking speed and at an imposed speed of 1.25 m/s. Movement patterns and maximum oscillation angles were calculated in each plane. RESULTS: Cross-correlation values of pairwise comparisons demonstrated almost comparable movement patterns between walking conditions (r > or =0.891; p<0.001) except for the movement in the sagittal plane (r=0.642, p<0.01). ANOVA for repeated measures revealed significant (p<0.05) differences in the gait cycle duration as well as reductions in oscillation amplitudes of the upper lumbar region and the pelvis in both the frontal and transverse plane during treadmill walking compared to walkway locomotion. CONCLUSIONS: Statistically significant differences exist for some angular lumbar spine movement parameters between walkway and treadmill locomotion. RELEVANCE: The observed differences between overground and treadmill locomotion should be taken in account when treadmill-based lumbar spine and pelvis kinematics want to be extended or compared to overground recordings.

Adult↗